The Baby Whisperer

At first I was holding the baby, and he was fussing.  But it was 9pm and I figured this was the best we could expect. 

Then Aaron took him in his arms. And the kid stopped crying.  Not just a little.  Together they went to this calm pensive place, and made no sound for about 20 minutes. 

Which is why Aaron's new nickname is the baby whisperer.

Circumcision

We haven’t had Elliot circumcised yet.  I always assumed that we would, mainly because I am.  But I haven't thought too much about it, and every time I look at his little wiener while changing his diaper it feels strange to think about cutting it.  I realized that I need to examine this question a little more closely, so I did a little early Sunday morning web review. 

The arguments for circumcision are hygeine issues (phimosis is not a fun thing; don't click that link if you're squeamish) and lower rates of STD infection. 

The arguments against circumcision are that it hurts, it reduces sexual pleasure, and simple principle: the foreskin is a normal human body part, why should we cut it off?

"Circumcision is not an ethical medical procedure," said Georganne Chapin, executive director of Intact America, a Tarrytown, N.Y., advocacy group. "You are removing a perfectly normal body part. We don't allow people to do that to their daughters. We should not let them do it to their sons."

On the topic of sexual pleasure, here’s a paragraph from another anti-circumcision website:

One must also consider that the foreskin contains 50% of the surface area of the penis. Each circumcision cuts off what would grow to be 6 inches of tissue, laden with 240 feet of nerves and 1,000 nerve endings Removal of it can only lead to a drastic loss of sensation during sexual activity.

These people seem to be saying that size matters.  If a penis was four times normal size, would the pleasure be four times as much?  The argument seems bogus. To quote the esteemed philosopher Raquel Welch, the brain is the biggest erogenous zone.  And the brain wires itself to the organ its connected to.

But that's just my gut feeling, I could be wrong.  So I looked for some data, and sure enough there's plenty.  Here's a study done a few years ago:

Objectives: Currently no consensus exists about the role of the foreskin or the effect circumcision has on penile sensitivity and overall sexual satisfaction. Our study assesses the effect of circumcision on sexually active men and the relative impact this may have on informed consent prior to surgery.  Materials and Methods: One hundred and fifty men between the ages of 18 and 60 years were identified as being circumcised for benign disease between 1999 and 2002. Patients with erectile dysfunction were excluded from the study. The data was assessed using the abridged, 5-item version of the International Index of Erectile Function (IIEF-5). Questions were also asked about libido, penile sensitivity, premature ejaculation, pain during intercourse and appearance before and after circumcision. Results: Fifty-nine percent of patients (88/150) responded. The total mean IIEF-5 score was 22.41 8 0.94 and 21.13 8 3.17 before and after circumcision, respectively (p = 0.4). Seventy-four percent of patients had no change in their libido levels, 69% noticed less pain during intercourse (p ! 0.05), and 44% of the patients (p = 0.04) and 38% of the partners (p = 0.02) thought the penis appearance improved after circumcision. Penile sensation improved after circumcision in 38% (p = 0.01) but got worse in 18%, with the remainder having no change. Overall satisfaction was 61%. Conclusions: Penile sensitivity had variable outcomes after circumcision. 

That's just one study.  Nine have been done --- three showed more penile sensation, one showed less, and five showed no change.  Here's the creepily comprehensive wikipedia page on the topic of penile sensation after circumcision. Of course, all these studies are done in adults, so it's impossible to know what might be different in an infant.  But

Now, what about infections?  Three large studies, involving almost 10,000 men, showed massive decreases in the number of HIV infections.  Here are the result of the biggest study:

 A total of 3,274 uncircumcised men, aged 18-24 y, were randomized to a control or an intervention group with follow-up visits at months 3, 12, and 21. Male circumcision was offered to the intervention group immediately after randomization and to the control group at the end of the follow-up.  The trial was stopped at the interim analysis, and the mean (interquartile range) follow-up was 18.1 mo (13.0-21.0) when the data were analyzed. There were 20 HIV infections (incidence rate = 0.85 per 100 person-years) in the intervention group [i.e. circumcised] and 49 (2.1 per 100 person-years) in the control group [uncircumcised], corresponding to an RR of 0.40 (95% CI: 0.24%-0.68%; p < 0.001). This RR corresponds to a protection of 60% (95% CI: 32%-76%). When controlling for behavioural factors, including sexual behaviour that increased slightly in the intervention group, condom use, and health-seeking behaviour, the protection was of 61% (95% CI: 34%-77%).

Until just this year, it had been a mystery why circumcision lowered the rate of HIV infection.  Now there's some actual data.  Sampling bacteria from the penises of men before and after circumcision and found that

there are gross changes in the penis's microbiome following circumcision, suggesting that shifts in the bacterial environment could account, in part, for the differences in HIV infection. Families of anaerobic bacteria, which are unable to grow in the presence of oxygen, are abundant before circumcision but nearly disappear after the procedure. The researchers suspect that in uncircumcised men, these bacteria may provoke inflammation in the genitalia, thereby improving the chances that immune cells will be in the vicinity for HIV viruses to infect.

There was an interesting article in New York magazine last year, in which the author examined the pros and cons and decided to circumcise her son.  She notes that

the foreskin is pretty much like the appendix or the wisdom tooth—it is an evolutionary footnote that serves no purpose other than to incubate infections. There’s no single overwhelming health reason to remove it, but there are a lot of smaller health reasons that add up.

Also, there are apparently thousands of men who are very angry about having been circumcised.

After all this reading, I'm pretty much where I started: not deeply committed to circumcision, but still leaning toward it. Then I came across this:

A picture is worth a thousand words....

Rage Against the Machine

We've been teaching Elliot to take a bottle lately, and it's a rough time.  When you've only every sucked milk from a real human breast, it's tough to accept the idea that the same stuff can come out of stiff plastic doohickey.

But I'm kind of enjoying it.  Because for the first time, the burdens of parenthood fall on me.  Every night, we wait until Elliot is in a good mood, and then Hannah goes into another room and closes the door.  And Elliot and I play around with the bottle. 

The key, I've found, is not trying to jam it down his throat.  I dab it on his lips, let him play with it a little, make it a toy.  Try and get him to take a swallow a few drops, so that at least the point --- this is to ingest nutrition! --- gets across. 

But pretty soon he will have to go a full eight hours with nothing but the bottle.  So I'm trying to step up my game.  I'm pushing him harder.  I'm forcing him to actually drink from it, not just play with it.  And that part hasn't been going as well.

It's more than just dislike of the nipple.  It's outrage.  Wait, you want me to drink from this plastic thing?  This is not a breast, why would I drink from this?  And the more he struggles the more indignant he gets.  How could even THINK I would take nutrition from this thing? The presumption!  How dare you! 

And as I hold him, staring down into his angry red face, I find myself feeling an unexpected emotion:  respect.  I'm proud of my son for fighting off the bottle, even as I'm the one shoving it down his throat.  I've been trying to think about why this is.

Like most of us, I have plenty of frustrations with plastic, ersatz world we live in.  I've shouted at my computer screen on a beautiful sunny day.  I've sputtered at the robot-phone that can't understand my words.  But, also like most of us, I've accepted it.  I've learned how to navigate, and I've put that red fist-clenched rage in a deep dark place.  (Because in the end, where else can you put rage directed toward a robot-phone?)

So Elliot's indignation toward the plastic nipple mirrors my own feelings toward a million other things in the world.  And I love him for it.

Now, I admit that this is a massive projection on my part.  He's a baby who doesn't like his bottle, and I should probably let the psychoanalysis stop there.

But I can't help but wonder if maybe that's when it all went wrong.  That moment when you took the plastic nipple in your mouth, when you accepted something fake in the place of something real; when you settled for the construct, the mock-up, the simulacrum.  That was when it started.  You knew it was inferior, unworthy of you.  You hated that plastic nipple, and you knew you deserved better, but in the end you were hungry.  In the name of expediency you settled for something you didn't want.

Is it really such a leap from that first plastic nipple to that first corporate job?

We all have to suppress our outrage, that's life in modern society.  We make small talk with irritating co-workers, we pay $3 ATM fees, we say "don't worry about it" when someone cancels at the last minute.  In the same way, Elliot will suppress his rage toward this nipple.  He'll grow so accustomed to it that he'll wonder why he ever found it distasteful.  Every once in a while it'll irk him, but he'll think hey, these annoyances are part of life.  You have to make little compromises to get through your day. 

So rage on, little Elliot.  Don't go quietly into that future, that future filled with emotional suppression.  For this brief four month-old moment, remain who you are.  A plastic nipple is just the first of a million strange things this world is about to throw at you.  You will have to give in to most of them.  But for now, go ahead and fight it.  Of all people on earth, only you have lived a life completely free of compromise.  Keep it up.  Your impulse redeems us all.

Behavioralism

Last week I put little Elliot on his back.  He squirmed, twisted, pulled his hands up behind his head.  He kicked one chubby leg forward and tucked the other in.  And Lo did he roll to one side, as had been prophesied.

Then I cheated.  I wanted to give him some tummy time, you see, and he was so close to being on his tummy....

As I was shoving him onto his belly, a thought struck me.  How will he react to this?  The physical sensation of flopping from your side to your face...would it be exciting? Scary? Disorienting?

It turned out to be none of the above.

His reaction was one I hadnt even considered: Pride. He thought he'd done it himself, and he was proud of this!  It was fascinating.  Not happiness, not pleasure, not love.  The pride of accomplishment, that's what flooded across his face.

No adult taught him to have this feeling.  He couldn't possibly have mimicked someone, aped the behavior of his mom or dad.  He's far too young for any kind of cultural apparatus to have taken hold.

I had a moment then, one that I would guess everyone reading this has had.  A simple thought suddenly seems profound.  A common truth feels like wisdom.  For a moment your mind's eye pulls back to take in all things, and you glimpse the larger meaning, you see how it all fits together, you touch the divine.

There's an impulse to share this great insight, so you open your mouth --- and a cliche pops out.  In my case it was, "Wow, it's like, we are born, like, totally complete human beings."

But during that nanosecond before the shutter snaps closed, and you realize that your profound insight was just common sense, it actually feels like you're the first person in history to have this thought.

Siobhan and Vadim

Hair

I knew there would be drastic, unforeseen changes in my life when Elliot came.  But I didn't know one of them would be my haircut.

A few weeks ago I was rushing home from work.  I had seen a million patients, I was late, and there were friends coming to dinner so I wanted to get home to help Hannah clean up.

In another section of my brain, I fretted about my growing shagginess. Even for me this was ridiculous.  I was starting to look like my favorite singer in 1989.

Since the next few days were equally busy, I decided to stop off for a quick trim.  I started down 1st avenue toward a barbershop I know and liked, but realized it would take 20 minutes to walk there.  Surely, I thought, there would be a place to get haircut on my walk to the subway.

And surely I was right.  I walked past the brightly lit window and saw that all the requisite elements were in place: a row of chairs, an elderly gentleman wielding clippers, semi-dirty magazines.  I sat down and told the  gentleman how much I wanted taken off.

And it was then that I first realized I was in trouble.  The gentleman looked over to his friend, a slightly younger man slouched against the mirrored wall.  The younger  man held up a thumb and forefinger spaced about an inch apart.  The older gentleman nodded and clacked his scissors next to my ear.

He started out giving me what I wanted, a trim.  But somewhere between watching the TV and chatting with his friend, he curved slowly toward the standard haircut he gives all the young East Village hipsters.  And I walked out looking like this:

Now some of you (Hannah included) will say that you like this look better.  And I guess I do look more professional, more mature, less young and goofy.  But I liked being those things.

I'm okay with temporarily shedding my mane.  But I am sad that I can no longer do this:

 

(I know it sounds like he's choking to death, but that's actually the sound he makes when he's on the doorstep to heaven....)

Baby Corn

Saturday morning, 9:30am

I'm a little reluctant to post these photos, because Hannah took them, and they make clear how much better a photographer she is....

The Repertoire

Elliot has, sadly, become less susceptible to singing.  By susceptible, I mean it doesn't put him to sleep as reliably.  That's the main thing I pay attention to these days: when does Elliot fall asleep and how long will he stay that way.

It used to be that if I put his little head against my chest and sang, I could get him to sleep pretty quickly.  The vibrations of the song combined with the rhythm of my heartbeat was better than a 10mg Ambien tab.

Now its gotten a little tougher.  Certain songs do nothing for him, others make his eyelids heavy.  Nothing will knock him out like flipping a light switch anymore.

This is teaching me which songs are real winners and which aren't.  "Slip Sliding Away" by Paul Simon is probably the number one song to put him to sleep.  I have no idea why.  But I will watch closely to see if there's any lasting impact on his affinity for mellow singer-songwriter acoustic guitar tunes.

I always thought that my favorite verse from that song was the one about the father.  Here's how it goes:

I know a father, he had a son

He longed to tell him all the reasons for the things he'd done

He drove a long way, just to explain

He kissed his boy as he lay sleeping

Then he turned around and headed home again

But I almost never sing Elliot that verse.  Instead I find myself singing this one:

I know man, he came from my hometown

He wore his passion for his woman like a thorny crown

He said "Dolores, I live in fear."

"My love for you so overpowers me,

Sometimes I think I will disappear."

As I write out those two verses, it becomes a little more clear to me why I sing one and not the other.

The winner of Most Unlikely Song to Put Elliot to Sleep is a Bruce Springsteen tune off the album Born in the U.S.A. called "I'm on Fire":

Hey, little girl, is your daddy home?

Did he go away and leave you all alone?

I got a bad desire

Ooh ooh ooh I'm on fire

Hey, little girl, is he good to you?

Does he do to you the things that I'd do?

I could take you higher

Ooh ooh ooh I'm on fire

I feel kind of icky writing out the lyrics.  But it's a gorgeous tune, spooky and silky smooth, like a ghost story whispered around a campfire.  Here's the second part of the song, which I also sing to Elliot:

Sometimes it's like someone took a knife, babe, edgy and dull,

and cut a six inch valley through the middle of my skull

Sometimes I wake up with the sheets soaking wet, 

and a freight train running through the middle of my head, and you, 

You cool my desire

Ooh ooh ooh I'm on fire

"Karma Chameleon" was an early favorite of his.  I'm not sure that's still the case--- he hasn't heard it for a while because it's no longer a favorite of mine.  So until Elliot learns how to put in requests, this will be a Boy George-free household.  For which I'm sure Hannah is grateful.

Talk to the Hand

Baby Tote

We're supposed to carry him in it, right?  That's why his name is on it.

Taking Out the Christmas Tree, Finally

Actually we did this a few weeks ago, I just got around to posting photos now.

"Why am I strangely attracted to this blurry image?"

Playing "I've got your nose" appears to be some kind of technique to improve dexterity...

The Unbrat

Elliot has recently become fascinated with the colander hanging from the pot rack in our kitchen.  He can see his reflection in it, except with little holes.  I agree with him that this is awesome: we stand in front of the colander together, and he stares contently for five or ten minutes without interruption.  His face is a mix of curiosity, intrigue, and generalized bliss.  

I would assume that when I pull him away from the colander, his face will register at least a momentary flash of disappointment.  Not the case.  He just turns his head, looking at the next thing, the newest thing.  He's not comparing one experience to the other, he's not considering his current level of amusement in relation to a previous quantity of entertainment.  He's just living.  

I guess this is connected to object permanence:  you can’t get upset about someone taking an object away from you when you don’t think the object still exists. But whatever the reason, it's a really nice aspect of his personality.  There's no whining when something fun is taken away.  He has absolutely no sense of entitlement.  And I'm sure that's not going to last forever. 

Everyone has that one wacky uncle....

Learning to Stand

Things I have done with my toes since Elliot was born

Turn on light switch in living room
Move laptop from arm of couch to seat
lift a coffee cup
lift remote control
lift newspaper and bring to hand
lift laptop power cord and connect to laptop (N.B. magnetized, reducing degree of difficulty)
remove one sock with foot of other
Open iTunes, download a podcast, and start it playing
Lift cover of closed laptop (technically this requires two feet)

Second verse, same as the first...

It's hard to be cameraman and baby coach at the same time...

He’s changing.  You can start to see his little intellect emerging from the haze of emotion that clouded the first three months.  He’s a curious child, he can be amused with the right trick or maneuver.  Which means that you can keep him quiet, but it actually takes work.  Not physical work, not patting and cooing and bouncing.  Now the work has become observation and imagination and pattern formation.

Two months ago you did what you could to calm him, but you didn’t take failure personally.  He was just a ball of emotion, so it wasn’t your fault.  He got upset by hunger and temperature and bowel rumbles.  Nothing to do with you.

But nowadays the toolbox of calming techniques is bigger, and using it requires a more subtle hand.  For example, Elliot always used to want to be held.  That was a given.  If you could get away with putting him down, congratulations, but it wasn’t the norm.  That’s not the case anymore.  Now sometimes he’ll cry in my arms but suck happily on his fist in his bassinet, staring up at his mobile.  

The machinery has gotten more complex, gone from lawn mower to V6 engine.  So maintenance becomes more complex too, as well as the diagnostic acumen required. 

Not sure what the point of these observations are.  But isn’t that one of the prerogatives of the blogger: aimlessness?

sadly he is about to outgrow this outfit...