Friday, November 27, 2009

Putting Your Mind At Ease

When a new baby arrives, there is so much to do.

Take care of older siblings, take care of mommy, take care of new baby.

If there's a Shalom Zachar: arrange the logistics of the Friday night party, tables and chairs, food and drinks, who will speak, and (if it's being done out of the house) arranging the location.

In the week leading up to the bris: the location needs to be booked, the caterer or food needs to be arranged, and the mohel needs to be called.

Many people are blessed to have family and friends take care of many of these things. Even calling the mohel can be done by someone other than the parents (though it's a good idea for everyone to know who is arranging the mohel so only one is hired).

Most of the things that need to be done can be done per your style, based exactly on what you want.

When it comes to the actual circumcision, however, most people do not know enough about the field to know there are differences in the way mohels may operate or work, in terms of technical procedural details.

I try very hard to give the baby's parents the forum to have the bris "how you want."

So whether you want a meaningful ceremony, a quick procedure, interactive with crowd participation, more of a show, or just a simple, dignified bris, give me a call! Let's talk about what fits your needs, and make the bris out to be all that you wish for yourselves, your baby, and this moment in your lives.

Mazal tov!

Thursday, November 19, 2009

A Note on Jews, Religion and Observance

According to the oldest understanding of Jewish law, a person is a Jew either through having being born to a Jewish mother, or through undergoing a rigorous, intense conversion. (Please Note - conversion in general is a hotbed for all kinds of issues which cross the borderline of politics. I generally try to avoid dealing with it as I am not an expert in the laws of conversion.)

Every mohel, when asked to perform a bris, will ascertain that the mother of the baby is Jewish either by birth or through conversion. This would automatically make the baby born to her Jewish, and fit to have a bris in its proper time.

The mohel will not ask about personal observance or religiosity, because it is irrelevant to his job (unless he is thinking of grabbing a bagel or danish to go, in which case he may want to know if the food is kosher.)

When the mother or baby is a convert, some mohels deal with this regularly, while some shy away from it unless they work with the first hand guidance of a rabbi who will help them through the steps of the conversion process.

The main thing to do is have an open conversation with the mohel. Recognize where he is coming from, where you are coming from, and understand that the mohel knows as well as you know, that this is a sensitive issue.

Wednesday, November 18, 2009

The Right to Choose

You're a young parent. You are about to have your first son (or your second, or your third, etc). You know you're going to be making a bris. You'd like to do research and hire the person you want to do the job. Then mom or dad call and say "Use our friend. He was good enough for you back then." You're thinking, "I don't want a guy who is old enough to be my parent (or grandparent). I want someone who can relate to my experience." Not that the person being recommended is not a good mohel. But your needs are different.

He's your baby. You have the right to choose.

Getting Ahead Means Constant Education - Static is a Formula for Mediocrity

In order to get to the top of one's field, every professional has an obligation to continue one's education. As one mohel put it to me after I had observed him work, "Please tell me what I am doing wrong. I am always learning." Mind you, this man has been a mohel for over 25 years. So I admire him for being able to say this.

When you're put on the spot like that, it is hard to be honest. Especially when you don't really know the guy.

So I told him, "Here are the things I would have done differently. I would wear sterile gloves (as opposed to your method of wearing no gloves and using your bare hands). I would have a wastebasket under the table."

What I did not say was, "I would make sure the wine and all materials are there before I begin. I would know who all the key players are (i.e. who is the father, and who are the grandparents) before I begin the ceremony. And I would not delay the start of the ceremony twenty minutes because I am not ready."

I once mentioned to my father that a person who had been reading the megillah on Purim for thirty years must really know it well. My father said, "Yes. Except he's been making the same mistakes for thirty years."

The World of Competition or 'Why Settle for Mediocrity?'It is amazing to me that people settle for mediocrity just because that is what they are used to.

Imagine this scene: There is one kosher restaurant in town. The food is OK (not great), the service is borderline (leaning towards lousy), and the prices are a little higher than reasonable (bordering on ridiculous). You go there only because you don't know anything else, and because you like to eat out every once in a while, but mostly because there are no other options

But don't you think you'd be checking circulars, ads, newspapers, yellow pages, the internet to see if a different kosher restaurant is opening? Let's say this mediocre restaurant is "all you ever knew." Can't you imagine that a different option might be an improvement? Especially if it is looking to compete with what has been, until now, the "only show in town?"

That is a depiction of restaurants.

Why I Prefer to Promote the Finer Qualities of A New Age Mohel

When I was a younger (not as busy) mohel, a friend of mine once said to me in commiseration "Does it really matter if a sixty year old [makes the cut] or if you do it?" His point was that the cosmetic result will be the same. The sixty+ year old in question (a certain mohel in NY), has a reputation and an endless supply of clients. Does it really matter to a young family if they get the thirty year veteran or the (then) five year veteran? All they want is for the bris to go well and for the baby to heal nicely!

Not really.

The New Age Mohel is in tune to modern sensitivities and sensibilities. He uses the most up to date methods of sterilization. He is neat and polished He is extremely aware of the clients he serves, their particular needs, and the needs of their guests who join in their celebration.

And he knows what new parents really want to get out of the bris experience.

What Do Parents Really Want?

New parents want to be treated with dignity and respect. They want the mohel to give them the time of day. They want a person who will sit with them and talk to them, and address their concerns. They want a person who will explain to them the process, who will raise and discuss important issues, who will give them the information they need to feel most comfortable with the process of the bris. They want a mohel who will help guide them and show them different options, to help them understand and find what they want.

They want to see that the mohel practices with a sterile technique. They want to see that he works in a clean space. They want to see that he treats their baby gently. They want to see that they and their baby are not just a number - that they are treated like human beings, like parents who have just had the amazing experience of birth, and who want to have an equally meaningful experience with the bris.

They want follow up. They want the mohel to visit the baby after the bris. To see that everything is OK. To give clear instructions. To call. To be in touch. To care.

See here for a list of good questions to ask a mohel

WARNINGS

Too many people go into the bris experience with too little information. You would never choose a surgeon for yourself without doing research: why pick a mohel for your newborn without doing research?

The bad stories and experiences are usually swept under the rug.

People are embarrassed to talk about their son's penis and his bris.I have heard the following statements from (too many) people who did no research before hiring someone for their son's bris. No one is perfect. But these statements should never have to be said after your son's bris.

THESE ARE ACTUAL QUOTES FROM PEOPLE I HAVE MET, WHO TOLD ME THE STORY OF THEIR EXPERIENCE AFTER LEARNING I AM A MOHEL (WHO DOES THINGS VERY DIFFERENTLY THAN THESE COMMENTS INDICATE ABOUT OTHERS' BRIS EXPERIENCES)

"The diaper was a mess after the bris."
"The mohel did not give us clear instructions."
"There was a bleeding problem."
"The baby got an infection from the bris." [THIS SHOULD NEVER HAPPEN]
"The mohel was not in touch."
"The mohel did not practice good personal hygiene, or in the way he conducted the bris."
"The mohel told us how to take off the bandage, and instructed us over the phone."
"The mohel was insensitive to our needs."
"I wish I had done more research."
"I wish I had even explored other options."

Feel free to contact me if you have any questions.

Sunday, November 15, 2009

Putting Parents At Ease - More Considerations

Over the weekend, I attended a presentation/discussion in which one person mentioned her impression that bris turns some people off from Judaism. Almost as an aside she said "They think it is barbaric."

It wasn't my forum, so I kept quiet. I have a lot to say on the subject, but it's for a different place. My blog, for example.

Firstly, I don't believe the bris turns people off from Judaism. It's a big world out there. People who are unhappy with Judaism will find any excuse they want.

As far as circumcision being barbaric, that statement is a hard sell in the United States when over 60% of the newborn male population is circumcised - either routinely with a clamp (with or without a local anesthetic), in the O.R. under general anesthesia, or as part of a religious or holistic ceremony - and until relatively recently, over 90% of the newborn male population of this country was circumcised.

The American Choice

In American culture, people have all kinds of reasons for circumcising their sons. I learned about this recently when our son was born, when my wife and I were handed a pamphlet about circumcision which boiled the choices down to two: "to circumcise or not to circumcise; that is the question."

They have a number of reasons why people may opt to circumcise.
* Medical suggestions that urinary tract infections, penile cancer, and other penile illnesses (including STDs) are less common and the penis is less susceptible when circumcised.
* It is easier to clean.
* Family - father and brothers are circumcised
* Cultural - everyone else does it
* Aesthetics - You like the circumcised "look" better than not.
* And, of course, religious reasons.

Reasons not to circumcise include:
* It is healthy tissue which guards a very sensitive area of the body
* No medical benefits if the child is taught how to clean under the foreskin
* Why subject a child to such surgery, which may be unnecessary?

The "barbaric" nature of circumcision is not raised, even if people may personally feel it to be such.

Why Jews Circumcise Their Sons

While the religious reason is most obvious, the best verbal explanation I have heard of late was in the documentary "Partly Private" - a film made by a secular Israeli woman living in NY, who was researching whether or not to circumcise her as-yet-unborn son (they had circumcised his older brother, but were displeased with the experience).

When a number of her Israeli friends gathered to be a sounding board for her deliberations, one of her friends who had become observant said, "If you are deliberating circumcision because you think it is 'barbaric' - you are right. Don't circumcise. But if you have faith in God and understand that this is what God asked of the Jewish people, as this is a mark of the covenant He forged with Abraham, then this is not barbaric. This is an act of love: for your child, for your people, for your God."

He is so right. The reason we circumcise is FAITH.

But it's still BARBARIC, Right?

It really depends on your perspective.

Most medical authorities who deal strictly from a medical perspective (in other words, who do not have an agenda), will argue the benefits versus the risks, the pros versus the cons. Very few will call it a barbaric procedure.

Most people who call it barbaric have an agenda, have an obsession, and find it hard to not think about how life (read "sex") would be different if the parents had not chosen to "make the cut" on them.

And they'll usually show a picture of a red, screaming baby to show the kind of pain a baby feels when undergoing a circumcision.

Before we continue, it is important to understand that there are different kinds of circumcision procedures, and all kinds of situations that can make a baby cry and scream bloody murder.

Setting the record straight

Babies cry. They scream. They can be in all kinds of discomfort. And sometimes there is not much we can do to ease their pain.

Babies who have blood tests, shots, raw diaper rashes, or sometimes just have colic may very well be inconsolable. Would you not have your baby have the necessary blood test or innoculation just so your baby won't ever cry?

Sometimes benefits outweigh the downsides. And sometimes not.

There are some who will argue that babies nerve endings are underdeveloped and so they don't feel the circumcision.

This is a lie.


Babies absolutely feel pain. But they only feel the pain to which they are subjected - and that, only if nothing is done to numb them from the pain. Which brings us to two points worthy of consideration when considering the difference between what is known as "routine circumcision" and a bris (A circ in an O.R. is a completely different story, because once the baby is under general anasthesia, all bets of pain and discomfort are off.)

SPEED OF PROCEDURE and NUMBING

Click this line to read the article in which it appears: "A mohel does not usually use anesthetic, because his anesthetic is the speed with which he does the circumcision. "

Most routine circumcisions are done elaborately, painstakingly, with a clamp that crushes the skin in order to achieve hemostasis. Since the skin is essentially dead when it is excised, there is usually no bleeding by the time the last skin is removed. Kudos.

Meanwhile, the baby has been in excruciating pain throughout the procedure (which usually takes between 5 and 20 minutes), unless the circumciser has used a penile block (3 injections around the circumference of the penis, along the lower base of the abdomen), to numb the area during the procedure.

3 injections = 3 shots. If your kid screams during one shot, imagine THREE, even if their outcome is a numbing. The shots themselves are painful!

A good mohel is usually done with the procedure, start to finish, in between 5 and 10 seconds. That's less time than it takes to administer the injections. Yes, there is usually a little more blood at a bris (only a little), but the drawing of blood is (like it or not) a necessity for the procedure according to Jewish law. The covenant was forged over blood. (If you like movies, you can see how a covenant is forged over blood in Kevin Costner's "Robin Hood" when he swears to avenge his father's murder in the first quarter of the film - I used to have a link to youtube here, but the video was taken down.)

NUMBING [See this posting - in which I revised what I wrote below - AB, 2012]

I happen to be a fan of numbing the foreskin, but not with injections. I prefer a topical analgesic with a dose of 30% lidocaine + 70% acid mantel cream base, to be applied to the penis at least a half hour before the bris. It doesn't hurt the baby at all in its application, and it does the same thing for the small amount of time it is helpful. Most of the discomfort at the bris comes from being handled, not from the pain of the bris (proof is that the baby usually stops crying once he is no longer being touched).

And even without it, the bris speed is, as mentioned above, its own form of anesthesia.

In Conclusion

If I were not Jewish, would I circumcise my son? Knowing what I know about circumcision, I probably would. My wife would probably not, just because she would not want to subject the baby to a painful experience - even a fleeting one.

As we are Jewish, we agree that we do it because the Torah commands it of us.

I don't think it is a barbaric custom, and I think those who do it properly have a tremendous sense of satisfaction that the baby is well and that the chapter of bris is behind them.

Consider the method and you have your answer. (Clamps, injections, drawn out, hospital v home, physician, resident, mohel, surgery v bris)

And hopefully, if you call me, you'll find what you're looking for in a mohel and you'll uncover the answers to more questions through our conversations.

Monday, November 2, 2009

When The Mohel's Wife Gives Birth to a Boy

My wife gave birth to a little boy on Shabbos morning! Really!

We are so excited and so blessed.

When our oldest was born, a girl, people asked me if I was disappointed. Of course I wasn't disappointed. (In the fifty percent chance of the child being a boy, I was excited about the prospect of a bris until the doctor said "It's a girl," and she was (and is) beautiful, healthy, and the joy of our lives.) Becoming a father is one of the most altering moments in a man's life. Any remaining ego in one's marriage disappears as your life becomes one of complete focus on doing everything for the sake of the child.

At the same time, I called my mohel teacher, Rabbi Sasson, to tell him my wife gave birth to a girl and he said, ".תמיד זה כחה. למוהלים נולדות בנות" - "It's always that way. Mohels always have daughters."

Two Things Everyone is Saying

1. Everyone's a comedian. "I can recommend a good mohel." "Who's going to be doing the bris?" "Have you called the mohel yet?" "We had a great experience with so-and-so. You might want to call him." "I guess we all know who the mohel is!"

Do people make such a fuss over the identity of the mohel before their other friends' brisses?

2. Many people ask: "Will you be doing the bris yourself?" I don't know what the source of this question is... unless people are thinking that doctors don't operate on their kids or immediate family.

To answer the question - Yes. I will be doing the bris.

The Ideal Mitzvah of Bris

The reason I will be doing the bris is because that is the ideal mitzvah. Every father is supposed to do the bris himself.
(Genesis 17:10-12: It's worth reading the whole chapter) But since most fathers are not trained to do it, it is much safer to have a mohel do it.

In this case, since the father is a mohel, the father will do the bris.

The first baby to be circumcised in the Jewish tradition was Yitzchak, who was circumcised by his father Abraham on the eighth day of his life. (See chapter 21, verse 4)

In an ironic twist, our son was born on the day we read the Torah portion describing the origin of the covenant - the Bris Milah (Genesis 17), and his bris will, please God, take place on the morning when we read the Torah portion describing the birth and bris of Yitzchak.

Pretty cool, no?

A number of years ago, my wife wrote an article about being the mohel's wife, and her impressions of anticipating the birth of our first child.

Now we will joyfully bring our son through this reaffirmation of our commitment to the covenant, as we continue to celebrate his arrival and the joy he brings to us, our family, our friends, our community, and the collective nation of Israel.