"I want my grandma to have the pills that stop you being grumpy. I know you've got them, because you gave them to my sister. So you needn't fuck about." I smile placidly and plot out my conciliatory riposte before digging about for a bit more background. But the seeds of doubt are planted. Maybe that is all I do: just dish out the happy pills. They don't seem to make many of you very happy.

"That's because they don't address the root cause." Suddenly a chorus of sanctimonious liberals appear stage left, dressed in pink and blue monopoly money and dancing under candy coloured spotlights. "They should all have individual therapy!" They chime in unison. "That might be a bit expensive for a condition with a lifetime incidence of 10%," I suggest nerdishly, pensively plucking a few notes off one of their costumes. One of the more attractive cash fairies dances over and rubs my nose flirtatiously, but in a slightly patronising fashion. "Oh, you sweet silly thing... " she squeals.

"Well?" And I am, in fact, in clinic, under striplights.

So I push the point as far as I dare with the scariest grand-daughter in the world, and of course our poor old grumpy grandmother is in fact as depressed as hell. Everyone she's ever known is either dead or the depressed and unemployed product of her ancient loins living on a hellish council estate, and she doesn't want anything apart from some tablets to take in the evenings because she markets herself to herself as a coper who wouldn't want to trouble a counsellor. Obviously it's my job to dish out the drugs and shut up, so I dish out the drugs and smile obediently.

I probably should have introduced them to the next patient. "Your tablets gave me a tummy ache." He glares at me, wounded and angry, like I'm the most evil bastard he's ever met in his life. If this was a husband-wife relationship, I should like to point out, instead of a doctor-patient one, I would at this point turn around in a huff and say something like, "Well, I was only doing my best to help. I shan't bother next time."

I look back at the notes. My predecessor didn't even think he was depressed, and throws the word "dysthymia" about in the summary. Dysthymia means you've just always been a bit of an unhappy person. The only thing that drugs do, as far as I can tell, is get them out of the clinic room on time for the next patient to come in.

I try and ask him how he spends his days, partly to get a bit of friendly chat going, and partly to find out if he does anything at all. "These drugs are useless. I'm still clinically depressed." I ask about daytime energy. "How long have you been a psychiatrist?"

Right. That's below the belt. I'm a perfectly nice guy, I know all the stuff in the books and all my lovely depressed patients this morning were very nice to me and I was very nice back to them and now suddenly you are being a bastard for no obvious reason. I start to sweat and start mumbling an explanation for my questions that ends up sounding like an apology, while he glares at me. What am I apologising for? Because it's my fault he's unhappy. Because I am a crap psychiatrist. I have no idea what to do.

I concoct a lame excuse to leave the room and call Conrad, my perfect predecessor, from the phone next to the loo. I explain the situation and struggle to make a joke out of it. "Conrad. Help me. My patients are making me have feelings I don't understand." He laughs. "Well don't expect any support from the boss. Isn't he pretending to be at another academic conference this week?" The consultant didn't tell me he was pretending to be at an academic conference this week. I've only met him about three times. I think he might be deliberately avoiding me.

"Boundaries, Mike. Just document the non-existent suicide risk, increase the dose and get him out of the door as fast as you can." "Is this transference?" I ask, lamely. "I don't care what they call it. You're doing fine. Regain the control you need without being controlling. Accept your feelings but hide them and try to understand them later. And remember, just because he's a psychiatric patient, that doesn't mean he can't also be a prick."