Progress notes for Patient 540463, OBAMA Barack, H.

2/7/2014:  It is a truth universally acknowledged among shrinks that patients with Narcissistic Personality Disorder [NPD] are the most difficult  and exasperating of all to treat. And so it is with my current primary patient. I discussed the case with Valerie Jarrett today to explain why I must raise my retainer and asked her if she recognized this description: Some people diagnosed with a narcissistic personality disorder are characterized by unwarranted feelings of self-importance. They have a sense of entitlement and demonstrate grandiosity in their beliefs and behavior. They have a strong need for admiration, but lack feelings of empathy." 
"The letters BHO come to mind" said Jarrett. "Exactly," I said.  "I can no longer provide house calls round the clock  to a patient who has never really acknowledged he even has NPD. "It is stressing me out."
"Charge what you want doctor," she said. "The military covers his medical bills." ---Dictated by S.H. Rink, M.D.