I have blocked 357 accounts that sent a random friend invite, where 302 of it were automated. I do have some stuff on my Team Fortress 2/CS2 inventory which attracts all sorts of scammers and bots, even though I've stopped playing both games for quite some time.
With that said, I'm cool with random invites from real people. There are lots of games where you can use more people to play with, regardless of how close you are.
It's honestly really sad for the surgeon. Before undergoing surgery the patient must disclose everything that could make complications on the operation for a reason, a doctor does not care what crimes the patient commits and won't have a reason to snitch, but not knowing the patient using banned substances that affect surgery could lead to life altering (and in this case outright ending it) problems.