Tuesday, May 12, 2015

Doctor vs Mohel

No, it's not the fight of the century.

But it is a question which comes up a lot. So here is the simple answer, from a mohel, of course.

[Though see here for a Reform Rabbi's answer http://www.jweekly.com/article/full/15332/which-one-is-better-doctor-or-mohel/]

Every person must do research and find the best operator for your needs, and for your situation.

In an ideal world, the person you are hiring is an observant Jew, who understands the significance of Bris Milah, the covenant, and all the laws associated with the performance of a bris milah. Whatever character traits you'd like in the person might also be significant to consider, when thinking about what kind of representative you (especially the father, who is really hiring the person to perform this mitzvah in your place) want to fill your place in this very important mitzvah.

ANYONE WHO FILLS THESE ROLES TO YOUR DESIRES IS A GOOD HIRE. [Even better, if he uses a marker when operating...]

Other things to consider:

1. Specialist

Who does more procedures? Many doctors I know (they are usually observant Jews) highly recommend a mohel over a doctor. They have the attitude that the mohel is a specialist. This is his field. He is the expert. Being highly trained in a specific discipline, and specializing in this unique field, makes the mohel most qualified to do this. [Obviously if a doctor happens to also be a mohel, this will work to his advantage in some people's eyes. But honestly, the service a doctor/mohel and a mohel provide is the same thing with respect to the circumcision and the result, except perhaps in two areas as I'll note below]

2. Method

Most doctors are more comfortable using a clamp - such as the Gomco or the Mogen clamp. Do research on these items, to decide if they are right for you. Some mohels (usually on the very modern side, or in the Conservative and Reform movements) use the Mogen clamp or a modified Mogen clamp. Most traditional mohels use what is called in Hebrew a Magen (מגן), a traditional "shield" (which protects the glans and the scrotum) which does not have a clamping arm. THIS IS THE PROCEDURE I USE While no procedure is completely bloodless (a real bris is not supposed to be bloodless), the clamps are supposed to cause less bleeding. The traditional method may have a little more bleeding, but in the hands of a good mohel, it is absolutely nothing to worry about.
And, as Rabbi Cartun points out in the article I linked to above (here it is again), the speed in which a mohel operates is usually much faster than any physician.

3. Numbing

See here for a discussion about this. Most doctors will give the baby several injections to create a nerve blockage. While the baby might not feel the bris, the baby will feel the injections (and may feel them hours later as well). Some mohels recommend or provide a topical anesthetic. Depending on its strength, it may remove the pain of the actual circumcision.

4. How is baby held?

Numbing does not help the baby's discomfort at having his legs held down. Most mohels have the sandak holding the baby's legs, and letting go as soon as the procedure is over. Many doctors might utilize a circumstraint to hold the baby, leaving the baby in an uncomfortable position significantly before and sometimes after the procedure as well.

5. Track record and Touch-ups
Probably the most important question is "what is the track record?" While I don't have statistical evidence, I have spoken to pediatric urologists and pediatric surgeons who have told me anecdotally that they do many more touchups on circumcisions done by doctors than by mohels. [Don't trust me. Ask similar doctors that you may know.]
Doctors tend to take off a little less foreskin, which leaves the penis looking uncircumcised in many cases of touch-up necessity.
[Many "problems" disappear when the child gets out of diapers, and certainly by puberty. But for babies who need their circ to be revisited - it is worth asking people and doctors who has a better track record.]
A surgical marker could resolve this issue, but most mohels and doctors don't use one (though I do! :))

I guess it is clear that I prefer a good and experienced mohel over a doctor. Surprised?

Monday, May 11, 2015

An Act of Faith

Life has taken it's toll on blogging, thank God. Our son was born a month ago, and I chose not to repost what I had written the last time this happened. However, I did post the news on my Facebook page, and I was summarily attacked by anti-circumcision advocates who are either self-hating Jews, ignorant Jews or erstwhile anti-Semites. All hiding under the guise of "liberalism." The essential message they share is "I respect your religion until I have problems with your religion." Or perhaps, "You can only observe your religion in the manner that I see fit." Sigh.

As I noted here, Maimonides goes into intricate detail of his view as to why we circumcise our sons. And while one may or may not like his arguments (some of them - certainly when taken out of context, and in either case when not taken in the overall picture of Maimonides' worldview - might be easily misunderstood), I think his view can best be summarized in this one sentence.
No one, however, should circumcise himself or his son for any other reason but pure faith.
It really is as simple as that.

These pages are not really an invitation for debate about the pros and cons of circumcision. The Jewish people do not care if other members of society circumcise, nor do we care if they choose not to circumcise their sons.

For us, the Bris Milah (Covenant over Circumcision) turns the act of circumcision into a Covenental Rite, and the question of the value of the foreskin is not even raised. (There is a very insightful way to understand it if one reads through the Bible (in particular the books of Judges and Samuel) and notes how the words "uncircumcised" or "foreskin" are used).

Bris Milah is an Act of Faith which includes a circumcision. I am truly sorry if that offends people. But our children don't find it offensive (except the self-hating or ignorant Jews as mentioned). And our dedication to this act has outlived all those who were against it before, and it will also outlive the modern day activists.

Tuesday, March 17, 2015

Getting Around Florida

In the last few weeks I've been as far north as Gainesville (by plane) and Port St. Lucie (by car) and I've gotten inquiries from Naples, Tampa, and Sarasota from parents to be.

I've been recognized by participants who've seen me at other brisses in further from home places.

Which is always very flattering.

Thank God, this mohel in South Florida is getting around.

As always, I appreciate the trust and the opportunity to serve.

Friday, January 30, 2015

Workshops Announcement

Tuesday, January 27, 2015

The Topic That Won't Go Away

That's right. Another article in the Forward about... metzitzah.

Here is the link. http://forward.com/articles/213364/is-controversial-circumcision-ritual-dangerous/?p=all

Unfortunately, this article is very long and says very little. It may have some or most of its facts straight, but there are too many questions left unanswered.

Of course, much of this is a response to this article I neglected to post last week.

The bottom line is that - as I wrote in my article in the Jewish Week - nothing will change based on the outside. The change must come from within. Rabbis must teach their constituents that this practice is no longer acceptable, and they must insist and demand that the mohels stop performing it.

When the internal community pressure brings about a cessation of direct contact metzitzah, these stories will cease to occur.

We will also rid this horrible "chillul Hashem" from our midst (just see the way the obviously not-Jewish media paints the metzitzah ritual).

Thursday, January 8, 2015

The Basic Information - All You Need to Know Consolidated

I get many phone inquiries months in advance of births. Sometimes the baby is a boy, and sometimes the parents don’t know yet. (Obviously those who know they are having girls don’t call!)

I am always happy to discuss all matters in advance of the bris. But for ease of reference, here is all the information you need (some of these links are at the top of the page as well). Of course, any topic you'd like to research more can be found in the Topical Index.
Here are the supplies you need for the bris, and for the aftercare.
Here are the honors you need to think about and assign for the bris ceremony
Here is a summary of what a classic bris ceremony looks like.     
Here is an explanation of how things will look like in the few days and weeks following the bris.
Here is a long term care reminder for some babies, and another for babies who gather much baby fat over the next several months. 

Friday, December 26, 2014

Another Metzitzah Tale Gone Bad

NOT BY ME, of course. This is out of New York. My method is completely safe, as there is no contact or transfer of fluid from mohel to baby (or vice versa).

See here: http://www.nydailynews.com/new-york/jewish-baby-contracted-herpes-bris-article-1.2055911

This story has a happier ending, as it seems the baby has been treated and will be OK.

But the beginning of the story is not so happy, because this baby should have never needed this kind of treatment.

A bris done under sterile conditions - with metzitzah being accomplished via sterile tube - does not produce an infection.

Properly sterilized instruments, sterile gloves, a sterile metzitzah tube, sterile bandages + the correct amount of skin being removed = job well done, quick healing time, healthy baby.

End of story.

Mouth on baby and whatever other ingredient which removes another step of sterility = good chance of infection.

I am not ashamed to be a mohel. But I am ashamed to share in a profession in which practices that can lead to this result (herpes infection on a newborn) are maintained by fellow practitioners, and desired by an ignorant herd who do not think for themselves and demand otherwise from their mohels.

Many non-observant Jews ask me "What is your policy on metzitzah?" (here it is)


We need to put these guys out of business, or force them to change their ways.

No baby need ever be put at risk, even the slightest risk, beyond the risk of the circumcision itself, which is commanded to us in our Torah. But metzitzah is not a commandment. And this method should be banned by rabbis, community leaders, parents, and mohels. NO MORE EXCUSES.