Tuesday, December 20, 2011

Chanukah and Bris Milah

See the entire thought in my other blog:
A thought occured to me related to Chanukah and bris milah. I blogged about it at my other blog, but I am reproducing the relevant-to-bris idea here:

"Why do we have EIGHT DAYS of Chanukah? After all, any miracle of oil only lasted 7 days (thay had found a jug of oil with enough for one day)!"

One approach to answering this question focuses on: "Is there a significance to the number eight that fits into this story?"

Two of the more known answers to the latter question are:
1. The rededication of the Temple was meant to emulate the original dedication of the Tabernacle in the wilderness, which was an Eight-Day-Celebration.
2. On account of the war, the Maccabees were unable to adequately celebrate the holiday of Sukkot. As such, upon the rededication of the Temple, they created a make-up for the holiday they missed. Since Biblically speaking the holiday of Sukkot + Shmini Atzeret is an eight-day period, this served as the model for the Chanukah time span.

Here I offer another possibility. I do not base this in any historical document or anything I found. But a unique connection came to me as I reviewed the decrees that traditionally accepted view of history offers as the background to the rebellion of the few against the many.

The Greeks aimed to destroy three fundamental tenets of Jewish life:
1. Shabbos
2. Rosh Chodesh
3. Bris Milah

Being a mohel, this simple (yet, I feel, profound) connection was staring me straight in the face.

There are all kinds of reasons suggested for why a bris takes place on the eighth day of life. One of them focuses on the idea that the baby will certainly experience a shabbos before he has his bris.

Chanukah goes for eight days, therefore, to remind us the eight-day period that leads up to a bris.
An Eight-day holiday will certainly contain a shabbos.
The fact that Chanukah begins towards the end of Kislev, on the 25th of the month, assures that Rosh Chodesh Tevet will always be observed during Chanukah.

Military celebrations alone are typically celebrated for one day. Think V-E Day (May 8) V-J Day (Sept 2), Purim (14 Adar). By all rights, Chanukah should have been a 1-day holiday.

But Chanukah is meant to be more than just a tribute to a specific date. It is a highly symbolic holiday that represents a victory over assimilation, a commitment to Jewish tradition, mitzvot, and heritage, a reemergence of a "fighting Jew," and the return of Jewish autonomy to our ancient homeland.

And if, in the background, the dates and length of the celebration can serve as a reminder to what we overcame from the perspective of those who made decrees threatening our way of life - what could be wrong with it? I find it very helpful.

Thursday, December 8, 2011

Jaundice - When Baby is Yellow

There are differences of opinion as to the propriety of circumcising a jaundiced baby. The argument is based in Talmudic and halakhic discussions, but the details of these Talmudic discussions might not refer exactly to jaundiced babies, and certainly not to "all cases" of jaundice.

As a precaution, I will delay circumcising a baby who has a bilirubin count above 16, unless the numbers are going down. Other mohels will run away from a baby with the number 12 or higher. [I have actually been called to do a bris on several occasions because the pediatrician said it was OK and the parents wanted to have the bris at the proper time, but the mohel they initially hired was scared to do it because he felt the bilirubin count was too high. All brisses went well and babies were fine afterwards.]

The one time I delayed a bris to a different day on account of jaundice (at least the one I recall most vividly, though there were probably others) was when the child's bilirubin count was 22 - he looked like a banana from across the room - and the bris was supposed to be on Shabbos. Since it wasn't feasible to check the baby the night before or the morning of (on account of Shabbos), we pushed it off, and the baby ended up being ready by Sunday.

I recently found this article that explains Jaundice in a very clear manner. It was written by Rabbi Josh Flug, a colleague (and client!), and is worth reading from beginning to end.

http://www.medethics.org.il/articles/JME/JMEM9/JMEM.9.4.asp

Monday, November 21, 2011

Including Women in the Ceremony

At a recent bris, some members of the family approached me afterwards to ask why (in that particular case) women are not included in the ceremony. The circumstances were, for me, far less than ideal, because I usually have a chance to talk with people in advance, to discuss with the baby's parents how they would like to have their ceremony. In this case, I was called in the late evening on the day before the bris, because the family found themselves without a mohel. The baby's grandfather called and made the arrangements.

I was not privy to any conversations they had with the mohel who cancelled on them, so I don't know what transpired - except in the end, the ceremony included the baby's uncle and his two grandfathers, and no one else.

Here are my thoughts on the subject - please read all before rushing to conclusions or judging.
1. There is no single rule that will work for everyone. For example, some mothers want to be up front during the bris, some want to be with friends or family in the middle or back of the room, and some don't even want to be in the room at all.
2. There are different protocols and sensitivities which must be adhered to depending on the venue where the bris is taking place. The rules of a synagogue, for example, are different than rules of one's private home.
3. Until relatively recently, women did not usually come to the bris.
4. In recent times, the sensitivity to be more inclusive of all grandparents in the ceremony has become a predominant concern for a significant number of people.
5. The Sandak (who holds the baby during the bris) must be male.

I could be chauvinistic and say that the bris is a mitzvah observed on a particularly male anatomical feature, and therefore the ceremony should involve males. [There is such a passage in the Talmud regarding who serves as the mohel. Since Avraham was told המול ימול - it is derived that המל ימול, that one who is circumcised will circumcise...]
On the other hand, I could say "Yeah? Well without women, there would not be any baby?!"

If you are looking for a traditional answer, the answer is that the kvatter is the traditional honor in which women are included.

If you are looking for a modern answer, the answer is that women should absolutely be involved when the protocol of the bris venue allows for it. In a traditional synagogue sanctuary (especially right after the morning services), you'd be out of luck. But in an egalitarian institution, and certainly in a neutral catering facility or at home, things would be different. I have been to and presided over brisses in which a grandmother either placed the baby on the chair of Elijah the Prophet or held the baby after the bris - sometimes alone or sometimes together with her husband. I've even done "hatafat dam" while the baby's mother held him.

In short, I don't think the right attitude is to say "NO." I personally go for the traditionalist viewpoint, but I also live in the real world. Some people feel very strongly about these things, while others are more open to seeing a different side. [Though I do think that claiming a "bris ceremony is paternalistic" is a little insensitive in the other direction - Would you want men to be involved in a ceremony that celebrates something related to female anatomy? I wouldn't!]

Bottom line: I think a conversation is in order. I think the baby's parents should have the final say as far as what they want their ceremony to look like.

And I think that all the relatives and friends who get offended by others' choices need to look at the bigger picture. Not being involved in the five minutes of the ceremony is, in the grand scheme of things, not that big of a deal. You can take all the pictures you want before and afterwards, and you can cherish the new baby in your family every waking minute you have the chance to be with him. Giving a guilt trip to those who "excluded you" (even though they meant no offense in it) will only strain a relationship, and is entirely not worth it. Remember that the new parents are going through a lot (especially with a first baby), and may not be thinking of every permutation. Cut them a little slack, cut the mohel a little slack, and just enjoy the day.

Monday, November 7, 2011

Been Updating Photos


That was before I created my Facebook page.

Since creating the page on Facebook, I've been asking people to send photos from their brisses (I obviously can't take photos while working), and some people have been very gracious and generous with their offerings. [The photo here is with the 90+ Holocaust-survivor great-grandfather serving as Sandak. His grandson is assisting him, holding the baby]

I've uploaded some recent ones to my facebook page.

Check 'em out!

Saturday, November 5, 2011

וכרות עמו הברית - Bris Morning Davening

There is a custom that on the morning of the bris, the segment in ויברך דוד (Vay'varekh David) that talks about the relationship between God and Avraham, and how it was forged through the bris, is recited responsively. (It is from Nehemiah 9:6-11. The Vay'varekh David part is from Divrei Hayamim I 29:10-13) Ideally by the mohel and the sandak, but otherwise by the mohel and the congregation. Everyone should, of course, recite all the words along quietly when they are being recited aloud by mohel, sandak, chazzan, etc.

This custom is recorded in a number of places. The Artscroll book on Bris Milah elaborates on this subject in the notes on pages 110-111, and Yossele Weisberg Z'L also quotes a number of sources to this effect in the first volume of his 4-volume "Otzar Habris", in footnote 22 on page 181.

This is the reason why just about every siddur makes a space in the middle of a verse (which should really not be done) to indicate that this is when the recitation for a bris begins. It is because this recitation was included in the siddur that we now - virtually everywhere - distinguish between "Vay'varekh David" and "V'charos Imo HaBris." Even though this break should only take place at a minyan where participants in a bris taking place that day are in attendance - the demarcation was made, and a 'minhag ta'us' (mistaken custom) is the run of the mill in just about every shul I have ever attended.
נחמיה פרק ט 
ז) אַתָּה הוּא יְקֹוָק הָאֱ-לֹהִים אֲשֶׁר בָּחַרְתָּ בְּאַבְרָם וְהוֹצֵאתוֹ מֵאוּר כַּשְׂדִּים וְשַׂמְתָּ שְּׁמוֹ אַבְרָהָם
ח) וּמָצָאתָ אֶת לְבָבוֹ נֶאֱמָן לְפָנֶיךָ       וְכָרוֹת עִמּוֹ הַבְּרִית לָתֵת אֶת אֶרֶץ הַכְּנַעֲנִי הַחִתִּי הָאֱמֹרִי וְהַפְּרִזִּי וְהַיְבוּסִי וְהַגִּרְגָּשִׁי לָתֵת לְזַרְעוֹ וַתָּקֶם אֶת דְּבָרֶיךָ כִּי צַדִּיק אָתָּה

I mention all this because I davened at a shul recently, on a morning when I was to be the mohel for the bris, and I went up to the Bimah to do this recitation at the appropriate time in the davening. (for the record, I only say two verses responsively - some say the entire אז ישיר (Az Yashir - Song of the Sea) responsively) When I was finished, a few people were waiting for me to tell me (one of them was visibly mad upset that I had done this) "That is not the minhag (custom) in our shul."

I apologized and chose not to ask why every siddur in the shul has the break in the middle of the verse, if not to leave open the possibility of marking one of the references to the covenant of circumcision that appears in the daily prayers that this person says every day, which happens to be appropriate to note in mornings like this one when we will be celebrating the bris at the conclusion of the morning service. 

[In his defense, it's probably not the custom because it happens to be that this shul doesn't have a bris every day of the year. It couldn't be because of ignorance, could it?! I highly doubt that the ritual committee voted against this "responsive reading on mornings when there is a bris in shul."]

It is a harmless minhag, and even helps get people in the mood of what will be taking place that day. There is no reason not to do it. And there is certainly no reason to get upset about it.

May all of us be blessed to achieve a greater appreciation for the bris, its significance, and the role it plays in our lives. And if a tiny inconvenience in davening can help us at least on the morning of a bris, I think it's worth it.

Post Op Bleeding - The Myth of the Bleeding Vein

When done properly (and barring extremely rare circumstances), a mohel should never be faced with a situation in which he requires medical intervention to help stop bleeding post-op.

Between the various coagulating bandages which are available, and the never-fail "if you put enough pressure on it it will stop bleeding" method, with a little time and patience, bleeding can be put under control.


It is important to me (for obvious reasons) that the baby not be bleeding when he is turned over to his parents after the bris. This is why I always check and change the bandage immediately after the bris, so I can give the baby the proper attention. For better or worse, the bris takes a very small amount of time. Some babies clot very quickly and my bandage-change takes 2 minutes. With some babies it takes a little longer. A Five-Minute-Pressure-Application usually does the trick on more seemingly-difficult cases. [It's never pleasant for a mom to be in the room, unless she is totally calm and collected, during this time. Some choose to stay in, some choose to stay outside. But the baby is usually crying during this time (unless someone is putting a pacifier in his mouth), until I let go and close up his diaper.]

Because I put so much care into this, and know that some babies bleed more and some bleed less, and also that much of the aftereffects are heavily influenced by the bandaging, the amount of time doesn't affect me. Of course I would love for all babies to be a "chick-chock" case with no extra time. But we are all human and imperfect, so we do our best.

Which leads to the myth. I have had some fathers call me after their son's bris, clearly concerned that something went wrong. These always happen when I did not do the bris, which I would venture to suggest is the reason they are calling me instead of the mohel they used. In some cases the father himself did the bris (which I offer as an option to fathers, but most decline), and in some cases the mohel did the whole thing. 

Note: when "the father does the bris" it is set up for him by the mohel, leaving him with the relatively simple task of excising the foreskin by cutting along a metal plate (see the photo in method #2). 
Also Note: The first time anyone does a circumcision, there might be a feeling of "how did I just do what I did?" which accompanies a feeling of "I ruined this child for life." Which isn't true, but it might feel that way.

So the father says to me, "It took a lot of time for the mohel to stop the bleeding. He said I cut a vein."

Well, let's see. There are veins in that section of anatomy. When otherwise healthy skin tissue is excised, it stands to reason a vein will be cut. But not a major vein, whose repercussions could be quite disastrous. Unless, when the mohel in question set things up, he set up a circumstance, where the father (who does not know otherwise) removed too much skin from the shaft!

The way I see it, there are two possibilities:
1. The mohel set things up improperly and did not guide the father properly in the act of the circumcision excision.
2. The mohel had a difficulty with the bandaging (possibly related to previous point, though not necessarily), and felt the best way to explain his challenges was to blame the father for the mohel's mistake.

The bottom line is this:
Problems arise when too much shaft skin is removed (the original shaft skin should be as close to the corona of the glans as possible - give or take a couple of millimeters). Bleeding challenges can arise in any circumstance. It is the skilled mohel who knows to remove the proper amount of foreskin, and who can then get the bleeding under control - sometimes in very little time, and sometimes with a little more time and patience. I have seen what look like open "bigger veins" in a freshly circumcised penis, but with pressure (like with the rest of it), the bleeding stops. I do believe God would not have given us this commandment, to be done in this manner, if complications would arise on a regular basis. A mohel should own up to his own inadequacies (if he has them) and should not fault a vein, a father, or anything other than himself if not everything goes smoothly. 

Wednesday, October 26, 2011

Are Women Not Part of the Covenant of the Bris?

A long essay on the subject. I was inspired!

I am a "Florence Melton Adult Mini School" instructor, and this week my assignment was to teach the class in "Rhythms" entitled "Birth and Berit." Sounds easy enough – doesn't seem like I need to prepare all that much.

[The Melton curriculum is officially "pluralistic." While I will engage all Jews where they are in their Jewish journey, I don't consider myself pluralistic in my approach to Judaism. With this in mind, let us continue…]

The class as formatted explains what the Covenant (Bris) of Circumcision (Milah) is, offers some rabbinic suggestions as to its purpose and why the mark of the covenant is placed on the particular part of the anatomy where it is.

It even asks important sociological questions that pertain to a society in which Jews and non-Jews are routinely circumcised, which would negate the "only Jews" element of circumcision, as well as a concern that non-traditional Jews continue to go through with the procedure on account of a connection based on conformity, as opposed to a religious or traditional conviction. Compelling conversation starters.

All this is fine with me.

But the part that bothers me is when the question is raised as to why there is no parallel ritual for girls, and why it seems women are not part of the covenant. 

Monday, October 17, 2011

A Special Feeling - Tremendous Zchut

At today's bris, the Sandak was the baby's great-grandfather. Wheelchair bound and over 90 years old, it was a true honor to tag-team with this Holocaust survivor, who has been through so much and has lived to see tens of great grand children.

We are a generation that is losing touch with the past - time takes its toll, as we all know.

For now, we can appreciate the miracles who survived and continue to live, and hope we can live up to the world they recreated from the nothing that was left to them.

Sunday, October 16, 2011

A Metzitzah Debate with a Chabad person

Please note this is a very long entry. If you are interested in this subject, I would encourage you to read the whole thing. Please comment below!
Disclaimer: I do not believe the individual in question is a fair representative of Chabad, and I do believe Chabad representatives in general are a lot more open-minded and caring.


Over the recent holiday, I had a conversation with a person who considers himself a Chabad rabbi (I'll grant his Chabad-ness, but I don't give much credence to his being a rabbi). This was the first time I encountered him since he told someone who had hired me as a mohel that I was unfit to serve as a mohel. (The father followed his advice and cancelled the hiring)

I wanted to know why he felt this way, and we proceeded to have the following conversation, which focused mostly on our approaches to the concept of metzitzah.

Monday, October 3, 2011

A Wonderful Compliment

The baby nurse from yesterday's bris said to me "You cut a perfect diamond. I have never seen a circumcision like this. No blood - nothing! Amazing job, Rabbi!"

I am not sure about the precious stone reference, but I'll take the rest of it to the bank.

Thursday, September 22, 2011

The Balance of the Conflict

Every now and then I'll get more than one call for a bris on the same day. When all people are adament that the bris take place at the exact same time, I obviously can't accomodate everyone - unless I lie and say that "I'll be there" knowing full well I won't be, and that people will have to wait for me.

[I've lost a number of brisses on account of being up front and honest on account of my schedule. I know of a number of mohels who prefer to make people wait, without being up front, so they can get as many jobs as possible.]

Monday, September 19, 2011

The Importance of Trust

I came to Israel to do my nephew's bris. My sister is a veteran bris-mom (her 5th boy), and some of her friends commented how calm she was during the bris. She is a pro, though, so it is not surprising. And, she has an advantage over many moms due to her relationship with her son's mohel.

And this is what made me think about what makes parents calm during the bris. Sometimes it is totally a personality thing. If you live your life chilled out, you will be chilled out during your son's bris. If just about anything makes you nervous, your bris experience will be nerve-wracking.

Unless.

Unless you trust your mohel completely.

Friday, September 16, 2011

The Part No One Talks About (a.k.a. Tzitzin Ha'M'Akvin)

[This does not happen a lot, but it may happen. You need not expect it to happen, but it is always good to be prepared in your mind for a "worst case scenario."]

You've done your research. You hired the mohel everyone raves about. Or at least he has a very good reputation.

And then, at your son's bris, you're not very impressed.

It's not that he's not a nice mohel. And it's not that he isn't clean and neat. It's just that it takes a really long time, and it seems like your baby is losing a lot of blood (he isn't - it always looks worse, even when the procedure and prognosis is 'normal' and 'what is to be expected'). Moreover, what did he just say about "fixing" things?

The particular circumstances might differ from bris to bris (which doesn't matter to you the parent - because all you care about is "this single bris"), but the fact remains that while most brisses go extremely smoothly without any mishaps or missteps, there are some that bring with it their set of challenges.

To bring two simple examples that can not necessarily be anticipated before the foreskin is removed:
1. The baby may have scrotal webbing which extends its way into the shaft. This webbing (a lower skin tissue) would need to be removed to a. loosen up the shaft and b. help things look nicer
2. The baby may take time to clot. While in an ideal world the baby will stop bleeding immediately after the bris, the fact is that some babies are "bleeders" and present more of a challenge in achieving the coveted clottage.

Thursday, September 1, 2011

The Mistakes Many Parents Make Before Their Son's Bris

I have met parents who had less than an A-1 experience with a mohel, who returned to have a similar experience a second time with their second son. Their reason? (usually one of three)
a. We heard you're not supposed to change mohels;
b. We only know one mohel;
c. We didn't want to hurt his feelings.
[I've also met quite a few parents who have told me, "You were our third mohel, and the only one we would call again, if we have another son."]

Is this about you and your baby? Or about the mohel? [Hint: IT'S NOT ABOUT THE MOHEL]

I want to make clear: If you had a positive experience with a mohel, you should absolutely return to him when you are blessed with another son. But if you didn't have such an experience, why would you want to?

So here it is: The Top Ten List : Mistakes Parents Make When Hiring a Mohel

Saturday, August 27, 2011

A Good Line

In the moment before the baby's father places the baby on the sandak's lap, it is my job to remind the father that the mitzvah to do the bris is actually his mitzvah, and that he is merely appointing me to serve as his "shaliach" (messenger or agent, in Hebrew) to do the bris on his behalf.  The formula is more or less "I, John Doe, appoint you, Avi Billet, to do the bris on my son."

As a mohel, I am trained to do this. As a person not trained to circumcise, the father usually complies and appoints me to do the bris. Occasionally, the father will ask me to set everything up so he can do the incision. This is the ideal way for an untrained person to do the bris, so I try to accommodate when I think it will work out fine.

Anyway, at today's bris - where the father is a friend of mine from way back - I said to him, "I am reminding you that the mitzvah of the bris is your mitzvah. So you have to appoint me to be your shaliach to fulfill the mitzvah."

He said, "I do."

"I didn't ask if you want to marry me," I responded. "Just appoint me to serve as your agent to help you fulfill the mitzvah." 

Then we walked through the formula as above. It was a great setup and comeback, and the people close by enjoyed our bantering.

May we have many opportunities to laugh together. 

Wednesday, August 24, 2011

Quick Audio Tutorials

In response to some people who had a little trouble navigating the Topical Index, I have uploaded brief audio files of the most common questions related to bris milah (usually from 1.5 to 5 minutes, though some are a little longer), hosted on yutorah.org.

When you get to YuTorah, type "Bris Milah" in the search engine and limit the search to classes given by me, and you will see the self-explanatory titles.

Feel free to share with anyone making a bris!
Thank you
A.B.

Sunday, August 21, 2011

The Magic of a Marker

Mohels are funny. When we see another mohel as a guest at a bris we are doing (some people know more than one mohel as a friend, but can only have one of them do the job), we will invite him to watch and to critique us. I don't enjoy critiquing. But I do enjoy watching so I can learn from someone else's techniques. For the record, the main "critique" I ever give is that the man might consider putting a wastebasket next to his working area, to cut down on the mess he either leaves or has to otherwise clean up afterwards.

[A dentist friend of mine once observed me in the 'critique' position and said to me, "How can you stand it? I hate watching another dentist do an extraction!" Translation: Since he's invariably not doing it the way I would do it, it becomes painful to watch. I told him I am learning what "to do" and what "not to do."]

But my real NUMBER ONE CRITIQUE (other than sterility, which people won't listen to anyway) is my belief that Every Mohel should use a magic marker to guide the incision he will be making in his circumcising the baby.

The results of not doing so are aesthetically unpleasant, at best, and cosmetically hideous at worst.

No human being is perfect, and no one can guarantee a perfect job any time. But taking precautions such as this one will help us be a little closer to perfect and accurate, in a manner that will be appreciated by all parents who trust their babies to our care.

Sunday, August 14, 2011

Mohel in CENTRAL Florida?

Though I maintain travelingmohel.com as one of my websites, that will more often attract brisses to which I must fly.

But I have also been called to do brisses in some cities and towns in the general vicinity of Orlando. I guess I could technically fly there, but the hassle of security, check-in, luggage, etc makes it so much easier to drive.

Which, with the help of the right mix of mp3s, cds and radio makes it an absolute pleasure.

And did I mention the phone? Ah yesss... what a pleasure.

Friday, August 12, 2011

News Monitor - being pro bris and anti circumcision (go figure...)

With the San Francisco story a thing of the past (sorry about the cliche), a not-so-new trend is making its way through news outlets and the blogosphere.

Just a few links to bring the idea close to home:
Beyond the bris - the header of the website says: "an increasing number of Jewish people are moving in a more ethical, more humanitarian and more Jewish direction" ---- hmmm... Not sure how getting rid of Torah commandments makes it MORE Jewish. But maybe I'm living in the wrong century.

Circumstitions - They surprisingly invoke this to say circumcision is against the Torah
"N 41 Not imprinting any marks on our bodies
N 45 Not making cuttings in our flesh
- 613 Mitzvos according to Sefer Hamitzvos of Rambam"

I guess they forgot about Genesis 17 and Leviticus 12:3. And, of course, they took both negative commandments out of context (tattoos and cutting ourselves over the death of a loved one) while disregarding that "bris milah" is a positive commandment. I guess you can pick and choose what you want to support your cause when it's convenient.

An article written by Professor Jon Levenson was republished today, and is well worth the read.




Monday, August 8, 2011

The Fusion Challenge

This is a topic which seems to come up every now and then, but since I've dealt with it twice in the past week, I write about it again. [Here is the original posting on this subject]

The two cases I dealt with in the past week were on babies who were circumcised by physicians, one two weeks ago and one 2 years ago. In both cases, the babies' parents were unaware of "why" the baby did not look circumcised. With no need to re-invent the wheel, I refer you to the post I linked before, where I explain how parents should deal with this to avoid it being a long-term problem.

When the skin on the shaft (especially since it may be a little more loose after the circumcision) is looking to settle down and get comfortable, it can easily sort-of-kind-of fuse itself to the edge of the glans, or even climb up on the edge of the glans.

THE GLANS SHOULD BE DISTINCT. YOU SHOULD SEE THE OUTER EDGE OF THE GLANS, AND IT SHOULD NOT BE FLUSH WITH ANY SKIN OF THE SHAFT.

As some babies develop, their body fat is deposited most heavily in the groin area. So it is not uncommon for the penis to seem as if it sinks in to itself. It is constantly being constricted inside the diaper, and the baby fat likes to swallow whatever might appear "extra."

In this case, the glans' rim sometimes appears to fall back into the shaft, but you can still see that there is a glans and a shaft.

There is a more extreme case, where the glans and shaft disappear entirely into the hole from which they may otherwise seem to emerge, and when you open the diaper, you only see a scrotum and a hole where the shaft should be.

Not surprisingly, this condition is called "The Disappearing Penis."

To avoid boring you with details (it is apparently a little more common, just people don't talk about it), I refer you to Dr Greene, where he more than adequately deals with all the possible scenarios.

Thursday, August 4, 2011

San Francisco Comes to a Close, It Seems

It seems it was "much ado about nothing."

See here from nbc bay area

I was never concerned that the vote would make circumcision illegal. It doesn't strike me as something that would pass, even in a town as liberal as San Francisco.

And a judge confirmed this sentiment, throwing the proposed law off the ballot.

Victory: Circumcision.

Until it comes around again.

Tuesday, August 2, 2011

Don't Let Finances Deter You!

Every now and then I either hear a story about someone or hear from someone directly that they either chose not to circumcise or to have a doctor do it instead of a mohel (which usually means when the baby is 1 or 2 days old, instead of on the eighth day - the correct day for the bris),  on account of financial reasons.

Often, they never even spoke with a mohel: they chose to go that route without even consulting with anyone.

This is very unfortunate, for a few reasons.

1. Any real mohel would prefer your child have a bris than a hospital-circumcision
2. Any real mohel will "work something out" if that is your circumstance
3. A circumcision before day 8, as well as almost any hospital circumcisions are not considered brisses
4. A routine hospital circumcision has a different definition than a bris circumcision. Significantly (and statistically) more often than with a mohel, the hospital cosmetic result will have a child who has not had enough skin tissue removed, who requires another procedure.
5. Anecdotal evidence (from physicians and pediatric surgeons I know) suggests that more "touch-ups" come from work done by doctors than by mohels. This is not to say mohels are perfect, or that doctors never do a good job. Just that mohels (generally speaking) have a better track record than doctors when it comes to the cosmetic results of their circumcisions. [Of course, the doctors who do the cosmetic touch-up work usually do a great job!]

Your research is a great first step. Now pick up the phone, and let's work something out!

Wednesday, July 27, 2011

What Makes YOU Different?

Someone recently asked me that - in the context of our talking about bris milah and this vocation of mine. Good question.
While some of the things I am about to describe are true with some mohels, I aim to bring them all together.
  • The Main difference is that I view the bris experience as an educational experience. I aim to share as much information as I can share with you, so you understand what will be happening to your son, and what you are really asking me to do on your behalf.
  • I am one of very few mohels who uses a surgical marker (or any magic marker) to guide the incision I will make during the bris. [Most mohels (arrogantly, in my opinion) "estimate" the foreskin, and don't pay much attention to aesthetics. I know it is important to you, however, and it is therefore extremely important to me that I 'get it right.' Using the marker assures a significantly more consistent result.]
  • I spend the time getting to know you, getting a feel for who you are and what you want the bris experience to be. You are never "a number"
  • From when bris mode sets in (beginning with our pre-bris meeting or phone conversation - not the "booking" but the "let's go over all the details" one) I am completely at your service until the last time I feel I need to see your baby. I communicate, call, keep you informed of all you need to know. If your home is within driving distance (as opposed to if I came by plane), I can come visit anytime you want afterwards to see how things are looking and let you know of what is still to come. 
  • Depending on your particular needs - participation of men, women, family, friends; as well as accomodations for religious observance and preference - I hope to tailor the bris ceremony and experience to your liking.
  • I don't have a particular formula that I use every time - it is more like a very loose script that guides our way, but is open to much ad-libbing. All to make each bris unique and special for its participants.
  • I am a superstickler for sterility
    - using sterile gloves (many mohels opt for non-sterile, which are less expensive)
    - creating a sterile field for the bris (as is done in an operating room)
    - metzitza with a tube stuffed with gauze - no passage of saliva/blood between mohel and baby
    - all sterilized instruments, drapes and bandages are opened for the first time at the bris

  • I am extremely careful to leave your baby with a clean bandage, after having observed for the requisite amount of time that his wound has clotted and that he is not bleeding.
  • I give you full instructions for how to care for the wound after the bris, and what you will be seeing.
I hope you will consider utilizing my services, and I appreciate the trust and confidence you put in me. 

Monday, July 25, 2011

Important Reminders

Sometimes I put the most important information at the end of a seemingly unrelated post. Then it gets lost in translation.  At the end of this post, I wrote the following:


He's YOUR baby, you have a right to choose whom you'll hire.  You have the responsibility to ask all the right questions to every mohel you interview before you settle on the one you want


And you also must take care to know what you are looking for to have the right kind of experience for your needs.  Always remember that the wrong attitude is not to ask.


I wish everyone best of look in having a positive experience the first time, and in learning what you need to know in order to make it so. I look forward to working with you.

Thursday, July 21, 2011

Personal Advertisement

I have to do this every now and then. :)

I have joined facebook! There is a "Rabbi Avi Billet, Mohel" fan page which I would appreciate if you signed up to (or at least click that you Like It).

I will be blogging on my new blog: thebrisblog.wordpress.com (for now) as well - and that will be the primary feeder to the fan page.

Understanding, of course, that participation in Bris Milah is only relevant to most people in the few days from the birth of their son(s) until a few days after the bris, nonetheless, it is important to me all year round, which is why I do what I do, and why I am doing what I can to have more of an internet presence.

Thanks for your support and your friendship!

Avi Billet

Wednesday, July 13, 2011

When the Baby Dies Naturally - Stillborn, complications from birth, etc

THIS IS A VERY SENSITIVE SUBJECT.

I was asked recently "what is the practice when a boy is born either stillborn or dies shortly after his birth? Is he to be circumcised?"

The simple answer is that it is up to the parents and what they want to have done. What follows is a more detailed analysis of the sources that address this topic, and what rabbis through the centuries had to say about it.

Tuesday, July 5, 2011

Remembering Our Roles

I tell this story to a lot of grandparents that I meet at brisses.

At a recent bris, in which I knew one set of grandparents (mother's family) very well for a long time (they have other grandchildren as well) but did not know the grandparents who became "first-timers" with the arrival of this baby, my first encounter with first-time Grandma went as follows.

I was in the private room preparing the baby, when the baby's father's mother walked in.

She promptly announced: "I am the mother-in-law."

To which I said, "You mean you are the grandmother."

And she said, "Me? I'm not the grandmother!" Then she thought about it a second and said, "O Right! I AM the grandmother! I guess I better get used to that."

Don't worry. You will!

Mazal Tov!

Wednesday, June 29, 2011

Shalom Zachar thoughts

When my son was born towards the end of 2009, I prepared a class about the custom to have a Shalom Zachar on the first Friday evening after the baby's birth.

I summarized the class online - it can be found in my other blog over here

Once I posted the audio class (previous post), I thought to share this one as well.

Enjoy!

Significance of Bris Milah

Click here for an audio presentation on this subject (54 minutes).
[The link sends you to Yeshiva University's online Torah website - yutorah.org]

Monday, June 27, 2011

San Francisco Ban - The Latest

The latest on the San Francisco ban-circumcision bill - a look at the people behind the bill, and some interesting observations about the Jewish community. It seems that even in San Francisco, where you have Jews of all colors and stripes, some of whom support circumcision and some of whom oppose it, are unanimous in their belief that a ban on circumcision is the wrong way to go.

As I have said before, the debate is legitimate, and the choice that parents make for their child is deeply personal. But making it illegal has no place in the United States of America.

Here is an article you may find of interest, from the Jewish Journal (reproduced in full below - minus the graphics - in case the link becomes inactive)

Except for the sub-headlines, the parts that are in bold are suggestive points that I have highlighted and emphasized due to their significance in this overall discussion (sometimes my point is to highlight what I see as an indication that the speaker or person in question is either hypocritical or operating with a loose screw or two)

JewishJournal.com
June 21, 2011

The great California foreskin fight of 2011

By Jonah Lowenfeld

Tuesday, June 14, 2011

When Baby is Really Small

A baby can only be given his bris when he is completely healthy.  When he is a preemie, or otherwise small, is he considered unhealthy?

For bris purposes, any baby over 6 pounds can be considered a "full term baby," regardless of how many weeks early he may be born. Barring any other health concerns, the bris should be on time.

A full term baby who weighs less - though almost all full-term babies are over five pounds - can also have the bris on time.

A preemie - fewer than 36 weeks, will almost always have his bris delayed until he gets a little bigger.

Many mohels have a "kabbalah" (an accepted practice passed from teacher to student) not to do a bris on a baby who is under five pounds. I have an ongoing debate with the grandfather of a set of triplets I circumcised many years ago, because he felt I was randomly picking a weight in order to have all three boys be circumcised on the same day (they all had different weights at birth - the brisses were delayed but ended up taking place on the same day). But it isn't random - a five pound baby has a different look than even a 4 lbs. 10 oz. baby.

In my case, the only exceptions I will make in order to circumcize a baby weighing fewer than 5 pounds are:
A. If the baby is full term, and both of his parents happen to be below average size
B. A case such as the triplets, where the baby is a few weeks old, in perfect health, and is gaining 1-2 ounces a day, and he has a brother who is also ready, whose bris is scheduled. If the baby is in the 4 lbs and double digit ounces range, I will consider circumcising him at the same time as his twin/triplet brother.

Tuesday, June 7, 2011

No indication of anti-Semitism HERE... (NOT)

The ballot in San Francisco looms nearer and proponents of the circumcision ban claim that their only agenda is to protect babies who have no ability to defend themselves, who are not given a choice not to circumcise. "It should be their choice to make when they're older, if they want it."

Let's leave aside the argument that most people really don't care if they were circumcised. And let's also leave aside the argument that for those who do "choose" circumcision, they generally much prefer (and appreciate) that it was taken care of for them when they were babies, rather than having to go through the ordeal as an older person.

The Jewish community in particular, those who respect the Torah and Mitzvot and (at least minimally) believe that the Covenant of Circumcision is a fundamental tenet of our faith, is aghast that policies of czarist Russia and many other historically anti-Semitic regimes are actually being considered for a vote in religiously-free (and tolerant) America.

Proponents claim their is no anti-Jewish bias in the proposed ban. None. It's all about the babies.

Mmm hmmm.

Then what is this?

Monday, May 30, 2011

Early Sources For Metzitzah

It's a little odd that this question takes up so much time and discussion in circles related to proper practices related to bris milah. I have mentioned elsewhere that metzitzah, the drawing of blood from the circumcision incision, is traditionally done with the power of the mouth. The debate as to how to do this best boils down to two practical possibilities:

a. Putting the mouth of the mohel, father, or erstwhile motzetz directly on the fresh wound
b. Putting a sterile tube (glass or disposable plastic) on the fresh wound

Both are followed by a quick "suction" action. In the former case, the mohel immediately spits out whatever blood enters his mouth.

If you have read any postings of my feelings regarding sterility, you know my feelings that the better method of achieving "metzitzah b'feh" is "method b," which certainly uses the mouth, but does not present any possibility of harm to the baby or the mohel.

Before the sterile glass possibility was introduced, there were those who advocated metzitzah be done with a sponge (what we would now call gauze) without the use of the mouth, due to the obvious problems that could come about from putting a "foreign" mouth directly on an open wound of a newborn.

There are still people who think there is no harm in a mohel putting his mouth on a fresh wound. And if you get lucky every time, I guess you can say there is no harm. But if something goes wrong once on account of this attitude, will you still say there is no harm?

Advocates for the mouth on baby method claim this is the way it's been done forever. Could be. It could also be they're wrong. It could also be that if it was done this way it was because people did not know any better. But we certainly know better now. I recently met an old acquaintance I hadn't seen in over ten years and he mentioned that his family's "practice" is to have metzitzah done with "method a." This young man is a cardiologist now. I asked him, "And how does this jive with your knowledge of medicine?" His answer was not very promising. "It doesn't," he said. "But it's our family's custom to do it this way."

Unbelievable.

So, in response to those who say the source is ancient, or that "God watches the simple - שומר פתאים ה ," or that "Those who are messengers to do a mitzvah are not harmed" or that "One who fulfills mitzvahs will not know of any bad results - שומר מצוה לא ידע דבר רע," there are two sources I'd like to share with you regarding lists of mitzvahs which are done with the mouth.

1. In Rabbi Yitzchak of Corbeil’s introduction to “Sefer Mitzvot Katan” he categorizes the commandments of the Torah based on the different parts of the body which will fulfill them. Commands 102-151 are to be fulfilled with the mouth. Metzitzah is not listed.  (Due to the length of the list, I am not reproducing the text here)

2. In Yalkut Shimoni Tehillim 723 King David reportedly praises all the parts of his body and the mitzvot he fulfills through them. The mouth and lips are mentioned only with reference to saying prayers and singing praise of God. Any reference to the practices of Bris Milah in this section aways group milah and priah together – with no mention of metzitzah as being part of the mitzvah, let alone metzitzah b’peh!


The male organ is for milah and priah, the knees are for holding a baby as a sandak, so milah and priah can be done.

ילקוט שמעוני תהלים רמז תשכג

כל עצמותי תאמרנה ה' מי כמוך, אמר דוד אע"פ שקלסתיך בכל אלו, עד עכשו איני יודע לקלס פי יספר צדקותיך כי לא ידעתי ספורות. כל עצמותי תאמרנה, אמר דוד אני משבחך בכל אברי ומקיים בהן המצות בראשי אני רופפו וקורא בתפלתי. בשערות ראשי, אני מקיים לא תקיפו פאת ראשכם, ותפלין אני מניח בראשי. בצוארי, עטיפת ציצית. בעיני וראיתם אותו. בפי, תהלת ה' ידבר פי. בשפתי תבענה שפתי תהלה. בזקני ולא תשחית את פאת זקנך. בלשוני, ולשוני תהגה צדקך. בלבי בלבי צפנתי אמרתך. בחזה, הציצית אני משים כנגד הלב כל זמן כל זמן שאני קורא קריאת שמע, שנאמר והיו הדברים האלה על לבבך. מאחרי ומלפני השלכתי שני כנפים של טלית כשאני עומד בתפלה. יד ימנית אני כותב בה ומראה בה טעמי תורה. יד שמאלית, בה אני קושר תפלין של יד, ובה אני אוחז ציצית בזמן קריאת שמע. צפרנים, לעשות בהם פריעה או מליקת העוף או שניהם יחד. ובוהן, להסתכל אור להבדלה. כליותי אף לילות יסרוני כליותי. מעי, ותורתך בתוך מעי. קרבי וכל קרבי את שם קדשו. רגל ימין לחליצה. רגל שמאל קודם לשלש פסיעות אחר התפלה. כרעים, כריעת ברכים בתפלה. הגיד, מצות מילה ופריעה. ברכים, בהן אני עושה סנדיקוס לילדים בשעת מילה ופריעה. לכך נאמר כל עצמותי תאמרנה ה' מי כמוך
I hope these two sources will at least give some form of indication for those who claim that a. metzitzah is a mitzvah (which it clearly is not), and that b. it must be done with the mouth, that the actual mitzvos which utilize the mouth do not include metzitzah as one on their rank.

FINAL THOUGHT:
Somebody once tried to claim that this midrash clearly states that there were three stages of a bris, Milah, Priah and Metzitzah.
במדבר רבה פרשה יא

מי מלן רבי ברכיה תני לה בשם רשב"י משה מוהל ואהרן פורע ויהושע משקה וי"א יהושע מוהל ואהרן פורע ומשה משקה
However, it does not take much to see that Yehoshua (or Moshe in the second version given) would give a drink to those who were circumcised. (It says משקה - to give to drink, and not מוצץ - to draw their blood through suction). Using this as a source for metzitzah is clearly an incorrect reading.

On that note, of course, there is no custom (that I'm aware of) to do metzitzah for an adult circumcision. [I shudder at the thought of such a practice.]

Wednesday, May 25, 2011

The Private Room

In a bris that takes place outside of one's home, it is important for a room to be set aside for the mother and baby, for before and after the bris. In advance of the bris, many mothers find it advantageous to have their own space, a little peace and quiet, and a chance to mentally prepare for the bris.

In addition, the mohel appreciates the opportunity to speak with the mother without interruption (and the father, when he is there too), and to prepare the baby for the bris in whatever manner he feels is necessary. I do a non-invasive preparation that consists of cleaning the baby with alcohol, marking the edge of his foreskin with a surgical marker and swadding his legs in a receiving blanket.

After the  bris, the room comes in handy in keeping the baby away from the admiration of friends and family who don't "get it." It is also very helpful in any post-bris checkings or monitorings that need to take place. I, for example, always like to see how the circumcision looks, and I change the bandage immediately after the ceremony is over.

As this last procedure might take a few minutes, and mostly because the baby cries during this time, it is best that it all take place in the private room. Additionally, a nursing mother will want to feed her baby after the bris, to soothe and comfort him and to give him the feeding he is ready for as he hasn't eaten for close to two hours. Having a private room is advantageous to giving you the space you need to bond with baby, without the interruptions others may bring - even if they are "only trying to help."

What is the Private Room?
It is either the rabbi's office or the synagogue office (both in a synagogue), the caterer's or manager's office (perhaps a synagogue or a restaurant). It might be the bridal room in a place that sometimes hosts weddings as well.
It will typically have a table or desk and a chair or two, which is ample enough for mother's needs and mohel's needs.

Tuesday, May 17, 2011

Interesting Portrayal of Adult Circumcision

In reading something else, I came across this positive description of an adult circumcision - done for conversion purposes - in 1844. The writer is a physician, William Clay Wallace, a non-Jew, and his narrative flows from the perspective of the neutral reporting anthropologist to the admiring physician who could not replicate what he saw when he tried to perform a similar operation.

See it here: http://onthemainline.blogspot.com/2010/05/account-of-adult-circumcision-of-male.html

It's amazing to me how the person in question seems to have been circumcised the same way mohels circumcize babies, and how the focus seemed to be on getting the bleeding to stop through cold water and lint (?). He leaves no indication of longer term bandaging, and makes no mention of suturing. I don't know if the aftereffects would pass the cosmetics test and muster of today, but I still found the account fascinating.

Let me know what you think in the comments here!

Saturday, May 14, 2011

On Creating Standards for Sterility

First an anecdote, then the reason for this posting:

I am big stickler for the use of a "sterile technique" at a bris.

One parent recently commented to me - unprovoked - how much he appreciates my systematic cleanliness and regard for sterility when dealing with the baby. I honestly don't see how things can be done any other way. Unrelated, a friend recently told me that a relative of his called a mohel, who came to visit them after they had brought their baby home. The mohel came in, and picked up the baby to examine him - and much to the dismay of the new mother, he did not wash his hands, ask them if they cared, or even use a hand sanitizer. (The mohel should say "I would like to examine your baby. Where can I wash my hands?")

You can say "they're being ridiculous." But they're not being ridiculous. This is their baby, and they have a right to assume and insist that their baby be handled in a manner with which they are comfortable. They subsequently decided to go with a different mohel. As is their right.

The Inspiration for this posting

A pulpit rabbi told me that he is uncomfortable when mohels come to perform a circumcision in his synagogue, and insist on doing metzitzah with direct oral contact to the baby. The first problem is that many of this rabbi's congregants are not even aware to ask, and were they to know what the mohel is doing, they would surely prefer he use a glass tube.

The second problem is that the mohel is not being completely upfront with the parents. To compare - I make it my business to tell the parents "In addition to my sterilized instruments and bandages, I use sterile drapes and gloves to the point that I am never in contact with your baby directly. Is there anything about the process of the bris you would like to know? Would you like me to show you what the foreskin is?"

Some parents appreciate the honesty and candor, and some are not interested in seeing what the foreskin is, preferring to say, "It's OK. I trust you." I appreciate the trust. And while I understand some people are squeamish, I don't understand why people would not want to know what will be happening to their baby. But that's just me.

Anyway, the rabbi said, "What should I do?"

So here are a few options:

1. The shul can have a few standards that must be followed in order for a bris to take place in the shul itself. For example, the shul can say, "The mohel must wear gloves, must bring all his instruments in autoclaved packages, and must do metzitzah with a glass tube." [The rules can be adjusted for a shul that thinks these standards are unimportant. But new parents should think long and hard about what kinds of rules they prefer to be adhered to in the circumcision of their child.] If parents prefer not to follow these standards, they are welcome to have their bris elsewhere. This is a strict shul policy.

2. The shul can do the research themselves and have a list of "acceptable mohels" they provide for their members - always happy to accept another mohel, of course, provided he abides by the standards the shul has demanded of those on the list.

3. Most importantly, the rabbi might need to have a frank discussion with prospective parents (better when they are expecting than after the baby is born) as to "WHY" these standards are important to us as Jews and as a community. Discuss why these rules benefit the cause of Bris Milah and all the individuals who will be doing brisses for their sons in the future.

IN CONCLUSION

I will not play the role of mohel basher. But I will say that some mohels have their own convictions take prority over the convictions of the people hiring them. It is dishonest and improper to support such behavior. The mohel is hired to give the child a kosher circumcision. He is not hired to bring in all of his own convictions in the realization of those ends. He must respect where the parents of the baby are coming from in their own Jewish experience.

Were you to go to a barber who reveals to you that he achieves the same result with a blowtorch that others achieve with a scissors and comb, you'd probably walk out the door before you allow this barber to touch a single hair on your head. You want the method you trust.

Should we not be as selective and careful when picking a mohel who will circumcise our sons? Just because the results typically look more or less the same does not mean the means to achieve those ends are the same.

What Is Done With the Foreskin?

There are so many misunderstandings about this one. For example, take a look at this link, where the author writes of all kinds of superstitions (segulahs in Hebrew), and includes an extremely odd idea related to a foreskin and its powers of helping a woman become pregnant.

I honestly think it is a mistake or a misunderstanding. No matter how you look at it - it is just plain wrong.

I suppose there are some mohels who discard the foreskin with the bandages and refuse created in the process of the bris (packagings, diapers).

But, in simple terms, most of us bury it at our first opportunity.

There is even a custom to get the ball rolling on the burial process by having a dirt-filled dish at the bris so the foreskin can be immediately deposited in the dirt once removed. Those who go so far to prepare the dirt bowl nowadays are usually either Hassidic or so-called "ultra-orthodox." It is by no means a law, it is only a custom.

If you think about it, burying the foreskin makes a lot of sense. Our regard for the human body once its function of housing the soul is complete is to treat it with respect and to return it to the earth "from whence it came." Once the foreskin's function - to serve as the vehicle to allow the completion of the Jewish male (see the midrash quoted in the 3rd and 4th paragraph here) - is completed, it too returns to the earth from whence it came.

Wednesday, May 11, 2011

Importance of Good Lighting

I did a bris in a country club a couple of months ago. While the decor was beautiful for the party, the lighting was a little inadequate for the circumcision.

Thankfully, when I asked for assistance, they were able to bring a standing lamp that provided the necessary light for the procedure.

When considering the venue - whether the bris will take place in a synagogue, a restaurant, a country club, or even your home - please remember that you want the mohel to be able to see what he is doing!

I would argue that as far as the choices you make for the circumstances of the bris, the lighting at the area where the bris itself will take place is perhaps the most important factor to consider.

People will either remember the party or they will not. But you don't want to run the risk of what could happen if the mohel could not see when operating on your son.

Tuesday, May 10, 2011

Gloves

I happened to look at a website of a mohel who posts photographs of himself "in action." I don't know the man, so I will not comment about the need to demonstrate the play by play.

But I notice he is not wearing gloves on his hands when he does the circumcision.

And this really really really bothers me.

We live in the 21st century. We know all kinds of things about cleanliness, sterility, hygiene, blood, transferring disease, not touching an open wound with anything other than something which is objectively sterile.

Unless you blowtorch your hands (which I don't recommend), they will not be sterile. Clean? Perhaps, if you scrub long enough. Sanitized? With the right hand sanitizer, it's my word versus the company's word. Sterile? Not possible. We have fingernails! And cracks in our skin!

How any mohel can still operate without gloves on is beyond me. How he gets away with it is beyond my comprehension.

And the parent who does not even inquire, who does not ask "Will you please wear gloves?" Or "In what manner are you protecting my son from your hands?" does not really understand what is taking place here.

If you would allow a doctor to go without gloves when doing a procedure on you in which blood will be drawn, then I withdraw my comment. (Though I question your concern for yourself, and your doctor's concern for himself or herself). If you would allow a dentist to poke around in your mouth without wearing gloves, then I withdraw my comment. (Though I question how your dentist has not contracted some kind of dangerous disease.)

FOR THE SAKE OF JEWISH BABIES, PLEASE DISCOURAGE MOHELS FROM CIRCUMCIZING WITH THEIR BARE HANDS! INSIST THAT THEY WEAR GLOVES!

Monday, May 9, 2011

Why I don't have tons of pictures in my Mohel Blog

For a whole host of reasons, I chose to blog about bris milah. I enjoy writing, and I enjoy sharing ideas. And I feel there is not enough information out there that is easy to find, and that truly gives you, the parents of a baby soon to undergo a bris (or in the post-op stage wondering why things look the way they look).

So I blog, and when things come up, I try to address them. Especially when they come up a lot in conversation, or in the emails or phone calls I receive on a regular basis.

People have asked me how come I don't have pictures of myself doing a bris? Because I work alone and don't have the opportunity to snap photos of myself when I am caring for a baby.

People have asked me why I don't have pictures of me smiling holding a baby? Because that gives no indication of whether I am a good mohel. All it does is demonstrate how starched my mohel-jacket is, and whether I am photogenic.

I prefer not to put up dozens of pictures of the same bris to make it look like I am very busy when I am not. Or even to put up single pictures from many brisses to prove how busy I am.

You need information. Not smiling Jon. So, poke around, read what I've written. And if you believe I care enough about sterility, and your baby, and you, and not about me, my "show" and how "I will look," then call (516 850 9694) or email me (avbillet@gmail.com)

When I do your son's bris, you can take a picture of me. And if you send it to me, maybe I'll put it in a posting. But only at your request.

Miami Mohel - In Search of a Mohel in Miami

  I googled Miami Mohel and when this website did not appear, I figured I'd have to write Miami Mohel a bunch of times to get it to show up. Miamimohel dot com takes up the first five slots or so. So this mohel in south Florida is writing about being a Miami Mohel or a Mohel in Miami with one motive in mind. To appear a little higher on a Google listing. If you are looking for a mohel in Miami, this is a website that will be helpful to you. You will want to call me or email me as soon as you can. There are other mohels in Miami, but you have seen them all before. Try something new, branch out, bring another Mohel into Miami.

Miami Beach Mohel will work too. Miami, Miami Beach, whatever. The point is to show up in a Google search, or a Yahoo search, or any search that will bring a search for "Miami Mohel" to this webpage.

Thanks for reading. And thanks for directing all those seeking a Mohel in Miami or a Miami Mohel to this website.  Now check out the FAQ section, and the testimonials. See that this is a real deal. And give a call. I am honored by your exploration and your sincere attempts at researching, to find the person that BEST fits YOUR needs.

Find the best mohel for YOUR needs. You have the right to choose the mohel that fits the empty silhouette in the front of your ideal bris picture.

Happy hunting and happy finding your Mohel in Miami.

When the Baby is a Girl (on a lighter note)

Before a baby is born, there is a fifty-fifty chance that I could be considered as the mohel. My standard line, when people ask me if I'll travel to circumcise their child, is "Only if it's a boy. I don't touch the girls."

I have had many friends call to APOLOGIZE (I kid you not) when their daughter was born. "Sorry we can't give you the business," they say. "I tried to get my wife to have a boy... But what can we do? She didn't listen to me!"

While I think the apologies are unnecessary - I, for one, am very happy for them. I am glad they have a healthy baby. And, of course, God knows (as do we all) that we need girls too. So I won't have a bris. Believe me - when it's a girl, it doesn't bother me.

But I think this week I received the funniest "apology" of all time. A father of a newborn baby girl dropped off a challah roll that his family had on their table for shabbos, with a note saying "Dear Rabbi, THIS is the only bris I can give you. Cheers!"

Saturday, April 30, 2011

A Thought on Metzitzah

According to the Talmud, there are a few steps that need to be followed when doing a bris properly. Incidentally, I am choosing not to "number" the steps, due to the variating ways people choose to read the Talmudic passage of the bottom of Shabbat 133a:


עושין כל צרכי מילה [בשבת] מוהלין ופורעין ומוצצין ונותנין עליה איספלנית וכמון
On the Sabbath, we do everything that needs to be done for the circumcision: Remove the foreskin, remove the membrane from the glans, draw out blood, put on a bandage and cumin.
The Talmud goes on to say that even if the cumin had not been properly prepared (crushed or ground) before the Sabbath, one could grind it with his teeth on the Sabbath, an act which would generally be forbidden on the Sabbath - but is permitted, presumably on account of the role the herb/spice would play in stopping the blood and healing the wound.

The differences in the reading open up a debate as to whether metzitzah, which I have defined as "drawing out blood" is considered to be: a. part of the steps of the process, or b. a suggested component that the Talmud records as the best known form of helping the wound heal.

If it is the former, then metzitzah must be done at every bris [how the blood is drawn is a topic of a different discussion, and of much debate, particularly in ultra-Orthodox and some Haredi/Hassidic circles]. If it is the latter, perhaps it need not be done,

Tuesday, April 26, 2011

A Consultant

People call for all kinds of reasons. Some are looking to "book a mohel right now." Others are expecting a baby in a few months and are doing research. Others don't know if the baby is a boy or a girl, but are preparing nonetheless, just in case.

Barring unforeseen circumstances, such as a health concerns, the bris usually takes place on the eighth day of the baby's life. Even though mostly everyone knows this, sometimes people - in the heat of the excitement - forget that mohels are used to being called after the baby is born. I blogged about this a long time ago, and tried to make light of the possibilities of when to call the mohel to book the bris itself.

There is never a wrong time to do research pre-birth.

Sunday, April 24, 2011

A Wonderful Relationship

In general, this blog is dedicated to sharing information with those looking to explore the significance and practical sides of bris milah.

On the one hand, it is meant to answer questions you may have related to the significance of the mitzvah, the specific practices, the rituals, the pieces of the ceremony that have been introduced and innovated over the centuries.

On the other hand, it is meant to provide you with hands-on information that is most useful for the parent who wants to know what happens during a bris, what happens to the baby, what the healing process is, and how things will be different after the bris. It also provides information for first time parents (or first-time parents of a boy who may already have a daughter or two (or more!)) about what needs to be done to put together a bris. You may have friends who will help you, but if you have trouble finding information, it's all here.

So, in this posting, I will detour to the personal side of this role I play from time to time.

I was invited to perform the bris for the second son of a friend of mine, who I've known for close to thirty years. (I had the honor of doing their first son's bris two and a half years ago) We'd been in and out of touch for the better part of our formative years, but a reconnection 6 years ago tightened our friendship to this day. I am better off because of it, and for that I am grateful.

I cannot express in words how special it feels to play such a significant role at any family's bris. Being invited into the inner circle at such a significant time, being given a tremendous level of trust and good faith is something I cherish from all the people who call me at this joyous, yet vulnerable time in a family's growth.

And when the parents of the baby are such dear friends, the feeling is exponentially greater.

And so NOA, I thank you from the bottom of my heart for being true friends,

What's In A Name?

Many bris speeches tend to focus on explaining the name that has been given to the baby.

Often enough he is named for a family member who has passed on, such as a grandparent or great grandparent, or an uncle or some other distant relative. Some families opt to name a boy after a grandmother - obviously he is not given the woman's name, but he may be given the same first initial. Grandma Nettie will become Natan. Great-Aunt Shirley will become Shlomo.

At its core, the practice is simple. Carry on a name, retain a heritage.

On a deeper level, we fondly recall those who are gone when we think about the name we have given this child, and we hope the name, and all it represents to us, will be embodied by the child who now carries it.

Thursday, April 7, 2011

How travelingmohel.com helped me

Since moving to Florida from New York, I have had a number of past "clients" and new clients call me to perform their son's bris in New York. If it works out schedulewise, I am happy to do it.

Many more have called from New York, but when I told them I'm in Florida, they opted to go local. Which is understandable.

Traveling gave me the idea to create travelingmohel.com, but it also forced me to become an even better mohel.

Thursday, March 17, 2011

A Long-Term Care Reminder

One question that comes up a lot, particularly when a baby boy is 4-12 months of age is, "Why doesn't it look circumcized?" (I get this a lot more often when I wasn't the mohel, but every now and then if I was)

In most cases, "it" actually does look circumcised, except that a minor issue needs to be tweaked.

Before I continue, let me be clear that this may be difficult to understand without the visual image, but I will do my best!

Clench your fist, and look at the profile of your arm. Imagine the fist is the glans, and your arm is the penile shaft, and you understand what the penis should look like from the side. The glans should sit above the shaft, and its outer rim should be completely separate and distinct from the shaft.

UNFORTUNATELY, not all parents realize this should be the case, until it is slightly too late.

What do I mean by slightly too late? I mean

Tuesday, February 22, 2011

Emotions Overtake Us

At today's bris, the baby's father served as the mohel.

You may ask, "what does that have to do with you?"

I'll answer: I set it all up for him, and he was the one who said the blessing and did the incision. And why not? It is, after all, the father's mitzvah!

As long as you know what you're doing, and have an awareness of the anatomy and what takes place at a bris, this can be the most genuine way for a non-mohel father to perform the mitzvah.

Sunday, February 6, 2011

Taking Decor to a Whole New Level

In my time as a mohel, I have worked with over a thousand people. In all this time, I have worked at brisses on every point on the extremity line.

The smallest event was attended by three people. It was in a tiny apartment, with people who did not want anyone present beyond the baby's parents and the sandak.

I am debating in my mind which of a few events qualify as the biggest event. Should I consider the one with seven hundred guests the biggest? How about the Independence Day triplets (all boys)? Perhaps the one in a Jewish Center of a wealthy community, which had bounce-houses, a magic show, and other events for the children while the adults had an endless supply of Kosher Chinese food?

I guess everything is relative.

UNTIL NOW

I have NEVER seen anything like this before. The Jewish Hostess... I don't know what to say!

Let's try this - the standing lollypops are made up of flowers.


No. I was not the mohel at this event.

But if anyone would like me to be a mohel at a similar event, my phone number is 516 850 9694. Call whenever you like.

Thursday, February 3, 2011

Symbolism I - 'ala Rabbi Samson Raphael Hirsch

Rabbi Samson Raphael Hirsch was one of the great leaders of German Jewry in the 19th century. His vast legacy includes significant works of scholarship and thought that continue to speak to us to this day. While some might suggest were he living now he'd be a champion of "Modern Orthodoxy," I question this premise simply because I don't think the label is very fair to modernity or to Orthodoxy. So we'll leave politics aside for now.

Hirsch's "Collected Writings Volume III" is dedicated to his studies of Symbolism in Jewish life. One of his primary foci is on the mitzvah of Bris Milah. I intend to share some of his teachings through a series of blog postings on this subject.

The following comes from his "preview" of the subject, which appears in his overview of the book, the chapter on "Symbols in Jewish History." (pages 23-24)

The forefather has been promised the nation and the land. He was already ninety-nine years old and his wife eighty nine, when the scion who was to be the bearer of this promise was begotten. But even as the original inhabitants of the promised land will lose the land only because they had forfeited their moral stature, so too, the fulfillment of the promise, the emergence of the nation and its possession of the land were to be dependent on Israel's attaining and maintaining its moral greatness. The resolve to achieve this end, and the acceptance of this obligation, were to precede the birth of the first scion. A year prior to Isaac's birth, God appeared to Abraham and said to him, "Conduct yourself before Me and be whole." (Genesis 17:1)

In that momentous utterance God expressed the full extent of this moral condition for the survival and prosperity of the promised nation. התהלך לפני! Conduct yourself before Me. Do so without any inducements from the outside, indeed,, if need be, even in opposition to all outside influences, והיה תמים, and be "whole." The adjective תמים "whole" (or "perfect") is the most flagrant antithesis to רעע, "broken." Be whole! Let all the aspects of your life, physical and spiritual, all of your character, be governed freely by one principle; subordinate yourself entirely, unconditionally, to the One sole God. This is the condition for the survival and prosperity of the promised nation, this the obligation in the Divine covenant to be assumed by Abraham and his people. Abraham fell upon his face and dedicated himself completely to the fulfillment of this obligation. However, the mission that was to be the everlasting foundation for the spiritual and moral development of the nation in every aspect of its life was not to be entrusted to the spoken word alone. "Now then," thus God concluded the verbal announcement of His covenant, "circumcised the flesh of your foreskin, so that it may become the sign of the covenant between Me and you. Thus My covenant upon your body shall become an everlasting covenant, and an uncircumcised male who does not circumcise the flesh of his foreskin, his soul shall be eliminated from the community of its people; he has broken My covenant!" (Genesis 17:11-14)

Is not the circumcised foreskin a symbol, and circumcision a symbolic act? Are both not אות ברית, symbol of the covenant that calls out to everyone who bears it upon his flesh the eternal admonition: התהלך לפני והיה תמים!
To be continued...

Wednesday, January 26, 2011

Knowing What To Expect Afterwards

[For much more detail on this subject, click here. The short version follows.]

When your child is circumcised, it is a good idea to get a good feel for how long the healing process takes.

In most cases, I need to see the baby only once after the bris, often enough to remove a bandage, but even when the bandage comes off on its own, just to see that everything is healing nicely. This has changed the time frame of my care for the baby - I used to see the baby, in some cases, two whole days after the bris. Now I see him within a few hours.

I FIND SEEING THE BABY A FEW HOURS AFTER THE BRIS TO BE MUCH BETTER: FOR THE BABY, FOR HIS PARENTS, AND YES, EVEN FOR THE MOHEL

There are mohels who like to see the baby a few days later, or even to see how things are looking a few weeks later. This is admirable.

At the same time, in the event that something is not OK at that two week period, there is really nothing that a mohel could/should do at that point. Any "correction" should be taken care of right away, which would perhaps necessitate an additional follow-up visit.

In simple terms:
* The glans (tip of penis) should be a dark red, and the extent of its outline - like a helmet on a head - should be visible all around
* There will or will not be remains of a membrane below the glans (also a dark red, though a slightly different hue). It is often swollen, though to what degree depends on how much membrane is present.
* The skin where the incision took place should be identifiable below the glans or membrance, and should be as close to even in its circumference around the shaft. Depending on the baby's anatomy, in some cases, the mohel might cut at more of an angle, to compensate for a differently angled glans.

If this is what things look like after the bandage comes off (with the caveat of the possibility of some swelling below the glans), all your baby needs is "time." Some colors may emerge (white, yellow, green) that are just the way the area scabs. But even all this goes away within a couple of days, and certainly very quickly once antibacterial ointments (bacitracin, polysporin, etc) are no longer applied to the area.

For instructions on how to care for baby, see here

Tuesday, January 25, 2011

Finding a Mohel in South Florida

A web search for a "mohel in south florida" or "mohel in florida" may have brought you to this particular page.

Ought you just go with the top search engine listing?

RESEARCH RESEARCH RESEARCH

Everyone who has any media sense or savvy will have nice pictures and guarantees of a beautiful ceremony. Of course that's what you'll find. After all, don't we all do the same thing?

Yes, and no.

Yes - we all do a ceremony, we all do a circumcision, and we all take care of your son.

No - it's not all the same.

Tuesday, January 18, 2011

Circumcisions versus Brisses - Circumcising Jews, Half-Jews, Non-Jews

As far as I can tell, citizens of the world who circumcise their sons either do so as a medical procedure or as part of a religious ritual that is a right of passage.

I have met doctors who perform circumcisions all the time, and some who do them every now and then. Each one has a method which works for them to achieve the desired result. (Doctors are wonderful people, and they usually specialize in a particular field. As such, I would be wary of doctors who do not do them regularly, simply from word of mouth from other doctors who've told me their colleagues ought to stick to what they know - but that is for a different discussion.)

Mohels find themselves in a unique circumstance. Most mohels (certainly Orthodox mohels) are not physicians, and yet they have what many would consider a medical expertise in a very limited field. Does this make them obligated, under a sort of Hippocratic Oath, to perform circumcisions whenever called upon to do so?

Firstly, mohels are also specialists and should never extend beyond their training. There is circumcision, which is more or less routine, and there are surgeries which require a reconstruction of the penis. A mohel who is untrained should not undertake such a procedure, particularly if the best setting for it is an operating room with general anasthesia.

Secondly, circumcision, particularly on a newborn, is not, objectively, a "necessary" procedure, and in most cases is not life-saving. As to-circumcise or not-to-circumcise is a choice made by parents, mohels are under no obligation to accept the job if they do not want to. (Religious law might require them to in the event there is no one else available, particularly for a bris which must take place on the eighth day -- though obviously if it does not work out on the eighth day, it can be done at the next opportunity, ideally as soon as possible.)

So we come to our question: May a mohel circumcise non-Jewish babies, or is he only allowed to do brisses (as opposed to routine circumcisions)?

Sunday, January 16, 2011

The Honor of Being Called Again

I've been in Florida for a little over 2 years, and I've already had a few repeat customers. (I have many in New York, but 2 years is about the average between most kids in a family.)

In general, I appreciate the trust you, the parents of newborns, put in me. If you knew me before your baby was born, it is obviously easier for you to make the call. And while I always view doing a bris as a privilege, it is a different experience when you already know one another. To misquote Barney, "I know you, you know me."

If you never met me before you needed to arrange a bris, the trust is even more appreciated. You are calling me "cold" - perhaps after having done your research. And you give me the job of bringing your son into the "mark of the covenant." This is the greatest honor.

Before I became a "Mohelinsouthflorida" I was a mohel in New York. It became a competition with some grandparents, how many of their grandsons had I circumcised.

I believe the record is 6 for two sets of grandparents. (Full disclosure - one of those sets are my parents, who have six grandsons). I have a few sets of grandparents with 5 or 4 grandsons I've circumcised, and whole host of triple and double-dippers - either one each from two (or three) of their married children, or two from one set of parents (which obviously makes the parents repeat customers), etc.

I cherish the trust, the friendship, and the opportunity to serve you and your family at this very special time for your family.

Saturday, January 15, 2011

FAQ - Frequently Asked Questions SUMMARY

Short answers to the following questions can be found here

The links will send you to longer answers to the questions categorized below...

MOST PRACTICAL 
* I'm a practical person and don't have time for all this. What do I need to know and do to prepare for a bris? You can start by utilizing all the "page" links at the top of the page, or you can go to this blog post which covers each essential thing you need to find, from the preparations for the bris to the longer term care instructions and things to note.

ABOUT THE MOHEL
* Anythoughts on how to find the right mohel? (Aside from calling the number on the right of the page? :) Seriously though -- Important to know what you're looking for and to ask the right questions, basically - do your research!! My own comparison of Billet vs the other guys
* What is your training? (read my mini bio on this homepage)
* Why did you become a mohel? What do you enjoy about being a mohel?
* Are you a doctor? No.  Does a mohel need to be a doctor? Read the second half of this post
* (or read this article from the jweekly of California)

PREPARING FOR THE BRIS - DETAILS AND MINDSET
* What do I need for a bris? Supplies
* What is the setup for a bris? Setting up the room
* What goes into preparing a bris party? What is an appropriate venue for a bris?

THE CEREMONY AND THE PROCEDURE
* How does the ceremony work? (General overview of the Ceremony)
* How is a circumcision done? Methods,
* What exactly happens in a circumcision? Before and After (note the link to the circumcised banana)
* Explain the honors of the ceremony: HONORS LIST (more detailed list of the honorsKvatter, Kisei (Chair of) Eliyahu (Elijah the Prophet), Sandak
* What is metzitzah? As straight as I can give it to you, An Additional Thought, Is it a "Mitzvah"?
* How do you balance inclusion of family, friends and guests in the ceremony? Having Family and Friends Involved (includes honors list)
* What surgical instruments and supplies are used in a circumcision?  SHIELD              TUBE               KNIFE              PROBE             HEMOSTATS           MARKER              GLOVES             NUMBING

AFTER THE BRIS
* How do I care for my son after the bris? Instructions  Thoughts on Tylenol
* What will it look like? Before and After
* What can go wrong? Common issues  Correctable and Really Bad, Long term Care Reminder

MISCELLANEOUS
* How does it work if one of us (baby's parents) is not Jewish? A: If his mother is Jewish...  What Makes a Jew, Mohel's role in circumcising half-Jews (one Jewish parent) and non-Jews
* What will the bris itself (circumcision - mohel's role) cost? Initial Thoughts   and    More straightforward
* How important is sterility really? OneTwo,  Three
* Is there a difference between a bris and a circumcision? This topic,  Related conversation