Overall a very detailed and informative letter. I would personally change a few things: "unauthorized preputioplasty" to "unauthorized foreskin retraction", and "plastic surgery" to "cosmetic surgery" or "cosmetic alteration" because the doctor did not CUT his foreskin, he retracted it, correct?
Also, I make the following suggestions:
This mother and son's experience has been tugging my heart and mind. Please let us know how the boy is doing. Is he feeling any better?
Name the individuals with whom the mother raised her pre-surgery concerns that her son's genitals not be altered during the procedure. Was this discussion with the surgeon, the intake admission's officer ... with whom did she talk?
For clarity, reorder the wording of the second paragraph to "... and society, in general, bombarded me with unsolicited advice to circumcise him."
Did the surgeon cut the connecting skin or rip it manually? If he cut it, then I would replace the term "forcibly retracted" with "forcibly and surgically retracted".
I suggest the term "manipulated" be removed as it is too benign and not inherently illegal or harmful. Instead, I think the mother should use the term "unnecessary and unauthorized surgery" (if there was cutting) or "unnecessary and unauthrozed procedure" (if there was no cutting) in combination with her reference to mutilation. The terms are red flags for malpractice.
If it is true, the mother should clearly state that her son had been under continuous medical care and was never diagnosed with phimosis, and that he had been examined as soon as XX days before surgery by Dr. Ignorance, who did not then, or at any other time, raise any concern of phimosis.
Thanks especially to painfulquestioning for being my medium during the waiting period before I could post my own messages.
Again, I want to extend my greatest THANKS to all of you that have helped me through this... I have taken in your suggestions and advice regarding this situation and edited my letter-here it is if you have 15 minutes or so to burn... I noted in the cc: list at the end of the letter that I was copying it here, since it is sent, I have not edited out names, etc...besides I'm only stating the facts, so...
I'd hate to post such a long letter... but will-in the event that another mother can use it as a template for her own fight for justice on behalf of her son(s):
Here is the cover letter...
Children’s Rights Activists and Organizations/
Medical Professionals/ News Media/State Legislators/
Dear Fellow Humans,
It is disheartening to come to the realization that we are a society conformed to living with conditions of normative abuse.
Routine Infant Circumcision, and recently, I’m sad to say (I’ve come to understand personally), Forcible Foreskin Retraction have become common cultural and social crimes that must be reintroduced to the American people as violations of children’s basic human rights.
Please take the time to read the enclosed letter written to the administration of the hospital where our two-year old son has recently been victimized.
Enforcing public awareness regarding these two very controversial issues must be our
immediate concern if we are to honestly and whole-heartedly protect our children from the ignorance that has engulfed the American medical profession for over the last 150 years. There is no national or international medical association that recommends circumcision.
We are just beginning to emerge from the plethora of myths and propaganda that have clouded our vision, judgment and protective intuition in the past. Someday, we will join with the now eighty-plus percent of the world’s population that doesn’t support, and in most instances frowns upon, circumcision. Our superior nation certainly should not be in the fifteen to twenty percent minority that doesn’t believe in leaving our children’s beautiful bodies intact and as whole as the day they were born.
Feel free to contact us if you might be able to be of some assistance or if we could help explain this issue further.
Thank you in advance for your time, support and efforts to help mold this world into a less cruel place for our future generations.
******* and the original enclosed letter ****** :
Children’s Hospital of Pittsburgh of UPMC
Roger A. Oxendale - President/CEO and
Board of Trustees
3705 Fifth Ave.
Pittsburgh, PA 15213
Our two-year-old son is a recent victim of an unauthorized premature surgical and forcible foreskin retraction.
“Almost all males are born with a fold of specialized skin - a foreskin (also known as the prepuce) - that covers their glans (head of the penis)…In infancy and usually during childhood, the inner surface of a male’s foreskin and the surface of his glans are one continuous structure. The cells that connect these two surfaces dissolve naturally over time – a process that should never be hurried...Forced retraction of the foreskin causes pain and trauma because it rips the child’s foreskin from his glans and/or tears his foreskin’s opening.”
-National Organization of Circumcision Information Resource Center
We have been trying to protect our son’s foreskin since prior to his birth when nurses, pediatricians, even family members and society in general with unsolicited advice to circumcise him bombarded us.
He is two years old. His name is Liam. He is our beautiful son, protective brother, and we are proud to say, fully intact.
Since birth, Liam has had an undescended testicle that occasionally allowed gravity to prevail. He needed to have an orchioplasty; a surgical reconstruction of the testes. It was also recently discovered that along with the undescended testicle, he had an inguinal hernia, which were both to be operated on July 11, 2007 in the Wexford-Bayne Children’s Hospital location. We authorized ONLY these two necessary medical procedures.
Prior to the surgery, during our consultation with Dr. Lynch in his Monroeville, PA office on June 19, 2007, we specifically explained our two utmost concerns. One of our strongest concerns, aside from Liam being put under anesthesia and receiving a caudal epidural block, was that his genital integrity not be compromised. We explained to Dr. Lynch that we made the educated decision to refuse to circumcise our son when he was born. We are self-educated in the potential and actual risks, involving physical, emotional and mental damage that circumcision poses on otherwise healthy babies. No national or international medical association recommends circumcision. One of the last things Dr. Lynch said to us during the consultation was that it was a non-issue that Liam was intact. He said absolutely nothing about adhesions, phimosis or retractibility of Liam’s foreskin, all of which Dr. Lynch later claimed to be the basis of his decision to perform this cruel procedure.
On July 11, 2007, our family drove two hours to Children's Hospital in Pittsburgh as we were convinced Liam would receive optimal care there.
We could not have been more wrong.
toward the penis as a result of the surgery. We also noticed and pointed out to her a mark on my son’s foreskin which looked like an impression left from a clamp. She said the Dr. probably just weighted down my son’s penis by clamping the foreskin forward and pulling it toward the opposite side of the groin which was to be operated on so that the penis wouldn’t “get in the way” of the surgery. We were leery of this explanation but it made sense that the surgeon, as we had discussed, would temporarily reposition our son’s penis away from potential harm during the operation to avoid jeopardizing my son’s genital integrity.
It wasn't until hours later, during a diaper change in a rest area on the way home from the hospital, that we realized, to our horror and disgust, that the surgeon had forcibly retracted our son's foreskin. Our son’s foreskin, just as most babies and toddler’s prepuces and glans are adherent in nature, was only about halfway retractable and otherwise fused, prior to surgery. During his diaper change (post-surgery), we realized what had happened to our son, as his foreskin retracted completely, revealing blood, and a red, raw, open wound. Fortunately, the effects of the anesthesia still had not worn off during this incident.
We were not asked permission to allow the surgeon to perform this barbaric procedure and certainly would not have given any authorization to do so. We were not advised by anyone after the surgery (until the surgeon returned our urgent phone calls once we were back at home) that our son's prepuce was forcibly and surgically stripped away from his glans penis (just as a fingernail would be torn from the nail bed), prematurely exposing what should be an internal organ. The surgeon's excuse for performing this horrific procedure was that our son had a (phony and commonly over/mis-diagnosed in prepubescent boys) condition called phimosis, adhesions, as well as a build up of smegma. The definition of phimosis did not apply to our son and certainly shouldn’t apply to anyone as young as our son. Liam’s old pediatricians, whom we trusted whole-heartedly with guidance on how to care for our son’s intact penis and whom had just seen Liam prior to our move to Pennsylvania in February 2007, never raised any concern over phimosis, smegma buildup or adhesions. Quite the opposite, this well-educated, trustworthy group of pediatricians can attest to the natural and regular development of our son’s foreskin. As I previously stated, for his age, Liam naturally had a semi-retractable foreskin. When it was necessary to clean after he had defecated in a diaper, his foreskin could be gently pushed back (without any force, retracted toward the abdomen) about halfway over the glans. The phimotic ring (or preputial sphincter) was otherwise loose and allowed non-painful urination (which is one of the key symptoms of phimosis). The smegma the surgeon referenced had been, over the last two years, working its way toward the tip of the penis (prepuce), as it is expected to do so in nature. Liam never had any complaints about his penis. Natural separation would have definitely occurred in its own time. His penis and his foreskin development were completely normal. The procedure performed by Dr. Lynch was ignorant and certainly not done for the benefit of our son’s well being, but as either a benefit to the surgeon’s and hospitals financial well-being or as a “learning tool”!
When he returned our calls, the surgeon instructed us to continue to completely retract our son's foreskin approximately 3-4 times daily during diaper changes and to apply Neosporin to the wound. Although at this point a bit wary, but still assuming the doctor knows best, we did this reluctantly three times, our son kicking and crying every time, screaming in agony when the ointment was applied. We called our old pediatrician, the new local pediatrician and urologist for alternate advice (which the pediatrician and urologist’s physician assistant gave us: being told to leave it alone with very minimal, not full retraction and gentle hygiene (soaking in a bath)!). It broke our hearts that we caused our son even further pain by following the surgeon’s after-care instructions for as long as we did that day. As if it wasn’t bad enough that a two year old endure any type of surgery and that Liam had the unfortunate experience of needing his testes reconstructed and a hernia corrected, our son had to also suffer the agony of diaper changes and urine coming into contact with micro-tears and a raw open wound.
potential iatrogenic infection, adhesions and acquired phimosis. During his most recent bath, Liam retracted his own foreskin no longer halfway, but about three-quarters of the way, revealing adhesions that have already re-attached the glans to the prepuce, preventing any further retraction. We can only hope this condition will
resolve itself over time, allowing him natural, non-painful, full retractability by or near puberty as it should have naturally happened. Although, we are disheartened to say, we have been advised by medical professionals and doctors that our son will probably need to have the foreskin surgically separated from the scar-connected glans in the future (as the synechia has already been damaged).
For ten years or more, the American Academy of Pediatrics and the rest of the world, including most of the medical organizations this letter is copied to, have been saying to leave the normal development of the prepuce (the foreskin) alone. This is not new information! I can’t imagine that the surgeon has not heard of the American Academy of Pediatrics recommendation.
Our son is two years old and had many years before him for his foreskin to naturally separate from the glans in a non-traumatic fashion without any uninvited medical intervention.
Liam has been traumatized. His body has been violated. He will likely suffer further physical, mental and emotional pain throughout life and consequently, require additional surgeries to correct his penis, all which would have been avoided had Dr. Lynch only performed the two authorized procedures.
I shudder to fathom the idea: had the patient been a two year old girl, would the equivalent procedure been attempted, or even considered? I’m sure it would cause a public outrage to hear of a two year old female patient going in for hernia surgery and coming out with tears in the genital flesh connecting her clitoral “hood” and the clitoris, or in the hymen, as the result of “necessary pre-operative cleaning of the area”!
Our whole entire family has been traumatized; our lives have been disrupted and adversely affected. We have lost countless nights of sleep and a deluge of tears.
Dr. Lynch not only violated our son, but also violated our trust.
It hurt Liam to urinate and his disposition overall has been altered. He is anxious and disagreeable (understandably so) about diaper changes and going to anyone with the label “Dr.” when he used to be quite passive in these contexts. As we explained before, Liam is already showing signs of complications (adhesions-two skin surfaces fusing together) caused by Dr. Lynch’s unauthorized, unnecessary, premature, forcible and surgical retraction of Liam’s foreskin.
We are reporting the harmful actions of Dr. James Lynch to the hospital administration, bio-ethics committee, patient advocacy group, any hospital where Dr. Lynch has privileges, any board, organization, medical practice and insurance (we have advised the insurance company that this procedure was not authorized) that may take interest in our son's situation and his future well-being (as well as the future well-being and competent care of all intact boys).
Any medical professional who undermines a child’s parents by ignoring their ethical responsibility to gain informed consent (and who consequently violates the basic human rights of a child) must be exposed, so as not to abuse the children of our society in the future as marketing tools or platforms for their own financial benefit. Our trust with the medical profession should not be compromised by condoning unnecessary and unauthorized procedures on our loved ones.
Has the medical profession lost sight of the first tenet of medical practice, Primum non nocere (First, do no harm)?
Colleen and Joe (Heartsick parents of Liam)
cc: Dr. James Lynch, Surgeon, Dept. of Critical Care, General, and Pediatric Surgery
Dr. Laima Pauliukonis, Anesthesiologist
Dr. George K. Gittes, Chief of Service
Dr. Timothy D. Kane, Clinical Director
Dr. Russ Kolarik, Medicine/Pediatrics Program Director
Elizabeth Lewis, Patient Advocacy Manager
Children’s Hospital of Pittsburgh, 3705 Fifth Ave., Pittsburgh, PA 15213-2583
Children's-South, 1300 Oxford Drive, Bethel Park, PA 15102
Children's-North, 2599 Wexford Bayne Road, Sewickley, PA 15143
Children's-East, 4055 Monroeville Boulevard, Monroeville, PA 15146
Magee-Women’s Hospital of UPMC, 300 Halket Street, Pittsburgh, PA 15213-3180
UPMC Presbyterian, 200 Lothrop Street, Pittsburgh, PA 15213-2582
Tammy Radel, Administrator, Professional Compliance Office
Pennsylvania State Board of Medicine P.O. Box 2649 Harrisburg, PA 17105-2649
Gina K. Bittner, Administrator
Pennsylvania State Board of Osteopathic Medicine 124 Pine St. Harrisburg, PA 17101
Joint Commission, Division of Accreditation Operations,
Office of Quality Monitoring, One Renaissance Boulevard, Oakbrook Terrance, IL 60181
Allegheny County Dept. of Health, 3333 Forbes Avenue, Pittsburgh, PA 15213
Beaver County Dept. of Health, 300 South Walnut Lane, Beaver, PA 15009
Cambria County Dept. of Health, 184 Donald Lane, Suite 1, Johnstown, PA 15904
Dr. David Kerstetter, 118 Anderson Street, Bedford, PA 15522
Dr. William A. Rose, Dr. Emily R. Brown, Yvonne Santiago, RN, Dr. Irvin P. De Stefano,
Dr. Hartley S. Bancroft II
Orange Pediatric Associates, 400 Midway Park Dr., Middletown, NY 10940
Kim Laush, Call Center Supervisor and Mary Bailey, Quality Assurance Manager,
ACCESS Plus Automated Health System, 9370 McKnight Road, Suite 300, Pittsburgh, PA 15237
Mike Leavitt, Secretary, Health & Human Services, 200 Independence Ave. SW, Washington D.C. 20201
American Academy of Pediatrics, 141 Northwest Point Blvd., Elk Grove Village, IL, 60007
David J. Llewellyn Attorney at Law, Director
Atlanta Circumcision Information Center, 2 Putnam Drive, N.W. Atlanta, GA 30342
John V. Geisheker, JD, LL.M. Attorney-at-Law Executive Director and General Counsel and
Mark D. Reiss, M.D. Executive Vice-President
Doctors Opposing Circumcision Suite 42 2442 NW Market Street, Seattle, Washington 98107-4137
Marilyn Milos, RN / NOCIRC P.O. Box 2512, San Anselmo, CA 94979-2512
J. Steven Svoboda, Esq., Attorneys for the Rights of the Child, 2961 Ashby Ave., Berkeley, CA 94705
Betty Katz Sperlich, R.N., and Mary Conant, R.N.
Nurses for the Rights of the Child, 369 Montezuma #354, Santa Fe, New Mexico 87501
American Iatrogenic Association 2513 S. Gessner, #232 Houston, Texas 77063
Mothering Magazine, Motheringdotcommune Forums (www.mothering.com/discussions)
Tim Hammond, Director, National Organization to Halt the Abuse and Routine Mutilation of Males
(NOHARMM) P.O. Box 460795, San Francisco, CA 94146
Dr. Eileen Marie Wayne, (www.informedconsent.org) 1302 7th Street, Moline, IL 61265
Ronald Goldman, Ph.D., Circumcision Resource Center, PO Box 232, Boston, MA 02133
Medem, Inc., 100 Pine Street, 3rd Floor, San Francisco, CA 94111
American Medical Association, 515 N. State Street, Chicago, IL 60610
Human Rights Watch, 350 Fifth Avenue, 34th floor, New York, NY 10118-3299
Office of the United Nations Petitions Team, High Commissioner for Human Rights, UNOG-OHCHR
1211 Geneva 10, Switzerland
Amnesty International USA, 600 Pennsylvania Ave. SE, 5th Floor, Washington, D.C. 20003
UNICEF House, 3 United Nations Plaza, New York, New York 10017
R. Wayne Griffiths, National Organization of Restoring Men
NORM, 3205 Northwood Dr., Suite 209, Concord, CA 94520-4506
INTACT TIMES, Lisa Stephon, Ed., NOCIRC of Pennsylvania, PO Box 103, Mountville, PA 17554
Intersex Society of North America, 979 Golf Course Drive #282, Rohnert Park, CA 94928
NORM NEWS, David Smith, editor, PO Box 71 Stafford, Stone, ST15 0QA, England
State Senator John H. Eichelberger, 309 Allegheny Street, Hollidaysburg, PA 16648
State Representative Hon. Dick Hess, 133 S. Richard St., Bedford, PA 15522
State Senator Jim Ferlo, 3519 Butler Street, Pittsburgh, PA 15201
State Senator Wayne D. Fontana, 930 Brookline Boulevard, Pittsburgh, PA 15226-2106
State Senator Jay Costa, 1501 Ardmore Blvd., Suite 403, Pittsburgh, PA 15221-4401
Hon. Jake Wheatley, 2015-2017 Centre Avenue, Pittsburgh, PA 15219
Hon. Don Walko, 3880 Perrysville Avenue, Pittsburgh, PA 15214
Hon. Chelsa Wagner, Castle Vlg. Shoppes, 5301 Grove Road-Suite M112, Pittsburgh, PA 15236
Hon. Joseph *******, Jr., 6203 Penn Avenue, Pittsburgh, PA 15206
Hon. Thomas C. Petrone, 179 Steuben Street, PO Box 8557, Pittsburgh, PA 15220
State Senator John Pippy, 937 Beaver Grade Road, Moon Township, PA 15108
Hon. T. Mark Mustio, 519 Broad Street, Sewickley, PA 15143
State Sen. Sean Logan, Ivanhoe Prof. Bldg, Suite 107, 117 Fox Plan Road, Monroeville, PA15146
Hon. Joseph F. Markosek, Commerce Building, 4232 Northern Pike, Monroeville, PA 15146
Hon. Matthew Smith, 319 Castle Shannon Blvd, Pittsburgh, PA 15234
Hon. John Maher, 2547 Washington Rd, 711 Summerfield Commons, Upper St Clair, PA 15241
State Sen. John N. Wozniak, 2307 Bedford Street, Johnstown, PA 15904
Senator Hillary Rodham Clinton, US Senate, 476 Russell Senate Office Building, Washington, DC 20510
Barack Obama, US Senator for Illinois, 713 Hart Senate Office Building, Washington, D.C. 20510
Congressman Ron Paul, 850 N. Randolph Street, Suite 122, Arlington, VA 22203
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Sorry, I have been away for a bit...
Upon my arrival home, checking my mail, I found a letter from Children's Hospital.
Responding to my complaint, the manager of "quality assurance" wrote that they were advised by Dr. Ignorant of my "concerns" as he received a phone call from me the day of Liam's surgery. Dr. Ignorant has apparently been "retracting" as a pre-op necessity his "...entire career without negative results...". The head of his dept., "...without having the benefit of examining my son..." (as if that would happen), does not foresee "...any potential problems as a result of Dr. Ignorant's actions...".
Although, they say they will address the issue of including this procedure (premature, forcible, surgical retraction) as part of the informed consent process for future patients/parents. WHAT??????
Can you imagine how I am ready to take a two hour drive to this hospital to ASSURE them this is not consistent with QUALITY!
Did they even read the AAP guidelines I copied and enclosed?
The NOCIRC "how to care for the intact penis/foreskin" guide?
I AM OUTRAGED EVEN MORE NOW THAN BEFORE, IF THAT IS HUMANLY POSSIBLE!
John Geisheker, Doctor's Opposing Circumcision, general counsel, has drafted a phenomenal 8 page letter on our behalf, complete with numerous medical references, addressed to the hospital administration.
It is a no brainer that we will be moving forward with a lawsuit. We've consulted a local attorney. This is not my usual disposition, but
THIS IS NOT THE KIND OF RESPONSE I EXPECTED... they obviously are not aware of an Irish scorpio, NewYorker's, temperament!!!
How many other boys have fallen victim to this ???
Alternative Medicine magazine will probably be publishing my letter about Liam and forcible surgical foreskin retraction in the "letters to the editor" sect.... will keep you all up to date...
thanks for all of the support everyone!
They are expecting you to sue and would never admit in writing that they messed up.
Keep after them. For some reason logic (and new medical advice) won't change most doctors' behavior, just a good, old fashioned lawsuit will.
I'll keep you guys in my prayers.
yet another update for all of you...
First, I want to publicly applaud and commend COMPLEAT MOTHER (excellent magazine of pregnancy, birth, breastfeeding and natural living) for reaching out to my family. I have permission from them to post information regarding their publication and want to encourage anyone who has not ever had the privilege or opportunity to read...to now do so. It is a VERY rich and warm publication.
You can obtain back issues or subscribe by contacting (me...or) Jody McLaughlin @ [Jody@Minot.com] or calling her @ 701-852-2822.
Mother/Jody has been a pillar of support to myself and my family during this difficult time and Compleat Mother will be publishing an article on Forced Foreskin Retraction (also covered in the Fall '05 issue) citing the letter I wrote posted near the beginning of this OT.
Secondly, I am happy to announce that I spoke with the investigator from the State Medical Licensing Board. He said that he has not received such a thorough complaint as I submitted in a very long time.(I can really !)
He was a very nice gentleman who seemed to be compassionate. (I was hoping someone like him would be assigned to investigate). I got a good feeling about him from the short time we were on the phone.
Of course, I had to correct him after he said two times that he thought Liam was circumcised!
But his disposition didn't change when I explained FFR...he was still pretty surprised...
He is sending a release for me to sign off on Liam's medical records to be copied and forwarded. (I told him I already obtained a complete record. He then asked, "Are you sure it is a complete record?"...I said, "OK, I see where you are going with this...send the form and I will sign")
I also told him I would copy him on the response letter from the hospital, the letter from John Geisheker (DOC) and any other pertinent info...
(I asked if he had any medical background...he does not...so I asked if he would like any more information on development, purpose, function of the foreskin to further his understanding...he said sure)...
I don't want to overwhelm the guy, but certainly DO want to make sure he has a clear understanding of why this practice continues to be ignorantly employed...and...how damaging, unnecessary and risky it really is!
You rock Colleen. As the mother of two intact boys, I want to say thank you for doing this. I mean, I know you are doing it for your son, but by doing so, you are doing it for all our sons.
Although I have to say...just as you are absolutely correct in that I will fight tooth and nail for my son, I AM thinking of all of those other sons while I fight this fight and they ARE ALSO the reason why I am doing this!!!!
I would do (and have done) the same for ANYONE who was/is wronged!!!
(I am not one of those passive types!)