Ashley Madekwe, Luke Kirby and Gustaf Hammarsten in Dr. Death.
An investigative journalist falls for her subject: A handsome, world-renowned surgeon.
That logline could be the start of a rom-com. Instead, it’s the beginning of a sinister story, one that’s told on Dr. Death.
The second season of the Peacock anthology based on the Wondery podcast brings to screen the true-crime story of Paolo Macchiarini (played by Édgar Ramírez), the pioneering Italian surgeon whose revolutionary biosynthetic tracheas could be a medical solution to the traditional trachea transplant. His work is so impressive, he becomes the subject of a TV profile from New York journalist, and former NBC producer, Benita Alexander (Mandy Moore), who — spoiler alert — ends up contributing to a much more important Vanity Fair article that ultimately unmasks the real Paolo Macchiarini.
But in the time between their first encounter in 2013 and that 2016 article, the pair fall in love. A whirlwind romance of sorts ensues, where Alexander — who is grieving the death of her ex-husband, the father to her daughter — risks her career and reputation for what she believes to be true love. She is planning a fairytale wedding to be officiated by none other than the Pope, who counts himself among an admirer of Macchiarini’s.
And that is just one of several facts that seem too wild to be true, before their romance unravels in the latter half of the season, when Alexander and several whistleblowers — the Swedish medical team around Macchiarini — work in parallel stories to hold him accountable for the lies, manipulations and abuses of power that lead to several patient deaths — all of whom are named and whose stories are told across the eight episodes of Dr. Death.
For showrunner Ashley Michel Hoban, telling the patients’ stories was paramount to the series. “It was important for us to name the patients and tell their stories as closely as possible,” Hoban tells The Hollywood Reporter. “Obviously, those patients are no longer with us. But their stories are documented and we tried to honor them and their stories by sticking as closely to reality as possible.”
Of Alexander’s story running alongside the doctors who ultimately brought Macchiarini to justice, Hoban says “these two stories could be individually eight episodes. So, there was definitely time for us to dig into the world of the whistleblowers, and particularly dive into the world of the patients in a way that was an honor to tell their stories in the way that we were able to do.”
The whistleblowers were written as composite characters who are played by Luke Kirby, Ashley Madekwe and Gustaf Hammarsten in Dr. Death. While some of Macchiarini’s story has been told onscreen before — including weeks earlier with Netflix’s Bad Surgeon: Love Under the Knife docuseries — Hoban says that diving into the medical side is what sets their project apart.
“This series is based on the podcast, so we had all of that research, which was an amazing treasure trove of interviews and transcripts,” she says of the podcast interviews. “Then it was really about finding our most interesting way in, and that ended up being, I think, different. I haven’t seen the Netflix series, but I think we got to take all of the stories, especially on the medical side, and composite characters down to create a whole new world of these characters, so that people who know the story are going to get a different side of it with these new characters we’re introducing, and also a deeper dive into the patients’ experiences.”
When it came to casting their leads, Hoban says she wrote the part with Ramírez in mind (“Who speaks seven languages and can have the charm and the charisma and the intelligence?”), and she never thought Moore, who had her second child, son Ozzie, only six weeks before filming, would be in the position to say yes.
“I didn’t think in a million years she would want to jump back into something and move her family to New York for six months,” Hoban recalls. “And my god, she did and she did it so wonderfully. The nuance that she brings to screen is just incredible to watch. She’s got that thing.”
Moore, who had also just wrapped her six-season run as Rebecca Pearson on NBC hit This Is Us with a May 2022 finale, laughs when thinking back at the whirlwind decision. “I was high on oxytocin, I just had a baby! I was like, ‘Yes, I’ll do anything!’” she tells THR. “I got the call and I had a one-month-old baby. It’s shooting in New York imminently. I was like, cool, cool, probably not going to be the thing. And then I remember reading those first two scripts and I thought, Damnit! I really want to do it!”
She adds, “I think the combination of Édgar, the story we were telling, being in New York; it was an anthology, it was eight episodes. I’ve just never done anything like this. Tonally, it was so different. And I loved season one. I was like: This is a no-brainer, let’s do it.”
The decision left Moore with little prep time; only two weeks before filming, in fact. So she dove into the podcast for research and spoke to an investigative journalist friend to get an understanding around the demands of a job like Alexander’s: “How do you mine through what’s going to be a good story and how do you bring it to your bosses? That sort of stuff was fascinating to me, as well as figuring out who this mother was who just lost her ex-partner and now was truly a single parent, and how she was navigating the world around her and what made her particularly susceptible to this brand of manipulation. How did she sort of allow herself to be vulnerable enough that she could fall victim?”
Ramírez, who had some more time, says he, too, pored over the podcast, but also focused on the aspects of being a surgeon. “I had very deep and thorough conversations [with friends who are surgeons] more about what they have to deal with every day, in terms of the trust that their patients put in them, which is precisely what my character betrays,” he tells THR. “And how close as a doctor you get to peoples’ faith, aspirations, dreams, hopes, which my character completely manipulates and shatters. For me, it was very important to understand how a good surgeon operates ethically and morally in order to navigate this character.”
Both of the leads walked away with an understanding about what motivated Macchiarini — and it’s perhaps the same reason why Hoban and her producing team never felt a need to reach out to their real subject in order to tell this story.
“It was a similar thing with [Dr. Death subject] Christopher Duntsch in season one,” executive producer Patrick Macmanus tells THR. “We always talked about, what is the story you would actually get from people like this? And with the podcast, there was so much there that, what would be the purpose to reach out to someone who probably would be telling you a version of the story that isn’t necessarily the most truthful?”
Ramírez says that for the real Macchiarini, “the lies for him are fantasies,” echoing Macmanus’ take. “He believed truly and deeply, almost pathologically, that whatever he was portraying, offering, selling was the ultimate truth,” he says. “And when you see all of the eight episodes, there is no moment of admission. There’s never a moment of introspection where he realizes or comes to terms with the damage that he has caused, both professionally and personally.”
Ultimately, Macchiarini is held accountable for his crimes. As the end title card of Dr. Death will reveal, however, whether or not he was brought to justice remains to be discussed.
Without spoiling the specifics (though Google will reveal), Hoban’s spin on the ending is as such: “The way we end the story, where we end the story, I would like people to take hope away from it, even though it may feel in the moment like an injustice. Because I can tell you that Paolo Macchiarini is not performing medicine in Sweden, and he’s not practicing medicine in the United States. These difficult choices that Benita and the whistleblowers have to make in our story have a real impact in the real world on Paolo’s life. So it may feel like an injustice, but I hope people take away what the whistleblowers were willing to sacrifice in order to hold him accountable, which they did.”
Moore and Ramírez also hope that the story of deception will speak to anyone who has ever been victimized by a person like Macchiarini.
“Ultimately, what I hope is that the audience sees themselves in Benita’s story. This a very capable woman; she’s very smart, she’s very strong, she’s at the top of her game, and yet even she allowed herself to fall into the fantasy of this man and this life that they could have had together. And ultimately, it was all just a bunch of lies,” Moore says. “I love that Benita shares her story for the benefit of herself but for other folks to not feel the shame and stigma around what it means to be portrayed or seen as a victim. I hope she finds strength and resolve in how we’ve told her story and hopefully what people take away from it.”
Ramírez takes that further.
“Definitely, the character that I play is a narcissist. There’s no way around it. There’s no coming to terms or getting some sort of admission of responsibility or accountability from a narcissist. I tried to pull back, so that I didn’t have the weight of the real character on my shoulders. Honestly, I’m more interested in what you said,” he says to his scene partner, referring to her take: “That Benita would feel destigmatized from the victim-blaming, which is something that happens a lot, especially to women who have been on the receiving end of manipulation and deception.”
He continues, “The reality is that people who know how to manipulate others are very smart, clever for all the wrong reasons. And that is my character. He’s very smart. He knows exactly where to go, what to touch, what weaknesses, what traumas. They know very well what points to pick. So I hope that anyone who has ever felt deceived and manipulated can come to terms and feel that it was not their fault. That no one is above being deceived. No one is exempt from being the victim of a manipulation of this kind.”
Dr. Death is now streaming all eight episodes on Peacock.