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Tuesday, January 25, 2011

To spare him pain: Healing by doctors through symbolic action

My son will turn 21 in a few days, and he's a fine, healthy young man, now bigger than me. He was born prematurely, and spent the first few weeks of his life in a NICU (neonatal intensive care unit). For such baby boys, Jewish law required that we delay his circumcision, normally performed on the eighth day of life, until after he arrived home. The circumcision was performed routinely, and was only notable for the number of my doctor friends in attendance who discussed their preferred techniques of circumcision. Other than that creepy conversation, it was a joyful event. Such a bris symbolizes the continuation of God's covenant with mankind, just as the Jewish patriarch Abraham first performed on his own son under God's direction.

In today's New York Times, Dr. Mark Litwin movingly describes how he performed a circumcision for a newborn boy, far less healthy than my son, who had just passed away. The parents had requested that it be performed after he passed away, to spare him any unnecessary pain. Dr. Litwin performed the bris so the parents could mark the baby's brief life "before being wrapped in the ancient tradition of his ancestors." Two years later, the couple bore, and circumcised, another son, a healthy one.

Sometimes doctors' symbolic actions like that circumcision can help people heal. Two very different examples come to mind. First, sometimes emergency personnel might persist with resuscitation efforts they know are hopeless, so the family will know that everything possible has been done to try to save the patient. That could clear the minds of the grieving family from dwelling on a painful question. Another type of symbolic action is a doctor's use of a placebo, given to stimulate healing without a pharmacologically effective drug. Dr. Litwin's essay shows that doctors have powerful, subtle, non-medical ways to symbolically help in healing.

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