Monday, March 5, 2012

The C Word (or A Nice Jewish Boy From Nairobi)

Because I’m Jewish, in some way, I get to sidestep the whole circumcision debate.  It’s off the table.  Not a choice.  I don’t think I could live down the heavy weight of finely tuned Jewish guilt if I decided not to circumcise my sons.  I’m not entirely sure if I’d be disowned, but let’s just say it would be something of a family scandal.
Plus, Jewish or not, we might decide to do it anyway.  There are some health benefits, and I know not a few men who were not circumcised as babies only to have to have a circumcision later in life in response to some infection.  Better earlier than later?
So, we find ourselves in the peculiar position of looking, in East Africa, for a mohel (a Jew who is trained and certified to perform a ritual circumcision on the 8th day of life).  We didn’t entirely think it would be possible.  We joked that we’d just guillotine a small carrot symbolically and then do the circumcision several months later back in the US.  Yup.  That could work, right?
But my mother, being the queen of Jewish Geography and at least twice as invested in this whole process, miraculously found a Jewish doctor here in Nairobi who would be able to help us out.  
So, here’s some Bris 101 to put this whole experience in perspective:  According to Jewish dictates a mohel should attend to the actual cutting.  He (or she) gives the babe a little wine to … you know… get them in the mood for some penis snipping and then the cutting happens with swift efficiency.  With Caleb I heard his little cry as they cleaned the area followed by another (I shutter to think what that was in response to) and then it was over.  Took about 30 seconds, and Caleb healed remarkably quickly.
Because this is all part of ritual celebration, there are witness to your living room table surgery (grimaces on the faces of all men, tears in the eyes of the women), followed by bagels and lox.  Maybe some nice rugale. 
Even as a Jew, I find the whole thing strange, a bit primitive and maybe a bit brutal.  But tradition is tradition and I appreciate that this is a 5000 year old custom; and who am I to get in the way of ancient ritual and what is, in the end, the celebration of my children?
For Emmet’s bris in Nairobi…  oy vey, the strangeness of it all.  I almost don’t know where to begin.
Let’s start with this:
Because we don’t have an official mohel, a Jewish doctor will do an initial ceremonial cut accompanied by the appropriate prayers, and then an Egyptian pediatric surgeon will do the actual procedure.  On an operating table. In the hospital.  This should give me some solace. but… As you may have gleaned from my last post, I’m just a wee bit hospital phobic.
This scene instills horror in me:
Emmet blissfully unaware of what is about to transpire

A hospital room just has too many needles and restraints, bright lights and complicated looking machines for my comfort level.

As we enter the room and inform the nurse we’re here for my 8 day old baby’s circumcision, she does a double take followed by that look. You know the one.  That puzzled “are you sure about this?” look. He’s only 8 days old!?!?
Here in Kenya circumcisions are traditionally done, for most ethnic groups, as a rite of passage when boys are 9 or 10.  We might cross our legs in horrified sympathy to hear that (Yikes, that’s old.  The boys will surely remember and feel that kind of pain), just as Kenyans might be astonished to hear that we do this to our babies (Yikes that’s young.  Can a helpless baby really withstand that kind of pain?) 
Normally, I’m quite sensitive to the judgment of others, but all I can think in response to the nurse’s apparent disdain is: “Lady, you don’t even know how weird it’s about to get around here!”  Just wait until we start praying and drinking wine with 10 Jewish strangers in the operating room. But I’m getting ahead of myself.
Then this as we are waiting.

This is the signature of our pediatric surgeon on some routine forms.  Notice anything? 
I'd much prefer the man who will be snipping a small but very vital organ on my very tiny baby have the eye site and precision to sign his name anywhere near the dotted line!  I’m about ready to abscond with my son, but then they start arriving. 
The minyan. 
You see, in Orthodox Judaism, you need a minyan of 10 Jewish men for the whole bris thing to be kosher. Never mind that I’m barely Reform much less Orthodox, but Nairobi has one synagogue and it’s Orthodox, so there we are.   
So, these 10 orthodox Jewish strangers (many from the Israeli embassy) start arriving and filling up the operating room. They don their prayer shawls and kippot. Someone produces a bottle of Mogen David and sets out wine glasses. There’s no escaping now.
In theory, I’m touched.  These people don’t know me, but they are taking time out of their work days to come permit me an official orthodox bris and celebrate my son. They are exceedingly kind and gracious.
In practice, I’m a bit overwhelmed. For a private, hospital phobic person who tends to avoid drawing attention to herself, this scene is a bit alienating:
See if you can spot me. Find the woman burrying her head in horror.
Then there’s this:  My mom, having done the bulk of the organizing and wanting desperately to be a part of this occasion, joins us by Skype. The computer is placed at the foot of the operating table, giving my mom, whether she likes it or not, a front row viewing.

So, there we are.  The whole mishigas, crowded into the operating theater, taking pictures, drinking wine and praying.  My mom says a few words over skype then sings Emmet a song, as the crowd politely listens from half a world away. 
What am I doing this whole time? Sitting on a chair, burying my head into my husband’s chest, wetting his shirt with my unendingly uglycrying, only occasionally looking up to ask if it’s over.
It’s not.  It’s not over. It’s taking FOR. EVER.  After the praying, the doc has to scrub in and wash things and do whatever they do to make surgeries happen.  The waiting is agony.  I just want to fast forward the whole scene. 
Then, it’s over.  We are mazel toved and move on to the bagel portion of the day.    
My next child will simply have to be a girl.

****************************

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43 comments:

  1. This whole episode is hysterical! Thanks for sharing :)

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  2. Kim,

    Given how distraught you were, you actually treated this with a light, balanced touch. I agree. It took FOR.EVER. If you have a choice, go with a mohel anytime. And,I as I told Josh, having an Egyptian surgeon wasn't so bad either; they have been doing them since the Pharoahs.

    I started singing to Emmet because I remembered Elijah's bris ceremony where the mohel sang. I figured that might cut (pardon the word) some of the tension. I didn't think anyone was listening.

    Mazel Tov! Dad tells me he is fine little boy.

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    1. THanks mom. As I was writing I was worried about offending someone, so I'm glad this came across as balanced. Since I certainly haven't felt very "balanced" lately. ;)

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    2. Some other thoughts - I remember how Grandpa Sid questioned that we were going to have Josh's bris at 8 days. Josh was only 5 lbs then. He couldn't believe we would proceed with a baby that small. I told him, "the mohel says he is a strong baby." Josh, in fact proved it, by breaking through the straps they had used to restrain him while they did the procedure.

      I have been impressed by how much support you have received through this blog.

      Mazel Tov again!

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  3. Crying and laughing, indeed. I think you really need to publish this on some Jewish blogging/Jewish news website. What it means to be Jewish in this global, hi-tech, post-modern world! Kol hakavod for making it happen despite all the challenges (ideological and otherwise)!

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    1. THanks Simone. THis is truly the world we're living in. I can't tell you how many events someone has been virtually attending through skype. (this is at least the 3rd bris to be Skyped or teleconferenced in my family!)

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  4. WONDERFUL, touching re-telling of this significant event. I hope you are keeping a hard copy to share with Emmet when he is older - perhaps, VERY much older, like 30! Your boys will have quite the collection of stories as "The Nice Jewish Boys in Kenya."

    We send you much love! Many hugs.

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    1. THanks Heidi. I'm not sure if Emmet will ever want to hear this though (does anyone want to hear about their bris? - maybe only to laugh and how their parents handled the whole thing). : )

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  5. Mazel Tov! I am so touched to see the outpouring of support you had from the Jewish community in Kenya!

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    1. Thanks Jennifer. Yes, it was pretty impressive considering I had never met any of them prior to the date.

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  6. Oh this was hard to read - I can't imagine going through circumcision as a mom or a baby - I'm glad it went well for you and what an outpouring of support you had!

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    1. THanks Ado. And it did in the end go well - despite the bad sign (literally) of the surgeon's signature. He's healling really well!

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  7. I sat Jeffrey down to read this piece. I heard him chuckling and sighing - high praise to be sure. He thought it was especially sweet that Judy had arranged for a minyan - and, truly, how lovely!

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  8. Oh my. The scene in the hospital room would have put me into tears too - only because I get claustrophobic and I'd be like, all you people are too near my newborn baby!

    We had our first son circumcised on his 9th day in the same hospital he was born, by the same doctor who delivered him (how convenient!). It was all very civilized - they applied anesthetic cream on his er, parts, we waited 45 minutes, they whisked him off and brought him back in 5 minutes. We waited another 30 minutes for him to pee to ensure all his parts were working, he obliged by shooting pee out and poop at the same time, just as a midwife looked into his diaper (thanks buddy). 5 days letter, the bell they put around his er, pee pee, fell of and all looked nice and clear.

    I believe that was not TMI :)

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    1. Not TMI at all. I often wonder what it's like for other people. At least they "whisked" yours off. I wish that had been an option for me! : ) And, just like you, the "bell" fell off in a matter of days and he's healed remarkably quickly. Phew!

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  9. The crowd of witnesses I was prepared to see. The mom on the monitor? Not so much! I loved the Max Headroom addition to this Bris! Mazel Tov ten times over!

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    1. I know. Totally surreal. Thanks for the mazel tobs and stopping by!

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  10. I attended a bris once but didn't witness the actual cutting. But I did hear the wail of the child, though thankfully it was short lived. And then, as you say, food is served. Everyone was dressed up. It does seem an unusual practice. I wonder who was the first ever to get that knife out? I come from a family of all sisters so it was not something we thought about. Great story, particularly as it took place way outside the familiar territory of home...

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    1. The first "to get that knife out" would be Abraham, father of Isaac and the partriarch of Judaism, Christianity, and Islam.

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    2. I give any non-Jew major props for attending one of these things. Considering I could barely stomach it!

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  11. Wow! What a tale! I have to admit the crowd of strangers would have been my undoing as well, but it sounds like you handled it like a champ (despite burying your head for the whole thing...I would have done the same!) Great storytelling!

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    1. Thanks Katie! Yup the crowd was a bit alienating, but I simply closed my eyes through the whole thing tried to teleport myself to another place. It was unsuccessful. ; )

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  12. Oh, I loved this! You told this story in a way that kept my attention all the way through. What a wild ride! My favorite line was, "Lady, you don’t even know how weird it’s about to get around here!”

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  13. Your mother is the Queen of Jewish Geography---there really should be a crown for that. Bris 101 should be taught, well, everywhere with a Jewish population under 10% (we could soooo use that around here!). You are one brave momma for doing this. But culture is culture and that stuff is way important especially in families. Sooooo worth every nerve-racking second to start your son and your family out the way you want. Following your heart always works in families. Oh, and a sense of humor (which you clearly have) won't hurt either. Erin

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  14. Oh my gosh! I learned so much reading this and enjoyed every word! Loved, loved this. We had our son circumcised too, but not with this many people...too, too funny and awesome all at the same time.:)

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  15. I truly believe tiny babies don't actually feel pain. I really truly do. I love these blogs where only a handful of us understand every single thing you say (Kvetch mom is one). Mishigas? Fantastic. I'm so sorry for your trauma!!!!

    ~The G is Silent

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  16. My husband swore up and down that if we were to have a boy, we, the good Catholics would hire a Mohel to perform the circumision.
    What a fabulous story to tell Emmett!

    Mazel Tov!

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  17. Oh, you poor thing! I'm not sure I could have handled it. I'm not experienced in the realm of Jewish circumcisions, but I imagine that only in Nairobi would they allow that many people in the operating room. I can't picture them letting the wine, etc. into the room in the States. Mazel tov!

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  18. This is one of the greatest blog posts I've ever read. The pathos! The random cultural elements! The pain and excitement and family and culture! Amazing stuff. I feel all reinvigorated about being an expat. Thank you xx

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  19. Kim, First a huge congrats on the birth of Emmet! I loved hearing this story too and the confluence of cultural influences on your son during his first days here. Please keep sharing these great adventures!

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  20. Kim, Wow, that is quite a story. As a fellow MOT, I'm very impressed that you could put together a minyan deep in Africa. I know people who've had a hard time here in L.A.!

    And gotta love the Jewish grandmother watching via skype from the foot of the bed. Hilarious. Mazel Tov.

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  21. That is really, really touching. . . even if overwhelming!

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  22. Bris 101: Dr. Leonard Glick's book Marked in Your Flesh (complete detailed history of Jewish circumcision):

    Interesting read, "that the Lord's covenant and his two definitive promises (prodigious reproduction success and a lavish land grant (all of Canaanite land) appears first in Genesis 15, an earlier J text but with one crucial difference, there is no mention of circumcision." "To seal this covenant the only requirement is that Abram offer several sacrificial animals- a heifer, goat, ram, dove, and one other bird. Here we find no mention of circumcision, no change of name, no mention of Isaac or Ishmael." "Like a number of their neighbors, the ancient Israelites had practiced circumcision, but not as a mandatory rite and probable seldom on infants; nor did they associate it with the idea of covenant."
    It was the Judean Priests who wrote Genesis 17 (P text) 13 centuries after Abraham's putative lifetime that called for male circumcision of infants. A initiation rite not so much for the infant but of the father who must circumcise his son himself for he is cognizant of the event whereas the infant is not. These type of circ.s were the cutting off the acroposthion (the part that hangs pastthe glans). No damage of tearing the foreskin from the glans (thus results scarring from the cut up to the tip of the glans) and no amputating the part covering the glans. The radical circ., also medically known as penile reduction, as we do happens centuries later. The Torah says not to mark the body, the original Covenant jives with the earliest Judea.
    (see also youtube Glick / Circumcision)

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  23. Please consider at what age to circumcise with what John Taylor, heart specialist and penis researcher and expert says in his 2009 October Newsletter: (sorry to have to post this entirety in two posts)

    SIDS (sudden infant death syndrome) and circumcision: What is the link?

    It may not happen very often but when it does, infant death following circumcision is a particularly devastating event, accompanied as it is by doubts about the wisdom ofcircumcision for no good medical reason. Here I offer some thoughts, from the viewpoint of a pathologist and anatomist with a longstanding interest in the anatomy and developmentof the human heart, as well as an interest in the anatomy ofthe foreskin or prepuce, as outlined in my website and summarized in the preceding newsletter. The two bits ofanatomy are entirely separate but I would like to explain how and why circumcision or, indeed, any physical or other trauma in the first few weeks of life might end up in sudden cardiac death resulting from disturbance of the cardiac rhythm. This is hypothesis but the basic, underlying, anatomyof the heart associated with the blood supply to theconducting system (the electrical ‘wiring’ of the heart) has not been disputed up to 10 years after publication in thepeer-reviewed Canadian Journal of Cardiology.

    This newsletter was spurred by a recent (2009) SIDS case in UK, half an hour after circumcision that was deemed, by HM Coroner, to be unrelated in any way to the surgery or actions of the circumciser, who was exonerated. In other words, the baby died for no obvious reason, thus meetingthe classical criterion of ‘SIDS’ (You can see how this argument gets a bit circular: SIDS almost by definition, is a diagnosis of exclusion.)

    Not necessarily so: Let`s take a closer look at the newborn heart and its nutrient blood supply. No doubt, oxygen and other nutrients reach the musculature and conducting systemof the neonatal heart through coronary arteries, which are filled with blood that has passed through the lungs. However,the nutrient supply to the embryonic heart, in the first two months of human development in the uterus, during which time the heart becomes almost fully developed in the total absence of coronary arteries takes place through capillary-like sinusoidal vessels. Coronary arteries sprouting from theroot of the aorta are not fully developed, especially to theconducting system, until about the time of birth at term. So, you can see the problem: at birth the conduction system ofthe neonatal heart may be immature with regard to its nutrient supply: it may still be dependant, at least in part, on its primitive supply through non-arterial vessels. These sinusoids come off the walls of the cardiac chambers to supply the major conducting pathway of the heart for severaldays or weeks after birth, at least until the coronary circulation is fully established.

    Unfortunately, the nutrient inflow into sinusoids, most ofwhich arise from the right side of the heart (right atrium and right ventricle) is sharply reduced the moment the umbilical cord is cut, separating placenta from the baby. Blood entering the conduction system via sinusoids is now ‘venous’ and de-oxygenated, quite different from the oxygenated placental blood. (cont.)

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  24. (cont.)
    So – this is a hypothesis, not a proven fact - any minor perturbation of oxygen levels in already de-oxygenated,venous blood would have a deleterious effect onthe transmission of cardiac impulses necessary to maintain a steady heart-beat. Ventricular arrhythmia ensues and thebaby dies without a mark on it. And the Pediatric Pathologist remains as mystified as ever.

    If you are in any doubt about the importance of a copious nutrient bloodflow to the development of the embryonic and early fetal heart, take a closer look at the way thedeveloping heart (which is fully developed by 2 months, much sooner than any other organ including brain) ensures placental bloodflow and hence the return of nutrient blood tothe right side (and conducting pathway) of the developing and early fetal heart. Both ventricles work at full blast to fillthe descending aorta and, thence, a pair of extremely prominent umbilical arteries (see Gray’s Anatomy plate), at least until the time of birth. After that, the right ventricle shrinks and its much-diminished output is redirected to thenow-expanding lungs, and from the lungs to the coronary and other arteries. The umbilical arteries, no longer feedingthe placenta, shrink to become narrow cords between theumbilicus and liver. Of course, the placenta supplies blood, via the heart, to all other organs and tissues of the body.

    The point I am trying to make is that the heart is the first recipient of nutrient venous blood, from chorionic vessels and then the placenta. Possibly the heart and the rest of thecirculatory system, by a process of natural selection, ensuredthe growth of the placenta over the generations. Generally speaking, however, Darwinian natural selection ofadvantageous traits takes place between individuals, not inside single individuals. But who knows what, exactly, determines organ size and development? Until we do know more, extreme care should be taken to avoid any insult tothe neonatal body that might upset interlinked respiratory and cardiac rhythms. Circumcision for no obvious medical reason is somewhere near the top of a list of don`ts; after circumcision, babies are in a state of pain and shock; they become quiet and respiration often slows. Now with some knowledge of fetal physiology, you can figure out the rest ofthe story.

    As with the heart, the development of the prepuce can be seen in the context of the wider development of a system oftissues. The preceding newsletter outlines one set ofpossibilities, reflexes triggered by movement of the prepuce and glans affecting events (reflex contractions) at the baseof the penis. It is ridiculous to suggest, as many do, that theprepuce is an isolated tissue that developed in the absenceof any other penile influence. So what is the final message? Simply that interference with one tissue or even a nutrient bloodflow might have knock-on effects, from sudden death to bedraggled sexual reflexes in later life, that are difficult to predict without a much-improved and more sophisticated knowledge of human anatomy and physiology.

    Bibliography:

    Taylor JR, Lockwood AP, Taylor AJ. The prepuce: Specialized mucosa of the penis and its loss to circumcision. Brit J Urology 1996;77:291-6

    Taylor JR and Taylor AJ. The relationship between the sinus node and right atrial appendage. Canadian Journal ofCardiology 1997;13:85-92

    Taylor JR and Taylor AJ. The thebesian circulation to developing conducting tissue: A nutrient nodal hypothesis ofcardiogenesis . Can J Cardiol 1999;15:859-866

    Taylor JR and Taylor AJ Thebesian sinusoids: Forgotten collaterals to papillary muscles. Can J Cardiol 16;16:1391-6

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    Replies
    1. ^ Who is this fucktard, and why did he post this insanity on such an otherwise beautiful page?

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  28. Is everyone shocked when you open his diaper in front of them now? That's the reaction I kept getting. However, my sister-in laws said they might consider having their baby sons done after seeing mine. But, I haven't heard this since we've been home so I suspect my nephews are destined for the much older 'snipping.'
    Oh well. There was no debate for us either. At 2 days, 8 days, 6 years, or 10... one way or another all of our boys will be cut.

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