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  Vol. 9 No. 3, March 2000 TABLE OF CONTENTS
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The Maintenance Man

Arch Fam Med. 2000;9:295.

ANOTHER hospital admission for chemotherapy, one of many for my spouse, Kate. She completed chemo for breast cancer several years ago and now needed it for ovarian cancer. Just walking into the hospital was a jolt. On entering the lobby, distinct hospital scents provoke anticipatory vomiting. Vomiting before, vomiting during, and vomiting after chemo.

We had barely settled into the room when we heard a knock on the door. We responded like Pavlov's dogs, "Come in." The stranger said, "Hi, I'm from maintenance and I need to check the ceiling. You don't mind, do you?" Well yes, we did mind. It was a time for family and friends, doctors and nurses, not for routine room maintenance. Then I remembered my grandfather was a maintenance man and said, "Oh sure, go ahead." I always think of my grandfather when I see these hard-working people with skills that I completely lack. "Thanks," he said, "There's a leak somewhere and I have to find it." Our privacy dissipated, we crouched in a corner and watched him, hoping he would leave quickly.

He hopped on the bed, dirty boots grinding stains into the white covers. As he lifted a ceiling panel he exclaimed, "Uh oh! Where did these wires come from?" He called on his walkie talkie to someone about the wires. Several of his associates came in, climbed on the bed, and squinted above the ceiling. All were dumbfounded. The loose wires baffled everyone. He finally said, "Oh well, leave them alone. I'll call the electricians. Let me clean up and I'll be out of your way."

That's when the comedy show started. It was an unscripted Oscar-winning performance by the Marx Brothers, Laurel and Hardy, and the Three Stooges all rolled into one person, the maintenance man. Best of all, he wasn't even trying to be funny. Something simple became simply hilarious for us.

Putting the ceiling panels back became a slapstick routine. It couldn't be done. He tried twisting and turning, pushing and pulling, bending and yanking, but to no avail. He contorted himself into every imaginable position. As if by their own willpower the panels boycotted being returned to the ceiling. I jumped up on the bed to help but only got in his way and embarrassed myself with my lack of mechanical skills.

"No problem, I have a saw," he said. And saw he did. The ceiling tiles burst into clouds of powder at the cut of the saw. The swirling dust squall blanketed the room like a new-fallen snow. Kate laughed. It was the first time I could recall her laughing in a hospital.

"Oh, sorry. I'll clean this all up. I have a broom too," he said. The "broom" was about 3 inches wide with a handle only 6 inches long. It appeared to be a product of hospital budget cuts and low bidding. Undeterred, he started swinging it with full force, creating cyclones of dust with each propulsion. Our room became a white cloud all over again. It reminded me of one of those globes that snows when shaken. "Wow, this never happened before!" he said. Kate continued to laugh.

His beeper called him away to another assignment before he could finish. He left as abruptly as he came, only now we didn't want him to go. We kept hoping he would return. All day long we hoped every knock would be his.

I soon found a real push broom and cleaned up the floor. New linen was brought in. Before long everything was antiseptic again, except the hole in the ceiling with those mysterious protruding wires.

It made our day! We had been sailing in a storm of self-absorption, and the maintenance man's dust brought us back to shore. Funny how enlightening a serendipitous dusting can be. (From dust we are made and to dust we shall return.) Laughing at our dusting with entropy strengthened us. We realized that our blessings and gifts far outnumbered our problems. Facing chemo was less daunting now.

Kate cheerfully recounted the episode to the hospital staff and visitors. She never tired of retelling the story. We laughed and talked about it so much we never noticed that Kate wasn't vomiting. It was the droll pinnacle among many nadirs of her treatment.

All the newest antiemetics were never as effective as laughter initiated by a stranger simply doing a routine job. Laughter was the most powerful antiemetic for Kate. It was free too. No copay, deductible, or preauthorization needed!

From that experience we started a nightly "Chemo Comedy Hour." We rented or bought old classic comedies. Kate never missed a show, no matter how ill. I have read Norman Cousins but now I witnessed firsthand the power of laughter.

When we returned next month I saw the maintenance man in the hallway and said, "Hi!" He quizzically nodded his head and I could tell he only vaguely remembered me. Like a doctor, he must see many people every day and often only once. What became a momentous treatment-altering event for us was just another room check for him. He had no idea of the effect he had had on our lives, or probably on the lives of other patients too.

Subsequently, Kate's ovarian cancer recurred twice, requiring additional surgery and chemo. While still dreading every admission, we always chuckle about the maintenance man, who, completely unbeknownst to himself, transformed our approach to chemotherapy.

Mark G. Jameson, MD, MPH
Hagerstown, Md






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