I am comfortable with the discomfort of a bris milah, the Jewish ritual circumcision. The attendees know the event is awesome. Jokes that break the tension belie the power of the moment. Nietzsche wrote, "Wit closes the coffin on an emotion." What we feel at a bris is primal, powerful, and often troubling.

Leonard Glick's provocative book, "Marked in Your Flesh," asks: Is what happens at a bris also cruel and unwarranted?

We accept that parents can make certain decisions for their children. Young children do not get to decide which city they will live in, which clothes they will wear, or which schools they will attend. But does it step over the line of parental discretion to choose surgery for your child that is not medically mandated?

These are not easy questions. Much of the time, Jews simply dismiss such concerns, because to think about them is to confront the discomfiting reality of a bris. Confronting them bring two sides of ourselves into direct conflict: on the one side are notions of autonomy, sensitivity to human pain, the stainless steel rationalism of modernity. On the other is a very ancient and sanctified tradition, one that has claimed Jewish allegiance, and even cost Jewish lives.

"Marked in Your Flesh" is part history, part medical analysis, and part intemperate polemic. Glick's anger shines through even those sections of the book that are putatively dispassionate. Throughout the book, there is a deep perplexity. The author--a cultural anthropologist with a medical degree--wonders what hold this "barbaric" ritual could have for people who in so many other ways are rational and thoughtful and even humane in their lives?

Glick thoroughly documents the history of circumcision. His research is admirable. Beginning in the Bible, Glick recounts how circumcision has changed throughout the history of Judaism and Christianity, highlighting the spirit-flesh polemic between the two faiths. (Disinterested bystanders like the Romans simply dismissed circumcision as equivalent to castration.) He indulges in some plausible and learned speculations as to the motivations of the rabbis, the medieval poskim (decisors of Jewish law) and even mythological flights relating to brit milah. He ends what is a fairly exhaustive survey by recounting bris vignettes from the writings of Philip Roth, Bernard Malamud, and even cites a "Seinfeld" episode (complete with footnotes discussing variations in the script).

A nasty, brutish obsession?
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Most of the time, the author refrains from launching into the polemic the reader can sense in the tension of his argument like a catapult drawn back, waiting to be launched. At certain points, however, the restraint slips a bit, and small polemical rocks shoot at the target.

For example, he writes of an "almost obsessive need to justify infant circumcision" on the part of the rabbis. Yet to anyone familiar with rabbinic literature, the redundant justification of law-that is, the rabbinic need to fashion many paths to the same conclusion--is the norm, not the exception. And although some of the rabbinic justifications are antiquated, Glick's aim is not to recast outdated answers, but a more ambitious one: to mount a cogent argument for ending the practice of ritual circumcision.

In the last few chapters, Glick unleashes his argument: Circumcision, though medical benefits have been claimed for it, is damaging and has no reliably demonstrated positive effects. He seems as thorough here as he is in recounting the ritual's religious history. A large number of doctors, publications, claims, and refutations are paraded before the reader.

To competently review all of this would take a great deal of time and probably a medical degree, but I did notice that Glick downplays the enthusiasm of those who findings he cannot ignore (such as Thomas Wiswell, the neonatologist, who conducted a large-scale study of male infants and, contrary to his initial assumption, went on to recommend circumcision). Glick also obliquely questions the motives of Jewish physicians who endorse the procedure: "...it is worth considering whether this physician has less personal investment in circumcision advocacy than is evident in the publications of Abraham Wolbarst, Abraham Ravich, Gerald Weiss, and Aaron Fink."

Although I had read other material that contradicts Glick's conclusions, (by Dr. Samual Kunin and others), how was I to evaluate this mass of medical material?

The morning I began writing this review, there was an article in the Los Angeles Times. The report notes that circumcision rates have been falling as states have cut Medicaid funding for the procedure, "even as growing evidence suggests that the surgery may reduce the transmission of HIV and other sexually transmitted diseases." One random trial in South Africa was halted because the results were so convincing that it was thought immoral to continue the experiment. The epidemiologists who were quoted in the article (Dr. Thomas Coates of UCLA, Robert Bailey of the University of Illinois at Chicago) said nothing about ritual circumcision. They advocate the procedure not because it is God's inscrutable mandate, but because they believe it saves lives.

Glick points out with puzzlement that even those who are estranged from the tradition cling to this seemingly antiquated and uncivilized ritual. He seems not to grasp the immense power of expressing the covenant in one's flesh. Jews do not practice circumcision because it is hygienic, but because it is one of those deep-throated, sanctified expressions of yearning and commitment. In ceremonial language, the parent says "I turn myself and my future to you, oh God, in a ritual that will forever identify my child as part of his people. In return, we ask that You help this people endure until we accomplish what we are charged to do: join together to fashion a world in which sacrifices will no longer be needed."

That is a commitment that supersedes statistics and transcends the shifting medical fads of the moment.

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