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The Art of the Circumcision

By Dr. Michael Litrel

A Lousy Way to Start your Day

A circumcision is a lousy way to start off life. For a newborn baby boy, the procedure’s only saving grace might be that five minutes of pain must pale in comparison to the agony of being born. Most mothers-to-be receive an epidural to alleviate the pain of labor. For the baby – no pain medication at all. Squeezed from the warm, dark comfort of his mother’s womb, he suffers through a ten-hour marathon of suffocating agony to land in the hands of yours truly.

And the next day we meet again, so I can cut the foreskin off his penis.

Moms generally like me pretty well.

Newborns probably don’t.

Making It Look Easy

I was taught the art of the circumcision by Paul Taylor, a Physician Assistant at Grady Memorial Hospital in Atlanta. In his thirty-year career, Paul had probably performed more circumcisions than anyone else in the country. To date I have done only fifteen hundred, a mere ten percent of Paul’s total count. I still consider myself pretty good. But Paul was the best.

A year ago, Paul was tragically killed in a bicycle accident. I think of him every time I do a circumcision. Sometimes I am saddened by his untimely passing. But then I focus on the five-minute task at hand, grateful for his lessons almost twenty years ago.

When I watched Paul do that first circumcision, I naively commented that it looked pretty easy.

“When Jack Nicklaus hits a golf ball 300 yards down the center of the fairway, he makes it looks easy, too,” Paul retorted.

Paul was right. There are subtleties to the art of the circumcision that I have come to appreciate. But Paul’s technique has no doubt been responsible for my years of circumcisions unbroken by a single complication.

“Give a man a fish, feed him for the day; teach him to fish and feed him for a lifetime.”

Alleviating Pain

There is, however, one thing I do differently from Paul. When my sons were newborns, it bothered me that they received no pain medication whatsoever. This was the traditional way to perform circumcisions: strap the baby down, cut the foreskin off his penis, and let him cry himself silly.

I am proud that I have used pain medication for every circumcision I have ever done. I apply topical pain cream an hour beforehand and also use an injection at the time of the procedure. Yet even though I am diligent in this “alleviate suffering” matter, my babies still cry. So sometimes I resort to another trick Paul showed me. Sugar water on the pacifier works like a charm. The baby sucks happily and usually stops crying.


The take-home message is this: life hurts, no matter what you do. The expectant mother with the epidural still cries when the baby is coming out, and the newborn on Dr. Litrel’s pain medicine cocktail still doesn’t like having his penis cut open.

Life’s pain begins when it’s our time to be born. And Life’s suffering ends, just in time for our funeral.

How we understand and handle that pain determines who we become. Do we take drugs, or alcohol, or sugar, to get through yet another day? Or do we build spiritual resilience, in understanding the purpose of our short time here on this earth?

Those are the questions we answer all our lives. The less we need to take, the more we have to give.