Communication... Will They Lead to A Bris?

When I lived in New York, the traffic of brisses came from a very simple formula.

A couple had a baby, and they called me. They had heard of me, seen me, had friends, knew what they wanted for months, etc. It was VERY rare that someone would call in advance of their son's birth to interview me or to "inquire."

In Florida, I find a very different clientele. I get calls or emails MONTHS in advance. In some cases people are doing research. Asking all the right questions (see links in this post), trying to find the right match.

Some people are getting the lay of the land - perhaps even thinking if they want to go the Mohel route or the Doctor route (see the previous posting!).

Some people are just looking for the best price. (Which is hard to determine in my case, because I don't really have a price)

Some people call when baby is born. Some do not. I am told by some of my colleagues that they have similar experiences all the time.

Other than the calls that will come out of the blue, I have somewhere close to 10 people who have called about my availability over the next few months. We shall see if they call when baby arrives!

God should only bless them with healthy babies.

News monitor: botched circ, not botched bris!

It's not a bris story, but it is a circumcision story.

See here or keep reading

CHICAGO FAMILY WINS $1.3M JUDGMENT FOR SON'S BOTCHED CIRCUMCISION

In 2007, one Chicago family underwent a nightmare at Northwestern hospital: their newborn son’s circumcision went awry, with a doctor amputating the tip of the boy’s penis. According to a lawyer for the family, Dan Kotin, the doctor missed three safety procedures that should have been followed. According to Kotin, the boy lost “the top 40 percent of the head of his penis.”

The doctor’s attorney argued that this was a predictable complication of circumcision, to which Kotin responded, “If that were a known complication to a circumcision procedure, I suggest to you that nobody would dare have a circumcision done because it would be too risky.”

The jury awarded the family $1.3 million in damages.

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Someone recently told me that a certain doctor (pediatric urologist) claims to hear of one case like this a year when a mohel does a circumcision with the traditional shield.

I've spoken to mohels and doctors and all agree this is likely untrue. If the mohel (or any operator) is using any kid of clamp, however, the chances are significantly greater that this could happen.

The person who told me of this doctor said it makes the doctor really angry. If it's true, it should. But the above article is a case in point to the surveyed opinion I have heard from doctors who do touch up work, that errors in circs are more often committed by doctors - OB-GYNs and pediatricians. So I wonder if the doctor from the conversation is anti-Semitic, hates mohels, is making things up, or if he actually has proof.

Are mohels perfect? Who is? But the competent mohels remove the right amount of foreskin and certainly protect the glans.

For clarification as to the differences between a traditional shield v the Mogen Clamp, see this posting.

Honesty From Your Mohel

Please note: This is not "confessions of a mohel." This is sharing of information, in which I try to be realistic about the pluses and minuses of the bris experience - with whichever mohel you may one day hire.

This blog was born after years of looking at different mohels' websites and finding them to be largely the same. Of course every mohel has a different style, and (obviously) a different web designer, but between explaining the "Order of the Bris," the "Honors/Kibbudim" and, every now and then a "Frequently Asked Questions" page, most of the websites offered little to no information beyond what the particular mohel wants people to know.

But over the years I have been asked MANY questions. Some are fairly simple and common, and some are much more complicated. Because as much as circumcision is a relatively minor surgery, the organ upon which it is done is not "minor," the nature of the procedure in question is quite sensitive - physically AND emotionally, and, perhaps most importantly, the results of the procedure (NOT the ceremony) will last a lifetime, and will be something parents will encounter every day, until the child realizes what privacy is, and from then on HE will encounter the results every day.

[Some people only realize afterwards how much the personality of the mohel, and perhaps how the way he personally experiences his Judaism informs how he runs the ceremony and perhaps relates to people, is also important to them!]

I have met many men who have confided in me that they are not sure if their mohel did a good job. Everything usually "works" but they don't like how it looks or think something is awry. But because it's embarrassing to discuss or address (who really wants to have a cosmetic touch up?), most do nothing about it. Except mention it in confidence to a friendly mohel - who is in the field, but is not interested in rendering an opinion nor is he in a position to do anything about it.

Some mohels have communicated with me how helpful they find this website to be. Others have communicated their opinion that I offer too much information and scare parents away.

To the former I say thank you, and to the latter I respectfully disagree. We live in the Information Age when people find whatever they need to know with a few clicks on a keyboard. And so I have tried to provide information on both extremes, and everywhere in between, so people can have a good understanding of how things can go perfectly, how there could be a few bumps on the road (including this error that some mohels are not careful to avoid) and how much care and thought people need to put into their research and decision making.

And if people choose not to hire me because I am honest and say I am imperfect, so be it.

When I lived in NY, a pediatric surgeon told me he had done touch up work on babies circumcised by every mohel in NY. Even the BEST of the BEST. Here in Florida, a pediatrician and a pediatric surgeon (2 different people) have shared similar statistics. 

NOONE is perfect. And parents, who are often doing research for their mohel on a very limited time frame (too often people wait until after the baby is born, at which time they have only 7 days until the bris), don't have the time to ask ALL the important questions to make sure the mohel they are talking to is exactly what they are looking for. Sometimes, they don't even know what that means.

I take the precautions to make sure I can deliver as close-to-perfect a job as I can. I double check afterwards to make sure everything looks as good as I can get it to look. I try to be as sensitive to your baby as I can, and to give you as much respect, courtesy, and straightforward information as I can. I want you to know what is happening and what has happened to your baby. The ceremony is flexible, depending on your background, your crowd, the setting, your level of observance, and any number of factors that weigh into your personal situation.

And the results show. I meet many babies months after their bris, and their parents are happy, and the babies don't remember a thing. They smile at me, coo at me, and have no ill will.

With the exception of one case where an anatomical abnormality was uncovered once the foreskin was removed (it was not evident while the foreskin was present), I am unaware of any touch-up surgeries that followed my brisses, on account of the precautions I take (the case I mentioned needed a surgery irrespective of the circumcision). Does it mean every circumcision turns out the same? No. And that I am unaware of touch-ups does not mean they never happened. I simply don't know. But most mohels will not say that "it sometimes happens." It's actually a lot more common when an OB-GYN does the circumcision, but it does happen to mohels too. Nobody is perfect.

There you have it. Up front and straight. Everything on the table. From a mohel who is honest with you, who will communicate with you, and who will do the best he can to give you and your baby a positively memorable experience - with the main positive memory being a satisfactory result that you and baby will be happy with for the rest of his life.

May A Bris Take Place At Night?

I've addressed this question in simple terms over here, when we discussed how to time when the bris will take place, along with the notion that the bris should take place while the sun is out.

But I came across the question in Yossele Wesiberg's magnum opus on Bris Milah (Volume I page 154), where he records 4 possible answers:

1. One would not fulfill the mitzvah and there would be a requirement to draw out blood for the covenant (Hatafas dam)

2. One does not fulfill the mitzvah and even Hatafas Dam would not change any status. It is an error that cannot be corrected.

3. One has nonetheless fulfilled one's obligation, with no requirement at all for Hatafas Dam

4. If it was on the night of the eighth day, no Hatafas Dam is required. Any other night would require Hatafas Dam.

Generally speaking, however, we follow the first approach if the circumcision happened to take place at night. But we do not schedule the circumcison to take place after sunset.

The celebratory meal, on the other hand, can go for as long as you like into the evening.

Amazing Bris Experience

I posted this on Facebook, right after the fact, but here is the account of last week's bris: 

Most amazing bris experience today! The father of the baby recently converted to Judaism (Orthodox), and while the baby today is his third son (Jewish mother, of course!), it is the first time he participated in the mitzvah of bris milah as a Jewish father who has the mitzvah to circumcise his son as per our Covenant. 

Easy to say he was the most emotional person in the room, "This is BIG, Rabbi. Isn't it?"

Yes it is. I haven't seen people dance at a bris in a long time, but the men in the room grabbed him (he was sandak as well!) and danced in circles singing "Siman Tov UMazal Tov."

It was AWESOME - this is what Bris Milah is all about. It's a little sad that we need these kinds of reminders of why we celebrate and how to celebrate, but we all got it today.

Truly a special bris. Honored to have been a part of it.

You want to know what Metzitzah is? (VIDEO)

See also the Metzitzah page

Here is a video I just found on youtube that depicts the two methods out there. (Link provided in case the video doesn't show up on a mobile device)  I believe both of these are from brisses in Israel. Note that in neither case is the mohel wearing gloves. They surely washed their hands, but the "traditional" way was not to use gloves because sterile gloves are a relatively new invention, and some people believe that priah cannot be done when wearing gloves (which is actually  not true if one uses thin gloves).

The video briefly describes then demonstrates the sterile tube method (at the 19-20 seconds), and then the direct oral contact method (aka MBP or "metzitzah b'peh") (at the 38-41 seconds). You'll note that both are done "b'peh" (with the mouth) though the first does not involve the mohel's mouth contacting the baby, and the second one does involve this kind of contact. 

My main objection is to the use of the words "more traditional" for the second one. I would call it "more cultic" than "more traditional" because the only tradition it reflects is living in an ancient world.

Having said that, the track record is relatively good. But as I say each time, if ONE baby gets infected from the second method (and that seems to be the reality out there), then it shouldn't be done.

Metzitzah in the News Again

It's been about a year since I set up the Metzitzah Page, and things have been relatively quiet.

Until the last few weeks.

First Rav Herschel Schachter was chastized for claiming there are 15 cases a year, most of which go unreported.

And this week, another report has come forward, claiming that two children have been infected with Herpes in NY, post brisses which included Metzitzah (Fox News originally mistakenly said HIV, but they meant HSV - Herpes Simplex Virus)

Here are a few links:

http://www.examiner.com/article/some-new-york-city-infants-contract-herpes-after-ritual-circumcision-1

http://www.dailymail.co.uk/news/article-2304793/Two-babies-stricken-HERPES-ritual-oral-blood-sucking-circumcision-New-York-City.html

The radio showman Michael Savage (nee Wiener) spent an hour talking about this subject - here is the youtube link: http://www.youtube.com/watch?v=RPLh36XYolc

Suffice it to say, the man knows nothing about bris milah and is a bumbling buffoon on this subject. The only thing I'll agree with him on is that the Metzitzah with direct oral suction needs to be stopped. And that the people who say "If it were dangerous we would stop" are not telling the truth. Yes, the numbers don't reflect it being an overwhelming danger, but as I've written before - if ONE baby gets infected or dies from this practice, that is ONE WAY TOO MANY!


It is an irresponsible practice in 21st century. Chazal would not approve if they knew what we know.
It's not a mitzvah. And the argument that it's been practiced for 4000 years is a lie.

It's a chillul Hashem (desecration of God's name). Plain and simple. 

A Mohel in South Florida

There are many cities in Florida that do not have a local mohel. There may be some people who will opt to have a physician play the role on the traditional eighth day, and there are some who will bypass tradition opting for a hospital circumcision in the hospital on day 1 or day 2 of their baby's life. [I don't recommend this path because I believe that a bris milah is incomplete unless it is done by the right person on the eighth day - or afterwards, if delayed for medical reasons.] If a person chooses this latter method, the procedure described here Hatafat Dam Brit, would be needed to turn the circ into a bris.

For those who are looking for the traditional method, a bris done with a mohel, the difficulty comes in finding the right person for your needs, as well as someone willing to travel. 

These are the things that make me - and therefore your bris experience - different than with a different mohel.

The travel expenses are sometimes the biggest deterrent for people contemplating the traditional route. But if you think of bringing in a mohel as a one-time expense which, in most cases, doesn't repeat itself for at least two or three years (if not more, if there's a girl somewhere in the mix), then it becomes a little easier to stomach.

So whether you are looking for a mohel, moyle, moil, moyel, in Naples, in Fort (Ft.) Myers, in Sarasota, in Tampa, in Western Florida, or in Kendall, in Miami, in North Miami, in North Miami Beach, in Ft. Lauderdale, in Hollywood, in Boca Raton, in Delray Beach, in Pompano Beach, in Plantation, in Cooper City, in Palm Beach, in West Palm Beach, in Boynton Beach, in Aventura, in Weston, in Pembroke Pines, in Margate, in Deerfield Beach, in Lake Worth, or in Wellington (not to mention Jupiter, Stuart, Port St Lucie, or Orlando) - or even Gainesville, Jacksonville, Tallahassee or Pensacola, to which I am accessible by plane, be in touch! I'd be honored to join your family for the bris of your son!

CONTACT INFORMATION

Calcium Alginate

New delivery arrived!

I love using calcium alginate as a bandage post-bris. It contains the blood very well and comes off so easily on account of the way it gels when it comes in contact with the bris-wound.

My supply was running low, so my friend Mr. JG from NY hooked me up with the latest supply.

Good for a year of brisses! And loving it

Metzitzah Tubes - Approved by Arukh HaShulchan

The two short letters were composed by Rabbi Yechiel Michel HaLevi Epstein, author of the Arukh HaShulchan on The Friday of Parshas Chukas 5659 a.k.a. 1899.

He blessese those who have innovated the glass tube for Metzitzah, expressing how the merit of the mitzvah (not clear if he's referring to the mitzvah of circumcision or the "mitzvah" of metzitzah) should protect those who made it and use it.