Mental Health

The Big Green Straw


One of the most powerful demonstrations of mindfulness I have ever seen in action was shown to me by Alec*, a former patient of mine. I first met Alec when he was 12 years old. He presented as autistic with complex communication needs. Alec is able to speak some isolated words in response to questions, but most of his speech is scripting—rote recitations of his favorite movies, videos, and TV shows.

Alec has a hard time adjusting to new situations, loud noise, and new people. His first appointment with me hit the discomfort jackpot. I was a new doctor in a new clinic building, with a very busy and sometimes chaotic waiting room.  On that Tuesday, the waiting room was humming with an energy all its own. Tuesdays were a particularly heavy patient load day as both the side-by-side autism/neurodevelopmental disabilities and first break psychosis clinics were in full operation. 

When Alec’s appointment time arrived, he was in full meltdown mode. It was heartbreaking to witness. He covered his ears while reciting the script to the latest Cars movie and squinted his eyes tightly, conveying the anguish he felt far more powerfully than any validated clinical instrument could.

Eventually, his mother cajoled him into my office just off the waiting room. I turned on every white noise machine I could find to create a calming atmosphere.  His mother worked to reassure him that he was safe. I explained to him that there was another way to leave the building; he would not have to go back to the waiting room. Despite our efforts, Alec remained in full meltdown mode.

And then his mother saw it. 

“Can I have that?” she asked.

She was pointing at my desk—all right, my very disheveled desk—and I couldn’t discern what she wanted.

“Can I have that?” she repeated.

I looked between her and my desk in confusion. At that point I would have given her anything—my cell phone, my wallet, my car—to help her son.

She moved closer, identifying a long green straw, one of those unnecessarily large ones they sometimes give you for iced coffee at fancy cafes. 

“Look Alec, Dr. Murray has your favorite. How did he know?”

Alec’s head swiveled. The sheer relief and joy that came over his face is something I still vividly recall. Alec grabbed the straw and twirled it between his hands in front of his face with a grin that lit up the room. He was totally absorbed in the experience.

As a clinician, I knew Alec was stimming, a type of self-soothing motor stereotypy. But I realized that this was also one of the purest examples of mindfulness in action that I would ever see. Alec was able to take a common everyday object, focus on sensory aspects of it, and regulate his physiological overload within a minute. Alec was a true master of grounding.

I often think of Alec and the many things he taught me that day.  Simple accommodations like having green straws ready for him at the check-in desk made a world of difference.  Something I may have labeled as a “problem” clinically could actually be a profoundly helpful means of self-regulation in an unpredictable world. Alec taught me that asking what a person needs to be more comfortable in a situation is not just an act of kindness—it is a sign of respect.

But more than anything, Alec reminded me to truly appreciate the value of neurodivergence both as a clinician and as a man. As much as I practice, I am nowhere near as good at grounding as Alec is.  I wish I were. As hard as I try, it is difficult for me to focus on what is within my control and accept the moment without judgment when I feel stress. But I remember Alec’s example, and I keep trying.

And any time I share this story with someone, I always ask the same question:

“What’s your green straw?”

Meet the Author

  • Michael J. Murray, MD

    Medical Director, Autism and Developmental Disabilities
    Autism Spectrum Disorder, Developmental Disabilities, Child and Adolescent Psychiatry