His ruddy face, firm handshake and soft English accent invites calm. He had performed hundreds of successful surgeries like the one he would perform on Troy. But a good record does not eradicate risk. During the surgery, a patient's heart can stop. Infections can occur.
Patients sometimes die.
Many patients even after dropping hundreds of pounds are left with folds of skin stretched out from years of obesity. A stomach once puffed with fat can hang flaccid to the knees. I look at him and say, OK, we have 300 pounds to get off this man. At 523 pounds, Troy didn't care about risk. He craved the operation.