10-14-2010
What happened today... As a medical student at America's oldest hospital, Pennsylvania Hospital, I was happy to be on the obstetrics rotation. While still in college, I had heard an obstetrician speak enthusiastically about his optimistic specialty. So now I was enjoying helping to bring babies into the world. While professors provided good background information in formal lectures, my real teachers were residents only a few years older than I was. They took turns talking me through normal deliveries. Almost every doctor can recall the joy of delivering a healthy normal infant. This joy was shattered one day when one of the residents said, "There are some circumcisions that need to be done, go and do them." At the time I guess I knew what a circumcision was, but that was about it. I had certainly learned nothing about the subject in medical school. Obediently, I proceeded to the newborn nursery, where another medical student was already waiting. I felt nervous, and he looked quite nervous, too. Strapped to a board on the long counter in front of each of us was a bawling male infant. Beside the infant was a surgical tray filled with instruments. Imagine our consternation when we found there was no one to tell us what to do. Obediently, we put on surgical gowns, then surgical gloves. Then we began to try to figure out how to use what I later learned was a Gomco Clamp. As far as I know, I made a fairly neat job of it. But my abiding memory of that day is of my colleague. He was one of the more brilliant members of our class, and was planning to become a radiologist. As for surgery, forget it. He was all thumbs. I still remember him, standing beside me, fumbling with the complicated instruments, proceeding to use them on the helpless penis before him, all the while just shaking his head! I look back on the only time I have ever performed any circumcisions with regret and resentment. I resent having had no opportunity to study circumcision in medical school or to consider whether I thought it a treatment for anything. I resent the resident commanding me to do it, while offering no further guidance or help. In fact, I was treated just as the medical profession treats innocent new parents today. Doctors tell them a circumcision needs to be done. Before the new parent has time to consider, it is all over. Then it is too late to say no, and everyone has to live with the consequences. I was a medical student, so a lot of the responsibility was mine. I clearly violated, all in one instant, the Golden Rule (I certainly would not have wanted that done to me), the major tenet of medical practice, First, Do No Harm, and all seven principles of the American Medical Association's Code of Ethics. Mind you, I did not realize it then, just as unwary medical students do not realize it today. Now I know there are no valid medical indications for routine neonatal circumcision. I realize much harm can be done, evidenced by the thousands of men who have written their testimony and who have told me personally of the harm done to them. Now I also realize that I violated my patient's basic human right to enjoy his entire body intact, while all he could do was scream his tiny head off. That was some years ago, but it might just as well have been last year. The United States is the only country in the world that, for no religious reason, severs part of the penis from the majority of its newborn males. I speak out in the hope that many parents and doctors will read this before getting swept into the cultural madness of routine neonatal circumcision. What should one do if called upon to consent to or to perform circumcisions? Just say NO! In so doing, you will be taking the only ethical position there is on this issue.
