Every Breath You’ll Take While Watching Dr. Death Season Two

Deep spoilers ahead for the second season of Dr. Death.

We’ve all felt what it’s like to struggle to breathe, the panic and helplessness of being unable to get a lungful of air. We generally take this automatic bodily function for granted, but it can so easily be ripped away from us in the course of illness or accident or chronic condition. In such a scenario, if someone came and promised that they could make it all better, would you believe them? What wouldn’t you give to breathe deeply again? Or sing to your child? Or swim in the ocean? You’d give anything, everything, right?

The question of how much trust we’re willing to give the medical professionals in our lives forms the heart (lungs?) of season two of Dr. Death. Based on the Wondery podcast of the same name, this season of Peacock’s anthology series focuses on Dr. Paolo Macchiarini (Édgar Ramírez), a jet-setting, award-winning, unbearably captivating thoracic surgeon whose cutting-edge research offers desperate patients the promise of full lungs and a full life. When he crosses paths with vibrant NBC journalist Benita Alexander (Mandy Moore), sparks start to fly and her ethics go out the window. Eventually, their relationship becomes Macchiarini’s undoing, exposing his global web of lies and deadly deceit.

Medicine is a profession built upon horrific experimentation (see: The Knick), and yet, the central credo for doctors is “First, do no harm.� So it’s understandable to want to give Macchiarini a bit of leeway when he promises to heal his patients … even as they start dying. Watching this season, I initially found myself wavering on whether or not Macchiarini was malicious in his intent — Ramírez is convincing! And dreamy! — and I also found myself very aware of exactly how I was breathing. I think I breathed just about every type of breath watching this ostensibly heroic doctor be revealed as a deadly con man, and you will too over the course of season two’s eight episodes. Let’s break them down, breath by breath.

Episode 1, “Like Magic�

The premiere episode sets the stage for the charming Macchiarini to take on the world. It’s an installment that engages in a bit too much time-jumping, but we get to meet the characters: the skeptical Dr. Nate Gamelli (Luke Kirby), the awestruck Dr. Ana Lasbrey (Ashley Madekwe) at the storied Karolinska Institutet in Sweden, and the smitten Benita Alexander in New York City.

Macchiarini himself flits effortlessly through each timeline, cool, confident, and charming as hell. We see him give a much-hyped speech about his new biosynthetic tracheas at Karolinska in 2012, but it’s a short affair, full of fluff and no substance. The man literally tries to explain that his tracheas work “like magic� and basically channels Zoolander when he says that “breath is the essence of life,� and he gets a standing ovation. All of this seems very corny and unscientific, and when Nate dares to question it, he gets insulted and rebuffed. Hmm. In the lab, Macchiarini corners researcher Dr. Anders Svensson (Gustaf Hammarsten) and asks him to team up with him to do rat trials on his tracheas. This seems odd to Svensson because Macchiarini is using these tracheas in humans, but he’s honored to be asked and agrees.

A year or so later, in 2013, Benita is struggling as her ex-husband is slowly dying from a rare disease. Looking for something hopeful, she gloms on to a story about Macchiarini’s new tracheas. She wants to believe. And she wants to believe even more after she has a meet-cute with the dashing doctor in a hotel bar. After Macchiarini operates on a child named Hannah Warren, the two fall into bed together. You wouldn’t think that watching a tiny girl get her trachea replaced would be an aphrodisiac, but here we are, folks.

Just Breathe: At first, you’ll want to sigh over the sexy Macchiarini, but prepare for it to get caught in your throat. The episode’s foreboding conclusion sees the doctor’s first transplant recipient in the throes of a coughing fit in a hospital bed. Coupled with the graphic depiction of the trachea surgery and Macchiarini’s fetishlike focus on Betina’s neck when they have sex, �Like Magic� has no shortage of gasp-inducing moments.

Episode 2, “Worth the Risk�

Hannah Warren dies mere hours after her operation, but Betina moves forward with her piece on Macchiarini and her forbidden relationship with him anyway. Did this man seduce this woman in exchange for good PR? Maybe? Probably!

But Betina is also starting to really trust and rely on the good doctor. When she unexpectedly falls ill with uterine fibroids (cue dramatic overhead shot of Betina writhing in pain on the filthy steps of a subway station), she inexplicably calls Macchiarini to come to the hospital to help her, and not her bestie, Kim (the always-effervescent Judy Reyes). Later, when they travel to Russia together to drum up more patients for Macchiarini’s magic tracheas, she has another attack. At this point, you might be wondering if this dude is poisoning Betina, Sharp Objects style, so she’ll rely on him. It turns out the answer is no, but he does cut her wide open in a Russian hotel room without telling her what he’s doing first, which seems like bad doctoring and bad boyfriending … just bad all around. But she still says an enthusiastic “yes� when the guy proposes a few weeks later.

Just Breathe: Macchiarini’s antics in this episode earn a derisive sniff. The run time doesn’t allow much time to check in with the gang in Stockholm, but when we finally do, we see that all the rats in the trachea trial are dead. Those swine trials that Macchiarini claimed were completed? I’m willing to bet that they never happened. This sniff is also directed at Betina, a seasoned TV producer who seems to have done no actual research into her subject/fiancé prior to choosing him.

Episode 3, “The Horizon�

Betina’s documentary comes out and she joyously plans for her wedding. Macchiarini convinces her to quit her job, uproot her life, and move with him to Barcelona. She’s dazzled by the constant travel, Macchiarini’s focused attention, and his personal relationship with the Pope. Yes, the Pope. Macchiarini told her that the Pope would be marrying two divorcées in the Catholic Church just because he’s a close, personal friend. Now, this is all starting to smell like a dead rat implanted with an artificial trachea. Kim knows it, so she Googles the Pope’s official schedule, and that’s when Bettina’s world falls apart.

We also meet another person who took a chance on Macchiarini: Christopher Lyles. Lyles’s story takes place in the 2012 timeline, and while we don’t know if he’s going to die, we kind of already know he’s going to die. In fact, at one point during this episode, I wrote, “Did any of this dude’s patients live?� in my notes.

Just Breathe: Deep breaths. We hear a lot about how the poor trial rats died — suffocating, stroke, heart failure — and this is enough to remind us that we should never take breathing for granted. Be prepared to take a sharp inhale at the end of the episode when Betina finally starts to snap out of her Macchiarini fog and actually does some research worth a damn.

Episode 4, “Tarantela Tenaraña�

The revelations start coming fast and furious. Betina finds out some sketchy stuff about Macchiarini, but the medical story is the more compelling one here. The rats are dead. They keep reminding us of that fact: All. The. Rats. Are. Dead. And soon, Macchiarini’s first patient, Andemariam Beyene, might be dead too. Beyene comes to Karolinska to be paraded around as a success story, but he’s trying to hide the fact that he’s struggling to breathe. Also, Christopher Lyles is already dead. In the wake of all the death, Nate and Anders do a bunch of research and find that all of Macchiarini’s research is based on a lie. They come to the chilling conclusion that the patients themselves are the trials.

The cherry topper on this asphyxiation sundae is meeting Yesim Çetir, a young, doe-eyed innocent from Turkey who seems to glow when she talks about Macchiarini. Of course she does. He’s offered her hope that she could live a life that she thought was out of reach. According to The Shawshank Redemption, hope is a good thing, maybe the best of things, and no good thing ever dies, but Andy Dufresne wasn’t accounting for Paolo Macchiarini and the string of hope-filled deaths he left in his wake.

Just Breathe: Take a big inhale and then scream “Run!� at your TV to anyone within Macchiarini’s orbit. They won’t listen — it’s a TV show, after all — but at least you tried.

Episode 5, “191�

This episode might be in the running for the most depressing and squirm-inducing of 2023. After Yesim places her trust in Macchiarini, he butchers her during what was supposed to be a mostly noninvasive test, capriciously removing one of her lungs. This allows her to qualify for the trachea replacement under the Compassionate Use Act.

Macchiarini is barely in this episode, but his influence is everywhere. As Yesim fights for her life following her surgeries, the numbers announcing how many subsequent surgeries she had as a result of Macchiarini’s treatment tick upward on the screen. Yesim struggles and Nate tries to help her as best as he can, jeopardizing his own personal life in the process. We see the human collateral that Macchiarini has left in his wake.

As the numbers creep into the double and triple digits, it feels unconscionable that Macchiarini wouldn’t be there for his patient during a time like this. This young girl gambled on Macchiarini, and then he just left her to die. Her painful descent as her body begins to slowly shut down is heartbreaking to watch, mostly because we know that she would have lived a full life if it weren’t for Paolo Macchiarini and his empty promises.

Just Breathe: Get ready to feel like you’re suffocating. Grab a paper bag to breathe into and an emotional-support animal and/or person to cuddle.

Episode 6, “The Fog�

Big mad over what her too-little-too-late research into Macchiarini uncovered, Betina tears into his life with all she’s got. She travels to Italy and finds a man that Macchiarini once scammed to the tune of 150,000 euros. Just like his other patients, he gave this man hope, only to snatch it away. It’s starting to feel like Macchiarini isn’t just a well-intentioned doctor with a busy schedule; he’s a bona fide con artist. When Betina travels to the Barcelona address that she was planning to move to with Macchiarini, she finds an empty lot. “What was the plan, Paolo?!� she screeches.

We can pose this rhetorical question in regards to pretty much everything Macchiarini does. As he readies a young Russian woman named Yulia for her voluntary (!) trachea operation, the details regarding the transplant are a bit murky. They take the artificial trachea and bathe it in the stem cells, readying it for transplant — we even see Dr. Ana Lasbury do this and receive a round of raucous applause from her colleagues — but that doesn’t fully track. If I poured a bunch of wine over a piece of plastic, it’s not just going to make more wine. I’m not Jesus. And neither is Macchiarini.

Just Breathe: As the credits roll, you’ll find yourself holding your breath as you try to do the math on Macchiarini, knowing his implants didn’t work and the surgeries he did leading up to that time. And yes, that does mean that he operated on little Hannah Warren knowing full well that his bioartificial tracheas didn’t work. Macchiarini has officially leveled up to monster status.

Episode 7, “Compassionate Uses�

Suspicious minds begin to converge on Macchiarini’s spotty past. Ana returns to Karolinska and teams up with Nate and Anders to get to the bottom of the science behind the artificial tracheas. They do an autopsy on Andemariam Beyene and find that his trachea had completely rotted in his throat. The doctors get in trouble, but that just fuels them to work harder and collaborate on a report summarizing the results of Macchiarini’s transplants. Ana shares a few bombshells from her time with Macchiarini, like the fact that the material of the trachea was changed for every patient. Excuse me? How did this woman not bail on him earlier?

Betina also finds herself facing this question as she offers up Macchiarini’s story to all the print journalists in the city. Everyone declines until one dude tells her that the real story is hers. The public won’t care about fake trachea implants; they’ll care about the jet-setting playboy and the jilted bride. He’s right, but he also questions Betina’s mind-set when she was with Macchiarini. How could she have believed everything he was saying? C’mon, the Pope?! But in real life, charismatic individuals like Macchiarini are able to get away with murder fairly regularly. There are oodles of true-crime podcasts (see: Dirty John, The Shrink Next Door), true-crime TV series (The Vow, A Friend of the Family), and true-crime podcasts turned into TV shows that boldly underscore this point again and again. As we watch, we’re taken in by the fact that others were taken in, often not recognizing that the story has enchanted us too.

At the conclusion of this penultimate episode, the scrappy band of doctors at Karolinska are seemingly punished for looking into Macchiarini’s research. Macchiarini himself comes to gloat in Ana’s face, adding the absolutely horrifying — but completely unsurprising — information that Yulia went through with the surgery after all. He convinced her, just like he convinced Karolinska, to keep his misdeeds under wraps.

Just Breathe: Ah, the time-honored tradition of money and power winning over facts and science. Feel free to let out a disappointed huff as the episode concludes.

Episode 8, “Surgeons, Bachelors, and Butchers�

Betina’s story goes viral just as the Karolinska crew goes on trial for their report. At first, it’s clear that no one has actually read the dense doorstop of a report — the board isn’t even aware of Macchiarini’s unauthorized use of something called TGF-Beta 3 in his surgical prep — and all seems lost. But then, Betina’s story comes out  and interest in the case soars.

The first half of the episode largely focuses on Macchiarini’s secondary enablers as they try to push back against the damning contents of the report. As Nate, Luke Kirby delivers an impassioned speech about Macchiarini’s doomed patients that I believe even Atticus Finch would admire. The speech underscores everything that was wrong about what Macchiarini did. Perhaps he was technically allowed to operate under the Compassionate Use Act, and perhaps certain things could even be overlooked in the course of research and an attempt to further the imperfect study of medicine, but the fact that he routinely lied to his patients and showed no remorse after their prolonged, painful deaths is unconscionable. There don’t seem to be any hard-and-fast laws about breaching trust between a doctor and a patient, but it’s an ethical and moral basis for treatment that Macchiarini flouted time and time again.

Thanks to the article about Betina and Macchiarini’s relationship, the surgeon finally comes under some scrutiny. But, as the season concludes, we see that Macchiarini was never brought to full justice for his actions. It would be nice to think that his motives are still unclear here, but it’s obvious he had a dangerous disregard for the well-being of his patients. This illustrates that people should do their research if they want to engage in experimental procedures or, at the very least, get a second opinion.

Just Breathe: The written coda to the episode tells us that Swedish investigators eventually brought criminal charges against Macchiarini, but he ended up serving no jail time. Get ready to gasp the biggest gasp when you see the final line: His research is still in use today.