Objective: Newly qualified doctors on the wards are sometimes faced with difficult situations and difficult patients on the wards. We report a case and provide insight into management of these patients. Methods: This was only second week into the job. This patient was admitted to psychiatry ward from medical assessment unit because of acute episode of psychosis. Results: The patient was given some medications along with physical restraint. He was first given haloperidol and then lorazepam. He settled after these medications. He was thoroughly assessed by a multidisciplinary team headed by the consultant next day. He was diagnosed as brief psychotic disorder. He stayed on the unit for some time and was then discharged home on regular antipsychotic. He was booked into 1 monthly clinic and was given community support as well. Conclusion: Aggression can happen for a variety of reasons, i.e. acute psychosis and mania. Management varies according to the diagnoses. Physical restraint and medications form an essential part of management. However it is of utmost important to rule out medical causes of aggression. Substance abuse is the most common cause of aggression in developed countries.