The Doctor Will Kill You Now

The story of the globetrotting thoracic surgeon Dr. Paolo Macchiarini, set out in Netflix’s Bad Surgeon, is as engrossing as it is intensely disturbing. It’s a season of FX’s American Horror Story mated with a Harlequin Romance; a Hallmark Movie from hell. 

Macchiarini was selling the dream of a swashbuckling, renegade surgeon pioneering a revolutionary new technique for regenerating damaged organs. There were plenty of buyers. After all, who could resist this soft-spoken, Italian-tailored, bestubbled amalgam of Jesus Christ and George Clooney? Certainly not an eager medical establishment looking for the next big buzzy profitable thing, nor a lazy ultimately enabling media ecosystem ladling out infotainment masked as journalism or the vulnerable, looking-for-love women with whom he so callously toyed. The women, the media, the internationally-renowned medical institutes; all of them swooned when suave Dr. Paolo walked into the room. 

And the world would be a lot worse for it.

Bad Surgeon painstakingly lays out the almost inexplicable–in retrospect–failure of the numerous people and institutions drawn into Macchiarini’s fragile worldwide web of deceit to engage in even the least bit of self protective due diligence. This collective failure to dig just a bit deeper into the often outlandish claims of this shadowy man with no permanent home and five phones enabled a medical research fraud of epic proportions and untold human suffering.

As with other uber confidence men like Bernie Maddoff who defrauded investors of billions, the debonair doctor seemingly had a dead circuit where his empathy center should have been and a fatalistic death wish regarding his inevitable exposure. Lies permeated both Maddoff’s and Macchiarini’s personal and professional lives. 

Like Maddoff, Macchiarini succeeded in his big con for so long because the people and institutions he so carefully cultivated wanted to believe him and had their own good reasons not to dig too deep. The women wanted their Hallmark movie fantasy. One of Macchiarini’s misguided amores, a veteran NBC news magazine segment producer who had done a fawning story featuring him, had her head turned by the good doctor’s intense whirlwind romancing and promises of a global dignitary studded (Barack Obama! The Clintons! Vladimir Putin?) destination wedding, with the Pope officiating. As far as whoppers went the already married Macchiarini was definitely in the go big or go home camp. (Fans of Baron Munchausen will appreciate his tales of secret networks of doctors and his work as a CIA “sniper”.)

For their part, the prestigious medical institutions with which Macchiarini was affiliated, such as the Karolinska Institute of Sweden, famous for awarding the Nobel Prize for Medicine each year, wanted a paradigm-shifting star player who drew praise, funding and ideally enormous profits. Serious background checks and CV verifications were for cafeteria workers, not men of letters. Meanwhile, a busy, easily-distracted media wanted quick feel good medical stories like “the world’s first synthetic organ transplant”. Nobody had much incentive to burst the bubble or look behind the curtain, no matter how startlingly easy that turned out to be.

Enter the heroes of the piece:  Two investigative journalists and documentary film makers Bosse Lindquist and Johannes Wahlstrom of Sweden’s publicly funded equivalent of the BBC and a handful of increasingly troubled surgeons associated with the Karolinska Institute not willing to just go along for the ride. None of these outwardly mild, often balding, sometimes bespectacled guys were going to send pulses racing. But they did their job.

At great risk to their personal and professional lives the Swedish surgeons set about doggedly piecing together evidence that Macchiarini had engaged in medical research malpractice. For one member of the whistleblowing team the pivotal “Oh no!” moment occurred when he attended a talk that Macchiarini gave to a group of scientists and doctors from around the world. As Macchiarini laid out his research it became glaringly apparent he seemed stunningly not to have employed animal trials to test his technique before performing the procedures on humans. 

Contemporaneously, the Swedish investigative journalists working on a tip began looking past the numerous puff pieces and adulatory documentaries promoting Macchiarini’s work to discover what actually happened to the good doctor’s patients after he operated on them. They started with the subject of a laudatory 2013 documentary “Super Cells” featuring a young former Russian dancer Julia Tuulik. Julia had damaged her trachea in a car accident then fatefully entered a contest promoted by Macchiarini’s Russian medical institute partner to receive one of these magical new windpipes. The 2013 documentary tracked Julia’s story up to and immediately after the revolutionary “successful” surgery. The Swedish documentarians followed up  on this “beautiful story”. What they found was not pretty. 

After a little digging Wahlstrom located Julia’s mother in St. Petersburg and inquired whether they could speak with her daughter. The older woman had been waiting for this call. Julia was dead. Her daughter’s dying wish had been that someone tell her story so others would not suffer the postoperative “horror” she had gone through. Just three weeks after her surgery Julia spent almost six months in a Russian hospital dealing with complications. Julia described herself as “rotting from the inside” and emitting an odor that made people “shudder” when they came near. Towards the end she weighed 47 kilograms, had difficulty breathing, and could barely walk. 

With those revelations, the dam broke. Lindquist and Wahlstrom began tracking what happened to Macchiarini’s other scattered across the globe plastic windpipe patients. Almost all were dead. In one case, Macchiarini recruited Yesim Cetir, a young Turkish woman with a damaged trachea that reportedly posed no real threat to her other than social embarrassment from coughing and excessive phlegm production. She travelled to Sweden for the operation.

After the procedure, Yesim spent the next four and a half years “kept alive in intensive care” where she endured some 191 additional procedures, including for years having to have the phlegm clots constantly forming in her trachea painfully surgically cleaned out every fourth hour. Macchiarini, in a pattern familiar from his approach to his other patients, was reportedly not interested in getting involved in Yesim’s post operative care. The doctors caring for her, including two of the whistleblowers, were relieved for her when Yesim finally died. 

What director Ben Steele’s Bad Surgeon strikingly lays out is not just how easy it was to expose Macchiarini’s tissue of lies, if one bothered to look, but shockingly how maddeningly difficult it was for any suitably serious consequences to flow from those revelations. Till quite late in the game the Swedish whistleblowers almost ended up confronting a worse fate than their alleged fraudster.  The institutional pushback they faced from those who helped create the Macchiarini mythos included personal attacks and threats of criminal prosecution for leaking private patient files. It was a dark time for the men that left one of the whistleblowing surgeons contemplating suicide. Pointing out the king has no clothes proved a lonely and dangerous business. 

The release of Lindquist’s documentary “Experimenten” in Sweden in late 2016 was critical in prompting long-hesitant Swedish authorities to seriously examine Macchiarini’s work. They could not ignore public outrage that the three-part documentary generated. 

As of late 2023, the civil and criminal repercussions of Macchiarini’s unprecedented procedures are still unfolding. In October, a top Swedish court refused to hear an appeal on Macchiarini’s sentence to two and a half years in prison for “causing bodily harm” based on a review of his Swedish surgeries. According to an article published in the journal Science published by the American Association for the Advancement of Science (AAAS) on December 18th of this year, Macchiarini should begin serving his sentence in Spain, where he now lives, “sometime in the coming weeks.”

Close to a dozen Macchiarini authored articles dealing with his procedures published in prestigious peer-reviewed medical research journals such as Britain’s The Lancet, considered by many “the world’s highest impact academic journal” have been retracted for containing falsified information or similar problems. 

Macchiarini himself continues to deny any culpability and argues pioneering experimental medical interventions always involve risk and his patients gave informed consent for their surgeries. 

The Netflix series has sparked fresh outrages. And season 2 of the Peacock Network’s drama series Dr. Death also features an adaption of Macchiarini’s story. As if he deserved any more publicity.