Ten months of being a doctor, and still nobody has put me in their will to spite their children. Instead, I am called to the ward at three in the morning (it's always three in the morning) to see a patient who is throwing things at the nurses and barking in a high-pitched voice. "I know that's usually your job, doctor, which is why I called you."

Only five hours ago, this man was a chirpy problem drinker with acute pancreatitis in casualty. How had they turned him into a monster so quickly? I bleep the night nurse for a bit of backup. "You're the one who is paid all that money," he chirps, "so you are the one who is responsible for the patients." He puts the phone down laughing.

Now, this is a baffling response, but not entirely unusual: often in a hospital, non-medical staff get a bit confused, and start thinking that because doctors take responsibility for all the medical decision-making, they are also the only people who need to take any responsibility for anything at all. Under this tradition, anything that everyone else refuses to do on grounds of taste or workload becomes the job of the house officer: that's me over here with the 70-hour week. I only wanted a bit of a hand, I thought, feeling hurt. So what if I am white and overprivileged, and sound posh on the phone.

I decide to have a look at the guy. He throws an NHS water jug at the door and it hits me in the chest. "Why don't you just sedate him?" They all look at me. Normally, as a modern-thinking Guardian-reading liberal type who thinks we should all be able to sort out most problems of this nature with a bit of even-handed counselling, I would balk at even the thought.

But there was no way this guy was going to let me close enough to find out how they'd made him bark like a dog, and he had just hit me in the chest with a full water jug, and I did now look as if I'd wet myself, and the overall picture was beginning to seriously impact on my gravitas.

"Give him four milligrams of midazolam would you, please, nurse?" I smile. "Fuck off," she suggests. Briefly my mind flashes with the words "incident form". Doctors don't fill them out too much, because we're not creeps, but the nurses - we believe - are constantly relaying our every move back to the clinical incident Nazis. "You fucking give it," she continues, with a broad smile on her face. This is worse than the day I lost my lucky Viagra promotional biro.

We walk over to the edge of the cubicle. "Mr Bundy?" I call out, reassuringly. An apple bounces off the door, and he starts barking again.

A reasonable man would have called security. A reasonable hospital would have had security staff. A healthcare assistant holds out a motorcycle helmet. "I can't wear that," I say. "I'm a doctor." She looks at me as if I just said it to show off in the pub. I ignore her and think through the options: body armour might help me survive the hostile environment of his side-room, but there was still no way I was going to get the drugs into his arm. My pocket textbook, usually so helpful, only suggested giving the drugs rectally. This seemed like it might further inflame an already difficult situation.

I walk in, bravely shielding my face and abdomen with my only two forearms: he is half sat up in bed and struggling away at the small portable telly next to him, trying to remove it from the flimsy bracket mounting. I reckon I've got about 30 seconds to complete the operation before he escalates. He picks a banana from the bowl of fruit he has been keeping menacingly on his lap, but throws it aimlessly at the ceiling. I scan the room further, and notice the umbrella near his right hand: and then I see the drip stand. I ease forwards and grab the litre bag of normal saline from its hook, retreating rapidly to below his line of sight at the foot of the bed.

"I am James Bond," I think to myself, as I crouch on the floor and inject the midazolam into the drip tube that is connected to his vein six feet away, and start squeezing on the bag, imagining I can actually see its reassuring little benzodiazepiney molecules moving along the tube towards his arm. An apple slams into the wall behind me. "Fucker!" he cries, with palpably less enthusiasm. I squeeze harder on the bag, willing the fluid uphill and into his arm, feeling only marginally shielded by my white coat.

"F-fuc . . . " And lo, he was tranquil.