I'M NOT SURE when medical science decided that sleep was not a necessary part of the healing process. Sort of an odd unilateral decision. Nevertheless, hospitals are little uncontrolled experiments in the effects of sleep deprivation on the seriously ill.

So I was sitting with my sleep-deprived mother-in-law one morning during her mercifully brief stay at Summit Medical Center, another tarnished jewel in the diadem of Sutter Health Systems, and chaos was all around her.

There was an argument near the bed across the room, as an elderly patient quarreled with her children. There was muffled laughter from the nurses' station. And, right near us, was an incessant beep. I finally went and inquired as to whether the beep was entirely necessary.

Someone came to investigate. The problem, it turned out, was that when the person one bed over had been moved, someone forgot to turn off her heart monitor. The heart monitor, sensing that no heart was beating, sounded the alarm. The alarm was not audible from the nurses' station.

Let me say that again -- the alarm was not audible from the nurses' station. The beeping, designed to alert trained medical professionals to a dire emergency, could not be heard more than 10 feet away. Suppose it had been my mother-in-law's alarm?

Maybe they malfunction so frequently that they are treated like car alarms on a quiet suburban street, as mere annoyances. Maybe the volume was adjusted because people complained. I do not know. But imagine -- a high-tech device always in use and always useless. Kinda gives you pause.

PAUSE IS PRECISELY what you need. My emphasis here is on surviving the hospital experience. The advice comes entirely from RNs and from doctors, who (believe me) are just as unhappy with the situation at Summit and many other Bay Area hospitals as the patients.

First, someone should stay with the patient at all times. If "all times" is impractical, at least be sure a relative or close friend is with the patient until the admission procedure is completed. Ask questions. Make sure everyone is on the same page.

Do not minimize your disease. An emergency room is not the place for macho stoicism. Bleeding helps you get to the front of the line. Vomiting helps you get to the front of the line. I'm not suggesting inducing either of these things, but I am suggesting not hiding them.

Remember, there are code phrases your doctor can utter. "Direct admit" is the big one; that will allow you to short-circuit much of the emergency room stuff. Also, "Patient may use meds from home, OK for inhalers to remain at bedside" -- or whatever details are appropriate. If the doctor says it, that gets the hospital off the hook, and "off the hook" is the most important position in any hospital.

ONCE ON THE patient is safely (perhaps) in bed, the helper should get to know the nurses. Remember that most of the people are not Registered Nurses or Licensed Nurse Practitioners, they are assistants and aides and what have you. They are helpful, but you will want to chat up the actual nurse.

Eventually you will learn the hierarchical semiotics of the uniforms and badges; in the short run, look for the older person -- the average age of nurses in this state is 46. Another interesting question: Where are the new nurses coming from?

If you've got a lot of money, or if you want to sell your home and live in a one-bedroom flat in Merced, the best answer is a private nurse. (No money? No equity? Uh-oh.) Yes, people can hire private nurses just for themselves in hospital settings. The regular nurses are in general not offended; they are grateful for the help.

The private nurse can provide peace of mind for both the patient and the relatives. Extra points if she can play gin rummy or figure out why the television on the ceiling only gets Channel 20.

Having thought globally and achieved despair: Tips for acting locally.