10/26/13: Oh, my word: patient has reverted to extreme Narcissistic Personality Disorder overlaid with paranoia. He presented today smelling of dope and giggling manically about the Affordable Care Act being nothing more than an elaborate prank he had played on the nation to show that he was is human as the next guy and the public should not see him as an aloof intellectual. That's true: they should see him for what he is: a socially-awkward, conceited little prick with an IQ smaller than his hat size. There is no point in prescribing any medication while this moron is as high as a kite.---Dictated by S.H. Rink M.D.