This is a Freudian examination of the interpersonal factors involved in Accident and Emergency Department work. The meeting of people immediately results in a deep and complex interaction which reflects much of their respective psychological life history. The particular reaction between patient and staff sometimes makes working in an Emergency Department extremely stressful thus adding to the existing pressure of the responsibility and complexity of the task. It is hoped that this psychodynamic appreciation, whose authors have a background in medical practice and criminology will enable staff to take a step back from and understand the stress of the moment.