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Thursday, March 29, 2012

Being Up Front and Straight

This posting is designed to address all the concerns that have been brought to my attention by a Mr. Anonymous who comments on some of the postings of, bringing up questions and "challenges" that are irrelevant to the post at hand.

If you want to have a conversation, feel free to call or email me. If you want to comment or ask a question that is on topic - that furthers the point in any direction - such a response will be approved. Inasmuch as you are looking for consistency, I ask the same for the conversations here.

Parents looking to hire a mohel have different reasons for choosing the one they end up hiring. I'll leave you to judge which of these seem good, fair and which are coming from a mixed-up sense of priorities.

  • He has an excellent reputation
  • I saw him do my friend's son's bris
  • When I asked for prices, he had the best rate
  • I can relate best to him
  • He did my bris, so it's great that he can do my son's bris too
  • He has a long beard, which indicates how pious he is
  • He does a wonderful service
  • I don't know what results he gets in the circumcision, but man is he funny!
  • People seem to like him
  • The baby doesn't cry when he does the bris
  • He is a really frum mohel
  • He wears a big hat
If I were to hire a mohel (were I not a mohel), the following would be my priorities (not in any specific order):
  • Is the mohel an observant Jew?
  • What is his track record with babies? Is there any history of botched circumcisions, or babies having to go to the hospital post-bris, or needing touch-ups down the road?
  • Does he operate using a sterile technique?
Here is why these questions cover it all:
Is the mohel an observant Jew?
If so, he needed to undergo a training program that assured he is an expert in bris milah laws. It is fair to assume that he is God-fearing (or was at the time of his training, because why else would he go into this field?), and he is aware of the steps of a bris that are mentioned in the Talmud: milah, priah, and metzitzah. How he does each of these, Jewish law wise, is a matter of semantics.
Milah - does he circumcise using a double-edged knife, a single-edged knife, a scalpel blade, or scissors? As the law says that the foreskin needs to be removed and can be done so with just about anything (that will not leave a splinter), even though it mentions some customs and the prevalent custom of using a knife, the specific cutting item need not matter as long as it is done quickly.
Priah - does he use a hemostat or have an incredible method for grabbing the foreskin and membrane together - removing them both at once, or does he do priah with his fingernails separately? Both methods have adequate sources in Rabbinic tradition. What we are looking for is the end result that the membrane is not going to climb back on the glans.
Metzitzah - does he use a sterile pipette, put his mouth directly on the baby, or offer for the father to do it? (of course, the direct mouth on baby approach would be a concern addressed by the sterile technique question). All methods have adequate rabbinic sanctioning. The mohel's view on the need for metzitzah would determine whether it is to be done on Shabbos.

What is his track record with babies? Is there any history of botched circumcisions, or babies having to go to the hospital post-bris, or needing touch-ups down the road?
A guy who does not adequately estimate where the edge of the foreskin is, who consistently takes off too little or too much skin, who leaves behind skin tags that need to be readdressed by a urologist - most often for aesthetic reasons, may want to consider finding a different line of work. 
[Obviously no one is perfect. But someone who has consistent issues, and more often than infrequently, in which results after healing leave an unsightly circumcision, has a real problem. Obviously people are not talking about the issues with their friends. It is important for concerns of this nature to be discussed by potential clients as long as they avoid personal ad hominem attacks and they address the specific point "We needed our son to have corrective surgery after a bris done by so-and-so." Unfortunately, people do not tend to talk about the aftereffects of the bris on their son's penis.]
Does he operate using a sterile technique?
If he does, I know no part of the bris can possibly cause my son to get an infection. A person who does not wear sterile gloves when operating, or who puts his mouth on the baby's open wound, opens the door to possible negative results which are completely avoidable, and which, frankly, are inexcusable.

1 comment:

  1. The original source is Rav Hai Gaon: see the middle of the section about the Bronstein Clamp in this article by Rabbi Howard Jachter:

    I send an email to all people who "hire" me which includes this link:
    My method, which describes using a shield and either a hemostat or the hands to do the "tfisah and priah" could be done whichever way parents prefer. As I was trained to do milah and priah separately I can certainly provide that service were it requested.


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