So it's three o'clock in the morning and I get called to the ward on call. Ha! Fooled you. Actually it's 10 at night. So I'm far from grumpy. Actually, I'm in rather a good mood. I trundle over to the ward, all smiles. The nurses look worried. "We need you to rewrite some PRN."

Now, PRN are tablets that the nurses dish out when they need to. Rewriting it is often a source of tedious friction. Doctors on call get miffed about doing it at night, when the chart runs out of spaces, because really that sort of thing should get sorted during the day. I understand that to you that seems really boring and petty. To us it is the difference between sleeping and not. Remember, they use sleep deprivation to torture people rather effectively in some places. So now you know. But I'm far from miffed. I'm in a good mood. It's only 10 at night.

"Thanks doctor, he's really distressed and he just needs some more lorazepam."

Now, watch how I make all kinds of unnecessary trouble for myself. Normally, you just rewrite the chart and do a runner. But remember it's only 10 at night, and for some reason I'm in the mood to be a proper psychiatrist. "Does he really need it?" I ask. Everyone looks at me suspiciously. I mean, people come into hospital depressed, usually because they present a suicide risk, or we need to tinker with complicated medication. But it's OK to have feelings. Even bad ones. Admitting someone to a psychiatric ward and filling them up with drugs to stop them feeling anything, that is the oldest cliche in the book. We don't do things like that any more unless we have to.

I grab the notes, with the uncomfortable feeling that people are starting to think I'm questioning their professional judgement. In many ways, psychiatric nurses are amazing. They work in the same place for years, unlike a lot of medical wards that are full of agency staff, and they always know the patients better than you. You could go through the whole of your career doing exactly what they tell you to do and everything would be fine.

But lorazepam is the same as mother's little helpers. It is a benzo; a nice warm feeling in a pill. It is an easy way to make things manageable for everyone in the short term. It is like drinking. It is too easy. In a parallel universe I would have swallowed a textbook, and be standing here shamelessly in front of you, talking about how it is an institutionalised maladaptive coping strategy.

They point out of the window at a man who is utterly - and I mean utterly - distraught. We have a quick chat, and he is painfully, gut-wrenchingly unhappy. My first impulse is to do anything I humanly can to make it stop. I look back at the notes. Nowhere does it say that part of their plan is to repress all emotions with benzos. But it wouldn't, would it? These things just develop gradually. It would be an easy thing to miss. And looking at the chart, it only ever happens at night, when there are always different staff on. And the doctor's signatures on the chart are all different, so they're probably duty doctors too.

I look up. Everyone is baffled that I haven't just rewritten it and buggered off, including me. Who do I think I am? Some junior doctor who was working in A&E nine months ago. It is the easiest thing in the world to rewrite it.

I think back to this afternoon, and our history of psychiatry teaching. You know, 30 years ago, when we were just starting to get a handle on drugs for psychiatric problems, we were dishing out these tablets called Dexamyl, that were half-amphetamine and half-barbiturates, like they were Smarties. "The antidepressant that works in an hour" was the strapline. I can think of plenty of street dealers who would happily provide a similar service.

What a drug: but more than that, how great it must have felt, as a doctor, to be presented with distressed depressed patients, and for it to feel like the best and most natural thing in the world to give them a mixture of uppers and downers, and make it all go away. Imagine how grateful the patients must have been. Imagine not thinking there was anything wrong with it.

I look at the chart. I look at the nurses. I take a long look at the patient. And I find myself rewriting the chart, looking at no one, and mumble something I hope is helpful, about maybe trying to avoid giving them out too often. And while I scribble something quickly in the notes, I wonder what it would be like to be good at my job, and how I'd ever know if I was.