Secondary Logo

Journal Logo

AAPA Members can view Full text articles for FREE. Not a Member? Join today!
Mindful Practice

Paying attention

Feld, Ellen D. MD

Author Information
Journal of the American Academy of Physician Assistants: May 2017 - Volume 30 - Issue 5 - p 1
doi: 10.1097/
  • Free

One of my favorite things to do is to accompany a group of students to a school and watch them teach. They are first-year physician assistant (PA) students, and as part of their PA practice course, small groups of them go out into Philadelphia public schools and teach the kids about health-related topics.

Two weeks ago I accompanied a group to a school in the city's Wissahickon neighborhood. Standing in the science room, under a banner that read “You're Made of Atoms. You Have Mass. YOU MATTER,” six PA students in crisp white coats taught a room full of fifth-graders about viruses, bacteria, and the importance of hand washing. Everyone got a piece of candy and a bottle of hand sanitizer at the end.

This afternoon, we've piled into a couple of cars and driven to the Southwark section of the city. School has just let out, and traffic around the school is heavy. The crossing guard helps us cross the street.

“Come on, kids.” She smiles and waves our overgrown group across.

My students are spending time in the afterschool program. Armed with colored pencils and a bag of little foam squeeze-balls, they're teaching a group of 25 third- and fourth-graders about stress. After a brief presentation about what stress is, the kids are split into smaller groups and rotate through four stations: in one, they color a face that shows how they are feeling today; in another, they practice yoga; in a third, they exercise, playing “Simon says” and doing jumping jacks; and in the fourth, they talk about stressful experiences they've had.

The classroom is crowded, so the exercise and yoga groups are out in the hall. I'm watching a little girl, probably 8 or 9 years old, with dark eyes that are framed by glasses. Her black hair is pulled back in a ponytail, and she's wearing tiny gold earrings and bright red tights. She's in the hall with the yoga group, but she is not participating; she's just sitting on the floor, leaning against the wall; the girl sitting next to her is holding her hand. As the other kids in the group laugh and chant “I am strong” in time to their breathing, she rests her head on her friend's shoulder.

It's time to switch stations, so the yoga group moves back into the classroom and settles into a circle with two PA students who start talking to them about stressful experiences. They explain that communicating with other people about what is bothering you can help you feel better. They ask the kids if they've had anything stressful happen to them recently. To break the ice, one of the students says, “I had someone say something really upsetting to me a couple of weeks ago.” She goes on to describe how she called her sister, talked with her about it, and ended up feeling much better. The other student talks about the stress she felt when she had a really difficult test last week; she talked with classmates, made a study plan, and did fine on the test.

A fourth-grader's hand shoots up. “I had a test last week.”

“Were you worried about it?”


“Did you study and do okay?”

The fourth-grader nods and smiles proudly.

“Has anyone else had anything happen that stressed them out?”

At first the group is quiet; then the little girl in the red tights tentatively raises her hand.

“Yes? Did something that was difficult happen to you recently?” my student asks.

The girl answers quietly, “Trump hates Mexicans.”

There is a long moment of silence. My student hesitates; then she leans forward till she's at eye level with the little girl in the red tights.

“But you have so many people who love you and care about you: your parents, your teachers, your family, and your friends.”

The girl responds with an almost imperceptible nod, then looks down at the floor.

Later that afternoon, as we walk back to the car, my student shakes her head.

“How do you answer that? I had no idea what to say. What do you say to an 8-year-old who thinks the president hates her?”

“Sometimes there is no answer. Sometimes there's nothing you can say,” I reply, “except what you told her.”

Box 1
Box 1
Copyright © 2017 American Academy of Physician Assistants