I had asked the man who I'm here calling Dr. Samuels to do some radical bariatric surgery on me, and he had initially approved. I was concerned that he would take it hard if it didn't work, so I sent him this letter marked "To be opened only in the event of my death". Since he subsequently decided that I was doing well enough on a diet and exercise program, he never did the surgery and he never read this letter.

Dear Dr. Samuels,

I know you're smart enough to have figured this out for yourself, but sometimes it helps to hear it from someone else. It wasn't your fault that I died.

Should you feel sad that I didn't make it? Yes, of course. Like anyone else I deserved to live a long and fruitful life. But nature is evolving and medicine still in its infancy. Against these two behemoths, your heroic efforts can only succeed some of the time, not all.

Should you feel discouraged? No. Put this behind you and go on. My story may be over, but there are many more Deans out there who still need you. Think about them.

Human beings are unique, and therefore infinitely precious. But we are mortal and our abilities finite. We can't do all we'd like to help others — but to fail to do all we can would be a crime.

Thank you for operating on me.

Dean