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.

O the Irony!

A Hebrew Name for Brooks

Last Sunday I presided over the bris of a baby who had been given the English name Brooks. His parents asked me if I have any recommendations for a Hebrew name, as they noted that one of the baby's grandfather's has the name Baruch.

I immediately thought of one of the great heroes of the Bible, who is actually mentioned in the Haftorah read the Shabbat of the bris - Barak ben Avinoam - ברק! (Judges, Chapters 4-5) I was not yet aware of the family's political leanings, and I told his mother that the name has been around a lot longer than it has been made famous by the current president.

The baby's mother said to me, "O dear God no. My father hates Obama, and that just won't be possible."

So they named him "Berel." Which is ironic, all things considered, because the President was known as Barry for most of his US formative years. Barry, of course, is a very common English diminutive for Berel.

I have met many Israeli "Barak"s – never been unimpressed. One of the great characters in Leon Uris' "Exodus" was named Barak. It's a great name.

Unless you don't like the President. O well.

Interesting Conversation About Clamps

I received a phone call today from Rabbi Yaron Amit. He is an Israeli mohel who maintains a presence in South Florida, who has an organization that provides free bris services to Jews around the world. He told me they do 28 brisses a day.

He called because I wrote a blog post in response to an article which appeared in IsraPost a few years ago in his name. As it turns out, my response was more against the way the article was translated than against the points he made. My original post has been removed - at his request, and in respect of the clarification - but I would like to share the points he made in our conversation, along with my own commentary.

Rabbi Amit's main issue is that brisses done with a clamp are not kosher. He says there is never blood from such circumcisions and that even when there is blood in the procedure it is blood which emanates from handling an open incision, which is different blood than "dam milah" - the blood of circumcision. He also referred to realities that changed for people - which he witnessed - after their circumcisions-by-clamp were corrected, such as a change in parnasah, finding a mate, and general shift in life turning positive - what he refers to as "spiritual benefits" (my translation - we spoke in Hebrew).

He maintains that any bris done by such a method is unacceptable and needs hatafat dam bris. And that a mohel who uses such a device is unfit to be a mohel, and is unfit for anyone to hire as a mohel.

He shared with me stories of surgical corrections that needed to be done to brisses done through this method, as well as horror stories of amputations of the glans that he has witnessed on account of the use of clamps.

I agree with him on almost all points. I have long advised against the use of clamps:
* For halakhic reasons: Rabbinic approval is scant        Mistake #4
* For practical reasons: Danger        Arrogance (here I outline another practice, which the Rabbi agreed should not be done - "Freehand")
* In addition, in the "methods of circumcision" I have described here (for education purposes), I have made it clear that while there are some mohels who opt to use the clamp, this practice has been forbidden by many many great rabbis and poskim


The points in which we might disagree are:
I maintain that according to Rabbi Moshe Feinstein, if there is minimal blood at the time of circumcision, the bris is valid b'dieved, as long as there was blood. Rabbi Amit believes there is never blood when a clamp is used, and any blood is not "dam brit" as I explained above. Rabbi Feinstein also makes it clear that the clamp is not to be used (Iggerot Moshe Yoreh Deah 3:99).

I am not a fan of telling thousands of people that their bris is unkosher and needs a touch-up, even if it is "merely" Hatafat Dam. With this Rabbi Amit and I will have to agree to disagree.

CONCLUSION: FIND A MOHEL WHO DOES NOT USE A CLAMP (WHO DOES USE A SHIELD) IF YOU WANT THE SAFEST RESULTS, AND NO HALAKHIC COMPLICATIONS FROM THE BRIS MILAH PROCESS. ASTHETIC RESULTS - IN ALL CASES - ARE DETERMINED BY THE SKILL OF THE MOHEL, IRRESPECTIVE OF THE METHOD. ALL MOHELS ARE HUMAN. ALL HUMANS ARE IMPERFECT. EVERY MOHEL SHOULD DO HIS BEST, AND SHOULD TAKE EVERY NECESSARY PRECAUTION TO ASSURE THE BEST ASTHETIC RESULTS HE CAN.

Rabbi Howard Jachter has penned an article in which he talks about the clamp. I don't believe all the responsa he quotes are being portrayed accurately. I also don't understand what he means when he says "As long as the clamp is used properly." The clamp being used properly happens when the clamping arm is closed. This is what all the rabbis wrote against! The clamp being used "improperly" is when the clamping arm is not utilized. If one is not closing the clamp, why not just use the more traditional shield?

The deleted post (that inspired this one) concluded with these links.
He's YOUR baby, you have a right to choose whom you'll hire.
You have the responsibility to ask all the right questions to every mohel you interview before you settle on the one you want
And you also must take care to know what you are looking for to have the right kind of experience for your needs.  Always remember that the wrong attitude is not to ask.

REMEMBER - IMPORTANT REMINDERS (similar links), as well as THE MISTAKES YOU WANT TO AVOID

Information For ALL Parents - Bris Concerns

You are a parent of a baby boy. You're going to bring a stranger into your life who will circumcise your baby. What do you need to know?

Don't Make Any of These Mistakes [Top Ten List]

You need to know that your baby's health is paramount, and that while most babies are healthy and their bris takes place on time, if a real question comes up, better to have the bris delayed and not be on time, than put your baby in a compromised situation because of inconvenience (such as family flight plans!)

You need to know which method of circumcision your mohel uses [and what is a "shield" vs a "clamp"]

You need to know how he estimates the edge of the foreskin

You need to know if he employs a sterile technique

You need to know how he does metzitzah [See the Metzitzah Page]

You need to know if he does Milah and Priah together or separately

You need to know how he deals with a redundance of membrane

You need to know if there are ever any complications afterwards see also this - "most common issues"

You need to know how to care for your baby

In some cases, you need these Long term Care Reminders:
CHUBBY BABY Syndrome - How alot of baby fat is disheartening for a few months
Fusion Challenge

Bris: One Stage or Two?

I've heard from some people that some of my warning postings are not very positive, [see here and here].

Here is another attempt to explain what happens at a bris, and what may happen at the bris.

During the bris, the mohel attempts to remove all of the ערלה (orlah)/foreskin, and as much of the עור הפריעה (or ha''priah)/ mucosal membrane (that lines the penis below the foreskin) as possible.

With a good חיתוך (incision) the proper amount of foreskin is removed and does not need to be revisited.

Sometimes "all" of the membrane is removed in that incision. Sometimes "some of it" is removed in that initial incision. Sometimes "none of it" is removed.

If any of the membrane remains, a good mohel will do "priah" - tearing and folding back the membrane beyond the glans before bandaging everything up.

Depending on how much of that membrane remains, as well as how it sits below the glans, it may need to be revisited (ideally immediately) either because the "bris" isn't kosher, or because it will be an unsightly eyesore.

So here is the bottom line:

Sometimes the bris goes well in one stage, as the foreskin and membrane are removed in one-fell swoop (so to speak).

Sometimes the foreskin is removed completely during the ceremony, but some of the membrane remains and needs to be removed in a second stage.

Obviously we would all prefer a one-stage and everything-goes-perfect-the-first-time bris milah experience. 

But if a quick revisit, when the wound is still fresh, is necessary, especially if/not doing it could bring asthetic consequences, I make every effort to be up front, honest, and most importantly to take care of it right away so it never becomes an issue. As I've written elsewhere, I much prefer people be angry at me for five minutes than for 5 plus years.

Results matter, and I try to take all the necessary precautions so that the results are pleasing and pleasant for a very long time.

News Monitor: Hamodia Update

I'll bet some will argue that Hurricane Sandy was a sign from heaven that this hearing should never need to take place. Oy. I hope for all who suffered from the storm to get back on their feet sooner than later - with God's help they will.

Most Important Kibbudim

One of the search terms that brought someone to this site recently was "most important kibbudim," so I figured the subject is worthy of a posting.

Other than being the father or mohel, the highest honor at a bris is unquestioningly the sandak.

Beyond the sandak it really becomes a matter of opinion. 

Some might call the "standing sandak" the highest honor. Though whether it was always called that or later called that to give similar honor to the honoree (such as the grandfather who did not serve as sandak) is a question for discussion.

Some might view placing the baby on the Chair of Elijah as a great honor. After all, if the presence of the prophet is noted and invoked through the appointment of this chair to such a role, being partner in placing the baby on this holy space is surely significant.

Some might view the speaking roles as most important - the recitation of the blessings and the paragraph in which the baby is given his name. Every other role at the bris (aside from the father and mohel) is a non-speaking and holding-baby-only role. If you view a speaking role as significant, then this one is pretty important (though the dramatist in me reminds all of the old adage "there are no small roles. Only small actors.")

The catch in this latter group of roles is that the speaker must be a fluent Hebrew reader, and insofar as the blessings go (from my perspective) the one saying the blessings should be an observant Jew - at least to the best of everyone's knowledge.  These factors often leave the mohel as the default person for this role, or the community rabbi. At brisses for Orthodox families, this role might be given to a family member, or a friend who is more cantorially inclined.

My only recommendation is that whoever names the baby not be a person emotionally attached to the name being given to the baby. I have seen too many a grandfather lose control when the baby was named for a recently deceased great-grandfather. 

On the other side, as well, one grandfather with "quite the sense of humor" got up to the part when the baby is named, gave the child his "Name, son of..."  At this point, he is supposed to say the baby's father's name. When he took a longer pause, I thought in the heat of the moment he had forgotten his son's name. Turns out, he paused as if to say to his kid, "who is the REAL father?" People laughed good-naturedly (I think), but if I had to do it again, I would have had someone else name the baby.

Those kinds of jokes are not funny, and while the baby's father "laughed," I don't think he thought it was funny either. "My own father... Sheesh!" 

The Rabbi With the Great Line

On Friday, I was privileged to work with my second set of twins of the week. The difference was that Friday's twins (as opposed to Sunday's) were a boy and a girl. Which means that while the bris took place, the sister was sleeping in her crib.

Anyway, the bris took place at home, where the living room was adorned with signs that say "It's a Boy!" and "It's a Girl!"

The bris spot (meaning where the chairs were set up) happened to be under the pink sign, and before he recited the blessings over the bris, the rabbi of the community remarked, "This is the first time I have ever done this under an 'It's a Girl!' sign."

Thank God for that!

[Photo below is not from the bris in question - I found it online and doctored it for the effect.]

My Article About Bris Milah

I write a weekly column for the Jewish Star in New York - which I reproduce on my Torah/Judaism-focused blog. Last week the topic was Bris Milah - or the Covenant of Circumcision, as it appears in the Torah in Bereshit (Genesis) Chapter 17, Parshas Lekh Lekha.

Here is the link to the Jewish Star      Here is the link to my blog

And here is the text for good measure: