When unexpectedly availing oneself of the services and amenities accorded by the nearby hospital emergency room, the following etiquettes — albeit eccentric — might well come in handy.

Backgrounder: I am relieved to report that a Sunday evening emergency appendectomy went as well as could be hoped, considering the abrupt and obstinate tantrum thrown by the offending appendage. A great surgeon and capable staff saved me from a painfully ticking time bomb.

The recovery room nurses were equally attentive and personable as I swam out from the haze of general anesthesia. When I first came to, the room was cold and dimly lit. All I could see was a stick figure on the wall, of Jesus on the cross. “Good lord,” I thought, “I’m in the morgue!”  “Stephan, how do you feel?’” asked one of the nurses. My voice was deep and gravely. Stuporous and punchy, I found myself singing, “In the morning gonna get my things together, I’ll pack it up and leave this place. I don’t believe your crying they’ll be – a smile upon yer face.” I am told I have the notoriety of being the first person to ever sing to the nurses upon regaining consciousness. And throughout the wee hours they would come check on me, marvel at my vitals, bring me sherbet and tea and brush away my fears.

Ah, but they were gone with the morning sun. I was medicated to the gills and slumbering peacefully when the day shift-show arrived. And this is where “The Unexpurgated Code” comes into play. As JP Donleavy explains in “A Complete Manual of Survival and Manners,” one need be proactive about their care. “To keep hospital employees on their toes and their hands on the right remedy, you must alternate between being highly irritated or generously polite. A little of each following plenty of the former is the recipe.”

I remembered his theory as soon as I realized I’d been parked inconveniently near the staff coffee room. Afforded the privilege of every tidbit of gossip and guffaws the nurses could muster at an early hour, I managed to volley a pained, “Hey, pipe the fuck down out there!” toward my door. Silence. With a whiff of satisfaction, I quickly fell back to sleep, for maybe 10 minutes. Now a new voice had joined the chorus, a haughty male tenor with authority and pomp. Raising my head in anger, I knew shouting at the door again would do me honor, and could reach neither of my shoes to hurl.

I called the nurses station. “I’m terribly sorry to bother,” I softly began in a stodgy English accent, “but would it be at all possible to ask the medical convention huddled outside in the hallway to please show a just a modicum of consideration…. and pipe the fuck down out there!?” “Stephan,” the nurse replied, “I know it’s you. I can see your room number.”

Enter Helga. Where compassionate night nurses Anne and Renee expressed admiration at my level of wellbeing and how I handled the emergency with calm and conviviality, Helga expressed no such amusement. Entering with a faint knock as I was exiting the bathroom and pushing the IV pole ahead of me, she exclaimed, “Spencer, you’re not supposed to be up!” “Yes, well, your colleagues saw to that.” And as I climbed back onto my gurney-like bed, an exposed butt cheek or two popping through the rear of the gown, I turned to ask, “Who the hell is Spencer?” “Please sir, your language!” She pointed to the crucifix above the bathroom door. “Oh, my God,” I muttered. “He’s stalking me.” Helga looked at her chart and then addressed me by my last name. “Michael, I am sorry I got your name wrong.” Things slid downhill from there.

But having now demonstrated Donleavy’s irritation in spades, I tried to employ an ounce of generosity. “Please forgive my being edgy, it’s the medicine talking. I’m not always so foul mouthed.” “Oh, that’s okay,” she said. But I insisted on contrition and continued, “no, that was really fucked up and I’m sorry.”

She didn’t react, but produced a pleated white paper cup with three pills in it. Two brown and one red. “What’s the red one?” I asked. “It’s a stool softener.” I smiled and said, “I don’t need that.” She looked down grimly and said, “Oh but you will; you will.” I paused. I know pain pills can have that affect, but her not knowing my name and her deference to a stick figure above the bathroom door made me leery.

“Look, I’m really paranoid of being poisoned, would you mind trying them first?” At this she laughed. I took my pills, tucking the red one under my tongue as she turned to the dry board on the wall. Popping out the ruby, I slid it under my pillow as she began reading every comment on the board, out loud. I begged her to stop. “Been reading it all morning. Got it memorized.” She said she would see if the doctor was ready to see me. “Please! I need to get out of here. I have a dog to feed!”

The room now Helga-free, I had a few comments of my own. Gingerly off my bed and pushing the IV cart as before, I added some notes…

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My poor and admittedly embellished homage to the late great J.P. Donleavy aside — it was the medication writing — a very gifted surgeon and her support staff probably saved my life. And for that I am very, very grateful.

Stephan Michaels
Hood River, Oregon
January 11, 2021