The Patient from Hell

This guy is probably the craziest person that I have seen outside a mental institution. Well, maybe not, but it sure seemed like it at the time. Clinic was running smoothly, everything was peachy, then I walk into a room with a complete psycho, part antisocial personality, part borderline, with a dash of ideas of grandiosity, who almost drove me up the wall. His whole M.O. was to try to pick a fight with everyone, and the kicker was that he didn't even have to be seen in our clinic. His dermatologic problem had already resolved but six months ago he made the last resident schedule him a follow-up visit. Here's a little taste of what happened:

Crazy pt: So I need three tubes of this each month and I four tubes of that and three of my other cream.
Me: Okay.
Crazy pt: Why are you saying "Okay?" Your generation says too much "okays"
Me: I'm just acknowledging what you said
Crazy pt: Well don't say okay.
Me: (Nods. Thinking to self, oooookay weirdo)
Crazy pt: Why aren't you saying anything? You can hear a pin drop in this room.
Me: I'm listening to you.
Crazy pt: Well, that's good, cause you should be listening to me. You're the doctor and I'm the patient.
Me: Sure.
Crazy pt: Why are you talking? I can put two sentences together, you know. (which happens to be his favorite line, as he used it on the medical student and the attending)
Me: I'm just trying to figure out why you're here and what I can do for you.
Crazy pt: I have this killer burning pain from the bottom of my feet all the way up to my thighs. Should I show you my legs?
Me: (Checking computer system - pt has chronic pain, seen in pain clinic and gets a ton of pain medications) The pain sounds pretty bad. Mr. Crazy, you were just in pain clinic last month. The pain specialists are experts at treating pain and I probably won't have much to add by looking at your legs. (his skin problem was NOT on the legs)
Crazy pt: What are you trying to say? That you're a doctor and you're refusing to look at an area I want you to look at?
Me: If you want me to look at your legs we can take a look at it. If you don't, we won't.

And so on. Yes, the patient did have a couple of horns, a trident, and maybe a hint of some fangs too. I'm pretty happy that at least externally I stayed calm through the whole painful scenario, but inside I was getting more and more agitated. Anyways, am a little less shaken now, but boy am I thankful I didn't end up in psychiatry... How do these people function in the world??!!!