staging pranks . . . bejeezus out of her. Interviews.

hidden under a sheet . . . shrieking down the hallway. Jim deMaine, “Gallows Humor is Only a Temporary Release from a Traumatic Situation,” KevinMD.com, November 13, 2011.

A California nurse has sprayed . . . Interview.

Nurses have awakened night shift . . . Interview.

“I am not the only nurse . . .” Interviews.

When a young Southern nurse asked . . . Interview.

“I’d been punk’d.” Interview.

“It tastes infected . . .” Interview.

urologists tend to have a lewd . . . Interviews.

“We get very naughty . . . like you mean it.” Interview.

A Texas nurse remembered . . . Interview.

“gallows humor. . .” tragedy or death. See, for example, Howard J. Bennett; J. Sayre, “The Use of Aberrant Medical Humor by Psychiatric Unit Staff,” Issues in Mental Health Nursing 22 (2001); Karyn Buxman.

when a doctor calls out . . . die in one night. http://themountainsarecalling.blogspot.com/2010/06/thoughts-on-death.html. Used with the nurse blogger’s permission.

“circling the drain” . . .“Eternal Care Unit.” Karyn Buxman.

“donor-cycles.” Ibid.

“the departure lounge.” “Gallows Humour in Hospitals Can Help Doctors and Patients Feel Better,” Daily Mail, September 27, 2011.

Gunshot wound . . . Celestial transfer. “Tragedy, Black Humor, and Coping,” Health Beat, November 1, 2012.

In the middle of the night . . . they ate the pizza.” Katie Watson, “Gallows Humor in Medicine,” The Hastings Center Report, September–October 2011.

nearly 90 percent used it . . . exercising (30 percent). Anne Villeneuve, “Why Paramedics Go for the Punch(line),” Dartmouth Medicine, Spring 2005.

In 2014, a Virginia patient . . . up a rectum. See, for example, Evan Bleier, “Colonoscopy Patient Sues Doctors for Making Fun of Him While He Was Unconscious,” Upi.com, April 22, 2014.

more than $5 million in damages Elizabeth Waibel, “Patient Says Bethesda Practitioners Mocked Him During Colonoscopy,” Gazette.net, May 13, 2014.

derogatory humor, in which . . . Delese Wear et al., “Derogatory and Cynical Humour Directed Towards Patients: Views of Residents and Attending Doctors,” Medical Education, January 2009.

make fun of patients’ names . . . locker. Interviews.

“Status Dramaticus” . . .“into the Hilton.” Interview.

hummed the Jaws theme. Interview.

“only one joke per patient.” J. Sayre.

targeted more than others . . . were removing. R. H. Coombs, S. Chopra, D. R. Schenk, and E. Yutan, “Medical Slang and Its Functions,” Social Science and Medicine (April 1993).

trade anecdotes . . . hospital urban legends.” Ibid.

“whose illnesses and health problems . . .” Delese Wear et al., “Making Fun of Patients: Medical Students’ Perceptions and Use of Derogatory and Cynical Humor in Clinical Settings.”

“difficult” patients . . . “us all look good.” See R. H. Coombs et al.

they usually intend . . . A lot. Interviews.

“There’s nothing potentially funny . . .” Ibid.

some ERs keep an orifice box . . . Interviews.

glass perfume bottles . . . an entire apple Interviews.

After Indiana nurses pulled a . . . Interview.

he had swallowed “something . . .” Interview.

required surgery to remove. Interview.

phone pictures of amusing X-rays. Interviews.

in meetings See, for example, Delese Wear et al. “Derogatory . . .”

“difference between whistling” Ibid.

humor helps medical professionals Ibid.

“Sometimes when something happens” Interview.

“find the bright side . . .” Interview.

shown to improve doctors’ . . . See, for example, Howard J. Bennett.

It allows them to express See, for example, R. T. Penson et al.

“having a common sense . . .” R. H. Coombs.

“How does it feel to be . . .” R. T. Penson et al.

“stray bullet effect”. . . type of patient. See, for example, Delese Wear et al. “Derogatory . . .”

“Critics of backstage gallows . . .” See Katie Watson.

medical students use derogatory . . . See, for example, R. H. Coombs.

“a safety valve for ‘letting off steam.’” These arguments are more persuasive than the idea that people who need to fill long stretches of silence in the Operating Room resort to gossip and jokes. (One medical student reasoned, “What else are you going to do? Oh yeah, that’s a nice tibia . . . ? You have to say something.” See Delese Wear et al. “Making Fun of Patients . . .”).

“It’s almost more depressing . . .” Interview.

“scandalous” . . . Interview.

can empower healthcare workers . . . locate joy or playfulness See, for example, Linda Caputi. “Humor in the Healthcare Workplace: A Cure for Stress.” Presented at the Healthcare Educators’ Conference, June 22, 2012; Karyn Buxman.

“Nurses need to blow off . . .” Interview.

nursing school educators who used humor . . . to combat burnout. See, for example, M. McCreaddie and S. Wiggins, “The Purpose and Function of Humour in Health, Heath Care, and Nursing: A Narrative Review,” Journal of Advanced Nursing 61, no. 6 (2007).

“Start a collection . . .” Karyn Buxman.

“When is behind-the-scenes . . . death won.” Katie Watson.

Chapter 6

“The nurse promotes . . .” The American Nurses Association’s Code of Ethics For Nurses: http://nursingworld.org.

“Hospitals tend to focus . . .” Interview.

base 30 percent of hospitals’ Medicare HCAHPS Fact Sheet (CAHPS Hospital Survey), May 2012.

“Delivery of high-quality . . .” Department of Health and Human Services. Federal Register, Vol. 76, No. 160, August 18, 2011.

Beginning in October 2012 . . . See, for example, Jordan Rau, “Patients to Affect Hospital Bonuses,” Kaiser Health News, in partnership with the Washington Post, April 28, 2011.

percentage will double in 2017 See, for example, Laura Landro, “The Informed Patient: A Financial Incentive for Better Bedside Manner,” The Wall Street Journal, November 8, 2011.

Blue Cross Blue Shield See, for example, Liz Kowalczyk, “Nurses Balk at Bid to Guide Dealings with Patients,” The Boston Globe, March 21, 2012.

Hospital Value-Based Purchasing Program “Administration Implements New Health Reform Provision to Improve Care Quality, Lower Costs,” Healthcare.gov, April 29, 2011.

thirty-two-question survey . . . improved the patient’s medical issue. See HCAHPS Survey: http://www.hcahpsonline.org, March 2014.

“my roommate was dying” See “Scrubs Contributor,” Scrubsmag.com, July 4, 2012.

“This somehow became the fault . . .” Interview.

“Many patients have unrealistic . . .” Interview.

Medicare calculates scores . . . Not an average rating. “Always.” Confirmed with a CMS spokesman; See also, for example, Cheryl Clark, “Top 12 Healthcare Quality Concerns in 2011,” HealthLeaders Media, January 4, 2012.

Medicare awards bonuses . . . See, for example, “Administration Implements New Health Reform Provision to Improve Care Quality, Lower Costs,” Healthcare.gov, April 29, 2011: “Hospitals will be scored based on their performance on each measure relative to other hospitals.”

Washington, DC, and New York patients . . . lower ratings. See, for example, Jordan Rau, “Patients to Affect Hospital Bonuses.”

either call or mail . . . See, for example, Jordan Rau, “Test for Hospital Budgets: Are the Patients Pleased?” The New York Times, November 7, 2011.