How can I get the option to perform his brain tumor surgery? Ive done the first two quests and still the option hasent came up. I have 95 medicine and 85 speech and 8 Int, so what am I missing?

Probably a bug.

I slaughtered him and his entire army in a wonderfully satisfying rampage. Much more fun than being his [censored].

I wanna go nuts with a fat man on his entire legion hahaha.