By the way, do you even know what Narcisism is?
There is no proof that he had that either. Anyone who thinks they can LOOK at someone and divine how their mind works, and what disease they have...needs some professional help!
You can't tell if someone is mentally ill by looking at him, sorry, that's the most prejudice and uneducated thing I've ever heard. I think that is a very, very poor analysis of the man's mental health and is not even remotely tenable.
My own feeling is that it is possible that Smith did it to himself, just based on the appearance of the physical evidence, but that isn't sufficient legal evidence to convict him.
He doesn't necessarily have factitious disorder exactly, some people are untruthful and manipulative and don't have that disorder - there can be many different disorders that are associated with seeking attention, lying and being manipulative. It is also quite possible that he did this for a concrete benefit - such as to further his career, or to suggest guilt in someone else that he wanted to get in trouble. That suggests manipulativeness, and again, could be associated with a number of mental disorders, or even just could simply be his 'personality'.
However, it was obvious he wasn't always truthful. There were accounts that suggested he made up stories of being wounded during service(perhaps even intentionally scarring himself to give the appearance of healed injury), and of his entire family being killed in Africa. Mentally ill people don't necessarily have all their functionality affected by their mental illness, they don't even often 'LOOK' mentally ill. They aren't even necessarily diagnosable with a mental illness, even, as most of these diagnoses require a very broad and all-encompassing pattern of disturbed thought and behavior.
Some people are very functional, and think rationally in most ways, some are even outstanding in their field of work. They may have only one area of disturbed thought and behavior. He wasn't necessarily even a bad medical examiner. He may have been a very good one, in fact, but still had one area of his thinking that was just not normal.
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