I can't read Qiaochu's mind, but I guess that something like the following is what he had in mind. Consider a homogeneous DE with constant coefficients $a_1,\ldots,a_n\in k$ (here $k$ is a field, either the reals or the complex numbers)
$$
y^{(n)}+a_1y^{(n-1)}+\cdots+a_{n-1}y'+a_ny=0.
$$
You undoubtedly know that the set of solutions forms a subspace $V$ of the function space. IOW, if $y=y_1(x)$ and $y=y_2(x)$ are solutions, then so is any linear combination $y=c_1y_1(x)+c_2y_2(x)$ for any constants $c_1,c_2\in k$.
Furthermore, if $y$ is a solution, then so is its derivative $Dy=y'$. In other words $D:V\rightarrow V$. Therefore also $D^2y, D^3y,\ldots$ are always solutions, if $y$ is. This allows us to act on any solution $y$ by any polynomial $b_n D^n+b_{n-1}D^{n-1}+\cdots+b_0$ as follows:
$$
(b_n D^n+b_{n-1}D^{n-1}+\cdots+b_0)y=b_ny^{n}+b_{n-1}y^{n-1}+\cdots+b_1y'+b_0.
$$
This action turns $V$ into a $k[D]$-module. Algebraically the ring $k[D]$ is just the ring of polynomials in the "unknown" $D$. So it is a PID, and we can use the structure theory of finitely generated modules over a PID. One variant of the structure theorem tells us that any finitely generated $k[D]$-module can be written as a sum of cyclic modules of the either of the form $k[D]$ or of the form $k[D]/p(D)^m$, where $p(D)\in k[D]$is an irreducible polynomial.
In this case there will be no free components. This follows from the fact that $V$ is a finite dimensional vector space over $k$. More directly it follows from the fact that the characteristic polynomial
$$
\chi(D)=D^n+a_1D^{n-1}+\cdots+a_{n-1}D+a_n
$$
obviously kills everything in $V$. This also implies that all the polynomials $p(D)$
that appear in the above direct sum decomposition must be factors of $\chi(D)$.
In the case $k=\mathbf{C}$ an irreducible polynomial $p(D)$ is linear by the fundamental theorem of algebra, i.e. $p(D)=D-\alpha$ for some complex constant $\alpha$. If $y$ is a generator of a cyclic $k[D]$-submodule $V_\alpha$ of the form $k[D]/(D-\alpha)^m$, then
$V_\alpha$ has a basis
$$\{y_0=y,y_1=(D-\alpha)y,y_2=(D-\alpha)^2y,\ldots,y_{m-1}=(D-\alpha)^{m-1}y\}$$
because any coset of the ideal generated by $(D-\alpha)^m$ has a unique representative of degree less than $m$. Here, by the properties of the module action, we have
$$(D-\alpha)y_{m-1}=0\qquad\hbox{and}\qquad (D-\alpha)y_i=y_{i+1},i=0,1,\ldots,m-2.$$
From this we can deduce that $y_{m-1}=c_{m-1}e^{\alpha x}$, and (selecting $c_{m-1}=1$) then $y_{m-2}=xe^{\alpha x}$ et cetera. Yet another way of looking at this is to observe that $V_\alpha$ corresponds to a Jordan block of the endomorphism $V$.
In the real case it is possible that $p(D)$ is quadratic and has complex roots, i.e.
$$
p(D)=(D-[\alpha+i\beta])(D-[\alpha-i\beta])=D^2-2\alpha D+(\alpha^2+\beta^2).
$$
I leave it to you to guess what kind of cyclic $k[D]$-submodules of $V$ look like the $k[D]/p(D)^m$.
I may have overlooked some aspects of this way of looking at a DE, but this answer is long enough as it is, so I stop for now.