Research into theoretical cause

Much research has been done into the "origins" or "cause" of Narcissistic (mis)conduct: Is this 'Nurture' or 'Nature'? To Emergency medicine, this is a complete irrelevance. Instead, the focus must be on the real-time egregiously evil conduct, its effect on others and the damage to the Emergency Medical system as a whole; and by derivation, the damage to wider society.

Narcissism is Anarchism. Narcissism is a destructive entropy that malignantly spawns chaos, conflict, tensions and disorder where there earlier was order and peace. Medical emergencies are fraught enough. They do not require any additional, synthetic, personal dramas.

Gaslighting

Gaslighting is "carrot and stick" but mainly "stick" method of brainwashing. Gaslighting attacks the Narcissist's perceived opponent. An opponent is anyone who is an obstacle, which means anyone who says "No" to a Narc's demand.

In that moment and regardless of any airs or graces previously acted out by him or her, the Narc immediately changes to stepped-cruelty, mental and physical. He immediately begins an erosional attack on the person's character, competence and core being.

Full Gaslighting analysis

Domination

The key drive of Narcissism and Anti-Social types is to achieve domination either by verbal assault or physical intimidation backed with threat of loss or violence to the intended victim, his family, wealth or property.