It's all part of the job

In my professional capacity,I have been insulted by the best and by the worst members of society.

The most effective " insulters", in my experience are always manic depressives who are entering their " manic " phases, as they can often latch on a weakness or defect in your psychi or personality and exploit it mercilessly.
It's a product of having a thousand thoughts flashing through your mind every second

My very favourite insult came from an incredibly well-to-do elderly lady of some means and standing. She looked me up and down as I was showing her around the psychiatric ward she had just been admitted to and with a click of her fingers referred to me as a
" pious double chinned little turd"
She also introduced me to a fellow patient as " an unfortunate fat wombat of a staff nurse" which tickled me too.....I have always loved a quick witted bitch slap of a put down.
Last night a confused patient called me a " pig ugly twat"
To which I said a calm and measured " please don't say things like that, I am one of the nurses looking after you"
The patient looked at me incredulously and called out a triumphant and somewhat lusty
" you are a pig ugly nurse then"
You can't disagree with logic