A 17-year-old male student was asked to take a leave of absence from school after being caught using marijuana. As a consultant for the secondary school, I was asked to assess him on consideration for readmission. The drug issue was trivial; he was no more involved than his classmates. However his leave of absence resulted from his apparent disinterest in concealing his behavior. Our interview revealed that he had a serious narcissistic personality disorder with grandiosity, little capacity for empathy, and a general aura of haughty disdain. He had no sense of any personal problem, no desire for help, and he made clear that he viewed me as a minor bureaucrat whom he had to suffer because of a silly rule. However, his pathology was serious. What should I do?