The unkindest cut of them all

Ah, summer! It’s always a great time for beach outings, remedial classes and circumcisions.

It was a bright and perky Saturday morning when I trooped to San Lorenzo Makati’s barangay to witness (and, hopefully, not participate) in the glamorously titled “Operation Tuli.” I was greeted outside the barangay hall by an assembly line of snickering, shivering and wailing male tweens who had an iron grip around their groins. As I saw them edge closer towards the makeshift operating rooms, I gripped my own groin out of sympathy as well. And I gripped it too lest the organizers mistake my boyish good looks as a sign that I would need a circumcision as well.

I thought I was brave enough to watch one of the procedures (purely, purely for journalistic reasons). At first, I was able to keep my composure when the doctor swapped the young boy’s entire pubic area with Betadine. Then I felt my sphincter muscles move as I saw the doctor take out a needle filled with anesthesia that was about five feet long and poked it into the base of the poor boy’s penis.

He asked the young lad to take a deep breath. “Now I want you to count down from 30,” the doctor ordered. Dear Lord, I thought, how can the doctor think about the boy’s math skills at a time like this?

As my sphincter muscles began to loosen up, the doctor took out a pair of clamps that looked like they could fasten down an elephant. That was when I finally passed out on the floor, but still firmly cupping my groin.

After being slapped back into consciousness, I spoke with Dr. Juan M. Lim Jr. of the University of Santo Tomas (UST), head of Operation Tuli — who also happen to be my neighbor — a man who has seen many a foreskin pass through his expert hands.

RJ LEDESMA: Hey, doc, can you share with me some neighborly love and check if my mom’s obstetrician-gynecologist did a good job on my little stud gun?

Dr. Juan Lim: That would be too hazardous to my health.

Sigh, that’s what my wife used to say to me as well. So are there actual health benefits to getting snipped in your pink parts or is it some sort of Jewish conspiracy?

Well, we usually advocate circumcision.

So you guys have a party-list group in congress?

For men who haven’t been circumcised, there is a higher risk of developing infections. There have also been reports of cancer developing  because of the smegma that is attached around the penis.

Smegma? That sounds like the name or a radioactive Japanese monster. Or a Pokemon.

It is a foul whitish discharge around the skin of penis.

DOM Chuwariap (sidekick): So not all discharges are good?

As we become older, we should be more health conscious and clean it more often.

Because cleanliness is next to Godliness!

But even some adults they don’t clean it, so they develop infections around their penis.

Well, thank God then for yaya. Huwag lang siya sanang tatamarin (I hope she doesn’t grow lazy). What cleaning ingredients are you supposed to use to clean that area?  An industrial detergent?

Just plain soap and water.

My yaya’s been going overboard, I see.  Are these circumcisions also performed for aesthetic reasons? Not that the penis is that aesthetically pleasing to begin with.

In some cultures, the females prefer that their male partners are circumcised.

Beauty is in the eye of the beholder, I suppose. Aside from the ridicule of your grade school classmates who make fun of your foreskin and use it for Chinese garter, can you actually live without a circumcision?

I have friends — mostly foreigners — who haven’t been circumcised.

Your advocacy must really take you into uncharted territories. Are there life-threatening dangers to being uncircumcised? Does it become a breeding ground for bacteria? Does it become a place where you can lose small household objects? Can you accidentally trip on your foreskin and break your neck?

As long as you clean the area, the risks are a lot lower. If you don’t clean it well, whether or not you are circumcised, there is always the risk of developing infections.

That’s why yaya helps me with all those hard-to-reach places.

Summer Fun

Why do you usually circumcise in the summer? Is there a medical study that claims that circumcisions are more effective in the summer? Or is circumcision a pagan ritual associated with the season? Or is it another government conspiracy that we should blame again on the previous administration?

Ah, no (laughs). It is just usually done after the school year.

 So it’s an extra-curricular activity.

During summer, a lot of people will go the doctor to ask for a circumcision. They probably go to medical missions so that they don’t have to pay.

The best things in life are free. My wife — who refuses to divulge her sources — tells me that there are medical studies that claim if you get circumcised at too young an age, you need to get another one as you grow older. Please break the truth to me gently, doc, lest my retractable body parts will never again see the light of day.

Sometimes when a circumcision is performed, there is some skin that is left over.

And you can’t have the skin for takeout?

So they have to repeat the circumcision to make sure that the first procedure was correct.

It there any problem with getting a circumcision as a baby? Aside from the fact that you are not able to make it yabang (boast) to the other newborns in the nursery?

In my case, I was also circumcised right after I was born. This is a lot easier because you don’t remember the pain and trauma associated with the procedure.

Gary Lising once told me that when he was born he weighed 25 pounds. After his circumcision, he weighed seven pounds. Gary’s foreskin is now in grade two.  

There’s actually no disadvantage as a baby. However, you just don’t go through the rite of passage for circumcision as a teenager where you can swap circumcision stories with your friends.

I guess it’s perfectly fine to swap stories but not to swap foreskin. How about for those cases when you need to circumcise post-adolescence? Is there any problem with that?

I’ve done some cases where I tell them to shave before doing the procedure.

Why do you have to be clean-shaven before a circumcision?  So you won’t scare off the doctor with your bigote (moustache)?

Because when you are suturing (the penis), the surgeon might mistake the pubic hair for the suture.

Oh.  That kind of shave.

For adults, we also remove most of the skin.

What do you leave behind?  Some flesh? A bit of cartilage? A little dignity?

As you grow older, your skin retracts as it develops. It becomes smaller as we increase in size. However, when you are an adult, the skin will just be the same size. I’ve had some cases where the circumcision was done in another place. When their wives saw “it,” there was just so much skin. So their wives told them to remove the skin..

Why? Because their wives couldn’t negotiate through all the skin.

Preternaturally Gifted

How many circumcisions have you performed in your lifetime?

Maybe a hundred.

That’s a hundred more penises than I’ll even want to see in my lifetime. And to perform a circumcision, what type of medical practice should you specialize in? Urology? Plastic surgery?  Dermatology?

You have to specialize in surgery. Preferably, you should have your circumcision performed by a trained professional. But in the provinces, I understand that some albularyos (local herb doctor) perform it, which could lead to some complications.

Like what? Their penis could turn into an anting-anting (amulet)? So it is a legacy for you. Where did you practice giving circumcisions? On mannequins?  On horses? On Gary Lising?

Our first patient is a human. I don’t think animals are circumcised.

Unless maybe those animals were kosher? I’m curious: what thoughts cross your mind when you have somebody’s uncircumcised penis in your hand? Or do you try your best not to think at all?

I imagine it is my own that I am taking into my hand, so I must be very careful and treat it with respect.

You must have a very fertile imagination. How do you know how much skin to cut off? Is there a dotted line that appears across the penis?

Until you see the base of the head, that’s when you stop.

 Sounds like advice that you could use in life as well. Are there things that you should and shouldn’t do after a circumcision? Like you shouldn’t take a shower? Shouldn’t take a picture of it and post it on Facebook? Shouldn’t lift heavy equipment?

We tell them to keep the wound dry, to clean the wound daily with Betadine, and not to touch the suture.

Unless that suture could actually be the first signs of pubic hair. And the most overlooked concern during a circumcision: what do you with all that used foreskin? Do you use it for designer bags? Thatched huts? Skin grafts?

 Sometimes I give it back to the patients. Sometimes we just throw it away. I have some patients who keep it as remembrance.

Remembering is such sweet sorrow.

* * *

  Thanks again to punong barangay Ernesto Moya and kagawad Ging Flaminano and Caloy Sario for letting me observe and not participate in Barangay San Lorenzo’s Operation Tuli.

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