I think you need better friends. sometimes it's better to be alone than be surrounded by toxic people.

There are not usually many openings to schedule surgery - Elective or not. I had a minor surgery on my own birthday a few years ago. Give your friend getting the surgery a break - Right now they probably have bigger worries than birthdays... OP, I get that some people are givers and some are takers. But you need to keep your perspective when it comes to your friend's surgery. Try reminding your friends of your upcoming birthday... Birthdays are big deal when you are a kid. Trust me as you get older they get less special.

Sounds like you are the one who needs to make your birthday extra special as nobody is as good as you at planning birthdays.

Did you try telling your friends it's your birthday?

So was the elective surgery actually your surprise party?

I often complimented my wife on her looks. She is very beautiful. Eventually we had a long discussion about what kind of compliments she would prefer. She prefers compliments about her personality. I stopped complimenting her based on her looks and she didn't even notice. I thought I was making some grand gesture by often complimenting her. Different people need different things. It sounds like you're expecting them to treat your birthday the same way you treat theirs which is almost logical. They may not appreciate it the way that you expect that they will and so they may not be inclined to return the favor. My wife for example cares a lot about birthdays but I don't. Just don't be too hurt when people value things differently than you do.