Ten years ago, Ralph Cheglak admitted himself into a Detroit hospital. He left the same day with "a closer connection to Judaism."
Cheglak, then 27 years old, had undergone a brit milah, a covenant with God. The Jewish ritual was a rarity in Ukraine, where Cheglak, now a San Francisco resident, grew-up under communist rule.
"Parents didn't usually circumcise their children — that way there wouldn't be a noticeable difference between them and non-Jews," said Cheglak, adding, "My parents did the right thing. We had enough problems anyway."
However, not long after emigrating from Odessa in 1990, Cheglak decided it was time to become "a little more Jewish than before." With the help of a Detroit rabbi, he and his older brother underwent "the operation."
"Sometimes you don't buy good things until someone offers you a sales pitch," Cheglak explained. "One day somebody told me that circumcision was good and I believed them. If I had to go back 10 years, I'd do it again."
Cheglak's situation, as an uncircumcised ex-Soviet emigre, is not a unique one. Between 90 and 95 percent of the Jewish males who immigrate to the United States each year from the former Soviet Union are uncircumcised, estimates Rabbi Shimon Margolin, himself an emigre.
Yet the number of adult immigrants who actually undergo circumcision, particularly in Northern California, isn't nearly as high as it should be, said Margolin. Out of hundreds who settle here each year, only between 30 and 50 will undergo the procedure.
"Any day the circumcision is not done, the Jewish male is missing a great deal of connection with God," said Margolin, head of San Francisco's Techiah Foundation and Outreach Center for the Jewish emigre community. "In traditional Judaism, it's considered a prerequisite for Jewish life."
The ability to obtain a closer connection with God through the brit milah is one thing San Bruno resident Leo Volkov is "absolutely, 100 percent" sure about.
Volkov and his wife, Rita, who both emigrated from Moscow in 1991, had been trying to have a baby ever since they married in 1979 — but for all 12 years they had been unsuccessful.
Volkov, now 42, wasn't ready to give up hope. After encouragement from a rabbi, Volkov decided the key to his wife's pregnancy was stronger involvement in Jewish life.
"I made a decision that because I'm a Jew I'd have to follow tradition," said Volkov. He and his wife began cultivating their Jewishness, even becoming kosher. In 1995, Volkov underwent a brit milah, performed by East Bay mohel Chanan Feld.
"Two years later, after 18 years of marriage, our baby was born," said Volkov of daughter Minna, now 2. "She's like a walking doll — I thank God every day for this precious gift to me and my wife."
Traditionally, the Book of Genesis decrees that the commandment of brit milah be performed on newborn Jewish males at the age of eight days. But in Soviet Russia, after the Communist Revolution of 1917, the Jewish birth ritual became almost obsolete, for a number of reasons, including "official religious persecution and even [fear of] jail time," said Margolin.
That number of circumcised ex-Soviet Jews remains low, even after they have been here for awhile. While a large number continue to come to the Bay Area every year, the statistics for adult circumcision among emigres tend to be higher in other areas of the United States, said Margolin.
The low circumcision rate, he added, has little or nothing to do with the rising sentiments against the procedure among pediatricians and other medical specialists, and also little to do with the pain factor.
In fact, people would be lining up if only they had a place to line up, said Feld, adding that the majority who seek circumcision do not identify as Orthodox.
"I have a list of many immigrants who want the surgery," he added, "and I get calls requesting it all the time. I just don't have the resources."
Since adult circumcision requires a local anesthetic and a hospital-like setting, it's exceedingly expensive, at $800 to $1,500. That's usually an unaffordable price for immigrants, said Margolin and Feld.
Although mohelim, like Feld, are often willing to volunteer their time for the brit milah, there are not many Bay Area doctors who will do the same — and because of hospital liability rules, doctors must be present and mohelim sometimes cannot, said Margolin.
The 1999 closure of UCSF Mount Zion Hospital didn't help this cause since the former Jewish hospital, said Margolin, "had a more accommodating policy about circumcision — and they were willing to charge on a sliding scale."
Stewart Rosenberg, a urologist in San Francisco agreed the closure of Mount Zion has made adult ritual circumcisions more difficult.
"Usually the mohel wants to come into the hospital, but if they don't have hospital privileges, the hospital won't let them — they don't want the liability," he said. "So, if we were to perform a circumcision on an adult, it wouldn't be a ritual one."
In the past Feld has been lucky enough to find a way around the hospital obstacle. Maurice Sandler, an East Bay doctor, has volunteered his San Pablo office, over the years, "as tzedakah," said Feld.
Sandler, however, is closing in on retirement. As a result, appointment times have grown less frequent, and soon Feld will be back at square one.
Feld estimates he circumcises approximately 40 adult immigrants a year. But that is a number that would increase significantly "if we had a regular setup, like in Israel."
Margolin blames the Bay Area's lackadaisical spiritual climate for a shortage of community resources for adult circumcisions as well as doctors who are willing to assist in the ritual.
"The importance of circumcision is not stressed in Northern California," said Margolin. "In New York, for example, the immigrants are more exposed to Judaism — there are whole Jewish neighborhoods. But in Northern California, the immigrants are not integrated into Jewish life that well. It's just a different type of community."
And, when he or his colleagues try to find donors to pay for the doctor and the facility, Margolin said, "it's like a small fund-raising campaign.
"Just to organize one adult circumcision takes so much effort. Sometimes, it almost seems impossible."
The surgery itself, unlike the usually routine procedure for infants, takes approximately 45 minutes, involving considerably more discomfort.
The patient's relatives don't stand around and watch, or throw a party afterward, said Joel Piser, a Reform mohel and urologist in Berkeley.
"I suppose God could have picked a hangnail for the covenant. That would have been a lot easier," Piser quipped.
But for a number of men undergoing adult circumcisions, the spiritual significance of the procedure may ease the discomfort.
Volkov, a mechanical designer, actually felt so good after the procedure that he went straight from the hospital to work. Of course, he added: "I didn't feel so good when the anesthesia came off."
It was "pretty painful," he remembered of the procedure's aftermath. "But after a couple days, the pain went away."
And Cheglak, who chose to be fully anesthetized for the procedure, "because I'm afraid of doctors and I'm very shy," doesn't remember the pain at all.
In fact, since his circumcision, Chelgak has had only good things to say about it. Not only does he say he feels healthier — recent reports point to a lowered incidence of AIDS and certain cancers among circumcised men — but even his sex life has improved, he said.
And then of course there's the improvement of his spiritual life:
"When you're circumcised as a child, it's done for Judaism," said Cheglak. "But it's not until you're an adult that you really know what that means."
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