Where We’ve Been, Where We Are, Where We’re Going

It is a tremendous honour to begin my term as President of the Canadian Spine Society. As I take on this role, I do so with a deep sense of gratitude; for the trust placed in me, for the strength of our community, and for the vision and leadership of those who have served before me. Each Past President has left an enduring mark on the Society, helping shape it into the national and international leader it is today. I step into this role humbled by their legacy and excited for the opportunities that lie ahead. Below are all past presidents from John Hurlbert to Ken Thomas, whose legacies I spoke of at the CSS Annual Meeting banquet in Charlevoix.

Our Society stands at a critical moment in its journey. We are a multidisciplinary organization of clinicians, researchers, educators, and advocates who care deeply about advancing spine care in Canada. Our members are passionate, highly skilled, and deeply engaged in solving the complex challenges that affect our patients and our practices. At the same time, we face persistent system-wide barriers: prolonged surgical wait times, regional disparities in access to care, growing demands for data-driven policy reform, and the need to ensure sustainability – not just of our healthcare system, but of the professionals who support it.

As President, I see my role as one of stewardship and collaboration. I am committed to amplifying our Society’s collective voice on the national stage – ensuring that policymakers, administrators, and the public understand the urgency of supporting timely, equitable, and evidence-based spine care.

I am also cognisant of the fact that many of our newer members may not know our ‘elder statesmen’ by first name, and so everyone gets their full name in this article!

Advocacy of course, must be grounded in unity. One of my central priorities is to continue strengthening connections across disciplines and regions, reinforcing that our greatest strength lies in our diversity and our willingness to work together. I am looking forward to continued collaboration with Mark Pahuta, CSS Advocacy Chair, and the many initiatives that will undoubtedly grow from his recent membership survey on advocacy.

Research and education remain core pillars of our mission, and I will continue to support initiatives that foster innovation, mentorship, and the next generation of Canadian spine leaders. The work being done by our members – across surgical and non-surgical, academic and clinical domains – is nothing short of extraordinary, and it deserves to be championed and shared.

Building on the visionary work of Charles Fisher, our research mandate is in the safe hands of Raj Rampersaud and the rest of the CSORN Steering Committee and the rest of the team. CSORN now has almost 16,000 patients enrolled, 21 participating sites and more than 75 peer reviewed publications. This is something to be truly proud of.

Brad Jacobs, also a leader in AO Fellows education, currently has the reins of the CSS Education Chair, and with Albert Yee and Scott Paquette, they will soon guide the Canadian Spine Area of Focused Competence Diploma through the final stages of implementation with the Royal College of Physicians and Surgeons of Canada.

Equally important is the wellbeing of our members. As Ken Thomas articulated so poignantly when he spoke of our friend and colleague Fabio Ferri de Barros, as a Society, we must not only promote professional excellence but also support personal sustainability. Burnout, moral injury, and the pressures of an increasingly strained system are real and urgent concerns. I want to make advancing wellness a leadership priority, not as a side project but as an essential element of a healthy professional community.

As I begin this term, I invite each of you to reach out, get involved, and share your insights. Whether you are a long-standing member or early in your career, your voice matters. Contributing to Spinal Columns is a great way of getting involved and reaching the CSS membership. Adrienne Kelly will be delighted to be inundated with articles!

Another tangible way to support our Society is through the Canadian Spine Research Education Fund. Mike Ford and his CSREF committee would be more than happy to unburden you of some of that unwanted cash!! But seriously, leadership starts and ends with example and what better way than a CSREF donation to demonstrate your commitment to our society.

This is our Society. Together, we will continue to build a CSS that reflects our highest standards, our deepest values, and our collective vision for the future of spine care in Canada. What better opportunity to showcase these values and vision than when the CSS hosts SPINEWEEK in Montreal, May 16-20, 2027. Raphaële Charest-Morin and Supriya Singh will undoubtedly have an amazing program for us all to participate in. Let’s show the world how we at the CSS do it!

An Irishman in Canada

As I take on this role, I do so with a profound sense of honour—not only as a spine surgeon committed to our shared mission of advancing spinal care across Canada, but also as an Irishman deeply aware of what drew me to Canada in the first place.

For over four centuries, the Irish have arrived on Canadian shores with a dream of being more than they could be at home. From the famine migrants who landed at Grosse Île in the 1840s, to the Irish navvies who carved Canada’s early canals and railways; from the Waterford fishermen who found refuge on ‘The Rock’ of Newfoundland, to the nurses, priests, teachers, and doctors who built communities in every province – the Irish have helped shape the fabric of Canadian society. For anyone interested I would highly recommend Lucille H. Campey’s very well researched book ‘Atlantic Canada’s Irish Immigrants’.

Today, as an Irish-born surgeon entrusted with the leadership of the CSS, I am deeply moved by this opportunity. Growing up, my grandfather told me of when he first immigrated to England for work in the 1960’s. And how he was frequently met with bigotry and suspicion, greeted by signs like ‘No Dogs or Irish Allowed’. That I now stand in this role of leadership and service is not just a personal milestone, but also a reflection of how far we all have come, and how important it is that we continue to emphasise inclusivity, tolerance and diversity within our society. The recent evolution of the CSS Women in Spine Surgery group is truly something to be celebrated.

Ireland has long been known as a land of scholars and storytellers, and spine surgery is ultimately a story of people: our patients, our colleagues, our mentors, and our students. Our work is grounded not just in technical excellence, but more importantly in empathy, humility, and service. These are values I carry from my Irish upbringing and that I have seen reflected in all of you, my Canadian colleagues, since my first CSS meeting, as a fellow, at Lake Louise in 2006.

These coming two years, I hope to lead with the same curiosity, collaboration, and camaraderie that have marked both our nations, and that has always been core to this society. I also hope to bring a touch of Irish wit to our work – because let’s face it, if you can survive spine call, Irish weather, or Newfoundland weather, you can get through just about anything.

To my mentors, my peers, and the generations of surgeons who have shaped the Canadian Spine Society, I say Thank You. To the new members and young surgeons coming up, know that your voice matters. And to the many Irish Canadians, past and present, who were lucky enough to forge a path of service and leadership in this country, you are never far from my thoughts.

Sláinte, and onward.

Leadership, A Journey Without Beginning or End

As I was finishing writing this article, with less than 48 hours before the deadline, my colleague and friend Nic Dea called me, to let me know of the passing of Marcel Dvorak. I couldn’t really write of my past, or my future, of leadership or of mentoring, without acknowledging the profound influence that Marcel, and of course Charles, had on me, on so many of us, and on spine care in Canada. I came to Canada in 2005 solely for the opportunity to work with them.  Such was, and still is, their impact on spine care worldwide. All I knew of Canada before I got to Vancouver in 2005 was Marcel, Charles and The Beachcombers.

Marcel was a mentor who saw things in people often before they saw it in themselves. I look at my group of colleagues in Vancouver, and I am beginning to understand the intent and purpose that Charles and Marcel must have had to create such a cohesive and complementary group. That did not happen by accident.

To call Marcel simply a colleague would be to miss the full measure of his impact on me. He was equally a steadying force for me in moments of uncertainty, and an unsteadying force in moments of complacency. He could be a voice of reason in times of challenge, and a voice of agitation in times of calm. Ultimately, he pushed me to aim higher, to think deeper, and to care more.

Marcel was a leader who never waited for consensus when conviction called. He was a visionary who challenged the status quo, not out of contrariness, but out of belief: belief that we all could do better, that we all could be better.

Marcel was one who always led from the front. He was not one to shy away from a challenge.  He was always where the work was to be done, where the tough decisions were to be made, and where the future was to be built.

Marcel was also an agitator. And in no way do I mean that as a slight. It took many years for me to realize that it was his secret key to leadership.  He agitated people and systems that had grown stagnant, routines that had lost purpose, and conversations that needed refocusing. He was never content with the way things were if he believed they could be better, more innovative, more meaningful. He was never shy to call you out, to say what needed to be said, regardless of who’s ‘sensitivities’ he might offend.

Marcel also made many of us uncomfortable at times—but that discomfort was always a starting point for change. And he never asked of any of us that which he wouldn’t demand of himself: integrity, courage, and a willingness to act.

As a mentor, he did not just teach us, but he also invested himself in us. He invested in everyone who came to learn from him. His door was always open, though you’d better be prepared for a dressing down if it was warranted.

Marcel’s style of mentorship was direct, often blunt, and always honest. And beneath the edge, there was always a bottomless well of genuine care: care for his colleagues, for his patients and for the future of the profession he loved.

Marcel was also a deeply faithful man, a model family man and I will miss him – not just his leadership, or his voice, or his force, or his fire – but how he made me feel that our work mattered, that real leadership mattered, and that the future was always ours to shape.

Marcel never asked to be remembered. But he made damn sure he wouldn’t be forgotten.

Dr. John Street
President of the Canadian Spine Society

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Past CSS Presidents

Ken Thomas 2023 – 2025
Scott Paquette 2021 – 2023
Albert Yee 2019 – 2021
Sean Christie, 2017 – 2019
Peter Jarzem, 2015 – 2017
Charles Fisher, 2013 – 2015
Robert Broad, 2011 – 2013
Raj Rampersaud, 2009 – 2011
Daryl Fourney, 2007 – 2009
Michael Ford, 2006
Edward Abraham, 2005
Richard Fox, 2004
Stewart Bailey, 2003
John Hurlbert, 2000 – 2002