Prime cut

On a gray Sunday morning at the Eldorado Country Club in McKinney, Rabbi Michael Rovinsky stands in a high-ceilinged back room that's nearly empty except for a few chairs. He's a mohel (the Yiddicized pronunciation is "moil"), a rabbi authorized by Judaic certification to perform the bris milah, the Jewish ritual of circumcision. While the family mills about anxiously in the hallway outside, he is trying to set up the room for this sacred 3,000-year-old ceremony that bonds their 8-day-old baby boy to God by slicing off the foreskin of his penis. Rovinsky's concern at the moment? Where to place the Chair of Elijah, the shawl-draped seat where the baby rests during the ritual, so the bris will receive the best light for the news photographer.

"Where's the best place, photography-wise, for you to shoot?" asks the short, slight 36-year-old rabbi with the mile-wide grin. He moves to one end of the room, examining the glass double doors that bathe the room in overcast light. Then he traipses to the opposite end--a solid wall--looking pleased. Near the wall it will be.

"I'm going on three hours' sleep here, which I should never tell the parents," he chatters amiably. "But sometimes I tell them, 'Oh, don't worry, I don't like to watch it either. I keep my eyes closed the whole time!'"

This is one ribbing rabbi. He keeps it up when little Benjamin's mother, a lovely but nervous Vietnamese-American woman named Lisa Eisenberg, arrives before the crowd begins to trickle into the room. He tells her the "I keep my eyes closed the whole time" line, then takes a couple of minutes to offer more serious, albeit brief support. They had met before: Rovinsky circumcised her first child.

As the room begins to fill with more than 50 friends and relatives, Rovinsky sets up his white-draped surgical table against the more photogenic wall. He lines the table with kosher wine, a ritual knife, surgical scissors, pink antiseptic, "secret healing stuff" ("If I told you what it was," he says, "I'd have to shoot you"), and what Rovinsky declares is his "secret weapon," an instrument that is used, he claims, by only three other mohels in the country--a hemostat, specifically designed for open-heart surgery.

With his narrow shoulders draped in an ornate prayer shawl, he tries to silence the loud buzz of conversation and begin the bris. He turns off the beeper stuck to his belt--he also has a toll-free number(1-800-85-MOHEL), a Web site, and a laptop with modem that he carries everywhere with him.

Rovinsky, who counts a bachelor's in education from Adelphi University in New York among his many degrees, is a master of showmanship to groups large and small. He offers the crowd a short opening speech, serious but still seasoned with a few jokey asides.

The crowd grows a bit restless, and Rovinsky later admits that this is a low-energy bris--loose and informal with only a few tears from the gathered women--an appropriate mood for a country club. Most brissim are conducted in the home or the synagogue, where strong emotions and religious pride are more freely vented.

"All right, what I'm about to perform is the 'bris milah' [meaning covenant of circumcision]," Rovinsky explains. "Medically, it looks like circumcision, but it's not. You can do that in a hospital. This ceremony will reconnect this child 3,000 years back to his patriarchs and matriarchs."

Rovinsky was referring to a passage in Genesis that describes God entering into a pact with Abraham and the Jewish people: "Every male among you shall be circumcised. And Ye shall be circumcised in the flesh of your foreskin; and it shall be a token of a covenant betwixt Me and you."

Then Rovinsky, after invoking the Jewish prophet Elijah, whose hands are said to work through the agent performing the actual snip, asks the dad if he wants to perform the bris: According to Jewish law, the mohel is merely the agent of Elijah and the father, and must hang in the background if poppa wants to make the cut. Paul Eisenberg, a tall, curly-haired man with a distinct Texas accent, declines without hesitation.

With sleeping Benjamin wrapped in a white blanket and resting atop a pillow on his grandfather Jerry's lap in Elijah's Chair, Rovinsky does the work that has made him a most popular mohel. Grandfather Jerry undiapers Benjamin and holds his chubby legs apart with five fingers each. In less than 30 seconds, with family and photographers in a tight circle around him, a surgically gloved Rovinsky slits and separates Benjamin's foreskin from the head of his penis using a speedy 380-degree rotation of his wrist. Bleeding is minimal; Benjamin screams nonetheless. The rabbi then applies a narrow, antiseptic strip of gauze around the penis. In accordance with Jewish custom, he also dips a finger in kosher wine and nudges it into the baby's mouth to suck--a token gesture to alleviate the baby's pain and the parents' anguish.  

"There are no Jewish winos," he says afterward. "There are alcoholics, but no winos. The taste of wine for a Jewish man has a bad association."

There's not much time to dilly-dally, because Rovinsky has circumcisions--not brissim--to perform, an estimated dozen for the St. Louis resident during his Sunday-afternoon visit to Dallas. He meets briefly with Lisa Eisenberg to describe what signs she might expect from Benjamin if he were not recuperating well. Rovinsky's flight leaves for St. Louis at 6 p.m., and he tells her, half-jokingly: "I've got a pager. I'm on the hook till a quarter to six; after that, nothing's my fault."

After he receives a $350 honorarium, the rabbi rockets back down Central Expressway to North Dallas, where his parents live and where Michael Rovinsky was born and raised. He has to be there before 11:30 a.m. to begin performing circumcisions on the dozen or so gentile clients. Although these families are scheduled at 30-minute intervals, Rovinsky's 30-second method makes it possible to do more than one during each appointment. Sometimes, when the families arrive early or late, loitering outside the open door or marching right inside because they've been here before, he deems this conveyor-belt approach necessary. All procedures are performed on a spotless blond wood table in his parents' dining area.

Rovinsky claims he's performed more than 40,000 circumcisions--both Jewish and gentile--in various states. Weekdays he is executive director of the H.F. Epstein Hebrew Academy in St. Louis, but weekends he travels wherever he's asked (his clients bring him back to his native city a couple of times a month). He also makes his bris-related ambitions apparent: "It would not be inaccurate to say that I want to relocate my family to Dallas. I want to make a living from my bris technique."

The rabbi's speed, precision, and borscht-belt banter have made him a word-of-mouth hit not only in the Jewish community but also in the midwife circuit that courses through the so-called "alternative medicine" scene. But his reputation has also traveled into anti-circumcision circles--those "intactivists" who have expanded their numbers in the last 25 years to include many doctors, ethicists, and medical institutions. Some wonder about the legal gray area in which Rovinsky works: Specifically, since he is unapproved by any legal or medical institution, is he performing surgery without a license when he circumcises gentile babies? Others wonder about the medical necessity of the procedure: Does it harm the infant, scar his sexuality by literally cutting off nerve endings that would otherwise enhance sensitivity? Rovinsky even has his critics within the Dallas Orthodox Jewish community, who see him as an interloper, a shameless promoter who might not follow the letter of Jewish law when he circumcises his clientele.

Rovinsky, who is an Orthodox rabbi, insists he's operating firmly within legal, moral, and ethical bounds.

"Does the money play a part in it? Yes," he says. "But I'm not doing it for the money. I'm doing it for the mitzvah, the good deeds."

The "good deeds" Michael Rovinsky cites can be broadly divided into two categories: his desire to deliver Jewish families a long-cherished religious ritual and, for those gentile families who request his drive-thru McMohel service, the desire to share what he insists is a fast and less painful procedure.

"Jewish law mandates that pain must be minimized whenever possible," Rovinsky says. "I use a topical anesthetic, and I can give an injection, but in my experience, that can be just as painful as the bris." With his awareness of infant pain, the rabbi is part of a national movement among medical circumcisers that has finally acknowledged what any baby would tell you if he was able: Having skin from your penis sliced off with a knife and without anesthesia hurts like hell. Nobody can give specific numbers, but more than half of all medical circumcisions in hospitals across the country are performed without anesthesia.

A January study published in the Journal of the American Medical Association suggests that the pain--measured from the heart rate, breathing patterns, oxygen intake, and the pitch of the baby's cries--may be greater than anyone had previously thought. A 1997 study in OB/GYN News suggests what Rovinsky and other rabbis insist they already knew: The mogen clamp they employ to hold the foreskin in place and guard the head of the penis is less unpleasant than devices used in most hospitals such as the gomko clamp (which crushes the foreskin before removal to reduce bleeding) and the plastibell (a device that stretches the crushed foreskin over a bell-shaped device, and results in many hospital procedures lasting over 20 minutes).  

"In my experience, the procedures that hospitals use are a lot more painful," Rabbi Michael Rovinsky says. Although he refuses to name the hospital, "I worked under urologic pediatricians in Baltimore. Over a three- or four-week period, we did our own unscientific comparison. The doctors hooked babies up to heart and breathing monitors, and these boys were sent into the red zone when the doctors used the plastibell and the gomko; they shrieked more and for a longer time. When we used the mogen and the hemostat, they shrieked less and just went into the yellow zone."

In the interest of promoting his speedy circular cut as well as what he claims is the more humane hemostat to pull the foreskin (it's a scissors-like device that doesn't pinch when the skin's grasped), Rabbi Rovinsky has created the Association for the Advancement of Bris Milah ("it's basically just me"). This one-man education machine went into full gear in 1990, when Rovinsky returned to Dallas after travels and studies in Baltimore and New York, and began to meet with other rabbis and Jewish community leaders to introduce his technique. His cousin, Bernie Dworkin, is currently shooting an educational-promotional video with Rovinsky in his parents' home to distribute to midwives nationwide. But what will this video promote more: a kinder cut or Rabbi Rovinsky?

Rovinsky nods, smiles, and concedes, "The video is self-serving."
Rabbi David Shawel, a practicing Texas mohel ("I'm the resident Dallas mohel; when you pitch your tent in a certain city, you're the resident mohel") of 20 years who lives in Dallas with his wife and five children, probably wouldn't be surprised at this admission. Shawel claims that when the Association for the Advancement of Bris Milah began its proselytizing work in the Dallas Jewish community, Rovinsky took business away from him with his aggressive promotional tactics.

As Rovinsky plied his trade, he became a big hit. "He does great work," says Keith Stern, former rabbi at Beth Shalom in Arlington who now heads a congregation in Boston. "Everyone I knew loved him, and my congregation used him more and more because he was such a character."

But Rovinsky developed an enemy in Shawel. "I don't have any problem with him working as a mohel. I just think he should do it in St. Louis and the surrounding regions where he lives, rather than taking my parnasa, my livelihood; I was the resident mohel here since 1984, and it's the way I support my family and support my community. I have the endorsements of most of the congregations here in the community."

Of Rovinsky's style, Shawel says, "He hustles business. I've heard from families who come to his parents' home that he just rushes them through; that he has three or four families waiting while he performs. Some people said they didn't get a sense of care, that they felt like they were on an assembly line. And I wonder, how much of a religious significance can there be to what he does?"

Rabbis Shawel and Rovinsky have been engaged in something of a turf war since Rovinsky's return in 1990. Shawel admits that he went to rabbis and Jewish leaders in the Orthodox community to complain that "this fellow is coming into a region where there's a regional mohel" and, he claims, "performing brissim on days that are not the right day" (Judaic law mandates that the bris milah must be performed on the eighth day after birth). Shawel insists there were four or five other people in the Orthodox community who had complaints about Rovinsky's "procedures." They met in 1993 at the Akiba Academy, a Jewish private school where Rovinsky was employed, to address these concerns with the academy president. Rovinsky's yearly contract was not renewed.

Rovinsky declares, "There is no problem between myself and the Orthodox community in Dallas. The only damage the other mohel did was, he became friends with my boss at the academy, and I wasn't rehired. It's a professional jealousy issue. His attitude was, 'I was here first, and I don't like you working here too.' But there's no Jewish principle to support that. Let's say you have one school, and someone wants to open another. They're both to enhance Jewish observance."

Although Rabbi Rovinsky concedes he is a self-promoter, he strongly maintains that he has never encouraged anyone to circumcise an infant son: "With Jews, it doesn't need to be encouraged. It's just something we do, something that's a part of our faith. And I have never recommended to a gentile that the son be circumcised."

Yet gentiles continue to seek his services, despite increasing evidence that circumcision causes significant pain and reduces sexual sensitivity in the adult. Intactivists have insisted that, historically, a primary function of the procedure has been to curtail sexual pleasure. Eleventh-century Jewish physician and scholar Moses Maimonides wrote that an important reason for circumcision was "to limit sexual intercourse, and to weaken the organ of generation as far as possible, and thus cause man to be moderate." During the "masturbation hysteria" of the late 19th century stirred up by doctors as well as religious leaders, the non-Jewish Medical Record declared, "In all cases of masturbation...circumcision is undoubtedly the physician's closest friend and ally. There must be no play in the skin after the wound has thoroughly healed, but it must fit tightly over the penis, for should there be any play the patient will be found to readily resume his practice."  

Perhaps espousing his own Orthodoxy, Rovinsky vaguely echoes both ancient Jewish philosophers and turn-of-the-century medical journals when explaining why God picked the foreskin and not the forefinger or the forehead as the place to mark His covenant. "A sign on the reproductive organ reminds Jewish men that we have choice, that we are not animals. Jews don't believe sex is sinful, but it has to be the right time and the same partner for the right reasons. Why weren't women chosen for this ritual? Because women are higher spiritually, they have a lower sex drive. They don't have a problem saying no."

The July/August issue of Men's Health puts a more deliberately anti-circumcision spin on the sexual inhibition issue. In an article titled "Separated at Birth: Did Circumcision Ruin Your Sex Life?" writer Mark Jenkins quotes urologists and pathologists who insist that in an area that grows to be about 12 square inches of skin in an adult male, the foreskin contains 240 feet of nerves and more than a thousand nerve endings. The article claims that one evolutionary function of the foreskin is to protect the head of the penis, which tends to grow rougher and less sensitive early in a circumcised adult's life.

"Separated at Birth" is only the latest salvo fired in the assault on sexual and medical excuses for routine circumcision. Conventional wisdom once held that uncircumcised men have higher rates of sexually transmitted disease. A 1997 Journal of the American Medical Association study now declares that "there is no evidence of a prophylactic role for circumcision, and a slight tendency in the opposite direction [with herpes, hepatitis, and chlamydia]." The study even suggests that circumcised men have higher rates of impotence and delayed ejaculation. And as far as the link between penile cancer in uncircumcised men and cervical cancer in their partners, the American Cancer Society released a 1997 statement asking pediatricians to stop making this connection, because rates of both are lower in countries where circumcision isn't routinely performed.

You might say that religious faith slams shut the door on such rational considerations--and indeed, for most Jews, the bris milah is performed as reflexively as Christmas is among Protestants and Catholics. But there are rumblings of dissent even from Jewish corners. Moshe Rothenberg is a social worker in New York and the author of articles condemning ritual Jewish circumcision. He defines himself as "not Orthodox, but observant." He has spoken at conferences from San Francisco to San Antonio for the anti-circumcision NOCIRC (National Organization of Circumcision Information Resource Center) and NOHARMM (National Organization to Halt the Abuse and Routine Mutilation of Males) and demonstrates a birth ritual for boys and girls that he describes as bris b'lee milah ("covenant without circumcision"). Along with Miriam Pollack on the West Coast, Ron Goldman in Boston, and Victor Schoenfeld in England, he's a Jewish gadfly on an issue about which community discussion is still very limited.

On the sexual inhibition issue, Rothenberg says, "I don't see men as being inherently sexually promiscuous; human beings are inherently social. And as such, we will always need constraints on our behavior. That's where society comes into play. You don't have to be circumcised to learn that you're not supposed to run a red light."

As far as the "Do we follow God's Covenant with Abraham or don't we?" question, Rothenberg admits it comes down to how one applies religion in one's own life.

"It's not religious law that makes me a practicing Jew but the love for my people and my culture. And I believe that performing medically unnecessary surgery on a Jewish infant is abuse."

If you let your eyes travel over the stats and studies, you will notice that U.S. circumcision rates dropped by 30 percent during the '70s and have held relatively steady at 60 percent, with just over a third of boys cut on the West Coast in 1996. But Rabbi Michael Rovinsky is unperturbed by changing attitudes. His gentile business through national midwife referrals grows larger every year. He's a natural for this market, a bladesman whose patina of a multi-thousand-year-old tradition dovetails with their desires to steer clear of anonymous medical technology and bureaucracy.  

Rovinsky claims he can understand why non-Jewish parents might decide to keep their son's foreskin intact. But for those who decide to circumcise their son simply because the father was cut or because they want their kid to look like everyone else on the soccer team, Rovinsky says: "Jews perform the bris milah because it's part of our covenant with God. On the other hand, the desire to look like everyone else just for the sake of conformity is a character weakness."

Still, it's a character weakness Rovinsky will indulge for a fee. Whether for cosmetics or conformity, his gentile clientele travel many miles to obtain his services.

On the Sunday afternoon following the bris milah at the Eldorado Country Club, eight families with weeks-old baby boys arrive in roughly two hours at his parents' doorstep. Some have driven from as far as San Antonio, Austin, Wills Point, and Quinlan. All are non-Jewish; most have another little boy in tow, an older brother whom Rabbi Rovinsky has circumcised.

Rovinsky's mother steps in and helps, ushering these children into a back room to watch videotapes of Barney or Winnie the Pooh. Another back room has been opened to the mothers, many of whom have been advised by the midwives and Rovinsky to breastfeed immediately after the circumcision.

At least four times before he dons surgical gloves to perform the procedures, he stands in front of the big-screen TV and repeats this spiel, sometimes to more than one family seated on the couches in his parents' living room:

"This is what your son looks like now." He extends an arm with the shirtsleeve cuff pulled over his fist. "Our goal is to have your son look like this." He pulls on his shirtsleeve and the fist pops out. "The pain that he will feel should be no more than having a torn cuticle." He pauses. "Or at least, that's what the babies tell me."

These parents appear happy and even relieved to be in the Rovinsky home. They laugh at his jokes, and when questioned, the mothers and fathers say they wouldn't think of having anyone else circumcise their sons. It's because of his fleet-handedness and professionalism--pro or con, you have to admit he possesses both in abundance--and, probably, because of the endless stream of wisecracks that makes the whole affair less tense for these parents. And he keeps the procedures free of religious cant, "out of respect," he says, because the non-Jewish families who seek his services are of so many different denominations.

"A lot of the jokes are forced," Rovinsky says. "They take the edge off. My goal is to provide families with as painless and comfortable a procedure as possible."

The one-liners come, fast and furious. Performing for the parents and the small black video camera that yarmulked cousin Bernie Dworkin has aimed at the dining-room table, Rovinsky lets 'em fly:

"This kid's so well endowed, I'm gonna have to charge the parents double!"
"Let me just make the snip here...Oops, it's a girl!"
A baby spraying him with urine right before the cut: "It's payback time! I always remember to wear my wet suit too late!"

Sometimes the parents get in on the act. When Rovinsky changes a boy's soiled diaper, he declares himself the "full-service mohel." To the mother standing beside him, he asks immediately afterward, "Do you breastfeed?" The father, on the opposite side of the table, counters with, "Wow! You really are a full-service mohel."

His fee--once again, he stresses it's an honorarium, saying he will perform the circumcision for free if the parents are in financial straits--is $150 for midwife referrals. Rovinsky says he performs an average of 15-20 a month, netting about $2,000 in that period--not enough right now, he admits, to support his wife and three children. Once, he did as many as 22 in a 24-hour period. For the bris milah, he's earned from zero to $1,000 plus plane fare.

But even as Rovinsky attempts to market himself nationally to the alternative medicine scene, some anti-circumcision advocates have raised questions about the legality of a rabbi performing what they call "surgery without a license" on gentiles. Some states exempt mohels and Muslim clerics who perform religious circumcision from official certification by state medical boards. In other states, such as Texas, they are simply non-entities, unaddressed by law or regulation. Mike Young, a veteran lawyer with the Texas Department of Health, says: "This is a hole you could drive a truck through. The Medical Practices Act, which the State Board of Medical Examiners concerns itself with, defines a physician as someone who declares himself a physician, someone who says he is performing medicine to cure or treat an illness or injury. Mohels don't claim to be doctors, so under this definition, they couldn't be prosecuted for practicing medicine without a license."  

For a district attorney to prosecute a mohel, Young says, the rabbi would have had to botch the circumcision pretty badly. "I mean, think about the publicity--some Baptist prosecutor charging a Jewish practitioner with injury to a child for a centuries-old religious practice? In my opinion, you'd have to have a rabbi who was routinely unclean and unsafe."

Camellia May, a Houston midwife and the head of its local NOCIRC chapter, is more than a little peeved about the state's refusal to regulate mohels and Muslim holy men who practice religious circumcision. "The state regulates the hygienic practices of beauticians or fingernail-parlor operators, yet ignores the surgical alteration of a baby's genitals. I guess it means adults getting their hair cut or nails done deserve uniformity in training and cleanliness, but babies don't matter. Just because a mohel or a Muslim holy man rather than an M.D. performs circumcision does not make it risk-free." Of course, she sees injury in all circumcisions, because they cause pain and alter a child's body.

May wants to make it clear that her efforts are focused on those in the 98 percent non-Jewish majority who circumcise. Yet she has discovered that the pull of conformity can be just as powerful as religious conviction. "When it comes to circumcision, there is no one on this planet who can be totally objective and without prejudice," she continues. "But people aren't open to discussion. If I say something against circumcision, I have people screaming that I'm trying to oppress their religion. If I try to talk about medical benefits to being intact, suddenly I'm trying to take away their parental rights to decide how their baby's penis should look or force them to have a son with ugly genitals...My belief is that this is the way baby boys are made by our Creator, and we shouldn't alter healthy, functional tissue."

Rabbi Michael Rovinsky sticks to his guns--he insists he is operating firmly within the laws of the states where he performs both bris milah and circumcision, including Texas. He knows his Jewish clients are coming to him to fulfill the Jewish people's covenant with God, and the non-Jews have equally strong, though perhaps different, motivations. For him, the belief that his technique reduces pain constitutes his mission to bring a humane Judaic principle to a widely practiced (if controversial) procedure.

And it's also his ticket to move back to Dallas and make a living from his work. For the rabbi with the beeper, Web site, 800 number, and customized license plate that reads MOHEL, the fulfillment of both goals means getting his name and his face out there.

He stands beside the operating table in his parents' dining room as cousin Bernie crouches over the video-camera eyepiece. He moves forward, then back; the two of them are trying to find the best location for him to stand during the making of the educational-promotional video.

"I want you to shoot close enough that you can see the procedure," Rovinsky tells Bernie, "but not so close that you can't see me.

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