Despite not caring for the well-being of other people, he also doesn’t wish them ill will (unless they wrong him somehow) and doesn’t feel any particular negativity towards humanity as a whole. He knows people are often awful but doesn’t hate them for it.
He’s become desensitised to a lot of stuff, especially because of his time spent as a servant to mobsters. At times, they’d killed and tortured people with him in the room watching. He learned apathy very quickly.
With both his father and the mobsters, he knew when to fight back and when to take a hit. Fighting back was reserved for life or death situations.
The version of the drug he took was still experimental, so while not as dangerous as it could have been, he had a good reason to assume he’d die because of it. He suffered through a virus-type illness as a result and almost succumbed. The fact that he pulled through in one piece made him the first successful subject. The drug became much safer afterwards.
Likewise, the fact that the drug was more dangerous than the one currently used may also explain how powerful his ability is. As they say, no pain, no gain.