My journey into spine surgery did not begin in a lecture hall or an operating room.

It began at my grandfather's bedside.

He suffered from a massive L2-3 disc herniation with cauda equina syndrome — a condition that, had it been properly treated, might have given him back his life. Instead, in the absence of modern medical care, he endured years of paraplegia and incontinence, his world reduced to the confines of a bed and the quiet dignity with which he bore his suffering.

The only intervention available to him was traditional cauterization — a desperate attempt to ease his pain that could do nothing to restore what had been lost. He never walked again.

I was young when I witnessed this, but the image never faded. The helplessness I felt watching him — knowing somewhere, somehow, better answers existed — planted a seed that would quietly grow into a lifelong calling.

I became a spine surgeon because of my grandfather. Because no family should watch their loved one suffer from a treatable condition without hope. And because every patient who walks out of my operating room is, in some deeply personal way, the chance I never had to give him back his dignity.

If I were to distill my most cherished memory from NASS into a single image, it would not be one moment — it would be a journey.

The journey of transformation.

I remember vividly what spine surgery looked like in Iraq during the 1980s, an era defined by limitation, by improvisation, and by the quiet frustration of knowing that better tools, better techniques, and better outcomes existed somewhere beyond our reach. We worked with what we had, and we gave everything we could to our patients. But we knew, deep in our hearts, that the world was moving forward without us.

Then came NASS, and with it, nothing less than a renaissance.

Through Instructional Course Sessions led by some of the most brilliant and generous minds in global spine surgery, we were guided — step by step, concept by concept — out of the shadows of outdated practice and into the light of modern spine care. These were not merely lectures. They were transformative encounters with knowledge, delivered by great people who genuinely cared about elevating surgical standards across the world, including in a country as challenged and complex as Iraq.

The industry partnerships and educational exhibits were equally eye-opening — introducing us to technologies and innovations that we had only read about in journals we could barely access. Seeing them, touching them, and understanding how to apply them in our own operating rooms was nothing short of revolutionary.

What moves me most, looking back, is not the technology itself — but the humanity behind it. The NASS educators, faculty, and industry partners who poured their knowledge into us did so with warmth, with patience, and with a profound belief that every patient — regardless of where they live — deserves world-class spine care.

Because of them, patients in Iraq today receive care that would have been unimaginable to us just a generation ago.

That is my favorite memory from NASS. Not a single meeting, not a single session — but the cumulative gift of transformation, given freely and generously across the years.

For that, I remain forever grateful.

In forty years of spine surgery, no voice has shaped my clinical philosophy more profoundly than that of Dr. Edward C. Benzel of the Cleveland Clinic — a giant of our field, and the most generous mentor I have ever known.

Over twenty years of friendship and guidance, Dr. Benzel gifted me not just knowledge, but a conscience as a surgeon. His wisdom was never about doing more — it was always about doing right.

He taught me to always begin with "doing the right thing" — not the impressive thing, not the profitable thing, but the right thing. To make surgery the last resort, not the first reflex. To search relentlessly for non-operative solutions before ever reaching for the blade. To never trust imaging alone, but to ensure the diagnosis is truly correct — because an L4-5 spondylolisthesis on an MRI means nothing if the real diagnosis is chronic pain syndrome. Those patients, he warned, respond very poorly to surgery — and operating on them is a failure of judgment, not a triumph of skill.

Above all, he believed with absolute conviction that value-based care must replace volume-based care — that our success should be measured in outcomes, not operations.

His words became my compass. I carry them into every clinic, every OR, every lecture:

"Do the right thing — make surgery the last option, not the easiest one."

"Value based care should replace volume based care — always."