An Act of Faith

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

As I noted here, Maimonides goes into intricate detail of his view as to why we circumcise our sons. And while one may or may not like his arguments (some of them - certainly when taken out of context, and in either case when not taken in the overall picture of Maimonides' worldview - might be easily misunderstood), I think his view can best be summarized in this one sentence.

No one, however, should circumcise himself or his son for any other reason but pure faith.

It really is as simple as that.

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

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

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

News Monitor: the circumcision debate

This debate has been ongoing for many decades, with medical views going back and forth on the subject of "to circ or not to circ." This is the latest installment (text embedded below).

As always, this is irrelevant to the Jewish people on account of it merely being a footnote to why we do what we do.

But the STD concern is real.

See also this article and newsreel from today.com

Wild Opinion Piece

Haaretz published an opinion piece that is so wild, it is indicative of where some elements of the Jewish world are headed. (Reproduced below in case it gets lost behind a paywall.)

  A few false assumptions at the end (the suggested paradox), and then of course, this line:

 Here are the facts: there is no Jewish death penalty. We do not put out eyes or cut off hands. There are no rabbinic executioners, or people who amputate limbs for violations of Jewish law. All that are left are the mohalim – those who are specially trained to perform circumcisions." 

 We never put out eyes or cut off hands in all of our history (an eye for an eye was always interpreted to be a monetary punishment). And the Talmud flatly rejects death penalties, for all cases except murder, and even winces at the suggestion that we have such a right in murder cases.

But there is no evidence anywhere prior to the advent of Reform Jewry (which today has Berit Milah Boards and hundreds of certified mohels) as well as post-modern liberal (read emotional and not intellectual or religious) "Jewish" thinking which supported such a notion that Bris Milah is to be rejected. The Talmud unabashedly praised Bris Milah assigning it numerous Covenants, blessings and rewards, as well as saying that when the Jewish people sacrificed for it (as we have for millenia), it was maintained in our ranks.

  The Covenant has always reigned supreme.

Achieving Perfection

Every mohel worth his sense tries to get a perfect circumcision every time. Some estimate the foreskin - others (I wish it were many more) use a surgical marker to note where the edge of the foreskin is (I offer for parents to see what this refers to when we meet in advance of the bris).

Any circumcision must account for a little bit of human imperfection - and I love quoting the line of the urologist grandfather who told me, "The penis is a very forgiving organ" meaning that for all the circumcisions that don't look perfect that he sees, most turn out fine on account of the way this organ heals over time.

While I have had my share of "perfect jobs," it would be dishonest for me (or any mohel, or any surgeon) to say that EVERY procedure goes perfectly without a hitch. Many do. But there are those that are a little more complicated. Thankfully, many "hitches" (when they occur) can be corrected, and I try to fix them ASAP after the bris. 

So what is referred to by "Achieving Perfection?"

It is the instruction given to Avraham at his bris! "Avraham - walk before me and become perfect" (some translate perfect as "complete." The Hebrew word is "Tamim" = תמים.)

The perspective of Jews that have always embraced circumcision as a mitzvah is that the act of circumcision makes the Jewish male complete.

[The thought process continues suggesting that women do not need a circumcision because they are created physically complete.]

Anti-circumcision people sometimes argue that a baby is born perfect. What gives us the right to do anything to the child.

It is a good argument. But it is ignorant of Jewish knowledge. Which is why we ignore it.

Parents cut umbilical cords, they cut hair, they cut fingernails, they clean out earwax, they pierce ears, they put injections, blood tests, and in some cases choose surgery as an option for either an emergency reason, or, in some cases, a cosmetic reason (yes! even on babies!). 

So we will continue to aim to achieve the perfection God spoke of in Genesis 17 (and we will not yell at anyone who cuts a "natural" umbilical cord off of its baby owner). That is our goal when we undertake the Bris Milah.

Maimonides on the Reasons for Circumcising II

This is not as much a blog post as it is an attempt at providing a source which has been misused, mistreated, misunderstood, etc. by people looking to sling bris milah under the bridge, and to bury it in mud. 

The previous blog post says all we need to know about Maimonides' view of circumcision. 

This excerpt includes a couple of paragraphs from Maimonides's introductions to "The Guide to the Perplexed" as well as the entirety of the passage which includes to oft-quoted segment in which Maimonides describes what the loss of the foreskin does to a man. 

Of course, as the entire book was written systematically, it is imperative that the paragraph in question NOT be read alone and out of context. It MUST be read in the context of the section being presented here: 3:49 of The Guide - interestingly, this section is entitled "Marriage Laws." 

Maimonides warned in his Introduction that he is talking to the religious person, and to the, in some cases, one intelligent person amongst ten thousand fools. Translation: Not everyone who reads The Guide will understand it. And people who misunderstand it (or who take it out of context) might be included in the group of ten thousand. 

The point of sharing this is simply to be intellectually honest. People who read what they want, and become Maimonideans for an out-of-context quote are not intellectually honest. You can't pick and choose. At least an attempt at consistency is warranted. And to use Maimoindes to bolster your argument, you MUST ALSO KNOW WHAT HE IS TALKING ABOUT, and understand the point he is trying to make, in its totality. What Maimonides says about circumcision is to benefit marriages. And he was preaching to the choir. So, once again, if you don't like circumcision in general, please vent your frustrations elsewhere. 

 All the translations here come from the Friedlander translation, which is available online over here: http://www.sacred-texts.com/jud/gfp/gfp003.htm 

 Anything in bold or italicized from here on is my emphasis. With the exception of a very rare comment here and there, the rest of this very lengthy treatise is Maimonides' words (translated) 

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.

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!

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.

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?

Emotions Vs Intellect Vs God's Law (Part I)

[At the risk of sounding repetitive - I've addressed some of these issues in this posting, using a different tone, albeit a similar point of view]

I came across an interesting article - the woman's personal story is intriguing, and the conflict she faces for herself is fascinating. You can read it here. As I was reading the article, it occured to me that if the "comments" section were open to the world, it would likely generate much feedback. And surely, as of this writing, there are over 300 comments.

While I only looked at the first page of comments (who has time for all that?) it became clear to me that not only does the author not understand why we do this, but all the negative commenters are also equally misguided.

The debate over whether circumcision is "mutilation" will probably go on forever. I've addressed it peripherally in this blog in the past. And, as this is a "pro-bris website" (as opposed to a pro-circumcision website), I would like to suggest reasons for why we do this, why we go through the ritual, the ceremony, and why our attitude need not echo or mirror the cynical ways of those who write negatively of "bris milah," who arrogantly believe that their own logic and emotions are wiser than thousands of years of Jewish tradition, which is grounded in a faith that brought monotheism (God) to the world.

Monitoring the News

There are some crusades which are just a little too reminiscent of bad stages in Jewish history. (It is ironic that this story came out in the weeks prior to Hanukkah - see the third sentence here as well)

There is a man in San Francisco who is reportedly gathering signatures for a petition to make it illegal to circumcise minors - which of course translates to anyone under the age of 18. The petition will merely allow the issue to be put to a general vote in the near future, which can always lose at the ballot box. But in San Francisco, who knows what can happen?

I am not going to go into the legalities beyond suggesting that such a ban is unconstitutional simply because it would step on the toes of religious freedom (for those religions such as Judaism that require circumcision), and also puts the law into people's private lives in a way that seems to be illegal according to US law.

Bris For Conversion

There are a few occasions that would warrant what is called in rabbinic terminology "Milah L'Shem Geirut" - מילה לשם גירות - circumcision for the sake of conversion.

1. When a Jewish couple adopts a non-Jewish baby and are committed to raising him according to their lifestyle.

2. When a couple converts to Judaism, and their children convert along with them. Any males who have not been circumcised - from father to adult children to babies - require such a circumcision.

What Makes a Jew

When I was studying to be a mohel in Israel, one kind of experience was repeated at many brisses.

As my teacher, Rabbi Mordechai Sasson, is a Sephardic mohel, most of the brisses he'd perform would be for Sephardic Jews, who have a rich cultural heritage which brings the entire family and community into every bris. (or should I say "brit"?)

Typically, after the ceremony was over and Rabbi Sasson was doing his post-op examination, some old-school grandmother or great-aunt would smilingly look upon the now circumcised baby and say עכשיו נהיית יהודי (akhshav nih'yayta yehudi) - "Now you have become a Jew."

Huh?

This concept may be true in other religions (e.g. before baptism, a Christian child is not a Christian), but in Judaism, one's Jewishness stems from one's birth mother. If the mother is a Jew, the child that emerges is a Jew. Consider girls, who are thankfully not circumcised. How are they to "become" Jews if circumcision is what makes a Jew?

Circumcision does not make a person a Jew.

While this blog is not the forum for discussing the rules surrounding conversion and the Reform practice of accepting people as Jews based on patrilineal descent, I am here to discuss the role of circumcision in all of these procedures.

Judaism manifests itself in Jews in two ways - nationally and religiously - and both are meant to be informed and enlightened by the totality of what we call "Torah" (not just the Five Books of Moses). According to Jewish law, the national element is given to a person at birth and can never be revoked (except in very extreme cases of apostasy). The religious component has always been a question of individual practice - there have always been Jews who were more observant of the law and the Torah's guidelines and Jews who were less observant of the law and the Torah's guidelines.

Religion

In the last few hundred years, there have been different movements in Judaism who defined new ways to experience the "religious" element of their Judaism (in no particular order): Hassidim (and all its branches and extremes), Maskilim, Reform (and all its branches and extremes), Conservative (and all its branches and extremes), Orthodox (and all its branches and extremes), Reconstructionist, BILU, New-wave, Humanist, Traditional, Cultural, non-affiliated (the list is surely not exhaustive).

Most continue to circumcise their sons. Some do not.

National

On the national level, a Jew should ideally feel a sense of camaraderie with other Jews. (Yesterday was Yom HaShoah - I have long advocated that if Hitler did not distinguish between Jews, why should we treat other Jews in any manner other than respectfully?) Some people express this through their family name, through a "Jewish feeling," culturally, identifying with other Jews ('some of my best friends are Jews!'), identifying with the land of Israel, the State of Israel, the people of Israel, Yiddish theater, eating "Jewish food," etc.

Most continue to circumcise their sons. Some do not.

Bottom Line

According to all Jewish approaches, if a child is born to a direct maternal-line of Jews, the child is Jewish, regardless of levels of observance. (The questions arise when a conversion took place in that maternal line, as to what were the circumstances of the conversion.)

The circumcision the boys undergo puts a mark on the flesh that is the symbol of the covenant God made with Abraham in Genesis 17.

When a male non-Jew decides to go through the process of conversion, he may undergo circumcision (if he was not circumcised as a child) or an equivalent procedure significance-wise (if he is already circumcised), but the circumcision is not what makes him a Jew, though it is part of the process and his conversion would be incomplete without it.

Any person who converts undergoes a program of study, and is dutifully tested for sincerity and commitment to the Jewish faith, and subsequently immerses in a mikveh, under the auspices of a Bet Din to complete the conversion.

Hatafat Dam Brit

With the holiday of Pesach (Passover) approaching, it is appropriate to discuss the connections that bris shares with the holiday - and there are many.

One of them is the role of blood in the covenant.

The name of the holiday of Pesach comes from two sources: A. the Paschal lamb, the offering that was set aside for three days before being sacrificed and eaten by the Jewish people in Egypt, and B. the fact that God "passed over" the homes of the Hebrew slaves in Egypt on the night of the "Death of the First Born."

The Paschal Lamb is called the קרבן פסח - Korban Pesach, and the verb to "pass over" is פסח - Pasach - which is formulated slightly different in the name of the lamb and the holiday itself.

What caused God, or the destroying angel, or the death force to pass over the homes of the Hebrew slaves, the Israelites? If the edict against first borns was only against Egyptians, did the Israelites really need to do anything in order to be bypassed?

The answer to the first question is the blood of the lamb. The Israelites were instructed to put the blood of the lamb on the doorposts and mantle of their homes on the evening of the final plague to cause their houses to be skipped.

The second question is a trick question. Surely God knows the difference between the homes of those He is looking to punish and those He wishes to avoid. That is clear. But the Israelites needed to do something, to indicate they understood what was going on. They needed to show their faith in God, and in Egypt, on that night, their faith was demonstrated through following instructions.

Thus, in Egypt, the people were physically and symbolically saved through the merit of the blood of the Paschal lamb.

While the greater significance of blood is not the scope of this posting - there is much written about it in rabbinic teachings - the general significance of blood is that covenants are forged through it.

To our point - bloodless circumcisions, medical circumcisions and circumcisions pre-conversion

In the event that a baby is circumcised through a bloodless technique - which can be accomplished through the use of certain clamps - the bris is not considered to be "kosher." (This point is worthy of discussion, and I will return to it in a different posting) Of course, once the baby is circumcised, (hopefully) there is no more circumcision to be done.

Circumcisions done either not for the sake of a bris (ie by a doctor), before the eighth day of life, or by a non-Jewish officiant are all not considered to be "covenantal." In order to turn the "circ" into a "bris milah" a minor procedure involving the drawing of blood needs to take place under the proper auspices.

We draw a minimal amount of blood from the circumcision scar, typically using a medical lancet, the sterile pin used for blood tests. Once blood is drawn under the auspices of a bris ceremony, the circumcision is now considered to be a bris according to Jewish law.

(To bring an example from a different religion, and NOT TO COMPARE THE TWO RITUALS, you can pour as much water as you want onto a baby or a convert to Catholicism. But until the water comes in the form of baptism and is done by the right person in the right place, it is considered meaningless.)

The blood we are talking about is absolutely minimal. Most people who experience it as adults (converts, or those who discover they were circumcised in the hospital and want to make sure it is "corrected") feel the significance more than they feel the pin-prick that draws the blood.

Babies upon whom I have done this are usually smiling and cooing through the half second it takes.  Healing time is virtually nothing.

What Will It Look Like Before and Afterwards?

I try to leave graphic images out of this blog, so I will do my best to explain here what the penis looks like before and after the bris.

BEFORE

Take a look at your baby! Now you know how it looks before the bris!

Just kidding.

The uncircumcised shaft of the penis looks like an inverted hourglass. It is thinner as it hits the scrotum, and thinner at the tip, but significantly fatter in the middle. The reason for this is because the glans, the part of the penis which is revealed after the circumcision, is hidden underneath the foreskin. Were you to slowly (and gently) pinch the tip of the penis, you'd see the "bump" in the middle of the shaft move it's way towards the scrotum. Let go of the tip of the penis, and the bump will slide back to its natural position. That bump is the outer edge of the glans - usually the 1/3 or midway point of a baby's penis.

THE FORESKIN

The foreskin (a.k.a. "prepuce") is an outer coating which covers the glans. It covers around half of the shaft. As only the foreskin is removed during circumcision, when the glans is revealed, one can easily see (contrary to popular culture's 'complaint') that the penis is not "smaller" - it just looks different.

[While I won't put the photo in the actual blog - I believe you can get the idea of what this all means when you look at this photo of a circumcised banana.]

AFTER

Before you read this section, understand that most circumcisions do not necessarily turn out exactly the same. All babies are different, and may have different "surprises" under their foreskins, which are not usually detected until after the circumcision itself.

For example, every baby has a differently shaped glans. Thus the first thing you see will look different from child to child.

Secondly, some babies have a minimal mucosal membrane underneath the foreskin, which might completely come off as well during the circumcision. Others have much more membrane with a significant amount left over after the bris, even if it is no longer coating the glans. Still others have significant tissue webbing, which would be undetected until the foreskin is removed. Depending on the extent of the webbing, it may need to be removed separately after the circumcision.

THREE SECTIONS

After the circumcision, one can usually identify three distinct sections on the circumcised penis.

SECTION #1: THE GLANS is the first things you see. It is the tip of the penis, and it almost looks like an army helmet - were the shaft to be standing upright.

A kosher bris consists of the farther rim of the glans being completely revealed, visible, and distinct, with no skin tags attached to it, and nothing hampering its distinct view.

It is usually a very deep, dark, raw RED COLOR (though it is sometimes PURPLE).

SECTION #2: THE MEMBRANE may or may not be completely removed in the bris process. If some of it remains, it may be slightly swollen, and may seem a little puffy below the glans.

Like the glans, it is typically a dark RED COLOR, though it does not usually have the same deep color of the glans. It will also look raw.

If the Membrane is completely removed, the area below the glans will look empty, but there will usually be a gap of a couple of millimeters between the glans and...

SECTION #3: The SPOT OF THE INCISION. This is the spot on the skin itself where the foreskin ended - or at least where the mohel estimated the foreskin ended. Ideally, the incision mark will be fairly close to the glans - but depending on the size of the baby's shaft, the mohel may have found the need to remove more or less skin in order to avoid future problems which may come from the glans falling back into the shaft and/or scrotum.

Dr. Neil Pollock - a very busy circumciser in Vancouver, has detailed information about this on his website. Feel free to read through the information he has - it can be found here [Start with the "Parents Guide to Circumcision" and move on from there!]

WHAT YOU WILL SEE

Aside from the dark red colors and the swelling, the scab tissue which sometimes develops in the area will typically be of a yellowish/ greenish hue. This is normal.

It is not advisable to pick at this, or to rub it as it will only cause the penis to bleed. A warm bath is good and promotes healing. Otherwise, like any scab, it is best to put bacitracin on it for a few days and then stop using ointments when the danger of infection is gone and it just needs to continue healing on its own.

Bris v. Circumcision

No - it's not one of those landmark Supreme Court cases.
But it is a question that comes up a lot: What's the difference between a circumcision and a bris? Isn't a bris just a souped up circumcision?

It is true that a bris contains a circumcision as part of its process, but a circumcision alone does not a bris make.

Circumcision

Male circumcision is the removal of some or all of the foreskin (prepuce) from the penis. (I got the concise definition from wikipedia, though the page has graphic images I don't recommend for the sensitive...)

Bris

A Bris includes the circumcision (though it would more accurately remove all of the foreskin), but also has ritualistic components as well as religious significance that is extremely important for the history and continuity of the Jewish people.

This is not the forum to respond to anti-circumcision people - so don't expect that here.

Do a google search of "anti-circumcision" or "against circumcision" and you will find hundreds of websites and millions of hits. This is not our issue. I assume you are looking to circumcise your son, just don't know if it would be better to do it with a doctor in the hospital or with a mohel in a bris ceremony.

A Medical Circumcision...

...consists of either an operating room procedure or an office procedure. Depending on who does it and how much pride the person takes in the outcome, and in his/her relationship with the baby and his family, you can get all kinds of different outcomes.

Doctors will use all different kinds of methods - some which produce excellent cosmetic results, some which produce shoddy results.

In cases where parents sign a waiver allowing hospitals to take care of the circumcision, unless they request otherwise, there is a good chance that a medical student will be operating, for the first time, on their baby.

Local anesthetic may or may not be used, and depending on the method of choice, the baby might be in a degree of discomfort for between 7 to 30 minutes.

Cosmetic results will differ based on the skills of the operator. A doctor who does many of these procedures will usually have it down to a science and should produce wonderful cosmetic results. Otherwise, you are at your own risk.

I have been inside operating rooms in which the surgeon took pride in his work, took the time, marked the foreskin, and made a clean and even incision, gently and carefully, all around the circumference of the glans.

I have also been in the operating room when the child in question was put "out" for a hernia operation, and the choice was made to do the circumcision at the same time, while the baby was under general anesthesia. In my own observation, while the doctor may have taken all the time in the world to do the hernia properly, the circumcision was an afterthought, and was treated as such. No mark, quick snip (forgive me), and a suture job afterwards that was not to my satisfaction. Argument: "It's only a 'circ.' What's your problem?" My problem is that it isn't "only" a circ.

A Bris...

... takes much less time. Depending on the operator, he may use a bronstein (Mogen) clamp or a Traditional Jewish shield, but will usually finish the procedural (circumcision) component in under a minute.

A bris requires the entire foreskin to be removed, as well as the mucosal membrane beneath the foreskin to be completely removed from the circumference of the glans. In addition to being the fulfillment of the requirement, this will inevitably produce a more asthetically pleasing result.

Not that we're doing this for asthetics.

The circumcision carries with it the promise made by God to Abraham in Genesis 17 that He will be the exclusive God for Abraham's descendants (defined in Genesis 15 as those who descended to Egypt, and ultimately experienced the Exodus and Revelation at Sinai - the Children of Israel) if they bear the mark of the covenant in their male offsprings' flesh.

For the Jewish people, this prospect of being "the firstborn of God" (see 4:22) is highly significant.

The Bris Ceremony makes reference to Biblical defenders of the faith, who outwardly defended the covenant and the concept of circumcision - Abraham, Pinchas, and Elijah the Prophet. It includes prayers to God on behalf of the operator (mohel), the father of the baby, the sandak (who holds the baby during the bris), and, most importantly, the baby - that he should experience his circumcision with minimal pain and discomfort and that he should heal speedily.

There is symbolism in the blood that emerges from the incision (compare this to the blood on the doorposts (12:7-13) that was used to effect the "Passover" event)

There are blessings that are recited invoking God, the covenant, and national significance for all the Jewish people.

The baby is given his name in ceremonial fashion, with a cup of wine - just as we have for kiddush on Sabbath and holidays, and at other important ceremonies such as a wedding.

And, perhaps most significantly, friends and family gather together to celebrate the arrival of the baby, the continuing of a tradition, and the continuity of the Jewish people.

I conclude with the words I've already written in this posting

The doctor v mohel question is for a different discussion - it has been addressed in the second half of this posting.

Methods of Circumcision

Most parents looking to have their son circumcised just want it to be done as efficiently as possible, as speedily as possible, with minimal pain to the baby.

Of course they'd prefer the circumcision be aesthetically pleasing, and that the circumcision heals sooner than later with no complications.

When doing research about ANY mohel, the end results are important. (I've written elsewhere about the demeanor and the ceremony and the need for things to be done at your speed.) And most people leave the method to achieving those end results up to the mohel, and how he feels most comfortable getting there.

However, there is not "only" one way to circumcise. And if it is important to you, it is important to ask about methods, and to inquire if the mohel can accomodate your desires.

Please note that I use Method #2 presented below and as described at the end of this post.

There are some methods which are questionable according to some (in some cases, many) rabbinic opinions. There are others which are standard - even if the "innovation" in them is "only" hundreds of years old. And there is old-school, bare bones (literally), which is advocated by few.

Sadly, those who advocate the latter method often knock everyone else, even going so far as to declare other circumcisions "unkosher" and requiring hatafat dam brit - a ceremonial drawing of blood from the circumcision scar that would "kosherize" the bris. This is not only a form of lashon hara and rechilut (talebearing), but is a lie, a form of fear-mongering, and does nothing but increase hatred amongst Jews.

Hmmmmm. That last paragraph was a mouthful. Take a deep breath and let's move on to methods:

INTRODUCTION

Bris Milah has three steps:
1. Milah - the removal of the foreskin
2. Priah - the removal of the membrane that is found between the foreskin and the glans
3. Metzitzah - drawing of "distant" blood

The foreskin is drawn forward and removed. The membrane is often removed with the foreskin. If it is not completely removed, then it is torn and folded back beyond the glans. Finally, blood is drawn from the wound.

In the interest of space, the methods described will not include metzitzah, which will be the subject of different posts.

And I will leave the issue of whether the mohel is wearing gloves up to you, the parents, as well. I've addressed this in a number of posts already. [Search "sterility" in the keywords]

Method #1. Clamp

The foreskin and membrane are grasped with a hemostat and a clamp is applied to the foreskin. There are two kinds of clamps that have been utilized by mohels over the last sixty years. The first is the Gomco (on the right in the photo), which is often the method of choice for doctors in hospitals, but is not largely used by mohels. The second is the Mogen or Bronstein clamp (on the left), which is the method of choice for many mohels in the US (though most Orthodox mohels, including me, do NOT use it). The foreskin and membrane are then removed together in one incision, with a scalpel or bris knife.

Method #2. Shield

The foreskin and membrane are grasped either with a hemostat (as in method #1) or skillfully with the fingers. A metal plate with a thin slit is applied to the foreskin, leaving the foreskin resting above the plate, with the glans safely shielded below. A scalpel or bris knife is used to excise the foreskin.

If the membrane is removed along with the foreskin, metzitzah follows.
If the membrane is not completely removed along with the foreskin, it will either be cut with scissors, or the mohel will tear it with his sharpened thumbnails - in both cases to reveal the entire glans.

Method #3. Free hand

Without using any device other than a blade, the mohel will estimate the length of the foreskin, grasp it with the thumb and forefinger of one hand and excise the foreskin with the knife in his other hand.

Membrane removal will follow that of method #2. Metzitzah will follow.

PROS AND CONS OF THE METHODS

Obviously, the "con" of the baby having skin tissue removed and being subject to the pain of circumcision, and any bleeding are a given. If you are having your baby circumcised, it is assumed you understand that this is the down side (if you even view it as a downside) of the spiritual, national and Jewish significance attached to this procedure - which is the fulfillment of a commandment.

The pro: Baby bears the mark of the covenant established between God and Abraham, and all of the Jewish people, which established God as our only God, and we, the Jewish people, as His firstborn, the chosen people who have a mission on this earth to spread monotheism and ethics to as many people as we can.

Pros and Cons of #1 (Clamp)

Benefits include:
* Usually a bloodless circumcision.
* The mohel may not even need to use a bandage.
* If applied correctly, the glans is protected.

Cons:
* Usually a bloodless circumcision. (Blood is an essential element of the bris)
* Estimating the end of the foreskin along the shaft is inexact
* The FDA has issued severe warnings about the use of the clamp, as it could grasp and amputate the glans or the tip of the glans.
* The pain of the crushing of the foreskin is immense
* Once the clamping mechanism is applied, the estimation of the foreskin is irreversible. Even if one were to remove the clamp and then reapply it correctly before excising the skin, the skin tissue that remains would be dead, and would liekly either become the equivalent of a growth or fall off on its own.

* In order to achieve its desired effect, the clamp usually needs to be on for a significant amount of time - from 30 seconds to five or ten minutes. This is significantly longer than the next methods which take 3-4 seconds.
* Rabbinic approval is scant.

While Reform and Conservative mohels will often use this device, Orthodox mohels who use it usually do not have rabbinic dispensation to do so. Many will use it out of their own convenience (in other words, not because they have the baby's best interests in mind) so they need not come back and check the baby. This is not nice - every baby should be checked after the bris. No matter the method used.
Those who use it usually swear by it. I think they feel this way because of the lack of necessity to follow-up. But I may be wrong.

Pros and Cons of #2 (Shield)

Pros:
Quick procedure
* There is blood (necessary component of the bris)
* No chance of anything happening to the glans
* Until the actual incision is made, nothing is irreversible

Cons:
* Estimating the end of the foreskin along the shaft is inexact
* While the foreskin is not crushed, it is squeezed tightly for a few seconds.

The shield is an innovation which dates back at least four hundred years. It's purpose was (and remains) to protect the glans which is at great risk of being cut or amputated when a bris is done by anyone other than an extremely skilled operator. Like in the previous method, once the shield is in place, the actual removal of the foreskin - cutting along the shield, is the easiest part of the job.

Pros and Cons of #3 (Free-hand)

Pros:
* Quickest procedure
* Relatively painless

Cons:
* Estimating the end of the foreskin along the shaft is inexact
* There is no chance to second guess because the mohel never gives himself a chance to double check before excising the foreskin
* The possibility exists that the blade might cut the glans
* If done by anyone other than a skilled operator, the outcomes could be disastrous

The only people who still do brisses this way are some Chassidic Jews. While each person is entitled to have an opinion, those who do it this way are the most outspoken about - and against - any other form of circumcision.

THEREFORE

You may have noticed that the con that reads "Estimating the end of the foreskin along the shaft is inexact" was on every "con list." This is because many mohels were never taught to use a surgical pen to mark the edge of the foreskin before beginning the procedure. If the mohel's initial estimation is marked with a pen or marker, the "con" is removed from each list, as long as the mohel makes sure to cut along the mark.

I wrote about pain in the last few sections of this post. In simple terms, I think it is important to numb the area before the bris, but I think injections are not the way to go about doing it. There are topical methods out there that do just as good a job, and don't cause the baby pain from three "shots."

My Method

In addition to marking the end of the foreskin, I use Method #2 for a host of reasons. While I personally do not agree with methods #1 and #3, I believe that the bris is kosher if the operator is fit to be a mohel. I also think that parents should know what they are getting in to when hiring a mohel, and that the method which best suits your needs should be employed for your son.

When I circumcise, I aim to remove the foreskin and membrane at the same time, to minimize pain to the baby and the need to bother him too much. I always check the baby later, either a few hours after, the evening after, or the day after the bris. I wear gloves. I package all my instruments and bandages and sterilize everything in an autoclave machine - unless it is sterile in its packaging, e.g. gloves and drapes.

I hope this has been helpful to you. As always, feel free to contact me by email with any questions, or call me

Bris Humor

Here is a quote from Rabbi Joseph Telushkin's "Jewish Wisdom," p. 141 (William Morrow, 1994)

“My friend Rabbi Jack Riemer of Miami likewise expresses great exasperation at the obscene jokes that frequently are told by people attending a circumcision. Turning the sacred ceremony through which a male Jewish baby enters the covenant into a source for ribald humor demonstrates how obscenity can desecrate the sense of the sacred. For if entering the covenant is turned into a source of jokes, then the covenant itself eventually will be treated as a joke.”

The sentiment is so true. (I only disagree in that I believe the boy enters the covenant when he emerges from his Jewish mother, as does a baby girl who will never be circumcised, when she emerges from her Jewish mother. The boy bears the mark of the covenant, the sign of the bris (אות ברית) at his circumcision.)

The covenant is critical to the definition of the Jewish people. If we disregard or make light of it, it will become meaningless.

At just about every bris at least one person will approach me to see if I've "ever heard this one." One of my colleagues likes to say, "I have respect for that joke, because it's older than you and me combined."

It is a rare occasion when someone tells a joke related to bris that I have not heard.

It is even more rare if the joke I am told is appropriate and worthy of being repeated.

Let us save our inappropriate humor for a night on the town, and minimally preserve our dignity when we have the chance to show the utmost respect for our tradition and heritage.

Why not?

Covenants in the Torah

In the weekly Torah portion, we have entered the territory in which most of the covenants between God and humans were forged.

The first covenant is forged using the rainbow as a sign: Genesis 9:12, 15
The rainbow serves as a reminder that all of humanity will never again be destroyed with water. This covenant is between God and all of humanity

The second covenant is made over the mark of circumcision: Genesis 17:10-11 (read the whole chapter!)
This is between God and Abraham's descendants and household (Abraham passes on the tradition of this covenant to his son in Genesis 21)

The third covenant is created through the Shabbat: Exodus 31:13-17
This covenant is between God and the Children of Israel.

The rainbow, circumcision and Shabbat serve as a sign (אות) of God's role and involvement in the world. Circumcision and Shabbat serve as a mark of the special connection the Jewish people have with God.

On one hand, this is a very cursory view of these covenants, but on the other hand, for the God-fearing believer, these are very deep concepts.

The rainbow is external - it is for all of humanity.
Circumcision (as a covenant) is a one time deal which is difficult when it happens, but you don't really notice it beyond that. It is for Abraham's descendants and his household, not as general as the covenant of the rainbow.
Shabbat is, for the uninitiated, more difficult, more taxing, more long-term commitments, and it involves the entire body, on a weekly basis, and is exclusively for the Children of Israel.

We go from very general to very specific. What does this say about God? What does it say about different peoples?