Why a Mohel?
If you have decided to circumcise your son, you want to choose a healthcare provider who will treat your son as if he were his own. Someone with the hands of a surgeon and the heart of a caring father. Rabbi Trager has four sons of his own and as a certified mohel offers a more natural procedure, in the nurturing environment of your home. Rabbi Trager is the only fulltime mohel in the Bay Area and he has done more than 5000 brissim in the 20 years he has been a mohel.
Mohels, like Rabbi Trager, are specfically trained to complete the procedure quickly. They are able to do so using the most effective pain control methods. Your baby will be held in the arms of a loved one, not immobilized in a cold hospital room. In fact, pediatricians and obstetricians often use mohels to circumcize their own sons because they know a mohel can ensure a procedure that is precise, complication-free, and less stressful for the baby.
For details about the differing techniques see the FAQ section.
A mohel is trained in the medical and surgical techniques of circumcision. In addition to being an expert in this field, the mohel is also an expert in the Jewish laws pertaining to Bris Milah. A doctor’s medical circumcision, usually performed in the hospital within the first few days after birth, does not fulfill the requirements of a Bris Milah and is not considered valid according to Jewish law. The Bris must be performed by a Jewish person who understands, upholds and practices the tenets of the Jewish religion and is specially trained to function as a mohel.
Doctor or Mohel?
For more detailed info about the differences between a circumcision done by a doctor and the procedure done by a mohel, scroll down to read a very detailed piece by Rabbi Ari Cartun of Congregation Etz Chayim in Palo Alto, CA.
Your baby will be held in the arms of a loved one,
not strapped down, immobilized in a cold hospital room.
My Take on the Mohel/MD Issue
by Rabbi Ari Cartun
A competent Mohel is, as they say, a specialist, used to circumcising “under pressure” (in front of a gathering of people) as most MD’s are not. A Mohel does not usually use anesthetic, because his anesthetic is the speed with which he does the circumcision. There are new responsa on this issue that permit anaesthetic, but Mohelim do not always take advantage of this ruling. (NOTE: Rabbi Trager’s experience has led him to use a combination of topical anesthetic, liquid infant acetaminophen, a small dose of Brooklyn’s finest wine –Manischewitz, and a 30-second procedure.)
In any case, it takes 5 seconds ( I actually count every time: “1 one thousand, 2 one thousand,” etc up to “5 one thousand,” and it is done) for a Mohel to circumcise, because a Mohel uses a Magen shield, not a clamp, and there is almost no application time for a shield. With a shield, the foreskin is grasped, usually with medical tweezers, then pulled through the slit in the shield, then sliced off with a scalpel. The shield protects the glans of the penis, which, because it is too large to fit through the slit, remains below the shield.
A Mohel circumcises with the baby on a pillow held lovingly by a family member or other person acting as Sandek (Godfather), instead of using a “Circumstraint” (a tray on which a baby lays naked on his back, while the baby is restrained from kicking by strapping his arms and legs down with Velcro straps). The worst thing about the circumstraint is that the baby is restrained like that for the duration of the procedure, usually 5 minutes or more before the service even starts, depending on how much anaesthetic is used. Then add to that the time it takes to get to the point of the service where the circumcision is done, after which the boy can finally be freed. When I officiate at a brit where the baby is on a circumstraint, I hurry through the service in about four minutes. But these are four more minutes that the poor kid is tied on his back to a tray, added to whatever time it took you to bring the baby to where the service will happen from the prep room.
Why a prep room? You would not want to do all the five to ten minutes of prep in front of your assembled guests. The baby screaming all this time would drive them all mad. And, as the MD’s are not used to doing this in front of people, they sometimes begin to sweat and get nervous. That is why this us usually done in a closed-door bedroom, and then the baby is brought out on the tray to the service.
MD’s most often use a Gomco Clamp (which takes a few MINUTES to put on, instead of the few SECONDS for a Magen Shield). The Gomco was invented to make a perfectly circular cut, whereas the shield that mohalim use cuts the circular foreskin with a straight cut, and thus leaves a small miniscus. This miniscus is baby-sized, and totally unnoticeable by toddlerhood. To put on a Gomco, the foreskin is grasped with medical tweezers and then a slit is cut in it. After that the bottom half of the clamp is fitted under the bottom of the foreskin, then the heavy top is screwed on until the clamp cuts off the circulation and makes a perfectly circular template around which the foreskin could be cut even by the unskilled. You could even do it without causing any harm, because you cannot cut through a quarter inch of surgical steel to accidentally cut the penis. I have seen MD’s apply the clamp and then the father cuts the foreskin.
MD’s often use anaesthetic, as well. This is theoretically to reduce the trauma of the circumcision. However, realize that everything you add to the procedure adds discomfort. Here is how anaesthetic usually works. A topical anaesthetic cream is first swabbed on, then, after a while when that has kicked in, a second anaesthetic is applied by means of a hypodermic shots all around the foreskin. This takes several minutes, all the while the baby is strapped to the circumstraint.
A precious few Jewish MD’s use a Magen Clamp. It takes a bit longer to apply than a Magen Shield, but not too much longer—nowhere near as long as a Gomco Clamp. Sometimes a Mohel will use the Magen Shield as well, depending on a host of things. Talk with the Mohel to see if he/she will use a Magen Shield or a Magen Clamp. Most of the Jewish MD’s who use the Magen Clamp will also allow the baby to be held on a pillow, if asked, but they usually bring a Circumstraint if you don’t. They are also OK with only using topically applied anaesthic cream.
So, here’s the summary. If you want a quick procedure done by a specialist, all the while the baby is being lovingly held instead of tied down, use a Mohel. If you want to strap your son down for up to ten minutes on a tray, then shoot his penis full of shots, then lay a heavy weight on his penis until you finally get around to cutting off the foreskin, use an MD.
This is, of course, all predicated on the assumption that the Mohel is competent. That you find out by reputation. An incompetent Mohel is not to be trusted with your son’s life. The ten minutes of discomfort an MD would impose are small price to pay for the security of knowing your son’s body is in the hands of a competent surgeon.
And what about the trauma that circumcision inflicts on us males? I have no clue how different I would be today had I not had that trauma. Nor does anyone else. I do know this. When my first child was diagnosed as a newborn with possible jaundice, I had to take her to have blood drawn from her heel. She was five days old. The technician had a hell of a time getting the blood out, and repeatedly stuck needles into her heel to no avail. My daughter screamed bloody murder for fifteen minutes as they tried and tried to get the blood out. I was holding her the entire time, and after they finally succeeded, I was a wreck. She, on the other hand, fell asleep, and when she woke up, she was fine. This was her first medical procedure, an unnecessarty one as it turned out. For when they found that she did have a slight case of jaundice, they said, “OK, it will get better on it’s own.”
This was not the last shot or blood drawing or stitches my children had to have. They screamed, they cried, they made me crazy, and they are fine.
If you have any questions, please feel free to call me at 650-813-9011.
Rabbi Ari Cartun