With his battle against brain cancer, 6-year-old Joe Charles O’Bryan from Louisville Kentucky received a bit of a reprieve when his doctor Craig Silverman asked him to “Pick your payback.” With an infinite array of options to choose from, little Joe Charles chose to pie Dr. Silverman in the face after he finished a month’s worth of radiation.

Silverman explained that he always allows his patients to “torture” him, from getting hit with water balloons to being dressed in drag. “It’s a small price to pay for someone like Joe Charles to get successfully through his treatment,” Silverman tells WDRB.

Check out the incredible video below.