How this Canadian doctor became the ‘Wayne Gretzky of vasectomies’ — and why he stopped

OTTAWA-For years, Dr. Ronald Weiss kept a rigid morning routine. He started his day at half past five with a series of push-ups and pull-ups, a workout he'd performed every weekday morning, almost without fail, since university. He ate a bowl of plain yogurt with granola and berries while reading the newspaper. He drank a single cup of coffee - with milk, no sugar. Then, a few minutes before 8, he walked downstairs to the medical clinic in the basement of his family home, where he performed 14 vasectomies, one after the other, before lunch. Then he had a nap.

Weiss did this day after day, sterilizing 70 men each week and 2,800 or so each year. His wife called him the vasectomy machine." His patients were teachers, engineers, lawyers, public servants, politicians, plumbers, bus drivers and construction workers. He snipped professional athletes, political figures and entertainers, some of whom flew in from as far as Japan and Los Angeles, drawn by his reputation and low complication rate. There were brave men and fainters, buddies who came for back-to-back appointments in matching T-shirts, and entire beer-league hockey teams.

In his 30-year career, Weiss has performed 58,789 vasectomies - more, his peers say, than any other doctor in the Western Hemisphere. His work earned him a reputation as one of the world's most prolific and skilled performers of no-scalpel vasectomy, a method that popularized male sterilization and helped shift the responsibility of birth control in middle age from women to men. Weiss approached his work with the zeal and commitment of a high-performance athlete. People called him the Wayne Gretzky of vasectomies."

With Debbie Halton-Weiss, his wife and office manager, he built a medical practice that became a model of efficiency at a time when the rest of the Canadian health-care system seemed to be falling apart. We were always running early," Halton-Weiss said. Never late."

As years passed, patients and reporters began speculating about Weiss's retirement, long before he reached retirement age. He used to joke that a wife who wanted her husband to hurry up and get snipped had started the rumour. The questions came so often that he had to write to local doctors, informing them that he was, in fact, still practising. Amused, he posted a Frequently Asked Questions" sign in his office.

Q: Are you going to retire soon?

A: No.

I first learned about Weiss in 2021, a few weeks after my son was born, when my midwife, who knew that our third baby had been a surprise, asked my husband if he planned to get Weissed."

We had recently moved to Ottawa and weren't familiar with the term. Even in the fog of new motherhood, I found myself curious about Weiss, this quirky doctor who performed surgeries out of his home and had snipped more men than nearly any other physician in the world. I wanted to know what was behind his drive to go all-in on vasectomies. And, yes, I wanted my husband to get snipped. Better hurry up," my midwife said. I hear he's retiring."

A few weeks later, I phoned the clinic - as a wife, but if I'm honest, as a journalist, too - to see about making an appointment. Weiss was on leave, the receptionist told me. Another doctor, trained by him, was performing vasectomies in the clinic. When I asked the receptionist if she knew when Weiss would be back, she seemed to hesitate, then said no. I got the sense that something was up, and I made a note to call back in a few months. But by that time, Weiss had quietly retired.

Weiss was the most famous vasectomy doctor in Canada, and one of the most prolific in the world, and he had retired without notice or fanfare. Why, I wondered, after seeming committed to working for at least another decade, had he suddenly stopped?

The answers ended up being more complicated than I imagined. Weiss, I learned, was a man who had embraced discipline to save himself from the chaos and disorder of his early years, with remarkable results. He believed that rather than accept uncertainty as a given in life, a person could, through discipline, arrange their life to avoid it. That belief would be challenged when, at the peak of his career, he found himself suddenly faced with the kind of uncertainty that can't easily be overcome.

The House on Clemow

From the outside, 29 Clemow Ave. looks nothing like a place where you could get a vasectomy. It is a three-storey Tudor-style house with a gabled roof on a tree-lined street in the Glebe, an upper-middle-class neighbourhood near Ottawa's downtown.

On a snowy January morning, I parked my car out front and followed a stone pathway to the side entrance, where a narrow staircase leads down to the clinic.

The office is small and functional. On a wall in the seating area are two dozen framed newspaper and magazine articles that Weiss has been featured in - Esquire, Chatelaine, Wired, the Ottawa Citizen - with headlines employing various vasectomy puns: Local doctor on the no-cutting' edge"; Cutting down on vasectomy pain"; The Big Snip." I noted the nicknames reporters have given him: Dr. Snip, No-slice Weiss, The Vasectomy King. One story, from a men's magazine, is just called Balls."

At precisely 1 p.m. I heard footsteps above, then a door opened and Weiss thumped briskly down the stairs. He was trim, bright-eyed and neatly dressed; bald on top with a horseshoe of dark hair around his head. At five-foot-five, he didn't have to worry about clinic's low ceiling. (His shortness, he told me later, is something he didn't recognize about himself until he was in his early 20s and complained to his wife about the tall" people in front of them at the movies. They aren't tall," she said. You're short." This was a revelation. He had no idea.)

Weiss led me upstairs and into his home - a mansion with the warmth and charm of a cottage. It has a stone fireplace, stained glass windows and wood mouldings. I followed him up a grand staircase to the second-floor family room, a comfortable space with plaid reading chairs, an island bar and a sun porch.

When Debbie found the house in 1997, he told me, it had been on the market for seven years. It needed work, but the location was perfect: in one of Ottawa's nicest neighbourhoods; near shops, restaurants and excellent schools. It backed onto a grassy park with walking trails that stretched east to the Rideau Canal.

It was also an ideal location for a vasectomy practice, in a community of families with young children whose dads were creeping toward middle age.

Weiss is a good storyteller. He spoke openly not only about his successes, but his failures, embarrassments and peculiarities. We chatted about parenthood, his mixed feelings about Toronto, my husband's vasectomy. (He did not get Weissed, and that's all I'm permitted to say.)

His openness gave me the courage to ask an awkward question: Have you had a vasectomy?

Of course I have," he said. Then he told me the story.

In 1992, Weiss became the second doctor to perform no-scalpel vasectomy in Canada. Dr. Michel Labrecque, a Quebec urologist, had been trained the month before him. Labrecque would soon become a friend, and, one year later, Weiss asked Labrecque to give him the snip. Labrecque agreed and prepared a five-course vasectomy-themed meal to celebrate the occasion, including a cake in the shape of a penis and testicles.

Many physicians do vasectomies, but Weiss made the rare choice to do them exclusively. Performing the same surgery 14 times a day would be boring for some, but not Weiss. He found satisfaction in refining the procedure, creating systems for improvement in his practice, making tiny adjustments that saved time or resources and led to a better patient experience.

At a certain point in my career it became almost zen to do a vasectomy," he told me. There was an automaticity to my movements and my behaviour. In a way, it was almost relaxing to work."

That skill and confidence was years in the making, and none of it would have happened without a chance encounter on a trip to Montreal in 1977.

The hippie musician

Before he met Debbie Halton, Weiss was an unemployed high school dropout living with his older brother in Vancouver, working on his music.

He had grown up in Montreal, the middle son in a family of five boys. His father ran a successful electrical contracting business. His mother was a homemaker. They lived in a house in the suburbs, next door to one set of grandparents and a block from the other, and spent summers at camp and the family cottage.

His teen years were less stable. His parents, fearing what the rise of nationalism in Quebec could mean for Jewish people, fled the province in the spring of 1970, when Weiss was 13. They shut down the contracting business and moved the family to Tsawwassen, a seaside community near Vancouver, then to Toronto. His father's new ventures failed, and finances never recovered. In Toronto, Weiss struggled to fit in. At 16, he quit high school, and his parents didn't seem to notice.

Looking back," he wrote later, it feels as though we Weiss boys raised ourselves and each other with little help, orderly or otherwise, from our parents."

With a group of friends, he started a school in downtown Toronto, run out of a rental house owned by the Church of the Holy Trinity. They called it The School of L.I.F.E. Living In a Free Environment." Volunteer professors gave guest lectures on poetry and math. Weiss worked as a busboy at Egerton's, a live music venue on Gerrard Street. He started writing and performing his own folk songs, traversing the city with a guitar under his arm.

Weiss soon realized that without a high school diploma his options were limited. He enrolled in courses at the University of Toronto, getting in on the strength of SAT scores and recommendation letters from the L.I.F.E. school lecturers. Over time he grew restless and moved to Vancouver, deciding to devote himself to music. He spent months isolated in a bedroom in his brother's apartment, learning classical piano and guitar, with plans to apply to the Berklee School of Music in Boston.

Midway through that year, he met Debbie Halton at the home of a mutual friend while in Montreal visiting family. She was a 20-year-old social work student with a lion's mane of curly brown hair. He was an aspiring musician with a scraggly beard who dressed exclusively in overalls. Afterward, Weiss arranged a goodbye party for himself as an excuse to see her again, and they walked the city, talking until 5 in the morning. Weiss was supposed to return to Vancouver the next day, but cancelled his train.

Meeting Debbie gave him purpose and changed his priorities. He shelved his musical ambitions and went back to school. His father had been a smart businessman who had lost everything after a few bad decisions. Weiss wanted to be a more stable provider for his family.

Weiss and Halton-Weiss married and settled in Ottawa. She supported the family financially while he completed an undergraduate degree in science and applied to medical school, law school and business school. His first med school interview at the University of Ottawa occurred soon after his father died, and went terribly. He tried again the next year, and got in.

By the time Weiss became a doctor, he had two children. He specialized in family medicine, which he viewed as the fastest route to earning a living, and joined a practice in a strip mall south of downtown. The clinic served a large community, but had only enough exam rooms for three doctors to work at once, meaning there were days Weiss couldn't see patients. The lost productivity bothered him.

Weiss looked for ways to use this time, trying psychotherapy, acupuncture, and even, briefly, hypnosis. One day, a physician colleague told him that he had been training under a doctor who performed vasectomies, but didn't want to continue. If you want to give it a shot, he told Weiss, go ahead.

The snip

The vas deferens, a muscular tube that looks like an overcooked spaghetti noodle, transports sperm from the testicles to the urethra. Along the way, the sperm mixes with seminal fluid to become semen. Snipping and blocking the vas results in sperm-free semen - and voila, that's a vasectomy. The tricky part, and the one that can make a grown man faint, is getting the vas out of the scrotum.

The conventional method of vasectomy required cutting one or two small incisions in the scrotum with a scalpel. It was considered safe and effective, but came with a significant PR problem: men didn't want knives near their genitals.

In 1962, Dr. Li Shunqiang, a Chinese surgeon, began looking into alternatives. Born into a farming family in Sichuan province, Li had seen women overwhelmed by the challenges of caring for large families while also performing farm duties. Why should they alone, he thought, bear the responsibility for family planning?

Li began performing conventional vasectomies, but found that many patients associated the procedure with castration. He needed another solution.

In 1974, Li developed a game-changing technique: the no-scalpel vasectomy, or NSV. Instead of a knife, the surgeon uses dissecting forceps to puncture a small hole in the scrotal skin, then gently stretches the opening to access the vas deferens. The vas is pulled out of the hole and removed from its sheath, then snipped, cauterized shut, tucked back in and sealed with surgical glue. The no-scalpel procedure was quicker than a conventional vasectomy and resulted in less bleeding and fewer complications. Above all, it was an easier sell.

Over time, the technique spread across the globe. In 1985, Li trained doctors from Thailand and the United States, who returned to their countries and became the first to perform no-scalpel vasectomies outside of China.

In 1992, a patient walked into Weiss's family medicine practice in Ottawa with a magazine article about the method. Weiss had started performing vasectomies the conventional way, with a scalpel, the year before. I think in the first year I did 50 vasectomies, a respectable number," he said, but it was using that standard technique and I thought: it could be better than this."

Weiss arranged for a doctor to fly in from the U.S. to train him. The American organization that arranged the training distributed press kits to no-scalpel vasectomy practitioners. Weiss had no media experience, but he sent out news releases as encouraged, expecting little interest. Soon after, he got a call from an Ottawa Sun reporter. Weiss had never done an interview. When the reporter asked how long the procedure took, Weiss said 15 minutes, then added: Once I get really good at it, it'll take about five."

He looked at the paper the next morning and saw the quote: Once I get good. He was mortified, but it didn't stop people from coming. Baby boomers wanted the snip and Weiss was the only guy in Ottawa practising the no-scalpel method.

He did get really good. Weiss had small, nimble hands and strong fingers from playing guitar. He was precise and focused. He found the work rewarding. He was providing young, healthy people with a service that gave them sexual freedom.

When Weiss was a medical student in the 1980s, tubal ligations - the female sterilization method, which is more complicated and risky - outnumbered vasectomies in Canada two to one. The balance began to shift in the 1990s, with the spread of the no-scalpel technique and as research on the safety of vasectomy piled up and societal ideas about masculinity began to change.

That November, Weiss got a call from a producer for the CBC Radio program Morningside," wanting to book him for an interview with legendary broadcaster Peter Gzowski. It would be his first national exposure. The night before the interview, Debbie went into labour. The timing was not ideal, but they both agreed he should proceed. Hospital staff found Weiss a room with a telephone. He did the interview and returned in time for the birth of his third child, Lauren.

Demand rose and vasectomies began to take up more time at his family practice, which created tension with his partners. He grew unhappy with what he viewed as the clinic's inefficiencies. It was time to move on.

House of vasectomies

In the summer of 1997, Weiss and Halton-Weiss opened the clinic at 29 Clemow Ave. Weiss found the move liberating. Now he could create his own systems to make his clinic run as efficiently as possible.

They scheduled appointments 15 minutes apart. Each procedure took seven to nine minutes, but he didn't like to be rushed. The patients arrived in sweatpants, their anxiety soothed with Valium, and were taken into the operating room early, before they had a chance to worry.

They lay flat on a sea-green examination table. They breathed in the scent of a eucalyptus vaporizer and stared into a canopy of Douglas fir trees on a poster that the doctor himself had affixed to the ceiling. The pre-op iodine sat on a coffee warmer so the cold wouldn't jolt the patient. Weiss used a jet injector to numb the scrotum, which he believed was a better and less frightening method than a needle. Everything was designed for the patient's comfort.

Hearing this, some women might ask: When has the medical system ever designed anything for our comfort? But if there was coddling, it was in service of a greater mission. Weiss wanted patients to tell their friends that it had been fine. Not a big deal.

All men, myself included, are babies," Weiss often says, but they come by their fear honestly. Their vasectomy appointment is often the first time they have seen a doctor since childhood. Women often have more experience with the medical system, through gynecological exams, pregnancy check-ups and childbirth.

Soon after they moved to Clemow, Debbie handed Weiss an envelope with $400 in cash and told him to buy a guitar. He began to practise music each afternoon with the same discipline he brought to medicine. He took virtual lessons from the Berklee School of Music, finally realizing that long-ago dream. He started a band, performed at local venues and released several albums.

The more vasectomies he did, the better he got, and the longer his wait list grew. In 2009, Weiss celebrated 25,000. In 2018, he reached 50,000.

Ronnie can set a goal, make a plan and work toward it, and I think that kind of behaviour is a bit addictive," said his brother, Peter Weiss. Once you have succeeded at achieving a goal with a certain process, you just can't help yourself. You make another one."

Weiss was obsessed with improvement. When smoke from the cauteries nauseated patients and staff, he brought in an extractor. When an instrument was too expensive or cumbersome, he created his own alternatives. When patients were failing to have their sperm count checked after the procedure, he introduced a courier testing system that increased compliance to 80 per cent from 50 per cent.

Dr. Doug Stein, a Florida urologist, said that when Weiss joined him on trips to the Philippines to run free vasectomy clinics, he was the guy you wanted on the team if you were behind. You just put him at a table and he would knock 'em out, one after the other," Stein said. He was fast, but skilled. He did about as good a vasectomy as you could get anywhere in the world."

When the pandemic hit, Weiss didn't want to stop. He closed the clinic under pressure from his wife and children. Even then, he couldn't stop setting goals. He started writing a memoir for his children and grandchildren. He took Spanish lessons, brushed up on his French, worked on his music. Halton-Weiss said he is the most disciplined person, maybe on the planet."

A strange feeling

On June 5, 2020, Weiss couldn't finish his morning workout. A feeling of exhaustion had overtaken him in recent weeks, but he had brushed it off as his body readjusting to work after the two-month pandemic closure. He completed his 14 vasectomies that morning but felt disoriented as he and Debbie took an afternoon walk. Ottawa was in the midst of a heatwave, and he wondered if the humidity was getting to him.

When Weiss woke from his afternoon nap, he scratched his head and felt a strange sensation, like his hand was a claw scraping at his skull. In a phone call with his daughter, Jessica, a lawyer in Toronto, he struggled to string words together. In his third-floor music studio, he picked up his guitar but couldn't play or sing. He found Debbie outside and told her what was happening. They drove to the hospital.

Doctors suspected a stroke, but an MRI revealed low-grade glioma, a slow-growing brain tumour. It was small, but located in the area of the brain responsible for speech, and would be tricky to operate on.

A month later, Weiss was wheeled into surgery. The operating room nurse introduced herself and quietly thanked him; he'd snipped her husband. The anesthesiologist called him The King."

Weiss was awake during the seven-hour craniotomy. He lay immobilized with his head in a steel halo, counting to 20 as the surgeon tried to remove as much of the tumour as possible without damaging brain tissue. I was fascinated by the process and terrified of the possibility of loss of a part of me, of some function or a piece of my soul," Weiss wrote later.

The procedure was a success. Weiss took six weeks to recover, then went right back to his old routine: workout, breakfast, 14 vasectomies, lunch, nap. He worked through chemotherapy and radiation. He felt well - great, actually, once chemo was over - and saw no reason to stop. The hospital sent a sample to Alberta for biochemical testing, to confirm the diagnosis.

The results came back in August and it was bad news. It wasn't low-grade glioma, after all. Weiss had glioblastoma, an aggressive brain tumour with a median survival time of 15 months, often preceded by a steep decline in functioning and quality of life.

Weiss had six months to get his affairs in order.

The new doctor

One year before the diagnosis, Weiss had agreed to train a young doctor who wanted to learn his method. The clinic waiting list had grown long, and he and Halton-Weiss needed someone to work a few hours each week and fill in when they were on vacation.

Jean-Philippe Bercier was a 36-year-old general practitioner at a rural hospital east of Ottawa. He had the right disposition for vasectomies. As a teenager he had spent four years working on a poultry farm, examining and grading eggs, then packing them into cartons. It was really repetitive," he told me. You go in, you have your station, you do your hours, and it's nonstop, eggs after eggs after eggs."

He also shared a similar mindset with Weiss on efficiency. He was a triathlete who knew the impact of marginal gains on performance. Having spent years working in hospitals, he had grown frustrated with the health-care system's inefficiencies and believed small changes could lead to big improvement.

Bercier had already performed roughly 3,000 vasectomies, but before taking him on, Weiss wanted to observe his surgeries and teach Bercier his exact method. Some doctors might have balked at this, but Bercier didn't mind. Weiss was a legend, and I knew I still had some stuff to learn," he said.

He began his work at 29 Clemow expecting vasectomies to be a small part of his practice.

Radical acceptance

For months after the surgery, they were waiting for something bad to happen. Weiss wondered: Is my speech garbled? Do I smell something? Is the tumour growing? Halton-Weiss lived on hope. Weiss wanted to be realistic. When people asked, How are you doing?" he would say, Good - for now."

How does a man who has guarded himself against uncertainty, and who thrives with order and routine, cope with a terminal cancer diagnosis?

Weiss took control in the ways that he could. He made arrangements for medical assistance in dying. He put plans in place to make things easier for Halton-Weiss when he dies. He kept his routine: workout, breakfast, 14 vasectomies, lunch, nap, music.

A year passed. He felt as healthy as ever. MRIs showed the cancer wasn't progressing, which was unusual.

Another year passed and still there was no change in the tumour. They wondered if the diagnosis was wrong, but doctors said no.

Glioblastoma has an L-shaped survival curve that begins with a steep decline, representing people who die within 12 to 18 months, and then flattens. For the small group of patients who outlive their prognosis, the curve remains relatively flat. Sometimes they just keep living, with no explanation.

What is extraordinary about Weiss, said his oncologist, Dr. Garth Nicholas, is not that he has lived for so long, but that he has lived so well. Many glioblastoma patients cannot resume normal activities after surgery and as the cancer progresses.

There is no explanation for why Weiss has fared so well. If I knew what it was, I would bottle it," Nicholas said. Tumour biology and the surgeon's skill may have played a role, Nicholas said. And he's a lucky guy."

One of the things that struck me about Weiss was the matter-of-fact way he spoke about his illness. I come from a long line of deniers," he told me, but he didn't seem to be in denial.

He understands what he's facing, but has chosen to put it out of mind. Not everyone can do that, but Weiss had unknowingly been preparing his whole life, with his intense focus on discipline.

My dad has studiously practised the art of internally avoiding the suffering of his diagnosis, in order to be able to focus on joy," his son, Dr. Joshua Weiss, a physician in Brantford, told me. His elder daughter, Jessica Weiss, describes her father's ability to cope with his diagnosis as otherworldly."

His illness has been harder on his family. He can really put things away," Halton-Weiss said. I'm not as good at that."

In the spring of 2021, Weiss came to a realization. It was foolish to keep working. He wanted to focus on joy. To spend time with his family, travel and make music.

Patient No. 58,789, the last man to get Weissed, was Mike Ackers, a 37-year-old Ottawa realtor and father of four children under eight. He and his wife had three girls, then a boy, and now they were done. Four kids is a lot," he said.

His wife dropped him off and he was out in less than 20 minutes. By the afternoon," he said, I kind of forgot I had it done."

The clinic didn't celebrate the final vasectomy. They kept things quiet, giving Weiss space to change his mind. But he didn't.

Goodbye to Clemow

In late February, Weiss and Halton-Weiss sat in the family room at 29 Clemow, reflecting on three decades in the vasectomy business.

There have been some memorable patients. At the old clinic, one man, built like a football player, fainted straight through a wall. Another fainted while visiting the office days before his vasectomy - he wasn't even there for the procedure. We learned to catch them," Halton-Weiss said.

I asked them about an excerpt from Weiss's memoir in which he wrote that before they started working together, Halton-Weiss had imagined his vibe as a doctor would be more on the curmudgeonly end of the spectrum."

She considered this. I thought he'd be a little sterner," she said. Instead he was compassionate and warm. She would hear him chatting and laughing with patients through the examination-room door. I didn't know that that's how he would come across."

Weiss smiled. She's saying I can be an a--hole."

Not true, Halton-Weiss countered. She thought he'd be more serious, that's all.

It has now been more than two and a half years since the diagnosis. Weiss thought he would be dead by now, but he isn't even unwell. Every three months, he has an MRI to see how things are looking. In the weeks before each scan, he sometimes feels like he's losing his words. It's like my mind is telling me this is it, this MRI is going to show the tumour is growing," he said. But every time, the news has been good.

In June, they will say goodbye to 29 Clemow. They sold the practice and the house to Bercier, and are moving to Toronto to be closer to their children and grandchildren.

The one thing that I remained curious about is the number: 58,789. For 30 years, Weiss kept precise count of how many vasectomies he performed, recording the new figure in his calendar each day. Why, I wondered, was it important to him?

His wife answered this one. It was never about reaching a certain figure, Halton-Weiss said. It was that he needed to use his time as efficiently as possible. He needed to get the most out of every single day.

He can't waste a minute of time," Halton-Weiss said. To waste even a moment feels like he's wasting a piece of his life."

Amy Dempsey is a Star reporter and senior writer based in Ottawa. Follow her on Twitter: @amydempsey