Why the Harrowing Fifth Episode of 'Dr Death' Season Two Is So Powerful

By Dustin Rowles | TV | January 3, 2024 |

By Dustin Rowles | TV | January 3, 2024 |

I’ll readily concede that I was won over by the trashy, addictive first season of Peacock’s Dr. Death, mostly thanks to Joshua Jackson’s sexy-sleazy performance as Dr. Christopher Duntsch, a profoundly incompetent spinal surgeon, who was able to continue performing surgeries even as he left behind a trail of death.

The second season of Dr Death tracks Dr. Paolo Macchiarini (Edgar Ramírez), a thoracic surgeon who essentially pioneered 3D-printed tracheas for transplant. The catch? They didn’t actually work, and the recipients, of which there were several, often died slowly and painfully as they choked to death. The patients, however, often lived long enough (two months or so) for Dr. Macchiarini to boast of his successes in research papers and move on to the next transplant (and the next round of funding) before the previous patient died. He got away with it because his patients (including a five-year-old girl) were already terminal, so the tracheas were hail mary transplants. However, he began attracting more scrutiny once he began performing elective trachea transplants for those with damaged but not life-threatening tracheas.

As with Dr. Christopher Duntsch in the first season, Dr. Paolo Macchiarini also had a messed up romantic life because scammer doctors are apparently obligated to have scam relationships, too. Here, Macchiarini developed a relationship with a news journalist, Benita Alexander (Mandy Moore), who was profiling the “Miracle Doctor” for network news. Alexander crossed some ethical lines herself, but she was more amenable to Macchiarini’s emotional manipulation because she was a single mom whose ex-husband had recently died, and had some health complications of her own.

Macchiarini and Alexander were engaged, and he had already developed a strong bond with her daughter before Alexander realized that all of his promises were lies (including their wedding arrangements) and that he had another family in Italy.

I don’t know if it was a lucky coincidence or if a lot of dramatic liberties were taken, but — as in the first season — there are also two doctors (Luke Kirby, Gustaf Hammarsten) and Macchiarini’s former assistant (Ashley Madekwe ) who grow increasingly suspicious, begin investigating Macchiarini, and ultimately risk their careers to expose him. Spoiler alert: Whatever consequences eventually doled out to Macchiarini are not nearly enough.

As with the first season, I only meant to watch a couple of episodes for review but got sucked in, mostly by my own incredulity. How? How? How does our medical system — not even the American medical system alone, but the medical systems of Italy, Sweden, and Russia — allow something like this to happen? When Anna Delvey cons a bunch of rich people too far up their own asses to do a simple background check, I get it, but this is the medical establishment. And based on the series, the medical establishment didn’t just turn a blind eye but actively helped Macchiarini cover up his botched surgeries because the medical establishment relied on them for funding.

I was less enamored with the romantic side of the series through no fault of Mandy Moore; it’s just that I’ve seen plenty of Dirty John-like stories and wasn’t all that interested in another. However, the series’ biggest selling point is Luke Kirby’s Dr. Nathan Gamelli, one of the investigating surgeons. The season’s fifth episode centers on him, and it is remarkably good and powerful television. The episode is devoted to one patient who undergoes a trachea transplant and Dr. Gameilli’s efforts to save her life. He is so devoted to doing so that he does more harm than good. The patient endures 191 surgeries, including numerous organ transplants, and by the end of it, she’s basically that patient in Metallica’s “One” video, furious with Gamelli for not letting her go (she eventually dies anyway, but not before months and months of suffering).

The series in its entirety is decent, particularly for true-crime fans who like feeling outraged. But that fifth episode is special, not just as it relates to the real human toll exacted by Dr. Macchiarini, but for what it says about science and medicine. Just because a doctor can save someone’s life doesn’t mean a doctor necessarily should. There are doctors who care too much to the detriment of their patients’ quality of life. The anger that Dr Gamelli’s patient felt — that he was the devil, the personification of evil — is all the more powerful because all he wanted to do was save her life. Instead, he left her a shell of a person trapped in a bedridden body that was constantly rejecting her.

I don’t know how true-to-life the fifth episode is, but it does illustrate that even the best doctors can be as dangerous as incompetent and fraudulent doctors if they allow themselves to become too personally invested.