This is session 179 with EJ, a 29-year-old man suffering from narcissistic personality disorder.

“Thanks for seeing me on such short notice, Doc.” “I didn’t have much of a choice, did I?”

“Don’t say it like that. You like our appointments as much as I do.”

“What can I help you with today?”

“Here’s the thing. Yesterday I went for a run. That was your advice, that I should be more active. So I was trying to do what you suggested.”

“That’s great.”

“Yeah, except when I was running, I twisted my knee.” “That’s unfortunate.”

“It hurts a lot. On a scale of one to ten, the pain is like a twelve.”

“You didn’t seem to be limping.”

“It’s not that kind of pain. Trust me, it hurts a lot. Deep inside.”

“I’m sorry to hear that.”

“So maybe you can help me out. Especially since it’s your fault. I mean, you’re the one who told me to go running.”

“I’m afraid I don’t know much about knee pain. Perhaps you should make an appointment with your primary care doctor?”

“I don’t have a primary care doctor.” “Urgent care then.”

“Well, I don’t think it’s anything serious. I just need something for the pain. I was hoping you could prescribe me some oxycodone.”

“Oxy…”

“Like thirty tablets should do it. I was thinking ten mg tabs.”

“If you have a knee injury, you should see a specialist who treats that. I’m a psychiatrist. I am not trained to manage knee pain.”

“Well, you went to medical school, didn’t you?” “Yes, but that was a long time ago.”

“It doesn’t matter. My knee is fine. I just need some oxycodone to get through it. Like I said, thirty tablets should be perfect.”

“I can’t just give you a prescription for a narcotic. These medications are controlled.”

“Don’t give me that bullshit. You prescribe stuff way stronger than oxycodone.”

“Psychiatric medications. Not narcotics. I can’t give you thirty tablets of oxycodone. I could get in trouble.”

“More or less trouble than if a video came out of you slashing someone’s tires?”

“I…”

“Like I said, thirty tablets should be fine. I won’t sell them or anything. I just want to get through this knee pain. Have pity on me, Doc.”

“I’ll give you twenty tablets. Five mg each.” “I didn’t realize this was a negotiation.”

“I could lose my license.”

“Thirty tablets. You could do the five-milligram ones if that makes you feel better.”

“Fine. But this is the only time.”

“Right. Of course, Doc. I’m not going to ask you for oxycodone again. I mean, unless I hurt my knee again.”