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“It takes a skilled set of hands,” he said.
Lerman could use a different device called a Mogen clamp, which is more commonly used by Orthodox mohels. Mogen clamps allow the circumciser to work faster, but they leave the head of the penis exposed. On the rare occasion a Mogen clamp circumcision goes wrong, the tip of the penis can be amputated, as it was in a recent case in Los Angeles when a boy lost 85% of the top of his penis. (In that case, the botched operation was a secular procedure performed by a physician in a hospital.)
Because the Gomco clamp takes so long, many Orthodox mohels view the use of it as cruel. They even oppose the injection of local anesthetic. “Forget about an injection,” said one Orthodox mohel, who has practiced in New York for 50 years. “You don’t want to do that to a child. That’s a terrible, painful process.”
Like many of his peers, the mohel, who did not wish to be named, uses a shield device inserted between the head of the penis and the foreskin. From start to finish, the operation is over in a few minutes.
Because he is not a physician, the Orthodox mohel cannot inject anesthetic into the baby. Instead, he can use an anesthetic cream, which he said he tries to avoid unless a parent demands it. The mohel said the “long-term effects” of the cream are unclear. Besides, he said, “the process takes a few seconds, and the cut is so swift and so sharp, there is no chance for the child to experience much pain.”
“Any discomfort seems to be very, very fleeting,” said Shmuel Goldin, president of the Rabbinical Council of America. “We certainly don’t want to impose pain on any child. [But] this is a fundamental ritual, critical to our religious practice. It has been practiced for thousands of years with no ill effects, and we are comfortable taking that approach.”
Of local anesthetic, Cantor Philip L. Sherman, also an Orthodox mohel in New York, said, “Injecting a baby for a penile block is probably one of the most ridiculous things I’ve ever come across, because injection in and around the base of the penis is so painful, you may as well just do the bris.”
Sherman, like most Orthodox mohels, gives a baby concentrated sugar water before the procedure and kosher sweet wine or grape juice afterward. He said anesthetic creams are not designed for 8-day-old infants. The creams also make the surface of the penis greasy. “I need a dry surface so I can grab [the penis] without fear of slipping,” Sherman said.