About a month ago, I attended the AAP annual conference in San Francisco at the invitation of Marilyn Milos to help out with the NOCIRC booth. I spent three days there with Marilyn, John Geisheker, and Steve Scott (NOCIRC-Utah) where we interacted with doctors and other health care professionals. This is my report with an epilogue on the future of this blog.
The Four Pediatricians of the Infant Circumcision Apocalypse (I jest!)
We encountered what I judged to be essentially four types of doctors. A fifth type, the ones who agree that infant circumcision has all sorts of ethical problems and who don’t do them are fairly well known to NOCIRC and not included in this report.
The first type could be termed the Eye Averters. This group would pass the booth eyeing the exhibit space on both sides of the aisle, including the ones just past and just before ours. They were steadfastly blind to our booth and our message. They are followers. When the majority of parents stop looking to them for advice on circumcision, they will fall in line and stop doing circumcisions. They are probably a rather mediocre set of doctors, having strong opinions on nothing and content to go along with any ol’ consensus.
The second group might be called the Saavy Smirkers. They would pass our booth, smugly smirking with a knowing eye-roll for effect. Sometimes they would stop and deftly refuse to engage on the subject while perusing our literature. They politely refused when offered a pamphlet to take with them or even the very generous offer from Marilyn of a more expensive gift, such as one of the many books we had available. Their tiny little gears that whirl about, protected behind their very thick skulls could be seen nonethless behind their beady little eyes. These doctors may be relatively competent and harmless in other areas of medicine, but undoubtedly are major perpetrators of infant circumcision. They will continue to do them until they can’t anymore. When other doctors and parents make it too uncomfortable, they will stop.
The third group of doctors could be aptly termed the Sassy Scene Makers. They would occasionally make a scene, but were nonetheless few in number. They know they are beginning to swim against the tide and have an emotional reaction to this fact. They are in the second stage of the five stages of grief. They have already gone through denial that circumcision is falling out of favor and has achieved a status of controversy sufficient to provoke parental questioning. They are now in the second stage of anger. Soon they will enter bargaining — a stage we have seen among certain high profile circumcision advocates of the last few years. Before long, they will sadly accept (depression and acceptance) that the foreskin is normal, parents don’t want to cut it off or pay for the procedure, and that kids will grow into men thankful to have normal, unaltered genitalia. Their passion masks their capture by cultural bias. Some are misguided. Some are financially conflicted. Few are inherently evil. They just need to get over it.
The fourth group of doctors I call the Mengeles of Medicine. Despite the fact it isn’t a perfect or necessarily apt comparison, I like the ring to it. These are the arrogant ones who stop to politely chat and nod in agreement that circumcision is so unnecessary, takes time and resources from other areas of their practice, and may even be bad for the child. “However,” they explain, “I do them because I know that if I don’t, the parents will find someone else to do them and the result could be bad.” At least, they apologetically insist, “When I do one, I know it’s done right.” These doctors knowingly violate their ethical duties to do no harm. They feel they are the bulwark against the worse harm surely to come from the implicit stupidity of the parents of their tiny patients and their incompetent colleagues these parents patronize. The Mengeles of Medicine see themselves as heroes who must step in and practice their own brand of harm reduction. These doctors are our worst perpetrators of genital mutilation because they cannot see or refuse to see their own role in its perpetuation.
I’ll give one example of this last category. A woman stopped by on the second day of the conference and explained that she practices in the northwest portion of Florida. Her patients are low-income and mostly African American. They come in with long-held assumptions about childbirth and circumcision and a poor understanding of their own health and health care. They are obese, poorly educated, religious to the point of superstition, and consistently make poor health choices. But, this doctor explained, “I try to help them by telling them to make better choices and to teach their children to make better choices.” She explained that when they insist on circumcision, she does them because she knows they “can’t be talked out of it,” will seek the surgery elsewhere, and at least “I know the outcome will be good if I do them myself.” She admitted that circumcision is harmful, but she sees her infliction of harm as less than the harm some other doctor might inflict. She violates her Hippocratic Oath, she reasons, in order to stop a worse violation by some other practitioner.
Bad enough, huh? But this woman explained that she knows the sexual value of the foreskin because she is German-born and trained without any of the anti-foreskin biases of the American medical establishment. She’s internationally experienced and sophisticated while her poor black patients are not. Therefore, she admitted she has to do some things she would rather not because of the stupidity of her poor black patients, patients which she has come to that part of America to help. Now, I’ll admit I’m making some assumptions on her motivations. But it is true she said everything I’ve recounted here. She simply didn’t see any parallel with the colonial mindset of Americans who go off to Africa to save the Africans from themselves or the irony of a German doctor coming to America to engage in ethically questionable medical practice among African Americans. She’s both clueless and sophisticated enough to rationalize her unethical practice. She is a Josephine Mengele of Medicine.
End of report.
Now, how about that MC_HIV website?
This will be the last post on MC_HIV for a while. Maybe for good. I have posted monthly for the past four years as of next month. In this time, the world of blogging and activism has moved on to facebooking, tweeting, and other forms of getting the word out.
I will continue to use twitter, maintain this site, and post items to facebook. I am committed to remaining engaged with the movement. However, my by-now years of guilt in not hitting the important stories in a timely manner needs to end. It isn’t healthy or productive for me to feel the pressure to post or the guilt in missing an important story. So I am making a conscious decision to end my commitment to regular blogging.
Thanks for everyone who has posted or commented, and been a part of this community. Please
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