Steve: when I was on the faculty at the UMKC SOM our teaching hospital was the county hospital. The patients were inner-city minorities (some very nice), lots of immigrants, and a big population who rotated between us, the city jail, the street, rehab, and the state psychiatric hospital next door.
Almost daily some poor med student was in tears when a drug addict would scream MF and FU at them, and I had death threats regularly. I told the students that hateful people hate themselves, and almost all are victims of something terrible - usually childhood sexual abuse. Childhood emotional and physical trauma is highly associated later drug abuse (to dull the pain), PTSD and Borderline Personality Disorder.
But I was not sharing the whole truth. Some people are just mean, miserable, SOBs whose only joy is making everyone else miserable. We can choose to not be like them, or to let them get to us. That does not mean we have to take the abuse however. Boundaries are healthy.
