"Alex is a perfect gentleman, working for him is not a trouble," Nathan added with a nod. "I think Pamela Xobed is my headache, she doesn't get along so well with her son, Alex and that in itself is strange. He calls her grandson Duke Xobed and not Duke Rexons, don't you see Alex is going through a handful already."
Doctor Paul knew Xobed was not only arrogant but a trouble maker and now, a potential threat in the hospital. The fact that Duke is not yet awake means Xobed who is well already will want to stay in the hospital for a few weeks or months, and that to him was ridiculous.
Why would she wait for Duke to get well before leaving the hospital?
He knew everything she said about that was insane, and now it looked like her mind was made up already.