Monthly Celebrations

Kwanzaa – Telsie Davis, PhD, Assistant Professor Atlanta VAMC. Here are some highlights about Kwanzaa:  (1) Invented and first promoted by Dr. Malauna Karenga in 1966; (2) It is a non-religious holiday celebration of the harvest and African heritage from December 26 to January 1; (3) Dr. Karenga believed the principles of the harvest are vital to building strong communities for African Americans; (4) The 7 daily principles of the harvest are: 12/26 – Umoja (Unity); 12/27 – Kujichagulia (Self-Determination); 12/28 – Ujima (Collective Work); 12/29 – Ujamaa (Cooperative Economics); 12/30 – Nia (Purpose); 12/31 – Kuumba (Creativity); and 1/1 – Imani (Faith); (5) The symbols of Kwanzaa needed for celebration are: Mkeka (Straw mat –  represents the foundation on which all rests); Kinara (7-space candle – represents the stalk from with African people originated); Muhindi (Ears of corn – represent children of the stalk); and Zawadi (Fruit – represents labor by parents and rewards of the seeds sown by children); (6) Traditional Kwanzaa celebrations include decorations, feasts and gifts, and inclusion of children in ceremonies. 

Birthday of Martin Luther King, Jr. – Sandra Parks, Administrative Assistant, Brain Health Center. Our family had not long moved to Atlanta from rural South Georgia when the Civil Rights Movement was at a pinnacle (late sixties).  At least it seemed that way, as I had never been any further north than Macon, Georgia.  Though a child, I understood our relocation was for my parents to secure better work opportunities to support our family.  Why was there so much fuss and unrest in Atlanta?  Things in rural Georgia “seemed” simpler.  Or, was my focus too narrow? Was this happening in other cities?  Had my parents made a good or the best choice?  I did not understand it all then, but I knew there were tensions—even vaguely understood it to be racial tensions from media coverage.  I was an American, born in America no less, the Great USA; but even as a child, I knew the tensions had an impact on our family.  Unfortunately, yep, my race was the one being tormented at the root of those racial tensions.  (In the eyes of a child, the Vietnam War needed attention but was too far away for my limited focus.)  Media coverage quite often featured this man, Dr. Martin Luther King, Jr. (born Michael King, Jr.), in conjunction with the Civil Rights Movement.  His skin looked like my own.  He was articulate, speaking with such authority that resonated and commanded attention with great ease.  He looked to be the age of my parents—especially my dad.  I would come to know many years later, perhaps after his assassination (April 4, 1968), that they shared the same birth year (1929).  Though they were both from the same race, their experiences were quite different.  Different but they were subjected to some of the same negative challenges from other race(s) and ethnicities. Dr. King had a mission that would benefit our entire race—perhaps others too.  Was his mission divinely appointed or was he just a fellow giving life to a cause?  Did his efforts contribute to the reason my dad was able to eventually engage in business management or exercise a spirit of entrepreneurship most of his working life in the metro-Atlanta area?  One has been deceased a little over 5 months (my dad) and the other (Dr. King) nearly 5 decades.  Both positively impacted my life; and for that, I am truly blessed and grateful.  In honor of Dr. King, please join me in celebrating his life and accomplishments. Before becoming a civil rights leader and activist, Dr. King was called to be a preacher.  He considered this his first calling and greatest commitment.  Because of his Christian faith, he felt the civil rights activities to be an extension of his ministry.  From 1955 until his death, Dr. King was instrumental in leading and organizing many campaigns to address human rights issues (e.g., 1955 Montgomery bus boycott, helped found the Southern Christian Leadership Conference [SCLC] in 1957, and led the March on Washington in 1963).  Also, he was the youngest person ever to receive the Nobel Peace Prize in 1964.  It was awarded for non-violent resistance to racial prejudice.  After his assassination, there were riots in many US cities.  Some areas physically devastated by the same have never been rebuilt, begging to the question of whether we have recovered.  Nonetheless, US Representative John Conyers (D – Michigan) and US Senator Edward Brooke (R – Massachusetts) led the charge to establish King’s birthday as a national holiday.  Efforts met with much opposition, falling just five votes shy of the number needed for passage by the US House of Representatives in 1979.  Though he did not initially support the bill, President Ronald Reagan did sign the holiday into law in 1983.  The first federal holiday observance occurred in 1986.  Similar to other holidays under the Uniform Monday Holiday Act, it occurs annually on the third Monday of January.  Needless to say, all states did not readily accept it; but by 2000 all 50 states did celebrate initial observance.  In 2018, it will occur on January 15, Dr. King’s actual birth date. Before we moved from rural South Georgia and while waiting at a bus stop to take public transportation to work, my mom was egged by White children on a school bus.  Even further south than where we lived, there was a family member savagely murdered over a dispute involving a White woman.  While attending an integrated school in the early 70s, I experienced racial name calling firsthand from someone to whom I hardly gave much thought and definitely had no interaction.  It was to be called “booger.”  No matter how horrific and insensitive, we all survived those incidents.  Thanks to Dr. King for sharing Mohandas K. Gandhi’s non-violent concepts and enlightening us to react in a more excellent way.  In addition, the following quote by Dr. King is encouraging and refreshing:

Nothing in the world is more dangerous than sincere ignorance and conscientious stupidity. In my lifespan, racially I have been known as a Negro, Black, and an African-American.  Whether considered a dated or politically correct term does not matter to me.  Learning long ago I am not dried nasal mucous, I am very proud to be who I am. I am thankful to have the day observed as a holiday away from work.  In Atlanta, we know there is a week-long celebration filled with many events recognizing Dr. King’s life and legacy.  It is culminated annually on the national holiday observance during the televised ecumenical services.  In years past, I have been blessed to either be a participant in the same, work on school projects with my children when they were school age, assisted them to be participants in volunteer efforts via our church, and/or to participate in extracurricular dance performance tributes.  As a woman of faith and a minister, I now better understand the intensity and steadfastness Dr. King exercised in being a champion for equal rights.

International Day of Remembrance to Commemorate the Victims of the Holocaust – Hannah Potvin, MD, Psychiatry Resident. My grandfather (mom’s father), Martin Heilbrunn, had a quite remarkable story. He was actually the only one of my grandparents I knew and would rarely speak about it but I did get a chance to have a long conversation with him before he passed about his life and some of his experiences.  My grandfather was born in Germany in a small Jewish community but eventually moved to Nuremberg to live with his aunt & uncle. After hiding under a neighbor’s bed during Kristalnacht, he was smuggled out of the country through Belgium and eventually legally entered the US. Once in the US, he actually joined the US army and went back working as a translator. He helped liberate parts of Europe but sadly found out that his parents did not survive. They died in Theresienstadt and Auschwitz. Our family still has his Judenstern (the yellow star marking him as Jew) and his military discharge papers among other memorabilia. He died while I was in medical school and was buried, fittingly, right around Veteran’s Day.

International Day of Remembrance to Commemorate the Victims of the Holocaust – Heather Greenspan, MD, Assistant Professor, Emory University Hospital Consult Liaison Services. As we reflect on the International Day of Remembrance to Commemorate Victims of the Holocaust, I am reminded of the strengthening and vividly harrowing ordeal my 2nd paternal cousin Moshe Ekstein, affectionately referred to as “Eki,” lived through.  He witnessed the execution of his mother and 2 siblings when Nazis were “collecting” Jews for one of the concentration camps in Russia, now considered Ukraine.  He hid in the forest until found by his father, who also escaped the execution. The trauma didn’t end there. He and his father were sent to an execution camp. After surviving the camp, he and his father emigrated to Israel, where they began anew. While I resided in Israel during medical school from 2004- 2008, he and his family (wife and 3 children) became my primary family and he was a father figure to me. He felt it was important to share his story with me to remember our shared history and relay the fortitude of our family and people to rebuild. He instilled in me the strength of our people and knowledge that no matter how challenging life seemed, things could always be worse.  Instead of dwelling on his traumas, he thrived in the community and attended a well- respected university (Technion- Israel Institute of Technology AKA “the Harvard of Israel”), and become a civil engineer. Eki continues to be respected in his community, having been instrumental in erecting Highway 6, a major highway in Israel.

The Spring Festival: Chinese New Year – Yilang Tang, MD, PhD, Faculty VA. This year on February 5 starts the Chinese New Year, also called the Spring Festival, which was traditionally a time to honor deities, as well as decreased ancestors. The Spring Festival is probably the most important and celebrated festival for Chinese people. People often spend much effort to thoroughly clean their house to prepare for it and to sweep away any “ill-fortune” and to make way for incoming good luck. Another custom is the decoration of doors and windows with red paper-cuts and couplets. Popular themes among these paper-cuts and couplets include that of good fortune, happiness, health, prosperity and longevity. Other activities include lighting firecrackers and giving pocket money in red envelopes (usually given by senior family members to children). The evening before the Spring Festival is often regarded as an occasion for all Chinese families to gather for the annual reunion dinner. People across the country travel from far away to return their homes, therefore the time around the Spring Festival in China is often the cause of the largest annual mass human migration in the world. According to the Chinese zodiac system, 2019 is the year of the Pig, the twelfth animal in the 12-year cycle. It is said that people born in the year of the Pig are easygoing, happy, trusting, and sincere; while the possible dark sides the Pig people include being naïve, stubborn and self-indulgent. February 5, 2019, marks the beginning of the Lunar New Year, a widely observed holiday in many Asian countries including China, Korea, Vietnam, Malaysia, the Philippines, Singapore, and Taiwan.  The week-long celebration ushered in by the New Year is known by multiple names, including the Spring Festival in mainland China, Seollal in Korea, Tết in Vietnam, and the Chinese New Year in Singapore, Malaysia, Philippines. The New Year beginning on February 5^th is the year of the Pig, the twelfth and last of the zodiac animals.  Legend has it that the zodiac order was determined by a race between the animals to the Emperor’s palace.  The pig was the last to arrive; some say this was because he overslept, and others say a wolf destroyed his house, and he had to rebuild it before joining the race. 

The Lunar New Year – Nicole Marie Azores-Gococo, PhD, Adjunct Faculty. Lunar New Year celebrations are marked by several traditional practices, including heavy use of the color red and of firecrackers.  Various legends mark the New Year as a time when demons and monsters can roam the earth until dawn.  Red decorations, including poems on red banners, and firecrackers are said to protect families from harm as they welcome in the New Year.  Children receive money in red envelopes.  Finally, people who were born on a previous year of the Pig are thought to be vulnerable to bad luck on subsequent years of the Pig.  But they can also ward off misfortune with the color red throughout the year; it’s even recommended that they wear red underwear!

We would like to draw your attention to the Principles in the Care of Transgender and Intersex Patients Conference.

Passover – David Goldsmith, MD, Assistant Professor - The holiday of Passover is a time when Jews reflect on the retelling of the Exodus story, when we recall the biblical narrative of being freed from slavery in Egypt. It is a holiday of great preparation – cleaning and clearing out homes of any unleavened food in preparation for eight days of Matzah. As a child, I remember having great fun packing up our usual sets of dishes and bringing out the boxes of Passover dishes stored away to come out for their yearly 8-day foray. Everything was cleaned and nothing was left unturned, as we would scour the house the night before the holiday looking for the last crumbs of bread. Passover was a time of getting together with family – it was one of the few times a year when I would see aunts, uncles, and cousins who would come for the Passover Seder at my Grandparents house. Today, memories of my Grandfathers leading the Seder permeate my mind as we sit around the table, telling the story of the Exodus for yet another year. Though the words don’t change and we sing the same songs, we try to bring some relevance to the discussion – connections to the holocaust and the civil rights movement, a discussion of modern-day injustices throughout the world and in our own country. I think this is the reason we retell the Exodus story each year. We’re commanded to teach the story of the Exodus to future generation, and though this may be our story, the history of slavery and oppression is not singularly ours. For this reason, the words of the Hagaddah that guide the Seder call on us to share in the matzah – literally referred to as the bread of affliction – not just so that others may have food to eat (as the text explicitly states) but to also hear their stories and feel connected to others (as I read the text as implicitly stating). To me, Passover is a holiday that forces us to look beyond ourselves – to recognize those who suffer and help with their struggles.

Passover – Betsy Gard, PhD, Adjunct Professor - Passover is a major holiday in the Jewish religion. Passover commemorates when the Pharaoh set the Jews who lived in Egypt free to follow Moses into the desert after experiencing ten plagues.   Jews celebrate their freedom by participating in two nights of Seders, which are held after Sundown.  Seders are ritual meals that include a service recounting the story of the Exodus from Egypt.  During the eight days of Passover, Jews are to refrain from eating any leavened products, called chametz. Chametz include foods with grain as these foods may rise, and in the Exodus story, Jews had no time to let their dough rise.  Jews may eat only prescribed, unleavened food items, specific for Passover, which have a special designation as KOSHER or meeting required Jewish law and customs. An example of a kosher for Passover food is Matzo, which is unleavened bread that looks like a cracker.  Observant Jews will be very careful to eat only Kosher for Passover foods, which can make eating out or eating hospital or cafeteria food very challenging.

Good Friday - Sandra Parks, BS, Administrative Assistant – Simply stated, Good Friday commemorates Jesus Christ’s crucifixion and occurs annually on the Friday just before Easter Sunday (preferably Resurrection Sunday).  Christians observe His death on the cross on this day, one filled with purpose for the salvation of all mankind.  Crucifixion has been considered the cruelest form of execution.  Why would observance of such a day be called “Good” Friday?  Jesus Christ was crucified, symbolically becoming the sacrificial lamb whose shed blood would redeem sinful mankind, restoring the righteous relationship between God and man.  In 2018 it falls on March 30; but varies each year.  (Determining the date can get complicated.  Easter Sunday is based on the vernal equinox which occurs on or around March 21.  However, the date—typically anywhere between March 22 and April 25—is set for the first Sunday which occurs after the first ecclesiastical full moon.  So, Good Friday will occur somewhere within this formula.)  Celebration of this day is almost second nature to Christians, but it deserves so much more reverence.  However, many fundamental premises of the Christian faith rest upon this day.  If there were no death, burial and resurrection, Jesus Christ’s story would not need to be told.  (At Christmas time, do not forget to add His birth to that sequence.)  Synoptic or not, the latter chapters of the four gospels—Matthew, Mark, Luke, and John—all tell some version of the crucifixion events.  Ironically, considering its significance to Christians, the Bible does not command we observe Good Friday.  This is not blasphemous, but it really does not command us to observe the resurrection either.  Maybe we should not tell this to all the little boys and girls who have labored to learn those dreaded recitations they must say before the whole congregation.  However, we can partake of the Lord’s Supper (1 Corinthians 11:23-26) to honor His death. Various faiths and denominations celebrate Good Friday in different ways.  Though it commemorates Jesus Christ’s death, it is not a somber occasion.  Starting with the previous Sunday, which is observed as Palm Sunday (Jesus’s triumphant entry into Jerusalem), several events are clustered together and recognized by Christians at this time of year.  Some engage in week-long (Holy Week) worship services where the Seven Last Words of Jesus Christ from the cross are preached.  Or, some simply have a similar worship service on Good Friday.  There are still others who choose to engage in personal or corporate worship, meditation, penitence and, of course, partaking of the Lord’s Supper.  Appreciation for this day rests solely in the heart of the believer.  Another piece of trivia—just as with Jesus Christ’s birth, we do not know the exact day of the week on which The Crucifixion occurred.  If you acknowledge it in any way, know that it is not about colored eggs or hunting for them, chocolate bunnies or baskets filled with other goodies or dressing up in your Sunday best to say recitations.  Again, simply stated for Christians, Good Friday commemorates Jesus Christ’s death by crucifixion for mankind’s redemption from the penalties of sin (Romans 5:8).

Autism Awareness Month – Kelsey Bohlke, LPC, CRC, Counselor Emory Autism Center - Each year during the month of April, individuals and organizations across the globe celebrate Autism Awareness Month with events to educate local communities and raise public awareness about autism. Almost 50 years have passed since the Autism Society held the first National Autism Awareness month in April of 1970. Since then, autism has become the fastest growing developmental disability in the world, with the diagnosis rate of children with autism increasing from 1 in every 2000 children in the 1970's and 1980's to 1 in every 68 children today. More recently, April 2^nd has been named World Autism Awareness Day, which helps to kick off events for the whole month. Some events taking place locally this year include the Autism Speaks Walk on April 29^th and the Light it Up Blue campaign on April 2^nd and throughout the month of April. The Emory Autism Center recently hosted an Autism Awareness Event on April 18^th at the Brain Health Center to discuss the representation of autism in the media.  

Regina Koepp is in the process of developing an Atlanta VA Mental Health Service Line (MHSL) Diversity Education Committee with the goal of providing an education series to all MHSL staff on various multicultural topics related to clinical care and Veterans; opportunities to enhance the cultural climate and ethical actions of VA MHSL staff through personal and professional self-awareness experiences/projects that encourage increased understanding of how diversity influences the beliefs, practices and interactions among staff, providers and Veterans; and collaborating with various ATL VA diversity committees to enhance cohesion and systemic growth that promote multiculturalism.  There have been three committee meetings to date.  Regina and Telsie Davis have presented two three-hour workshops to multidisciplinary staff entitled “Deepening a Practice of Cultural Humility.”  

Ramadan – Ishrat Khan, MD, Assistant Professor, Atlanta VA - Ramadan is the 9th month of Islamic (Lunar) calendar. It is considered one of the holiest month for Muslims as they believe that the Holy book, Quran, was first revealed by God to prophet Muhammad (may peace be upon him) on a special night called “Layat Al Qadr”, one of the last ten nights of Ramadan. Quran, decree upon adult healthy Muslims to fast during this month. Muslims believe that fasting cleanse the soul from impurities. They think of it an opportunity to practice self-discipline, sacrifice, and develop empathy for those less fortunate. 

Muslims fast during this month for about 29–30 days depending on sighting of the moon. The annual observance of Ramadan is considered by Muslims one of the “five pillars of Islam”.

Ramadan usually begins when a moon sighting committee make an official announcement. People usually greet each other by saying ‘Ramadan Kareem”. This roughly translate to “Happy Ramadan”

Adult Muslims are required to fast every day during this month. During fasting, Muslims abstain from all sort of eating and drinking by mouth including medication. In addition, Muslims are required to refrain from smoking, sexual intimacy, hurtful speech and indecent behavior during the fasting hours of Ramadan. The duration of fasting starts before the beginning of dawn and ends with dusk, which can last for 11 to 16 hours, depending on the time of the year and the geographic location in the world. The Quran has made a clear exemption for the sick, elderly, travelers, children, expectant, or breastfeeding mothers and menstruating women not to fast during Ramadan. Those who travel or are unwell may fast on different days later.

During Ramadan, people start their day with a pre-dawn meal called” suhour” and they break their fast after sunset with a meal called “iftar”. Traditionally they use dates to break their fast. Muslims offer a special long prayer during Ramadan called” Taraweeh” after the regular midevening prayer that last for 1–2 hours. People usually offer this prayer in congregation in their place of worship called “masjid” where the person leading the prayer called “Imam” recites different chapters of the Quran during prayers each night until the Quran is completed by the end of Ramadan. At the end of Ramadan there is a three-day celebration which is considered a public holiday in Muslim countries.

Health care providers need to be aware of several situations that may arise while treating Muslim patients during Ramadan. They need to learn culturally sensitive approach in handling these situations.

Although people who are sick are exempted from fasting, Many Muslims still choose to fast during this month. This may complicate management of chronic diseases such as Diabetes, increase medication nonadherence, may result in refusal of necessary medical tests or examinations such as blood draw, oral, pelvic and genital examination. 

Healthcare providers treating Muslims patients should inquire about fasting during

Ramadan and offer education on the following.

Advice on Safe fasting given a particular medical condition: Clinician should use their medical judgment when advising patients about safe fasting given a particular medical condition, for example most people with well controlled diabetes should be able to fast, but if fasting is judged unsafe (such as brittle diabetes, kidney disease etc.), clearly communicate this.  They may offer referral to Muslim Clergy if so desired by patients, to get spiritual advice on abstaining from fasting.

Medication intake:  Patients’ medication regimens should be examined with particular attention to timing of doses, to ensure adherence during the fast and to avoid complications. Switching medication to equivalent dosages that can be given once daily or transdermal patch can be an option.

Diabetes: The main concerns in fasting for patients with Diabetes are hypoglycemia, post prandial hyperglycemia, dehydration, and ketoacidosis. Therefore, education about physical activity, food consumption, and medication adjustment is crucial to prevent complications. Studies supports that dietary counseling and education of Muslim diabetic patients who choose to fast during Ramadan are associated with a significant reduction of acute complications. The International Group for Diabetes and Ramadan recommended (2015 guidelines) that Taraweeh prayers should be regarded as a physical exercise with the potential to induce dehydration and hypoglycemia. (I have included BMJ open Diabetes research and care, consensus guide reached by the International Group for Diabetes and Ramadan published in 2015). Individuals with diabetes are advised to drink plenty of water and to guard against hypoglycemia during Taraweeh prayers. Dates, a customary fruit that Muslims break their fast with, are regarded as having low glycemic index, but Moderation such as eating no more than three dates should be advised. Healthcare providers should advise individuals with diabetes about the risk of developing hyperglycemia after Ramadan. Eid al-Fitr festival is usually celebrated with sweets and there is a potential for high caloric intake. It is, therefore, important that healthcare providers emphasize the importance of resuming normal medication dosages and timing. 

Pride – Patrick Amar, MD, Assistant Professor.  This is something that did not come easily for me --pride in being a member of the LGBTQ community and pride in myself.   I remember feeling all alone as a boy.  I could not tell others about my identity for fear they would hate me and I had no role models of anyone who was openly gay – really not one single person.  There were a few teachers who were rumored to be gay but no one who would say so.  The only portrayals of gay men were the very silly and frankly offensive Jack on Three's Company and an occasional pedophile on a TV series.  There was no Will and Grace yet.  I thought there was no way to live a fulfilling and meaningful life as gay man. 

One turning point in my life came when I saw the movie The Sum of Us with Russel Crowe portraying a young gay man and his father both looking for someone to date.  I was amazed at the openness and acceptance with which the father and son dealt with the son's homosexuality.  Russel played soccer and was not silly at all.  He was honest, caring, and thoughtful.  I could actually identify with him.  It was exhilarating to see the movie.  I felt empowered to be visible and known.  Maybe, just maybe, I could actually be my authentic self – not a freakish silly character but not a conforming “normal” person either.  If I was going to live my life as a gay man I was going to have to break from expectations and not conform to societal norms.

Thank goodness for some caring friends and a good psychoanalyst to help me find my way to pride in being a gay man and in being myself.  I think there is a lesson in this for all of us.  We all have aspects of ourselves and of our story that can bring up shameful feelings.  None of us conforms to society norms completely.  We are unique people on a unique path in life and that makes us all pretty special.  We in mental health are very aware of this.  We have the privilege of helping people along their unique journey in life.  We help people became comfortable with who they are by helping them understand themselves, becoming aware of what they are thinking and feeling, and helping them weave together their unique story.  It’s at the very heart of the therapeutic relationship.  So, this month of PRIDE celebrate your patients!  Celebrate you! Celebrate the people you love!  Happy Pride! 

Americans with Disabilities Act – Erica Lee, PhD, Assistant Professor, Grady Health System. July 26^th is the anniversary of the Americans with Disabilities Act (ADA).  In 1990, President George H.W. Bush signed the ADA into law, making discrimination against people with disabilities by employers, educational institutions, transportation providers, public and commercial facilities, telecommunication and state and local government agencies illegal.  It was divided into five sections outlining the provision of civil rights protections for individuals with physical, mental, mobility, cognitive, speech and intellectual disabilities.  The ADA facilitated many quality-of-life improvements by holding relevant public and private agencies accountable via implementing reasonable accommodations and eliminating a number of barriers many individuals experienced.  The Americans with Disabilities Amendments Act (ADAAA) was signed into law in 2008 and expanded the law by making significant changes to the definition of disability. 

Americans with Disabilities Act (Erica Lee, PhD, Assistant Professor, Grady Health System). July 26^th is the anniversary of the Americans with Disabilities Act (ADA).  In 1990, President George H.W. Bush signed the ADA into law, making discrimination against people with disabilities by employers, educational institutions, transportation providers, public and commercial facilities, telecommunication and state and local government agencies illegal.  It was divided into five sections outlining the provision of civil rights protections for individuals with physical, mental, mobility, cognitive, speech and intellectual disabilities.  The ADA facilitated many quality-of-life improvements by holding relevant public and private agencies accountable via implementing reasonable accommodations and eliminating a number of barriers many individuals experienced.  The Americans with Disabilities Amendments Act (ADAAA) was signed into law in 2008 and expanded the law by making significant changes to the definition of disability. 

International Day of the World’s Indigenous People (Erica Lee, PhD, Assistant Professor, Grady). August 9th is the United Nations’ (UN) International Day of the World’s Indigenous People.  It is a day of observance that celebrates indigenous people stemming from the first UN Working Group on Indigenous People meeting in Geneva in 1982.  The UN General Assembly decided that August 9th would be the annual day of commemoration on December 23rd, 1994.  Indigenous People have historically been among the most vulnerable groups globally.  They have fought to protect their unique social, political, economic, and cultural distinction from the majority populations in which they live.  On September 13th, 2007, the General Assembly adopted the United Nations Declaration on the Rights of Indigenous Peoples encompassing global standards for the dignity, survival and well- being of indigenous people.  Honoring the rich cultures of the approximately 370 million indigenous people living in 90 countries on this day is demonstrated through art, education, public forums, and etc.

Eid Al-Adha (Ishrat Khan, MD, Assistant Professor, Atlanta VAMC). Eid Al-Adha is one of the two major festivals celebrated by Muslims around the world to commemorate the commitment and obedience of Prophet Abraham (may peace be upon him) to the will of one God. It is a three-days celebration that starts on the 10th of Dhul-Hijjah, the twelfth and final month in the Islamic Lunar calendar. Eid Al -Adha celebration coincides with the end of Hajj period, which is one of the five pillars of Islam for Muslims who are physically and financially capable of performing pilgrimage to the Holy city of Makkah in Saudi Arabia where Ka’bah is located. According to Muslim belief, Ka’bah is the house of God, originally built by Prophet Abraham and his son prophet Ismael (May peace be upon them) at the command of God. The rites of Hajj, which are mostly enactment of struggles of the Prophet Abraham’s family, are performed from the 8th to the 12th of Dhul-Hijjah. One of the reasons Muslims celebrate Eid Al-Adha is to thank God for sending a lamb to Prophet Abraham to slaughter instead of his son. It is strongly recommended in Islam that every Muslim man, woman and child participate in this joyous occasion by going to Eid prayers which is performed in congregation, listen to the sermon after prayers which is mostly a reminder of one’s responsibilities to God, other Muslims, and fellow human beings. After the Eid Sermon, Muslims greet each other, give gifts to the youngsters, visit each other at their homes, or participate in other family and Eid related community festivities. Those who have financial means, offer the sacrifice of an animal to God such as a lamb, sheep, goat etc. the meat is divided into three equal portions, one is kept for oneself, second is given to family and friends and third is given to people in need. Some people donate money to charities to make sacrifice on their behalf which is then given to poor and people in need. The two Muslim celebrations, Eid Al-Adha and Eid Al-Fitr are official holidays in Muslim countries. They are not federal public holidays in the United States but the US government has issued postage stamps since 2001 to commemorate Eid al-Fitr and Eid al-Adha to highlight religious inclusivity and acknowledge the business, educational and social contributions of American Muslims.  New York City Mayor Bill de Blasio made Eid al -Adha and Eid al-Fitr official days off for the city’s 1 million school children in “a change that respect the diversity of our city” in 2016.

National Hispanic Heritage Month – Rob Cotes, MD, Assistant Professor, Grady Health System and Associate Director for Residency Education.  National Hispanic Heritage Month reminds me of the journey and career of my primary mentor and inspiration for becoming a physician, my father.  He was raised in the town of El Saibo in the Dominican Republic (population 90,000).  He grew up under the Trujilo regime in a three-bedroom house with 10 brothers and sisters.  His family stressed the importance of education and treating everyone, despite their standing in society, equally.  He was the first of his family to become a physician and left the D.R. the day after graduating medical school in 1969.  He only knew several words in English at the time.  He initially practiced in Man, West Virginia, a coal mining town, as an Emergency Room doctor. He fondly remembers the kindness and generosity that community showed him as a young immigrant.  He then completed an OB/GYN residency in Augusta, GA, where I was born.  Our family returned to West Virginia, this time to Charleston, where I was raised.  For years, he was in solo private practice, on call every night.  His incredible work ethic, sense of calm in crisis, and ability to make a friend anywhere inspired both my mother and I to pursue careers in medicine.  One of his proudest moments was becoming a U.S. Citizen.  Last year, my father retired after a long and successful career.  His story, and others, make me extremely proud of my Dominican heritage.  Now, we continue many Dominican traditions in our home, mainly centered around food and family. Highlights include a marinated pork roast on Christmas Eve, fried plantains, rice and beans, and locreo (a rice casserole served with a variety of meats).

Suicide Prevention Month – Andrea Florez, PhD, Adjunct Assistant Professor. Suicide is another example of our failure to help our most marginalized individuals. Although losing someone by suicide affects all of us equally, among sexual and gender minority individuals’ rates of suicide are more than double, and quadruple in younger population, when compared to heterosexual and non-transgender people. Furthermore, this population is at higher risk of experiencing other psychosocial issues, continues to be underserved in behavioral health settings, and has more difficulties accessing comprehensive medical and mental health care that addresses all of their needs. Given these differences in vulnerability of suicide, the field of suicide prevention underscores the importance of examining the impact of suicide thoughts and suicide behavior from an intersectionality framework.  An intersectionality approach to suicide prevention sustains that group membership and individual psychosocial differences (and the combination of such variables) renders an individual more or less likely to experience suicidality. For example, the interception of being from a sexual and/or gender minority group and from an ethnic minority group increases even more the risk of suicide than belonging to only one of these minority groups. This intersectionality approach to suicide calls for suicide preventive and treatment efforts that recognize differences in layers of privilege versus oppression, individual identity versus group identity, and contextual factors that might increase or intensify an individuals’ experience of suicidality. In this suicide prevention month, thus, the invitation is to advocate for improved and inclusive services of identification, referral, and treatment of suicide and behavioral health problems of those who have been most neglected and who are at increase likelihood of experiencing suicidal thoughts and behaviors. 

Hispanic Heritage Month – Andrea Florez, PhD, Psychology Postdoctoral Resident, Colombian Citizen. For a Hispanic immigrant, the Hispanic heritage month (September 15- October 15^th) is always a good reminder of the great efforts that United States has made to include us, honor us, and celebrate our culture. At the same time, this month is an opportunity to reflect on the remaining work that must be done to improve the quality of life among Hispanic-Americans. During this year’s Hispanic heritage month issues were raised about United States’ commitment with the Hispanic-American community when Hurricane Maria hit Puerto Rico, affecting the lives of millions of Americans.  Many people were disappointed at the government’s response (or lack thereof) to mobilize resources to help Puerto Rico, and others like me, were hopeful that this unfortunate situation would open the door to a nation-wide conversation about current unaddressed needs of Hispanic-Americans. This conversation, ideally, would not only focus about the issue at hand related with Hispanic-Americans´ perceived sense of alienation and marginalization but also about systemic and social barriers that keep Hispanic-Americans from accessing equal and high quality educational, socio-political, and health-related opportunities. I have been a witness of these systemic barriers as a Hispanic Mental Health provider and immigrant. On multiple occasions, I have struggled to find public resources to provide culturally-sensitive treatment, or any treatment, to Hispanics; experienced anxiety about on-going political changes that negatively impact our community; or been labeled in a way that narrows my ability to help others. So in this Hispanic Heritage month I invite you to not only celebrate this rich and diverse ethnic group, who is grateful to call United States home, but to also have discussions about ways to contribute to make Hispanic Americans feel included, supported, and equal.

Diwali – Sanjay Shah, PhD, JD – Adjunct Assistant Professor. It's that time of year for many South Asian families. Light the diyas, create rangoli, prepare the feast, and turn on the lights to celebrate Diwali. This is the Hindu religious festival celebrating light over darkness, goodness over evil, and prosperity. As an Indian American, I associate Diwali with community, belonging, and identity. I was fortunate to have traveled to India at a young age. Looking back, it was palpable how one's identity can be tied to family, extended family, neighborhood, and yes, caste. You alone are not responsible for your own well-being but you are responsible for being a part of your community. In many ways, the pressure of self-reliance that many feel in America is released while the good of larger systems takes precedence. Growing up in the United States, Diwali was a time when I got a flavor of my identity being more closely tied to a community as so many Indian families within a geographic area (for me, it was Southwest Florida) got together to celebrate. Working with and treating several South Asian immigrants and first-generation South Asian American individuals, I have found that stress, worry, depression, anxiety, and other mental health concerns can often be traced to the reconciliation in identity that needs to be made between individual versus community. I encourage you to explore and learn what this means for the South Asian patients you encounter. 

Indigenous Peoples Day (Allie Ramsay, PsyD, Adjunct Faculty). Indigenous Peoples Day fell on Monday, October 8th this year. Many of you may recognize this day as Columbus Day (or Canadian Thanksgiving, if you’re from the Great White North like me), so here’s the back story. The first Columbus Day was celebrated in 1937 when then-president Roosevelt made it a federal holiday in response to lobbying by Italian-American community groups. Columbus Day, these groups said, would be a day to honor Christopher Columbus and his arrival in the Americas. Over the years, there has been building criticism of the U.S.’s celebration of the “discovery” of America, a place that was already inhabited. Previous mayor of Berkeley, California, Loni Hancock (who is currently a California senator), explained that celebrating Columbus Day is “Eurocentric and has ignored the brutal realities of the colonization of indigenous peoples” (TIME Magazine, Monday, Jan. 27, 1992). Although Columbus himself was not the sole perpetrator of the colonization and destruction of the indigenous peoples of America, his name has come to represent the doctrine of “discovery” (the notion that the person who discovers something has a claim to it). Protests of this holiday began the moment Roosevelt made it into a federal holiday, but the movement to change the holiday began to gather more steam in the 1970s. To many, celebrating indigenous people rather than Christopher Columbus challenges the idea that Columbus “discovered” America and provides us with the opportunity to celebrate those who lived here before Columbus (and others) ever set foot here. In 1990, South Dakota became the first state in the United States to recognize Indigenous Peoples Day/Native American Day as a holiday. Also in 1990, the First Continental Conference on 500 Years of Indian Resistance was held in Quito, Ecuador. This then spawned another conference among Native American groups in Northern California, who brought concerns about the holiday to the Berkeley City Council. Following this, in 1992, Berkeley, California was the first city to institute Indigenous Peoples Day as a holiday (coincidentally, this occurred as the rest of the country was celebrating the 500^th anniversary of Columbus’s journey). Following that, in 1994, the UN declared August 9th as International Day of the World’s Indigenous Peoples. Currently, four states (Minnesota, Vermont, Alaska, and South Dakota) celebrate Indigenous Peoples Day (although South Dakota has named it Native American Day). In addition, 53 cities have chosen to recognize Indigenous Peoples Day in place of Columbus Day, and two cities have chosen to recognize both. Three universities (Minnesota State University in Mankato, University of Utah, Brown University) have also chosen to recognize Indigenous Peoples Day in place of Columbus Day. For those who feel as though changing the holiday silences the celebrations of Italian-Americans, Loni Hancock says “that was not the purpose – the purpose was to really affirm the incredible legacy of the indigenous people who were in the North American continent long before Columbus.” 

Domestic Violence Awareness Month (Ana Martinez de Andino, MS, Psychology Intern). October is Domestic Violence Awareness Month. As a co-facilitator of the Nia Domestic Violence Support Group, I am amazed at the continued stigma faced by individuals currently experiencing or who have experienced intimate partner violence. On a typical day in Georgia, domestic violence hotlines receive approximately 21,000 calls. That is 15 calls per minute. Nationwide, 1 in 3 women and 1in 4 men have experienced some form of physical violence by an intimate partner. As health professionals and providers, it is so important that we stay informed about the prevalence of domestic violence, as well as regarding the resources in our area. In addition to the National Domestic Violence Hotline, the National Coalition Against Domestic Violence has a wonderful website that contains statistics, resources, and a list of domestic violence programs in Georgia broken down by congressional district. I encourage you all to check it out and stay informed!

Domestic Violence in Georgia

National Coalition Against Domestic Violence

Native American Heritage Month – Frank W. Brown (Native American – Cherokee). This month is an opportunity to provide education about the unique challenges Native people have faced both historically and currently.  American Indians were granted U.S. citizenship in June 1924; currently, less than 1.5% of the U.S. population is comprised of Native Americans.  CDC reports that in 2014, suicide was the leading cause of death for American Indian/Alaska Native girls between the ages of 10 and 14, and suicide was the second leading cause of death for American Indian/Alaska Natives between the ages of 10 and 34.  While the majority of Native Americans are free of mental illness, continued research has shown that Native Americans suffer a disproportionate burden of mental health problems including alcoholism.  As we recognize Native American Heritage Month, we should pause for the continued plight of the mental health burden of this population.

Veteran’s Day – Courtney Crooks (Veteran – United States Navy). Although I didn’t come from a military family, my professional development and most of my adult development has occurred while immersed in the military culture. The military is very much a unique, binding culture, with its own set of standards, values, and norms. Although I didn’t grow up in the military culture, for personal reasons I was drawn to serve my country following graduate school, and joined the US Navy as a commissioned officer in 2002. Shortly thereafter, I was married, and then had two children while on Active Duty and a Reservist. My own development was significantly influenced by the culture of the military, and I am immensely proud that my children have also now had the opportunity to grow up and identify as part of a military family. In addition, my young cousin with whom I have always been very close, has just married an Active Duty Navy fellow, and is now beginning her adult life as part of a military family. I think I can speak for all my family members when I say that we will always consider ourselves military, and be proud to be part of the military culture, regardless of where our lives and careers take us.

Veteran’s Day – Karla Ramsey Shore (Veteran, U.S. Army).  I didn’t originally join the Army with patriotic thoughts in mind.  My reason for enlisting was a pragmatic one, to pay for my college education.  I have a very vivid memory of my First Sergeant in my advanced training standing over me in formation asking, “Why did you join the Army, Private Ramsey?”, and answering back “To pay for college, First Sergeant”.  This answer did not satisfy him and after a few rounds of the same question repeated, I caught on and answered, “To serve my country, First Sergeant”.   After my advanced training, I settled into my first duty station and began to learn about my fellow soldiers and the military culture.  However, it wasn’t until after I was deployed to Saudi Arabia as part of Operation Desert Storm that I began to fully appreciate the commitment of our service members and the sacrifices that they make for our country.   I was fortunate to be a part of a brotherhood of soldiers from many different backgrounds and cultures, who worked tirelessly together towards a common goal.   I learned that there is no timeclock for the military, other than accomplishing the mission.  The long hours, sleepless nights, and missed holidays with family were seen as minor inconveniences, necessary to getting the job done.  I gained so much more than a college education from my enlistment.  My time in the military gave me a new respect for our military and our service members.  I can’t walk by the United States flag now without reflecting on the pride and appreciation that I feel for our country and our military. 

World AIDS Day – Allison Ramsay, PsyD, Psychology Postdoctoral Resident, Grady Pediatric Infectious Disease Program. Since 1988, December 1^st has been designated as World AIDS Day. This is a day dedicated to raising awareness about the HIV/AIDS pandemic and to mourn those who have died of the disease. Globally, over 70 million people have been infected with HIV/AIDS, and approximately 35 million people have died from AIDS-related complications. As a postdoctoral resident at Grady’s IDP, I am surrounded by innovators in the field of HIV treatment and I am continually amazed by the developments in research that have led to simplified regimens, fewer side effects, and notable improvements in quality of life for those living with HIV/AIDS. However, it was not long ago that “living with HIV/AIDS” was not a commonly heard phrase. People were dying of HIV/AIDS-related complications faster than doctors could treat it, in some places wiping out entire communities. As a gay man in his 60s, my dad witnessed firsthand the devastating impact of the HIV/AIDS crisis and how it forever changed the gay community. My dad has told me stories of the community in which he now lives, in the Castro area of San Francisco, where during the height of the crisis, many of the homes in his neighborhood stood vacant as their residents lay dying in hospitals. The fear surrounding HIV/AIDS was very real, and fear along with HIV-related stigma and discrimination persists today despite major advances in treatment. As a mental health provider, I continue to see the sequelae of that fear, stigma, and discrimination every day with my patients. It impacts patients’ adherence to treatment, their relationships, their mental and physical health, and their sense of self. Certain populations continue to be extremely disproportionately impacted by HIV/AIDS as well as the continued fear, stigma, and discrimination, including racial and ethnic minorities, men who have sex with men (MSM), transgender communities, and IV drug users. World AIDS Day has always been a somber day for me. I always try to take a moment to visit the AIDS quilt when it comes to Atlanta to read the stories and learn about those we have lost. The theme of World AIDS Day this year is “Increasing Impact through Transparency, Accountability, and Partnerships.” It is my hope that as a department, we help strive to bring this theme to life to work to eradicate not only HIV but also the fear, stigma, and discrimination that have become all too familiar for individuals living with HIV.

International Day of Disabled Persons – Alison (Ali) Pickover, Psychology Intern, Trauma Track.  At age 8, I was diagnosed with DYT-1 dystonia. This movement disorder affects my left leg and right hand and is most noticeable to others when I write. While it’s unusual for me to talk about my diagnosis with colleagues, I frequently disclose to patients if they see me write. It seems to put them at ease, and it brings comfort to me. And though living with dystonia brings challenges, in honor of International Day of Disabled Persons 2017 (which this year was December 3), I would like to bring awareness to the way having this disorder enhances my ability to quickly develop rapport with my patients. I currently work on the Nia project, with survivors of violence, many of whom have comorbid physical and mental health disorders. This population is like the ones I have been working with since I was a research assistant in college. Frequently, I conduct in-depth diagnostic assessment in which extensive writing is unavoidable on my part. In the seven years I’ve been doing these assessments, I have yet to meet anyone who has disclosed a diagnosis of dystonia. Yet every time I talk to patients about seeing me write, telling them that “it might look a little unusual how I hold my pen, and it might take me a bit longer than other people to write down what you say, and yeah, having this disorder makes it a little harder, but everyone’s dealing with something, and we’re all doing the best we can with what we’ve got, and we make it work, right?”, a connection is formed instantly. This comes in part from my vulnerability, and in part from their empathy and understanding, conveyed through their responses. I have found this to be true even with patients who have extreme difficulties forming attachments, and with patients who, at least on the surface, appear to have very little in common with me. The choice to self-disclose is personal. Sometimes, it is optional. Other times, it is not. My patients share a tremendous amount of personal, often traumatic, information with me and with their providers and have no other option if they are to get optimal care. Disclosing my dystonia is a reminder of that to me, and a way of facilitating a connection that would be hard to establish in a short amount of time otherwise. It’s also a reminder that talking about aspects of identity, even when uncomfortable, is an important way to learn, and can ultimately have a positive effect on relationships. And thus, I am grateful for how my disability has affected me as a clinician and a person. If anyone would like to talk more about DYT-1 dystonia, feel free to contact me.