How low have I sunk as a junior doctor, when I actually look forward to being on call? Apart from the fact that I secretly love my job, and love the stress, and love being on the spot, and love having a good excuse, now that I'm a psychiatrist, to talk to people about the things that mean most to them: more than that, I love the fact that suddenly there are no machines, and communication is my tool.

If that isn't cheesy enough - and I have a big bag of anti-emetics to hand for anyone who appreciated my previous (cough) ruggedness - I have a terrible confession to make. In psychiatry, I've found something I'm really bad at. I mean, it's not as if I was ever that good at hospital medicine anyway, or I wouldn't be working in this suburban hole.

Anyway, switchboard are very excited because they've just been bought a new pager system that lets them broadcast their voices direct to the little speaker on your bleep, and they can't stop playing with it. Apart from being counterproductive in a psychiatric hospital, this is also rather irritating and weird. The last time I was on call I woke up the next morning to the sound of the bleep on the table next to me, shouting, "Oy! take me back to switchboard," and giggling.

Suddenly it crackles in my pocket. "Your food's here, Mike. Oh, and there's a 136 on the way." These are not two compatible activities. A 136 is someone being brought in on section by the police, and I've been told they're usually pretty angry. I've never seen one. I call the night nurse. Do we accept 136s here? "Yes, we do," she sighs in that special way that nurses have when faced with yet another junior doctor who will try anything, no matter how pathetic or hackneyed, to avoid doing any more work that involves standing up in their 20th hour on the go. "We do accept 136s, Dr Foxton. In the 136 suite. In fact I can see them driving in right now." I look out of the window. So can I. Two police vans. Goodbye curry.

And then all hell breaks loose, or at least that's how it seems to me: somewhere in among the policemen piling in through the door there's some guy who really doesn't want to be here, and there is a lot of shouting, a lot of screaming, a lot of struggling, and a bit of biting. I stand around and look calm about it, like the nurses. An important policeman comes over. "Lot of shouting and aggression in a public place. We got called and he went berserk." They're holding him down on a foam chair. So far he just looks nasty, not mad. Anything odd, I ask? The policeman repeats himself, almost word-perfectly. I go over to try and engage my so-called patient.

"Fuck," he gasps, "off." He's wearing 1970s Oxfam clothes. Maybe that's why they brought him to me. I try a few more friendly openers. "Fuck off. Ten times." Still not mad. I try again with the fuzz. "Did he have anything weird in his pockets?" Like a note saying: take me to Dr Foxton, I am quite mad, maybe. "Like a prescription, or some tablets? Or an appointment card?" I begin to run out of steam. "Or, you know, anything, odd . . ." They look at the man screaming and struggling, and then at me, as if the situation should be self-explanatory, which, in a funny way, it should be.

"Look, we've got two-thirds of the county's night-time police force here, are you going to sedate this man?" I don't know if you could hear the silent "or what" on the end of that sentence. I look at the patient again, and almost will him to do something mad. But he's just angry. I look at the nurses. No backup. Do they all want to get back to finishing the nightshift paperwork? Or am I actually being an overcautious, sanctimonious twat? I can be a fascist too. I think maybe we should sedate people who behave like this. I don't like them either. But I'm not a policeman, and the rules just aren't like that.

I carry on trying to talk to him, and get nothing but sane abuse. The nurses gang up on me. "We've all got to get back, you know." I wish I looked more commanding. I wish I'd worn a better tie. The patient and I both stare at it in a moment of silence. Suddenly he recoils and lets rip. "The gates! Cambridge! The coat of arms! The twisted staff and snake!" And out comes the most intensely paranoid delusory system about Cambridge medics that I have ever heard. Bingo. Haloperidol, 10mg.