When journalists arrive in a country at war their learning usually starts with taxi drivers. They see and hear a lot. They know the dark side of life, particularly those who drive at night. I learnt a lot from the taxi driver who picked me up at 5.45 this morning. I was his last job of the night.

He was well spoken for a taxi driver, and I learnt during our journey that his wife had a degree. He probably did too, but he’d been driving the taxi for 10 years, always nights. “I hate traffic,” he told me. The great advantage of his job is that he can have breakfast with his children every morning and then take them to school. Two “power naps” during the night plus two or three hours during the day are enough sleep for him. “Like Margaret Thatcher,” I said.

I asked him about experiences with drunks. (I didn’t record our conversation, but I’ve written the piece with what he said in inverted commas as I think it works best that way. I’ve tried to use only words he used, including the word “professional,” but they are not his exact words.)

“Most drunks are simply talkative,” he answered. “You get to know how to handle and talk to them, and most are no problem. It’s the job of a night taxi driver to get drunks home safely. I take the responsibility very seriously. I’m in a caring role. Sometimes people get out of the cab to be sick. Many taxi drivers leave them then, because they don’t want sick all over their taxi. I would never do that. It’s my job to get them safely home.”

“But have you had bad experiences?”

“Some, the women are the worst. Once I drove two women home. One couldn’t stay awake. I suggested that we take her home first, but the other woman said no. She got out first and told me to take the sleeping woman to Wood Green. I was reluctant, but I did. But I had no address. I drove to Wood Green station and stopped. The woman in the back was sound asleep. I didn’t dare touch her.” Perhaps I should say here that the driver was a dark skinned South Asian with an English accent.

“I shouted, banged the doors, turned the radio up loud. After about twenty minutes she woke up. But she didn’t know where she was or who I was. I had to explain. I asked her where she lived. She asked where we were, and I told her Wood Green. She asked why we were there when she lived in Camden. I told her and asked her to stay awake to guide me to where she lived in Camden. She could hardly stay awake. Suddenly she said she could see her house. We were still in Wood Green. I drove her to her door and watched her go in.”

“Another time I drove a woman I knew from the taxi office. She was always smartly dressed and very polite. I liked her. One night a man put her into my taxi and asked me to take her home. She was very drunk and began to say the most awful things to me. I was heavily abused. I couldn’t help thinking that many people might throw her out or even hit her, but I felt a responsibility to get her home—and I knew that this wasn’t the real her.”

“A few weeks later I drove her when she was sober. She remembered nothing about the incident, but I told her about it. I thought that it was important that she knew what happened to her when she was drunk. She was very apologetic and offered me money. I said that I didn’t want her money, but I said that perhaps she needed help.”

“As a night taxi driver you get to be very good at knowing when people are going to throw up. It’s horrible when people throw up in your taxi. You have to stop work and go home and get the taxi thoroughly cleaned. That’s why the standard payment is the fare plus one hundred pounds. I was driving one couple with the woman in the front and the man in the back. I could see he was going to throw up and suggested that he should get out and vomit. The woman said he wouldn’t throw up and that he had never done so in his life. A few minutes later he did throw up. I drove them home and asked the woman for the fare and one hundred pounds. She gave me fifty. I said it should be one hundred. She gave me another thirty, and I said OK. But driving home I discovered she’d stolen some valuable headphones worth about one hundred pounds.”

I asked him if he went to the police. He didn’t.

“Another time I drove a young man, very smartly dressed. He’d just come down from the North and had got a good job. He was very drunk, and I could see he was going to throw up. He did, luckily after he’d got out of the car. He got back in and told me that he didn’t have the fare, which was going to be about thirty pounds. He had only five pounds. But I drove him home. I couldn’t leave him. It was my professional responsibility. When I got him home he gave me the five pounds but said that it would mean he wouldn’t have any breakfast. I told him I didn’t want to stop him having his breakfast and gave him his five pounds back. He said he’d pay me back, but I never thought he would. But two weeks later I got a letter from him with £100 in it. We are now friends.”

In a night taxi, as in war, you see the worst and the best of humanity, and you learn a lot about handling drunks and knowing when people are going to vomit.

Richard Smith was the editor of The BMJ until 2004. He is now chair of the board of trustees of icddr,b [formerly International Centre for Diarrhoeal Disease Research, Bangladesh], and chair of the board of Patients Know Best. He is also a trustee of C3 Collaborating for Health.