Awareness Factor

Parents of a new baby have different approaches to hiring a mohel.

Some call the mohel based on the recommendation of friends. They have no questions. Their friend had a good experience and they want the same. 

Some call many mohels, ask a few questions to each, and try to find the mohel that best fits their needs.

Parents who have been through the bris process before - whether once, twice, or more - more or less know from experience what they want the bris to be like. If they were satisfied in earlier brisses, they'll call their mohel back each time. (Unless they've moved states, or he's moved! Though I've had a number of people call me from NY, my old stomping grounds, and I still go back there on occasion for repeat customers)

In this past week alone, I've met with a couple of families dealing with their third boy (I did not do any of their previous brisses), and they articulated to me why they called me this time.

Their concerns included that a previous mohel did not and refused to wear gloves

They were unsatisfied with a previous mohel's standards of cleanliness and sterility

In their most recent bris, the bandage came off and there was blood everywhere (here's why this should not happen)

They wanted to understand metzitzah and why previous mohels insisted on doing it the way which does not conform to their sensibilities (see also here and here)

One wanted to know if I use a clamp.    I do not.

ASKING IS ALWAYS THE BEST POLICY. Here are links from the Topical Index about important questions to raise before the bris

Good Questions to Ask ANY Mohel
Prioritizing Our Questions
Wrong Attitude is NOT to Ask

FAQ - Summary (links to answers to the questions) - Shorter Answers Appear in a Link at the top of the page
Inquiries Welcome

CONCERNS - SUMMARY OF IMPORTANT LINKS

GOOD LUCK WITH EVERYTHING! Be in touch with your inquiries!

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.

A Wise Opinion About NYC and Metzitzah

My position on metzitzah is clear. And the politics that have been going on over the practice in NYC has been a public discussion for far too long.

Here is an article from the NY Post which concludes with the following paragraph.

"This is a crucial election for New York, with many vital issues at stake. It’s tough enough to know what to do about schools, taxes, spending and crime without having our candidates have to weigh in on a Jewish ritual that never should have become a government issue in the first place."

Couldn't have said it better myself. 

Gloves Revisited

Rabbi Aryeh Leibowitz recently wrote an article/essay that explores the halakhic appropriateness of using Gloves while performing a mitzvah, with a specific focus on whether gloves (sterile, of course) should be worn when a mohel performs a bris.

I have written about gloves here. And if I did not make it clear there, I believe that once a mohel chooses to wear gloves (which all parents should INSIST upon!), the only gloves of choice are STERILE gloves - which usually come packaged in pairs.

Full disclosure is that I discussed some of these matters with Rabbi Leibowitz while he was in the draft stage, though I did not review the article before it was posted on the internet.

Here is the link to Rabbi Leibowitz's article. (link goes to the TorahMusings website)

Feel free to chime in (though only relevant and appropriate comments will be approved below)

Bris Wine and Baby

I originally wrote about giving the baby wine at the bris here

A recent experience caused me to rethink not the concept, nor the method, but the source of the wine we give to the baby.

As discussed in the original posting on wine, the source for giving the baby wine most likely comes from the situations in which he is the ideal candidate for drinking it because everyone else is fasting, and no one else has had any of the wine. That the wine is soothing and may act as a kind of analgesic is an added benefit - but is frankly, irrelevant after the circumcision is over (which is the point in time when most of the wine is typically given to him). 

"What happened recently?" you ask.  I'll tell you.

I was about to give some wine to the baby, when the person who had just taken a sip said to me, "I'm sick! Don't give the baby any wine from that cup."

I readily complied and dipped my gauze directly into the bottle, to give the baby "untainted" wine  

After that day, it occurred to me that while the baby is highly unlikely to catch anything from the wine, especially if the drinker merely takes a sip (which is usually the case) and particularly if he does not backwash, but still... If we are trying to keep the baby safe, shouldn't the baby have a cup of wine designated for him, which is not touched by anyone?

Now, there are some rabbis who specifically do not drink from the cup.  While they say the blessings, some wine typically drips on their fingers, and they taste the wine on their fingers, leaving the cup alone.  In those cases, the cup and wine in it remains untainted, and the wine in the cup is as "safe" as the wine in the bottle. But in most cases the one reciting the blessing sips from the cup. Wouldn't it be better for baby if there were a cup of wine dedicated for his use only, so he need not share a cup with an adult who may possibly have some virus in his mouth that could possibly be transferred...?

May be extreme, but seems logical to me... especially in light of the second source quoted here!

3 Day Yom Tov Mohel Blues

This year, Rosh Hashana falls on Thursday and Friday, leading into Saturday, which creates what is called in observant circles a "Three Day Yom Tov."

It also means that anyone who gave birth naturally this past Thursday, Friday, or Saturday, who is looking for a bris to take place on time will need to get a mohel who either lives within walking distance, or who is willing to come for the 3-day period - because an observant mohel is not driving over these three days.

Of course this is not normally a concern. A mohel with a car comes and goes at his schedule during the week. And even a typical Shabbos-bris is only 1 day. But here we are talking about 3 days - 72 hours!

While in a Metropolitan area a walking-distance mohel should be fairly easy to find, in some places, this is not the case.

And finding someone willing to come for the 3-day yom tov is extremely hard. Any mohel with younger children living at home will most likely not be able to come.  And anyone with significant holiday plans will most likely not be able to make it either. In my case, I serve as a rabbi in a synagogue on Rosh Hashana and am therefore unavailable.

Who might come? A single (unmarried) mohel. Or an empty-nest mohel. The latter case may come with or without his wife.

In either case, aside from needing to arrange a place for the mohel to stay, and a seat in shul (though I am sure most shuls would be accommodating), it needs to be understood that the mohel is giving up his yom tov, in whatever way it was planned, for YOU the parents.

Now, some mohels might say, "I am not available. If you can't find anyone, I will do it Sunday." It is OK for the mohel to do this.

But the parents have a responsibility to have the bris take place on the 8th day of the baby's life. Which is probably why I got a call today from Michigan, and I was contacted a month ago by someone from Tampa who was concerned about a possible Rosh Hashana bris (and wouldn't you know it, she confirmed for me today that her fears turned out true!), and I heard from someone in Maryland about another RH bris. And I am sure there will be many brisses around the world over the 3 day yom tov.

Hopefully the parents and the mohel can come to an agreement. The mohel should come "b'simcha," and the parents should be sensitive and offer a generous compensation for the mohel putting himself out in a significant way.

Mazal Tov to all!

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) 

Maimonides on the Reasons For Circumcising

There is one reason why we circumcise our sons: Because it is a mitzvah in the Torah.

We don't do it because Abraham did it. He certainly set a precedent and we follow his example. But

as the Rambam (Maimonides) explains in his commentary to the Mishnah Hullin at the end of Chapter 7, EVERY MITZVAH STEMS FROM WHAT MOSES TAUGHT AT SINAI BASED ON GOD'S COMMAND.

פירוש המשנה לרמב"ם מסכת חולין פרק ז 

[ו] לדעת ר' יהודה האוכל כזית מגיד הנשה של בהמה טמאה חייב שתי מלקיות משום בהמה טמאה ומשום גיד הנשה. ואין הלכה כר' יהודה. ושים לבך לכלל הגדול הזה המובא במשנה זו והוא אמרם מסיני נאסר, והוא, שאתה צריך לדעת שכל מה שאנו נזהרים ממנו או עושים אותו היום אין אנו עושים זאת אלא מפני צווי ה' על ידי משה, לא מפני שה' צוה בכך לנביאים שקדמוהו, דוגמא לכך, אין אנו אוכלים אבר מן החי לא מפני שה' אסר על בני נח אבר מן החי, אלא מפני שמשה אסר עלינו אבר מן החי במה שנצטווה בסיני שישאר אבר מן החי אסור. וכן אין אנו מלים בגלל שאברהם מל את עצמו ואנשי ביתו, אלא מפני שה' צונו על ידי משה להמול כמו שמל אברהם עליו השלום, וכן גיד הנשה אין אנו נמשכים בו אחרי אסור יעקב אבינו אלא צווי משה רבינו, הלא תראה אמרם שש מאות ושלש עשרה מצות נאמרו לו למשה בסיני, וכל אלה מכלל המצות. 

Translation of the two bolded statements:

"You must know that everything we are careful about or do today, we only do it because of a commandment of God [delivered] through the hand of Moshe."
"And we do not circumcise because Abraham circumcised himself and the men of his household. But because God commanded us, through Moshe's hand, to circumcise, just as Avraham, Peace upon him, circumcised..."

So Maimonides makes it quite clear that we have a mitzvah to circumcise. And that the only reason we do so is because of the mitzvah.  

This is an important set up to the next posting, which will specifically target the Jews who are anti-circumcision, who like to take a quote of Maimonides out of context to argue why we should not circumcise.

They do not listen to anything else Maimonides says. They don't read Maimonides at all. And they don't understand what Maimonides writes. But they champion him as the anti-circumcision advocate because of something he wrote, when applying such a moniker to him could not be any further from the truth - stay tuned... for part II

Looks Swell - Doesn't it?

In the "milah" (circumcision) component of the Bris Milah, the intent is to remove the foreskin and the underlying mucosal membrane from atop the glans.

No two circumcisions turn out exactly alike. In some cases more foreskin is removed, in some cases less. In some cases more membrane is removed, in some cases less. The angle of the incision as well as the amount of membrane removed (or left behind) will determine what the final look will be once all is healed.

Which brings us to the swelling. If the membrane and the frenulum didn't swell after the bris, most circumcisions would look awesome immediately. Alas, there is sometimes swelling. And depending on the degree of swelling, things might not look as nice as we want them to for perhaps even a few weeks.

I don't put pictures of this nature in my website, because I don't take pictures of before and after. Nor would I post them anyway. But I found this pdf file online that has pictures (on page 16) of the few days process (between 2-3 days to 2-3 weeks) of post-circ swelling. Hopefully it does not get more extreme than this.

http://www.brismilah.com/bris.pdf

Some of my colleagues suggest waiting three months before getting all excited. 

But then you run into the Chubby Baby Syndrome and the Fusion Challenge

Swelling isn't swell, but at least it doesn't last forever.

Born Without a Foreskin - Anything Done Differently?

The male organ develops differently for every (male) child in utero. In some cases it even develops without a foreskin, or with barely any foreskin - it develops in a manner that is described in Halakhic works as either "Mahul" (a fully circumcised look) or "Chatzi Mahul" (a partially circumcised look).

I have seen this a handful of times in my fifteen years in the business. The procedure for removing the "partial foreskin" is obviously quite different than a run of the mill circumcision - for what I hope are obvious reasons.

When there is a partial foreskin, the circumcision "cleans up" the extra skin that is preventing the circumcised look. While not a full circumcision, it is nonetheless a surgical procedure and should be treated the same way a circumcision is, insofar as that if the baby is ill, we would delay the bris 7 days until he is completely healthy.

But when there is no foreskin at all, and the child only needs "Hatafat Dam," which is a (mostly symbolic) minimal drawing of blood, will the same rule of waiting apply?

Here is from "Bris Avos" - same chapter (see previous blog post), paragraph 4.

In the Responsa "She'eilat Shalom" the question was asked whether a child born without a developed foreskin ("Mahul") [who cannot be circumcised, but would need "hatafat dam"] can have the hatafat dam on the 8^th day if he became ill. [Hatafat Dam is a ritual which does not require follow up medical care]. The answer he gave is that it is not only forbidden to do anything to him while he is ill, but one would need to wait the same requisite 7 days after he is healed in order to do the Hatafat Dam, just as one would wait the requisite seven days before doing a full circumcision.

Amazing chiddush! I would have thought since Hatafat Dam is really "no big deal" it wouldn't matter, and it could be done right away. But he says it is treated like a regular Bris Milah, and the requisite seven day waiting period would apply were the baby to become ill before the eighth day of his life.