Could those of you who are drunk please go home? And there are so many of you, scattered decoratively about the accident and emergency department like a series of lovingly hand-tooled porcelain figures: drunk person receiving stomach pump, drunk person counselling wife after unconvincing suicide attempt, drunk person contemplating mortality in a bowl of bloodstained vomit and, my personal favourite, drunk person covered in pond weed who has tossed a boiling casserole down his front while cooking when wearing Y-fronts.

I try not to wince as I tease apart yellow underpants from saggy burnt flesh (because I do still have feelings) and distract the patient by taking a quick history. "Were you drunk?" I hazard. He hangs his head, picking algae out of his chest hair. "Yes," he slurs. "Quite drunk."

I nod, caringly. Burns mean nothing to me. If they go red, they just need clever dressings, and dressings are a mysterious world truly understood only by nurses. If they go white and the patient loses sensation, then you're truly buggered, and we refer on to people far cleverer than us, who prune it out.

I carefully examine his willy: he seems to have got off quite lightly. The worst case scenario for burnt peripheries is a circumferential burn: and I was worried that in removing his underpants we might have degloved the old chap. But apparently, in a moment of drunken clarity, he had the presence of mind to run for the garden and jump in the pond.

Accident and emergency is the random anecdote generator of the NHS, the strange attractor to which all ridiculousness will gravitate. The worst possible outcome of every risk you ever took is prominently on display. In our weekly teaching sessions, they try to encourage us to take a history and think through the mechanism of the injury.

"So this girl was driving home in a mini," says the registrar, as he takes me over to a patient in the assessment bay. "Drunk." She is on a spinal board. "Very old car, welded together by her boyfriend, the wheels flew off and the car skidded along the floor." He grabs hold of the blanket. "We spoke to the firemen," he takes on a conspiratorial air, preparing for the denouement as if he were a character in an Agatha Christie whodunnit, "and they said the floor had been peeled back." He is hugely pleased with his detective work, and triumphantly pulls back the blanket to reveal: no feet. "Yes," he beams, as the orthopaedic team arrives smelling of cigarettes, "she wiped them off on the road."

But the worst of it is the unbreathable stench of the street drinker. Now, I'm not an unfeeling man, and on an objective level I have a great deal of sympathy with the way your lifestyle options can narrow down to a pretty unappealing margin. But I'm no saint, and it's difficult to be right-on when you're exposed to the socially unacceptable edge of other people's cock-ups. This, for example, is why we don't want police making political decisions about tearaways and drug users.

This man had a smell that seeped into my clothing. If you breathed through your mouth you could still taste him. The fact is, we can't go round dishing out scarce trolleys to people for a good night's sleep, because even if things do slow down at three in the morning there is a matter of principle at stake. Actually, because it's August, all the doctors in A&E are new, and we all take twice as long as we should do to see patients, so things don't really slow down at 3am anyway. This, you may have noticed, is why a few more punters than usual have died on trolleys after 18-hour waits over the past few weeks. They don't tell you that in the press releases.

So, normally, the nurses deal with booting out the nutters, but on this occasion even our bullish sister was getting nowhere. She called me over to see if the dread hand of my doctorly authority could sort out the situation.

"I'm afraid you have to go now." The pissed punter sits up and mumbles. I look at sister. "He says he loves you. You're his best mate," she explains. "That's very kind," I smile, "but you still have to go." He lunges, I try to duck, but he catches my head in his enormous hands, and clutches my face lovingly towards his tender moist belly. "I love you," he cries as he locks his fingers behind the back of my head and topples backwards, vainly trying to use my head to regain his balance. My face is now approaching his crotch. He pulls my nose towards his piss-stained trousers. There is clearly no escape.