Purnanto is the king of the snip, the master of celebrations for what, for most Indonesian boys, is the most traumatic—but also proud—moments of their young lives. In Indonesia, young boys aren't considered a man until they are circumcised. Nationally, attitudes around circumcision are mainly influenced by Islam—which requires all Muslim men to be circumcised. These beliefs later translated across religious and ethnic lines. Little Catholic, Christian, and Hindu boys are also circumcised here, but it's generally seen as a health issue by their parents, not a religious one.Since this is a coming of age thing, boys are circumcised when they are like 8 to 11 years old. The whole thing is a massive celebration. Sometimes it's a mass circumcision where a doctors shows up at the mosque and does a whole bunch of them in a row. Other times it's a more personal affair. Either way, the boy gets a party, some gifts, and treated as a man—albeit a man who is in a lot of pain.Purnanto runs a clinic called "Raja Sunat,"—or the "Circumcision King." It's a quick and thankless job. Young boys want to get the whole ordeal over as quick as possible. So for most it's a quick snip, snip and they're out the door.Purnanto told me that he does a lot of these procedures—at least one every single day. That's a lot of teary-eyed boys limping out the front door of his Cilandak, South Jakarta, clinic. But how does one become a circumcision doctor in the first place? Is it difficult work? And what happens if something goes wrong? Can they fix it?VICE: So how did you end up becoming a circumcision doctor?
Purnanto: I started my career as a general practitioner, but I was always curious about circumcision. It just so happened that I took a basic surgery course in university, so I knew how to do it. Plus, in Jakarta, the market for circumcisions is huge. It's a big business.So you got into this for the money?
Well, not exactly. I kind of like doing it too. It's like a hobby that pays.Wait, seriously? You like cutting off foreskins?
I mean every year the number of people who want to be circumcised increases. There are always children who need to be circumcised. Adults too. As long as there are men in this world, there's going to be a market for it.How did you learn how to do this?
I started out in medical school. It's common for med students to assist doctors to gain experience and I happened to assist a circumcision doctor one day. I watched him closely and learned a lot. When I started to practice on my own, I was accompanied by the same doctor. After that, I just sort of went for it.Did you feel nervous the first time you did it?
I was nervous since it was someone else's genitals. But I wasn't disgusted or anything. I just wanted to help the patient out. I don't really remember the first time I performed a circumcision, but it could've been at UGM's mass circumcision. That was more than ten years ago.Is it harder to circumcise a child or an adult?
It depends. If you're a pro, then it's adults since they are more cooperative. They're not so fussy. Kids tend to rebel and kick you. So technique aside, you have to be smart and persuade the kids to work with you. Once the anesthesia is injected, then half the job is done. But there are some adults who are a pain in the ass as well. They might be afraid of needles, scissors, or even blood, so they will ask for full anesthesia. This is rare though. Normally, partial anesthesia does the trick.Have you ever botched a circumcision and made someone penis look ugly?
I've never caused heavy bleeding or anything like that. I mean, I maybe have over-cut or under-cut the foreskin, but that's no big deal. You can always fix it.You can fix it?
If you under-cut, that mean that part of the foreskin still covers the head. So you just need to cut some more. For adults they would feel pain when the head of their penis is not covered by foreskin. Now if you over-cut, that means you need to stitch up the wound. If this happens to a kid, then it's easier since their skin will adjust as they grow. And sometimes you get sticky foreskin that attaches itself to the penis because of dirt or sweat. So you need to clean out the layers first.I always wondered, does anyone ever get an erection during the procedure?
Ideally, the penis should be limp. If it's hard it means the veins are full of blood, so if you make a mistake, the bleeding may be excessive. So, I would wait until it goes limp. I might walk out the room first. But by the time it goes limp, the anesthesia may have worn off, so I need to anesthetize the patient again. Then when I touch the penis, if it goes hard again, it's very annoying.Last question, what do you do with the foreskin? Do you keep it? Do you stitch them together into a bag?
[Laughs] We throw it away immediately. It's considered medical waste, the same as blood or other skin after a surgery. There's no specific procedure to throw it away since it doesn't contain any harmful substance. It's just human skin.
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Purnanto: I started my career as a general practitioner, but I was always curious about circumcision. It just so happened that I took a basic surgery course in university, so I knew how to do it. Plus, in Jakarta, the market for circumcisions is huge. It's a big business.So you got into this for the money?
Well, not exactly. I kind of like doing it too. It's like a hobby that pays.
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I mean every year the number of people who want to be circumcised increases. There are always children who need to be circumcised. Adults too. As long as there are men in this world, there's going to be a market for it.How did you learn how to do this?
I started out in medical school. It's common for med students to assist doctors to gain experience and I happened to assist a circumcision doctor one day. I watched him closely and learned a lot. When I started to practice on my own, I was accompanied by the same doctor. After that, I just sort of went for it.Did you feel nervous the first time you did it?
I was nervous since it was someone else's genitals. But I wasn't disgusted or anything. I just wanted to help the patient out. I don't really remember the first time I performed a circumcision, but it could've been at UGM's mass circumcision. That was more than ten years ago.Is it harder to circumcise a child or an adult?
It depends. If you're a pro, then it's adults since they are more cooperative. They're not so fussy. Kids tend to rebel and kick you. So technique aside, you have to be smart and persuade the kids to work with you. Once the anesthesia is injected, then half the job is done. But there are some adults who are a pain in the ass as well. They might be afraid of needles, scissors, or even blood, so they will ask for full anesthesia. This is rare though. Normally, partial anesthesia does the trick.Have you ever botched a circumcision and made someone penis look ugly?
I've never caused heavy bleeding or anything like that. I mean, I maybe have over-cut or under-cut the foreskin, but that's no big deal. You can always fix it.You can fix it?
If you under-cut, that mean that part of the foreskin still covers the head. So you just need to cut some more. For adults they would feel pain when the head of their penis is not covered by foreskin. Now if you over-cut, that means you need to stitch up the wound. If this happens to a kid, then it's easier since their skin will adjust as they grow. And sometimes you get sticky foreskin that attaches itself to the penis because of dirt or sweat. So you need to clean out the layers first.I always wondered, does anyone ever get an erection during the procedure?
Ideally, the penis should be limp. If it's hard it means the veins are full of blood, so if you make a mistake, the bleeding may be excessive. So, I would wait until it goes limp. I might walk out the room first. But by the time it goes limp, the anesthesia may have worn off, so I need to anesthetize the patient again. Then when I touch the penis, if it goes hard again, it's very annoying.Last question, what do you do with the foreskin? Do you keep it? Do you stitch them together into a bag?
[Laughs] We throw it away immediately. It's considered medical waste, the same as blood or other skin after a surgery. There's no specific procedure to throw it away since it doesn't contain any harmful substance. It's just human skin.