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  • Male Circumcision and HIV provides a place for a public health policy debate on the linking of male circumcision and HIV/AIDS. It seeks to address questions of cost versus benefit, the effectiveness of circumcision in the fight against HIV/AIDS in real world settings, and the differing points of view of researchers, the media, and all contributors to the policy discussion.

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  • David Wilton

    David Wilton is a lawyer by training. He has a long-standing interest in issues of body integrity and HIV/AIDS. He maintains this site and blogs from San Francisco, California. His primary interests outside of nurturing a debate on the controversial measure of removing sexual tissue to reduce the spread of HIV are in the areas of international relations, languages, and journalism.
  • Adrienne Soti
    Adrienne Soti has provided research and monitoring of the media for Male Circumcision and HIV. A native of Hungary who came to the US in 1990, she lives with her husband and two small children in New Jersey. She has a B.A. in Psychology and Philosophy from Rutgers University. She lists biology and medicine among her many interests and is particularly interested in bio-ethical issues. The circumcision controversy came to her attention after the birth of her son in 2005.

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« Notebook: The majors convene this week in Europe to debate the meaning of the circumcision studies | Main | Circumcision bombshell »

Monday, March 05, 2007

"The Rise and Fall of Circumcision"

Occasionally fiction spells out a problem more clearly than volumes of non-fiction prose can. In Esquire's short story series, called Napkin Fiction, by up-and-coming young writers, we see a metaphor emerge for the more powerful making decisions for others they might not make for themselves.

Read the text after the break or click through after the click-through to read it on Esquire's site in its original format.

The Rise and Fall of Circumcision

In an airport, yesterday is in the carpet. Carpet made out of man-conjured synthetic fiber, but colored and dyed by a few thousand shuffling feet, dripping lattes, kicked-over sodas, and now, as I watch, by a few ounces of once carefully pumped breast milk knocked away by an angry infant.

The milk settles into the carpet at my feet.  Three drops stare up at me from the toe of my shoe.

"Sorry," the mother says. I smile. She doesn't. She can't even pick up the small bottle, the rubber nipple that has rolled away. Her baby boy, or hairless, blue-dressed girl, yells at me, yells at her, pulls hard at the neck of her shirt.

I can't pick the bottle up. It's covered with her breast milk. There's something private about it. Something sacred that makes it too holy for me to touch.

Still, she needs the help.  She's alone and dark rings hang on her cheeks from the child's abuse.

Before I act, a shoe, a black slouching velcroed shoe, grinds the milk deeper, kicks the nipple down the  row.  The shoe stops and wide body eases into the vinyl seat beside me.

I glance.

The body belongs to a man, or almost a man. He is heavy, young, and straining against the buttons in his white shirt, against the pleats in his black pants.

The skin on his face puckers around old childhood pocks and a failed moustache struggles on his lip. He wears a black hat and long dark ringlets hang down from above his temples.

"What's wrong with him?" he asks the mother.  "I thought you fed him in the car."

Her shirt is up now.  The baby kicks and groans beneath it.

"I tried to," the woman says.  "But he's so uncomfortable."

"Why?"

"Why do you think?" she asks.  The baby pushes up her shirt.  I look away from the soft belly, the tiger-striped stretches.

"You just had to have it done," she sighs.

"My family will check," he says. "They wouldn't let us stay in their house if it wasn't done. He's already too old. They'll probably be upset that the cut's fresh."

Suddenly, the man turns to me.  I've been acting invisible, pretending to be elsewhere.  I can't help but look at him now.

"I'm Jewish," he says.  My eyes drift to his ringlets.

"Right," I say.  "So am I."  I'm not.  Not more than one-sixteenth.  My wife is.

"Jewish religiously," he explains. "Not by blood. Don't know what I am by blood. Plain white I guess. All my dad's family converted two years ago."

"Huh," I say.  I want to say less.  The man looks across the aisle at the mother of his child.

"We're moving to Spokane," he says.  "You know Spokane?"

I nod.

"I got an opportunity up there.  My uncle  owns a convenience store.  I'll be working graveyard."

His freshly circumcised child is screaming again. Suck it up kid, I want to say. Abraham had to use a rock. But then Abraham didn't have this guy for a father.

I look off into the distance, wishing I had a magazine to protect myself, wondering if I should move on, take a stroll through the people herd. The guy pokes me in the arm, raises his eyebrows into his hat.

"Three most dangerous jobs on this continent," he says, holding up fingers. "NY cop, bounty hunter, graveyard in a c-store." He nods like I don't believe him. "Not necessarily in that order."

His wife is blushing.  Staring down.

"If you can't deal, if you can't stay cool when someone's trying to kill you, then go to college or someplace safe. C-stores are the frontline man. When the sun goes down that counter can be the last trench. Holding back the jungle."

"You don't' got it," his wife says. Her voice is quiet but there's an edge on it. She slips out of her seat and kneels on the floor, gently laying the baby on the carpet.

"What?"  the man asks.  "I don't' got what?  What are you doing?"

I'm wondering the same thing.  The baby is arching his back and I can already see grit from the floor  sticking to his shoulders.

"I'm changing him," she says. 

"Here?" he asks.  "Why here?"

"Because I want you to see him.  See what you did to him."

She looks up at me.  "He acts like the baby isn't even his.  Then he mutilates him just to keep his uncle smiling."

The man leans his bulk forward.  He points.

"I only asked if he was mine once.  Once,    okay?  And if you want the paycheck don't be complaining about how I get the job."

The woman looks away and sniffs.  She unsnaps the legs of her son's pants and pulls them up around his waist.

"You don't got it," she says again.

"What?" he snaps.  "What don't I got? Besides a woman with brains."

"Guts," she says calmly.  "Any kind of c-store guts.  You wouldn't even get cut  yourself.  You had to cut your baby to get the damn job."

I look at the man and I feel my mouth opening.  I can't help it.

"You're not circumcised?" I ask.

"Hell no!" he snorts. "My dad made me watch his. I almost pissed myself. I grew these instead." He bobs his ringlets. "Same principle, really."

"Hypocrite."  His wife doesn't even look up.

"I can't see my uncle checking me.  Can you?"  He shifts in his seat.   "I'm just fine."

"Who is your uncle?" I ask.  "Does he just own one store?"

"Oh no," the man grins.  "He's doing real well.  Hoping to build two new places on Division.  I've got his card here."

He fishes it out of his pants and hands it to me, wrinkled and warm.  I take it.

"Great," I say.  I stand up, look into his eyes and wince. 

"Sorry," I say.  "I really am.  But it just doesn't feel right.   I can't let you face the jungle with that much foreskin."

"What?"

"I'm going to drop your uncle a line.  I'm sure he can recommend a doctor.  Or a rabbi."

His wife's laughter is sudden and awkward.  She's out of practice. 

"Invite me if you have a potluck," I say.  And I turn.

I can't hear her laughter long.

The baby is screaming.

=end=

Reference

Wilson, N.D. The Rise and Fall of Circumcision. Esquire Magazine. February 20, 2007.

http://www.esquire.com/fiction/napkin-fiction/ESQ0207Rise

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Elsewhere on the Web

  • Circumcision and AIDS at MGMbill.org
    A decidedly anti-circumcision site with a calm approach to addressing the human rights issues likely to become problematic in the rush to roll out circumcision as an HIV prophylactic.
  • Circumcision and HIV at circumstitions.com
    One of the most thorough reviews anywhere of circumcision and the history behind the HIV prevention community's study of it. The science behind this prophylactic tool is much more equivocal than the most recent researchers would have you believe. New Zealand based.
  • Circumcision and HIV: Harm Outweighs Benefits from circumcision.org
    From the Circumcision Resource Center, Boston, Massachusetts. This human rights organization has published such books as Questioning Circumcision: A Jewish Perspective and Circumcision: The Hidden Trauma. Sitting on its board are a number of individuals affiliated with Harvard and other Ivy League institutions.
  • Circumcision and HIV infection from CIRP.org
    From the Circumcision Information Resource Pages. Not as up-to-date, but an excellent primer on the issue.
  • Doctors Opposing Circumcision statement on HIV
    Doctor's Opposing Circumcision is a Seattle based physicians group that provides education, information and advice on medical circumcision and its effects.
  • Statement on AIDS and Circumcision from the International Coalition for Genital Integrity
    Another thorough treatment of male circumcision's likely impact on the spread of HIV from an "alliance of organizations dedicated to protecting the normal anatomy of males, females and the intersexed ... [that] was formed to coalesce the many activist organizations, each with a specific focus, into one, common voice."
  • Does circumcision prevent HIV infection? - NORM-UK
    John Dalton puts together a critique of the African studies and their weaknesses. He examines the evidence, appropriateness, and possible outcomes from promoting circumcision and calling it a "prevention."

Sources

  • HIV/AIDS Medscape [free registration required]
    This site is owned by WebMD.com. It is a great source for breaking news. I wouldn't necessarily trust it completely on the issue of circumcision as it is US-based. But the HIV/AIDS coverage is pretty good.
  • UCSF HIV InSite Gateway to HIV Information
    The University of California - San Francisco is a leading medical teaching and research university in the HIV/AIDS field. Generally very reliable, it occasionally oversells or misstates the prevention message, most obviously and unfortunately regarding circumcision.
  • IRIN PlusNews
    I don't like this source because it tends to be a bit sensationalist, in my opinion. But it is pretty good for divining which way the wind is blowing.
  • Aidsmap: Circumcision News
    An otherwise great source, they have recently begun to climb on the bandwagon. The tone of the reports seem reticent as evidenced by their providing some great quotes. Coincidence? Inadvertent? Maybe, but hope not.

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