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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.

Other issues have been discussed in this very important post of "what could go wrong at a bris."
And in this posting about "The Danger of Arrogance" (on the part of the mohel, of course).
Point is - any number of things "could happen" that will make the entire process a little less than perfect.

One of the worst things a mohel can do is leave something alone and allow it to become someone else's problem. And certainly, if he does not communicate, and be up front about everything. As I wrote in the posts linked immediately above, I would rather the people be upset because of what I had to do to correct a problem right away, than that I left the problem for them to deal with down the road in a corrective surgery (or even for me to revisit the next time I see the baby). Of course, many parents don't get upset and say things like, "You are doing what you  need to do to give my kid the best circumcision." Their trust, confidence and understanding makes the mohel's job a more pleasurable experience.

Because in the end, if the baby is fine and he has a kosher (and fine looking) circumcision, that is what I was hired to provide. And as a baby nurse I recently worked with said "It doesn't matter how you get there, as long as you get there in the end."

Remember that anything that goes on behind closed doors often stays behind closed doors. If there was need for the circumcision to be adjusted to look better, some parents choose not to know about it, and some prefer to put the memory out of their mind. Others like to know that "you're doing what you need to do to do right for our son." Most don't talk about it after the fact, because their son is fine and the bris is fine, and it was just "one of those things" that happens.  (Most also don't talk about if there are long-term complications or a need for corrective surgery, or if the mohel left their son with a bad circumcision.)

I wish for every mohel to have smooth bris experiences, so that parents can have smooth bris experiences. But I hope that if not enough skin or membrane is removed in the actual bris moment that the mohel will take the responsibility to put things right immediately and that the baby's parents will find a way to understand that what is being done, while uncomfortable for now, is in the best interest of the baby - he won't remember it, and the parents will enjoy a more perfect circumcision, which will be noticed every time the baby's diaper is opened.

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