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[dramatic music plays]
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ADAM CIRALSKY: This is a story about a pathological liar
with a scalpel... Paolo Macchiarini.
DAVID MARCHI: Who is this man?
I am well, thank you.
ADAM: Paolo's extremely charming.
He's this good-looking man of mystery.
JUDY HO: There was this allure about this man, you know,
this kind of George Clooney thing going on,
that charismatic charm.
ADAM: He claimed to be part of an international
society of surgeons who catered to VIPs.
That he had operated on Barack Obama,
Hillary Clinton, and others.
He was this Italian surgeon
with the cure for people who had problems
with their trachea, their windpipe.
REPORTER: It's considered the holy grail in its field.
A transplant of the trachea using stem cells.
It's a major achievement in the history of medicine,
but especially for the patient.
Paolo was selling a miracle,
and people wanna believe in a miracle.
PATRICIA MURRAY: These are desperate people,
and they're being promised something that could cure them.
BENITA ALEXANDER: The promise of just giving her
a normal childhood.
As long as you are doing this in a very ethical way,
you do just your job, and you do it very good.
[audience applauding]
But the problem is, Macchiarini's miracle
was a total nightmare.
[reporters speaking in other languages]
REPORTER: Stockholm authorities are gathering information
about operations conducted at Karolinska...
OSCAR SIMONSON: It's unimaginable, the feeling
that you're about to suffocate all the time, 24/7.
MATTHIAS CORBASCIO: I think in total she had 191 surgeries.
It was medical torture.
Paolo was fooling everybody,
both professionally and personally.
BENITA: I don't know what kind of game he's playing.
This is sick.
ADAM: The guy was lying,
and there were deadly consequences.
It was getting scarier by the moment.
MATTHIAS: Paolo couldn't have done this alone.
Because, you know,
loyalty is always more important than truth.
ADAM: For me, the question has always been...
how did he get away with it for as long as he did?
***
ADAM: The Karolinska Institute.
It's kind of hard to understand
how important an institution this is.
But it's arguably the most prestigious
medical establishment in the world.
It is the institution that hands out the Nobel Prize
in medicine or physiology.
Everything is focused
on achieving new goals in medicine.
So, it can be a lot of pressure to succeed.
MATTHIAS: The work environment was intense.
Rank matters.
So, you know, you stay close to the walls
and keep your head down.
This is a perfect environment
for a person such as Paolo Macchiarini.
He fitted right in.
ADAM: When Paolo arrived at Karolinska,
he was nearing the height of his popularity.
Hi.
OSCAR: When Paolo Macchiarini came to the Karolinska,
he was introduced in a very big fashion.
Almost like the second coming of Messiah.
[audience applauding]
Senior leadership of the Karolinska
were keen to have him there
because he was such a high-profile figure,
and they felt he was somebody who would bring a lot of money
into the university.
The first time I actually met Paolo Macchiarini
was some meeting where he was gonna set up his lab.
I remember he looks a little bit like George Clooney,
but he spoke very quietly.
You are an adult. You can do it.
You could also feel that, you know, he came in with power.
MATTHIAS: I got the sense that he was a very confident,
impeccably dressed Italian.
ADAM: Someone described him to me
as the world's most interesting man.
Like, straight out of the Dos Equis commercial.
I mean, what other surgeon have you heard of who invites
a documentary camera crew to capture him
speeding through town on a motorcycle?
MATTHIAS: I remember thinking, "Who is this guy?"
It's really hard to find...
set aside believe,
the details of Paolo's early life.
ADAM: As the story goes,
Paolo Macchiarini was born in Switzerland
to an Italian family...
and talked about always feeling like an outsider.
So, he goes to medical school at the University of Pisa
and becomes a doctor
in his parents' country of birth.
But his father falls ill,
and he goes to see his father,
and he can't seem to find anything wrong with his dad.
And so he goes back to Pisa, and his father dies.
When someone like Paolo has this type of tragedy
where they tie themselves to that responsibility of,
"Maybe I should have saved my father, but I couldn't,"
this could be really something that profoundly affected him.
Perhaps it's why he developed this hero complex.
He wants to save as many people as possible,
and it got bigger and bigger.
The other possibility is that this myth
is a way to garner sympathy from other people.
This is a way to get people to wanna be closer to you
and almost wanna rescue you.
After medical school,
he would've continued his studies in Italy,
but according to Paolo,
the powers that be were trying to keep him out.
ADAM: Paolo claimed that unless you're from the right family
or had the right connections,
it's really hard to get ahead in Italy.
And he blamed his upbringing in Switzerland
as the reason he didn't get these posts
that he felt he deserved.
In time, he would get, what I would describe
as a pretty big chip on his shoulder.
It's possible that after feeling like he was kept out,
he decided, "I'm not going to let this hold me back,
"and I'm gonna become this world-renowned surgeon
"that no one can ever say no to."
ADAM: And so, according to Paolo, he leaves Italy...
to go rack up a series of massive degrees abroad.
He's getting these different master's degrees
and multiple PhDs and residencies
and fellowships in thoracic surgery.
He became the guy with the golden resume.
And there was definitely an impression among his peers
that he was an incredible surgeon.
But Paolo Macchiarini
didn't abide to the rules and regulations
of the clinics that he worked in.
PAOLO MACCHIARINI: What about this?
KJELL ASPLUND: He was taking very high risks
with the patients.
Science moves pretty slowly,
and I think Paolo had bigger ambitions.
PAOLO: If it works,
we will get stem cells immediately.
So, let's go and see if we can succeed
with these ideas.
[intriguing music plays]
ADAM: In the early aughts,
there was sort of a stem cell revolution going on
where it was considered to be, you know, a cure-all.
REPORTER: Stem cells have been used
to transplant bladders,
and researchers are working on ears,
heart valves, and other organs.
Stem cell research and regenerative medicine
was thought to help treat people much cheaper.
So, governments were quite keen to invest,
you know, quite a lot of money into this area of research.
That's incredible.
It's incredi-- It's just a new way of thinking
and of using the resources of medicine, of science.
Paolo definitely dove in headlong.
PAOLO: Have a look here.
MATTHIAS: Paolo was trying to take a trachea
from a dead person, remove the cells,
and then replace those cells with new stem cells
from the patient, and replace the tissue,
and that would be revolutionary...
Because if it worked,
the body wouldn't reject the organ.
- [machine beeps] - [somber piano music plays]
With the patient's own stem cell seeded onto the trachea,
there was no need for immunosuppressants,
which make patients susceptible to infections
and also getting cancer.
So, to be able to have an organ transplant
that didn't need immunosuppressants
would've been a big breakthrough.
ADAM: In 2008,
Paolo finally completes his first experimental operation
in Barcelona.
Following the surgery,
Paolo claims the patient, Claudia Castillo, was thriving.
The state of Claudia is excellent.
She's enjoying her life.
As long as she stays in this health,
I will be the most happiest doctor in the world.
PATRICIA: I think Paolo won over a lot of people's trust
'cause he had Claudia interviewed
very soon after the surgery.
And I think when a lot of people saw
this patient speaking, looking okay,
I think they weren't really so keen
to look in detail anymore at the underlying science.
ADAM: The operation on Claudia Castillo
really takes Paolo from, like, zero to hero.
The press dubs it the dawn of the stem cell revolution.
REPORTER: Paolo Macchiarini was the lead surgeon
on the first-ever transplant involving an organ
grown from the patient's own stem cell.
It's a major achievement in history of medicine.
ADAM: Paolo goes on to repeat the procedure
on a handful of patients all across Europe.
PAOLO:
ADAM: The story was too good to stop.
And so he kept going.
PAOLO: This was always my dream to transplant trachea.
Well, what now?
What should I do now?
And who comes knocking on his door?
The Karolinska Institute.
PAOLO: Okay.
ADAM: Where he's given a lot of running room
to perform these experimental procedures.
This is the most advanced lab that we do have here.
Of genetic medicine, one of the most advanced in,
I can frankly say, in the world.
The Karolinska wanted him to develop,
like, a surgical unit there.
And then the idea is that
the Karolinska would become famous
for a new kind of experimental surgery.
Paolo's next innovation
is to make a fully synthetic artificial trachea,
bathe it in stem cells,
and insert it in the human body
and getting the body to accept it and not reject it.
A completely new approach
where we don't use natural windpipes,
but scientific polymers
to build a custom-made individual windpipe.
PATRICIA: But, there was one problem.
The trachea isn't like a kidney
or a liver where it has, like, a main feed artery
that makes transplantation easy.
The trachea just has lots of tiny, tiny blood vessels.
So, if you take the trachea out and put in some plastic,
it's not really possible to join up those tiny capillaries,
so it doesn't have a blood supply.
Paolo never sort of discussed this
or explained how that was possible.
So, I was curious, how does this work?
MATTHIAS: But Paolo Macchiarini said
that testing had been done in animals,
and that his new synthetic trachea worked.
[dramatic music plays]
If it's a success,
Paolo was solving for a huge issue in medicine.
There are not enough donor organs,
in this case, the trachea.
He was basically pitching
off-the-shelf organs for everybody
without anti-rejection medicines.
What he was proposing is steps beyond
what really we have been able to do in the medical world.
But you can also see how exciting that is.
Within a year, Paolo claims to have found
the perfect candidate for his groundbreaking surgery.
His name is Andemariam Beyene.
He's an Eritrean man living in Iceland.
He's a loving father of two,
studying geology at a university.
MATTHIAS: Andemariam was a geology student
getting his master's in Iceland.
And he had developed a slow-growing tumor
in his trachea.
If I bend a little bit like this,
no more air in or out.
I have to be straight.
But the patient, Andemariam,
was not that interested in the surgery.
ANDEMARIAM BEYENE: They told me that synthetic organ,
it has never tried into human being.
I was scared.
I was about to refuse.
One of Paolo Macchiarini's gifts
that he could sell this concept very convincing.
OSCAR: He has a way, I think, when he's talking to you
to understand what you want to hear.
He's very good at how to make them feel special.
Paolo basically set it up so that the patient didn't think
they had any other alternative
than to have a synthetic trachea.
ANDEMARIAM:
[machine beeps]
The first operation had an atmosphere
of great expectations.
This would be the first ever type of operations
that had been performed with a synthetic trachea.
[brooding music plays]
The surgery initially went well.
But then, very quickly...
it became pretty disastrous.
KJELL: There were problems with the synthetic trachea.
It was very difficult to sew in this plastic material.
Paolo Macchiarini was quite frustrated.
Suddenly, there was an injury to the pulmonary artery,
which lies just adjacent to the trachea.
And massive bleeding ensued.
KJELL: And a very large bleeding.
Seemed to be unstoppable.
But instead of acting quickly to address the situation,
Paolo, as the lead surgeon, throws up his hands.
MATTHIAS: Paolo basically gave up...
and left the OR.
When the head surgeon walks out of the OR
that means game over, the patient is dead.
And I was just taken aback because
what surgeon would do something like this?
[heart rate monitor beeps rapidly]
[flatline signal beeps]
ADAM: When Paolo walks out of the OR
in the middle of surgery...
his colleagues are left scrambling.
When he left the operating theater,
one very experienced thoracic surgeon,
who assisted Paolo Macchiarini,
went in and succeeded in stopping the bleeding.
[monitor beeps]
MATTHIAS: The patient miraculously survives
and has his now new synthetic trachea.
He recovers from the surgery and, um,
is eventually sent back to Iceland
for further care.
REPORTER: How do you feel?
So, even though they almost had a catastrophe in the OR,
the Karolinska Institute
made as much of a moment out of it as they could.
Very quickly thereafter,
a paper is published in The Lancet
describing the absolute success of the procedure.
You need to prove evidence that what you are doing
has been proved to be safe and effective
before going to the clinic.
So, in spite of whatever reservations
his colleagues may have had,
Paolo goes on to become this international sensation.
A groundbreaking surgery gave a man back
his trachea and his life.
REPORTER: A team carried out the world's
first synthetic organ transplant.
PAOLO: Papers have been published
involving research of artificial scaffolds.
It was the sense of,
now that the train is leaving the station,
you need to get on.
ADAM: The entire world was saying,
this guy is a super surgeon.
He's a miracle worker.
In a way, this is Paolo's revenge
on people who control and pull the strings.
Now he's pulling the strings.
He's a big deal.
And it catches the attention of some folks at NBC News,
including Meredith Vieira.
Meredith Vieira goes to one of her go-to producers
named Benita Alexander.
Says, you know, "I think we should adapt this for TV."
BENITA: I did a lot of big specials at NBC,
and we wanted to do something about regenerative medicine.
And so as we started looking into it,
Paolo Macchiarini's name kept coming up
'cause he was the leading figure in regenerative medicine.
So, as Benita goes down the road
trying to adapt this story for television
she finds out that Paolo has another surgery planned.
Except this one is on a two-year-old
Korean-Canadian girl named Hannah Warren.
BENITA: We went to tape with Hannah and her family
and to do preparations.
ALL: Yay! [applauding]
[Hannah chuckles]
BENITA: And I just fell in love with her family.
It was such a heart-wrenching story
because she was born with no trachea
and she had spent her entire little life in the hospital.
REPORTER: Two-year-old Hannah Warren
lived her whole life in an ICU with a breathing tube.
Her parents, Darryl and Young-Mi Warren
were told Hannah would not live past age six.
BENITA: The hope of what this could do for her
and the promise of just giving her a normal childhood,
there was immense hope.
Hannah's parents look at Paolo
as close to a lifesaver as you're gonna get.
Their daughter was very sick, and he was her last best hope.
In April 2013 in Peoria, Illinois
at Children's Hospital,
the operation on Hannah Warren takes place.
This was no ordinary surgery.
You've got a foreign doctor coming to an American hospital
to do experimental surgery on a two-year-old,
and there's a camera crew.
Paolo's inclination towards these high-danger,
huge-stake surgeries reminds me of individuals
who thrill seek over and over again.
They have to keep upping the ante.
The surgery ends
and what the public saw
in the reporting...
WOMAN: Show me how you kick it. All right.
ADAM: ...was that it appears to be a huge success.
She looks so much older, so much more mature,
stronger, more beautiful.
She was reborn again.
We're just so blessed that she was able
to get this unbelievable opportunity.
This is like a new chapter in medicine.
What you're seeing right now
is her first taste of a lollipop.
Something most kids have done all their lives
she didn't do it till last Friday.
She likes lollipops.
PAOLO: Every time that we can help
children especially,
it's just something unique,
and it is worth all the money of this universe.
- Thank you so much. - [audience applauding]
BENITA: After Hannah's surgery,
I was certainly, as everybody was,
I think quite impressed with him,
you know, and intrigued by him.
He definitely commands the room when he walks in.
He speaks six or seven languages.
There was definitely some sort of
instant attraction between us.
You know, we would go out to dinner sometimes
after shoots.
A few times alone.
I thought this man was kind of incredible.
If there's someone who we admire,
someone who impresses us
by their achievement and their personality...
and they like us...
it's love and it's trust.
And in the wrong hands,
it's a tool of betrayal.
[dramatic music plays]
BENITA: Obviously, as a journalist,
you do not get involved with the subject of your story
and there's a good reason for that.
But I, at the time,
was in a very vulnerable position.
My ex-husband was dying of brain cancer.
The father of my daughter, our only child,
who at the time was nine.
I ended up opening up to him about this,
and he just looked at me, and he gave me this big hug.
You know, one of those really tight, warm embraces.
And that was the moment I just thought,
"Oh, man, I'm falling for this guy."
I knew it.
ADAM: At this point, Paolo has a new romance.
He's done this miracle surgery.
He's got the fame, the fortune, and the reputation.
And for a time, everything seems to be going well.
But then a couple months after the surgery in Peoria,
Hannah Warren was dead.
For Hannah Warren,
the surgery is initially a success,
but by July she had passed away.
REPORTER: The family says, "Our hearts are broken.
"Hannah would've turned three in August."
BENITA: We all thought we were gonna have
this beautiful happy ending, you know,
Hannah home, running around the yard.
And it was so sad.
And Paolo was very, very distressed.
Paolo explains Hannah's death as she was very sick,
she was out of options,
and this was her last best chance.
If you have a patient that is dying,
and you think that it might help,
then what is ethical?
To leave her alone?
If you have a chance to survive,
that's the correct attitude.
BENITA: It sort of morphed into a mission
to keep going for her.
And I was really moved, actually.
You have to imagine
if Benita wasn't enamored with him by this point,
how she would really think about this more objectively
when she's in her journalist role.
NBC maintains it didn't know about Benita's affair
with Paolo during the production.
But love blinds us to faults.
And it seems like Benita may not have been looking
as hard as she could have
at some of the red flags.
Like the fact that this wasn't the first time
Paolo's patients wound up worse off
than when he met them.
PALOMA:
ALVARO:
ADAM: Around this time the operation
on Claudia Castillo using a donor trachea
was all over the news.
REPORTER: Claudia Castillo's life
has been transformed.
A few months ago she couldn't even push
her daughter on a swing, she was so out of breath.
A revolutionary transplant has changed everything.
It's a major achievement in the history of medicine.
[tense music plays]
PALOMA:
ALVARO:
PALOMA:
ADAM: Claudia Castillo's surgery in 2008 was a big deal.
But after the bright lights were turned off
and the media decamped,
she's beset by dozens of complications.
PALOMA:
JUDY: It is possible that he thinks,
"Well, I know better than you.
"I'm the specialized surgeon.
"And you may wanna say no,
"but this is what's gonna be good for you."
But also, it shows that there's the potential for him
to not stop at any cost.
I have something very specific in mind,
and I don't care what happens, I need to get it.
[brooding music plays]
PALOMA:
Paolo's surgery on Claudia Castillo
was not a triumph of medicine.
And afterwards, after the media left,
the administration of the hospital realized
they had a problem.
And instead of publicly retracting papers
or media coverage
about what had happened with her surgery,
they let him go out the back door.
PALOMA:
ADAM: So as far as the press
and the general public are concerned,
Paolo was still this miracle worker.
I get the big institutions don't want to take on liability.
The safest thing to do
is to kind of just pass someone off
and say they worked here from this day to this day.
But this is a doctor who operates on human beings.
And he goes to other institutions,
and that had deadly consequences.
[pensive music plays]
Months after first synthetic trachea implantation,
I met an ear, nose, and throat doctor
in the changing room,
and I asked him how was it going "for the first patient?"
And he just turns to me, and he just says,
"It's going terribly."
And I'm like, "Okay, what?"
And he says that it's not working.
ANDEMARIAM: Something is going wrong.
Feeling shortness of breathing.
OSCAR: The Icelandic patient came back
to the cardiothoracic clinic.
So, we did a bronchoscopy.
And when you see a normal bronchus
is a pink, yellow, nice open tube.
But when it came to this Icelandic patient...
it just looked really, really inflammated
and just rotten.
He then had an acute problem
with the narrowing of this windpipe.
And the patient have the feeling that you're about to suffocate.
This patient died due to this problem.
ADAM: Andemariam's widow gave an interview
years later to Swedish TV.
And you can hear in her voice the sense of betrayal.
The information I was getting through the grapevine
that, oh, it was perfect and this really works.
And so this death came as a shock.
The tumor was slow-growing.
So, it's possible that he could have lived for many years
and maybe even been cured
with a standard surgery or palliative care.
This is one of those things
where you understand that something is off,
something is wrong, but you don't understand
how huge the problems were.
Paolo's response to criticism about the success rate
of his experimental operations...
he just kept moving forward.
The first liver transplant,
the first kidney transplant, the first heart transplant,
did they go all well? No.
If you do something such radically new,
you expect complications.
ADAM: While Paolo's surgeries are failing...
what was he doing?
He was busy gallivanting with Benita.
BENITA: Flew me all over the world,
the most incredibly romantic trips.
Everywhere we went, there was a surprise.
He loved to surprise me.
ADAM: I think this relationship was transformative for Benita.
She was a single mother,
and all of a sudden she's swept away
by this international man of mystery and great renown.
BENITA: He told me that he wanted to get married.
He said, "I wanna plan the wedding.
"So, I just want you to find your dress and show up."
DAVID: Matthew Christopher is a designer
for couture wedding gowns.
Matthew and I were married in New York City in 2012.
And his business--
Starting to establish a really good business
with clients and celebrities.
The head of sales kinda grabbed us all together
and said, "I don't know if this is real or not,
"but I just got a phone call from this woman.
"Her name is Benita Alexander,
"and she's gonna get married,
"and it's supposed to be a very big wedding.
"It's very secretive now we all have to sign NDAs."
And we've never signed NDAs
for someone who wants to buy a wedding dress.
So, it was just a little strange, you know?
And I was thinking, "Who is this man?
"What dude is gonna plan the whole wedding?"
And I'm just generally a skeptical person.
But I started thinking to myself,
"This sounds a little weird, it doesn't sound right,
"but let's go with it."
That moment of truth was when we were at her house
and Matthew was showing her some sketches.
And she pulled up her computer and she said,
"I wanna show you guys the guest list."
All right, you know, a guest list is a guest list.
I'm like, "All right." But this was a guest list.
ADAM: John Legend,
the Obamas, the Putins, Andrea Bocelli.
It goes on and on and on because Paolo claimed to be part
of an international society of surgeons who cater to VIPs.
He told Benita he had operated on Barack Obama,
Hillary Clinton, and others.
JUDY: It's possible that that one-upmanship
that he was doing in his professional life
also applied to his personal life.
Every surprise that he was giving her,
it was like, it had to keep building.
It can't just be the same.
BENITA: And I remember he calls me,
I was at work, and he said, "I have great news.
"You might wanna sit down."
Oh, God.
I remember that day,
and I'll tell you exactly where I was.
I was in Miami.
When I was walking on the beach, and I got a phone call from her.
And she said, "Well, I got a call from Paolo
"and the Pope is marrying us."
I'm like, "The Pope?
"Like, the Pope in the Vatican Pope?"
And she said, "Yes."
[dramatic music]
BENITA: He said, "I have been Pope Francis'
private personal doctor for many years,
and he wants to thank me."
It seemed absurd on one level.
On the other hand, it seemed equally if not more absurd
that this man would make any of this up-- why would he?
My skeptical meter was going really high up.
And then like out of the blue, we get this wedding invitation.
It must've been extremely expensive.
It was lambskin on the outside. It was embossed.
It was beautiful.
So I'm like, "This is real. Here's the wedding invitation."
You know, like, no one sends out wedding invitations with,
you know, flight information and where you're staying.
And, you know, this has to be real.
Paolo was in town so Benita invited us for lunch.
Paolo came in with an awesome-looking suede coat
and shoes that looked like they were custom-made.
And he had a very expensive watch.
He could have walked out of Vogue Magazineor,
you know, Vanity Fairor something
'cause he was so well put together.
After some time with us
kinda getting to know each other as much as we could,
he asked Benita if she would leave the table
'cause he had a couple things he wanted to talk
to Matthew and I about that were a surprise.
So she got up from the table,
and he said he spoke with the Pope
and he wants us to receive communion from the Pope.
For the Pope to give communion to a gay married couple,
that has, like, never been done before.
Matthew actually teared up.
It was very emotional for the whole LGBTQ+ community.
To me, that was the biggest thing.
Like, look what we're doing.
Look what he did.
Every time he's coming up with another new detail,
another fabulous thing that he was gonna do,
not only was it giving him this thrill,
but also it probably projects back onto his self-esteem.
Makes him feel like he's on top of the world.
I haven't diagnosed Paolo Macchiarini,
but in cases of psychopathy, there's a real mastery of that
as a manipulative technique.
And it never enters our minds until it's often too late...
that this person is not what they seem.
ADAM: While Paolo's planning this fantastical wedding,
his colleagues back in Sweden are starting to really question
whether he's the miracle worker he's been touted to be.
[monitor beeps]
Because Paolo has another patient
who's been laid up in an ICU bed for over a year.
MATTHIAS: Before she came to Karolinska, Yesim Cetir...
was a 22-year-old university student in Turkey
studying to be a teacher.
She had a common elective procedure
performed incorrectly.
And they damaged her trachea.
The surgeon in Turkey is friends with Paolo
and recruits her to come to Karolinska
to have her trachea replaced with a new synthetic trachea.
[monitor beeps]
But after Paolo had performed the surgery,
she's developing all sorts of complications.
The mucus was building
due to inflammation and infection.
MATTHIAS: The trachea clogs up, so every fourth hour,
somebody would go down in her trachea
and clean her trachea so that she wouldn't asphyxiate.
She had 7,600 bronchoscopies.
She was on a respirator for God knows how long.
She wanted her doctor to help her,
and be engaged with her problem, that he actually put her in.
MATTHIAS: Paolo was in Sweden.
He was gonna come by and visit her,
say hello to her.
So she put her makeup on
and-- and tried to make herself look nice.
But he just walked by her intensive care bed
and walked down the hall.
[elevator dings]
MATTHIAS: I don't think he ever saw her again.
[somber music]
OSCAR: Your patients that you are responsible, are suffering,
and you are flying all over the world and doing other stuff.
It says a lot about you,
and it says a lot about your-- your lack of moral and ethics.
[monitor beeps]
I've never met Dr. Paolo or treated him,
but sometimes individuals with antisocial personality
or narcissistic personality
they have a very, very hard time with empathy.
Almost a part of them
that subconsciously or consciously is saying,
"I don't wanna feel what you're feeling
"because then I can't keep doing what I wanna do."
I remember very vividly
that Oscar and another surgeon
came into my office in the afternoon.
They were quite despondent and-- and upset.
And the question was, you know,
"What are we gonna do about this patient?"
We started to go through everything
to see if we could find some-- some way to help her.
We reached out to different other hospitals
and experts around the world.
We did this very systematically as research.
We didn't realize
how much this would take over our lives.
[pensive music]
ADAM: Across the ocean,
Benita is really embracing this new life.
BENITA: I felt like I was floating on clouds.
You know, I was so blissfully happy
and I was so madly in love with Paolo.
We were supposed to get married July 11th.
In May, he told us that we were going to move
to Barcelona, me and my daughter,
to his house in Barcelona after the wedding.
I quit my job, which was a huge decision for me
and something I never imagined I would do.
But then literally one day after leaving her job...
Benita gets an email from her friend.
BENITA: I was at the spa. My phone had been turned off.
And I turn on my phone
and the first thing I see is an email from a colleague,
and the subject line just says, "The Pope."
And I click on it...
and it's an article that says
that the Pope is going to be in South America...
on the date of our wedding.
And that this trip has been planned for a very long time.
And when I read that email, I just knew.
And I felt sick, I-- I literally almost fell on the ground.
I just said, "This is all a lie.
"This is all a lie."
It was, like, the moment that this world,
the-- the Cinderella ran down the stairs
because it was 12:01
and everything was stripped away.
Not even a glass slipper.
For me, it was like, "Oh, my God.
"I've told everybody."
I've told my parents.
I've told my brothers and sisters.
I've told, like, the world that this is happening."
The dresses were made.
Between the four dresses, it-- it was well over $100,000.
The question really is, if that article hadn't come out,
what would he have said?
All these people had bought tickets
and were planning to go to the wedding.
Like, talk about leaving a bride at the altar.
BENITA: What the hell was his endgame?
Because this clearly was going to implode.
He had taken it so far.
How in the hell did he think he was getting out of it?
Some individuals, especially when they're building these lies
and they're becoming so grand,
they're not necessarily thinking ten steps ahead.
They're just thinking,
how are they going to keep this person
still caring for them, loving them,
and doing what they want.
BENITA: I mean, I was enraged.
[plane engine droning]
And in so much shock.
So I decided to do more investigating on my own.
So I arranged with a couple of girlfriends.
We went to Barcelona.
We rented a car and we drove to his house.
I had not been to his house in Barcelona.
He had flown me all over the world.
But every single time we were supposed to go,
there was a last-minute cancellation.
I had no idea what I was gonna find,
and I was shaking nervous.
And I decided that I was gonna do
some reconnaissance.[laughs]
I got this hideous blonde wig, which is kind of funny,
but I just wanted a disguise in case I needed it.
First thing I see is him coming down the stairs.
And then I see a woman
and two little children coming, you know, on-- on the porch.
And even from where I am, I can hear them calling him dad.
And I lost my mind.
He's hiding a whole family.
I don't know what kind of game he's playing,
but this is sick.
I finally confronted him.
I wrote him a very long text
telling him everything that I knew,
calling him every name under the sun.
[phone line ringing]
Hi, my love. Um...
I'm sorry we had this dispute.
When Benita finally confronts him, he records a video
treating it like it's all some big mistake or lover's quarrel.
Sometimes it's hard, just damn hard to--
to understand why you have all these reactions that are,
at least to me, overreaction.
It's conning and manipulative behavior as a sport.
There was a very realistic end to this.
So why keep pushing it?
'Cause you can.
I, um... I love you very, very much.
This is where I enter the story.
I'm a contributing editor at Vanity Fair.
I tend to do long-form investigative pieces.
And I got a tip-off from a friend in TV
who said, "There's this NBC news producer
"who's having an affair with her story subject."
When I met Benita, she had snapped out of it.
She was furious.
And so she was more than happy to cooperate
in telling the story.
Benita made no bones about the fact
that she had crossed the line,
and I respected that.
She wasn't trying to dress that up at all.
She just started sending me,
I mean, hundreds of texts,
emails, documenting her affair with Paolo.
[plane engines droning]
So I fly to Florence to begin my reporting,
and it was like a whirlwind.
I went to the three-star Michelin restaurant...
which was supposedly catering his wedding.
I mean, thanks, Vanity Fair.
And I said, "This Dr. Paolo Macchiarini says
you are gonna cater his wedding."
The co-owner had no idea who Paolo was.
"And the Pope was gonna officiate."
She's like, "What?"
They had done one big wedding before.
Interesting side note? Kim and Kanye.
I'll never forget having to ask the Vatican
if Pope Francis agreed
to preside over the wedding of Benita and Paolo,
and getting this very snarky response.
But I put the story down for a couple weeks.
-[phone ringing] -I felt it was a little tawdry.
But then I made this call to Dr. Ron Schouten.
He is a JD MD, he's a psychiatrist
who at that point was at Harvard,
whose expertise is in psychopaths.
And he listens to me as I'm telling him about this doctor.
And his advice was pretty simple.
Get ahold of his resumes.
There's a possibility that this world-famous person
who had gotten so much attention from the public
and from the scientific community
wasn't who he said he was.
He might not even be a doctor.
[dramatic music]
ADAM: And so I start collecting
every CV resume, bio that he's submitted
to conferences or academic institutions,
and I divide them up on a spreadsheet
because it was so hard to figure out.
There were so many degrees, master's degrees,
and multiple PhDs and residencies and fellowships.
But by putting them on a spreadsheet,
I could see-- like, wow.
I mean, how do you do a master's in biostatistics
at the same time as a fellowship
in thoracic surgery down in Alabama?
[intriguing music]
So I called the University of Alabama at Birmingham.
24 hours later, the guy calls me back.
He's like, "Nope, no master's in biostatistics.
No fellowship in thoracic surgery."
He hadn't been a full professor,
an associate professor, or a real researcher
in any sense of the term in any of these places.
One of the few details
I could actually prove is that he's a medical doctor.
Otherwise... he was a total fraud.
[keys clacking]
I remember being, like, "Wow, the stakes are really high here,
"but at the same time, am I getting it wrong?"
Because you could look at every newspaper in the world
talking about the super surgeon.
Like, I was way out there on a limb.
On the other hand, I had a fake wedding.
I had people saying assertions that Paolo had made
were just demonstrably false.
I mean, this was a pathological liar
with a scalpel, and people were dying.
That needed to be told.
So I started writing.
MATTHIAS: I remember we were sitting in my office.
We went through his papers line by line
and compared it with the medical files of the patients.
One of the things we looked at
was the size of the tumor in the first patient.
Paolo described that the tumor
was a golf ball size and unresectable.
But when we actually looked at the medical files,
the tumor was the size of an almond.
That was very important because he claimed
that they were in immediate threat of dying.
He said that it was compassionate use.
A doctor is allowed
to try something untested on a human patient
if it's an attempt to save a life
and if there isn't any tried and tested treatment available.
This new loophole was called "compassionate use."
Compassionate use gets you around regulatory bodies
that would evaluate, "Is this procedure
or is this medical device safe?"
MATTHIAS: But these patients,
they could have lived for many years.
And in Andemariam's case,
maybe even been cured with surgery or palliative care.
That's when we started realizing
that this whole thing is just-- is just smoke and mirrors,
and an immense amount of fabrication
and lying and manipulation.
The lies were sort of bigger than we had realized.
MATTHIAS: We had found that Paolo lied about
the large animal studies,
lied about the small animal studies.
There was no real testing that had been done.
The microscopic pictures were falsified.
The radiology was falsified.
One of the drugs being used
was not even allowed to be used in animals
and he was giving this to people.
There was actually no scientific basis
for what he was doing.
PATRICIA: I kind of think it in a way
as we have a vacuum cleaner and the hose that comes out.
It was just like saying,
"Well, why don't we just take a bit of this
"and put that in and see if that will work."
It was as ludicrous as that really.
We do not understand
the specific entire mechanisms, but...
Can we have a small resuction?
...I personally have track record
on tracheal transplantation of about 26 years now.
At this point, half of Paolo's patients were dead
and more were dying.
Meanwhile, he's running around the world doing surgeries.
There were patients being actively recruited
and operated on in Russia.
PAOLO: He's above 90. So that's not a problem.
MATTHIAS: We feared that more patients
were gonna meet the same fate as Andemariam and Yesim.
PAOLO: Don't do what you want. Go up, up in this view.
I want to see the scaffold, if it is okay or not.
MATTHIAS: But he had to be stopped
from carrying out any more of these procedures.
MATTHIAS: We compiled a report
about what we had found in the clinical papers.
And we submitted these reports to the university.
And tried to instill upon them
the seriousness of what was going on.
We were definitely hoping
for some sort of judicial reprimand to Paolo.
But there was really no response from Karolinska whatsoever.
He was the golden goose at the Karolinska.
To do these procedures,
Karolinska brought in hundreds of millions
in different research grants.
And maybe it was naive,
but still that was a little bit heartbreaking actually,
that nobody wanted to act on it.
MATTHIAS: Months went by...
and nothing happened.
We were screaming at each other and like,
"What the hell's going on?"
OSCAR: So we sent it
to the Central Ethical Review Board in Sweden.
ADAM: And it catches the attention
of The New York Times.
OSCAR: The New York Times article states that
there are problems with these transplants
at the Karolinska.
MATTHIAS: That was a wonderful victory for us
because we thought,
"Well, now The New York Times is on this.
"This is really gonna be a major game-changer."
After that article surfaced Karolinska was scared.
[news reports in other languages]
ADAM: Almost immediately, Paolo starts speaking to the press
as though he's the victim.
I was attacked brutally and, uh, vehemently
with unfounded... uh, allegations.
When he starts to be confronted
with a web of lies that he's built,
he just flat-out denies it.
There's this footage of Paolo comparing himself to Gandhi.
There's a version of himself
that he can explain what has happened
that allows him to still be intact with his ego
and to feel good about himself in the morning.
MATTHIAS: We had been asking for
some sort of external review of our case.
And the next day after The New York Timescame out,
Anders Hamsten, the head of the Karolinska,
announced that there would be an external reviewer.
I'm Bengt Gerdin.
I'm a retired professor in surgical specialties
at Uppsala University.
I was asked by Karolinska Institute
to do an external investigation.
My report was submitted...
summer 2015.
My opinion was that the whistleblowers...
had been right.
All I needed to do was to look at their report
and see is it true or is it not true?
And it was all true.
Paolo Macchiarini lied about the animals,
lied about the success of the first patient,
lied about the details,
about the success of the other patients.
They were lies, very simple.
So I thought now I've done my job.
Let's see what happens.
To be attacked, to be on the front pages and...
at least if we would have done something wrong,
then I would understand it, but...
I believe we didn't, so let's wait tomorrow.
There was a press conference run by Karolinska Institute.
OSCAR: It's the head of the Karolinska Institute,
the head medical officer,
as well as the head of the Nobel Committee.
We're informed that there's gonna be guards
at the press conference,
so that we can't come in and be present.
Anders Hamsten goes against everything
that the external reviewer has said
and expunges Paolo of any wrongdoing.
I was so convinced...
that I had been right.
The whistleblowers had shown it,
and I had shown it that it was a lie.
They did not want the truth.
I failed a responsibility
to communicate with Anders Hamsten.
So I wrote him a letter.
What do you want external investigators for
if you just threw it away?
The fact that now we are, again, back to science and clinic
and not lawyer stuffs and so forth.
So that's a-- that's a good thing.
OSCAR: We started to realize
we're not only fighting against Paolo Macchiarini.
We are fighting against sort of the entire Karolinska
and entire Swedish sort of scientific community.
Paolo had become Karolinska's superstar surgeon,
so they were gonna protect him.
And it's about protecting what he represented,
which was money and prominence and all of that.
All institutions do exactly the same thing
when they have a-- a situation like this.
The first thing you do is discredit the people
who are coming with the accusations.
OSCAR: We started to get threats,
sanctions, accusations.
I mean, Karolinska was gonna do everything they could.
They're gonna pull out every stop
in order to make our lives as miserable as possible.
They scheduled us for more and more on-call hours
in order to basically quit yourself or make mistakes,
so they can fire you.
And if you had even the most minor complication,
then it would be discussed as, you know,
"This is just an under-par. This is not acceptable.
"We need to do an investigation, "and dah, dah, dah, dah, dah."
There's incredible amount of stress going on.
At the time, my wife was a researcher
at the Karolinska Institute.
And I was marching off to war
every morning with the institution,
which was our employer.
And, of course, this put a lot of pressure
because there was a serious risk that she was gonna be
collateral damage in this trench war.
I mean, it's partially, I think,
responsible for what led to the end of my marriage.
I mean, I don't put all the responsibility on that.
It's definitely my responsibility.
But I mean, um, I think it was an incredibly...
hard period for everybody.
OSCAR: In the beginning of 2016,
I actually came out of the OR after a surgery.
And Matthias calls me and he said,
"Oscar, you need to come down here to my office."
[brooding music]
It was this Vanity Fairarticle about Paolo Macchiarini.
I read it.
I knew that there's no way he's getting out of this.
He was done.
ADAM: Right up until January 2016,
what the public saw on Paolo Macchiarini was,
this guy is a super surgeon.
He's a miracle worker, he's a water walker,
the magnet for superlatives.
But when the story comes out on Vanity Fair...
it's like a bomb went off.
My article exposed him.
Exposed that he lied to a news producer
about a fairytale wedding with the Pope.
And he had lied consistently throughout his career
about his credentials...
and his capacity to do what he was doing.
He's a serial liar.
I mean, there's no other way to get around it.
I instantly ran out and bought three copies of Vanity Fair.
REPORTER: There was a feature in Vanity Fair
that made some shocking allegations
about both your personal and your professional life.
How do you respond to that?
Well, I will not comment on my personal life, of course.
Um...
I shall comment on... the...
uh, fact that, uh...
this article claims that my CV is false,
which is a false statement.
ADAM: Macchiarini was claiming that he was a victim.
It's very easy to accuse.
It's very easy to vilify someone.
But a couple of weeks later,
a documentary on Swedish television drops.
JOURNALIST: For me, it all started when Macchiarini
was accused of falsifying research results
and a gross misconduct.
I decided to find out what had happened.
I don't have that much time, so we need to hurry.
ADAM: What Swedish TV did quite well
was show that his patients were dying
Patient after patient.
The combination of their piece...
Okay, can you switch off this?
ADAM: ...and my piece...
it-- it-- it brought down the house.
ADAM: The leadership of Karolinska resigns.
Secretary of the Nobel Prize Committee in Medicine resigns.
Six papers were retracted from prestigious medical journals.
And the police started investigating in earnest.
REPORTER: Stockholm authorities are gathering information
to see if there are grounds for manslaughter charges.
When it starts being developed as a case
we're really optimistic.
We thought, "Now, finally,
"this is gonna yield some fruit."
But this whole process is taking...
years and years.
There was a question of whether the injury
was intentional or did something go wrong in the surgery.
Unfortunately, it's really difficult to prove.
During that time, he's been out operating patients in Russia.
He should have been in jail years ago.
Macchiarini is ultimately charged
with three counts of aggravated assault.
And in April 2022 the trial begins.
[indistinct chatter]
The press was there and...
the courthouse had high security.
He came in the back door.
He didn't want to go in the front door.
I guess he's scared. I don't know.
I mean, I would be.
Seeing him in court finally...
was-- I mean, I felt like a witness
at the Nuremberg Trials.
I sat as close as I could to him
so that he would see that I was there.
And we had sort of eye contact where he just,
you know, our eyes met
and he tried to pretend like I didn't exist or whatever,
but I wanted him to know that, "I got your ass."
PAOLO: I would like to-- to thank the court
for giving me this chance to speak out.
I have been silent all these years.
If you do a first-in-man or an innovation therapy...
ADAM: Macchiarini relies on the same defense
that he's always had, which is people die
in the course of medical innovation.
But now he's suddenly
expanding the radius of who's responsible.
PAOLO: I cannot do anything
without the approval of my superior.
I cannot do any surgery.
So I thought that according to Sweden's standards,
everything was perfectly managed.
And then in June 2022, Paolo was convicted
of one count of causing bodily harm,
but not aggravated assault.
[dramatic music]
MATTHIAS: The judgment was a complete joke.
What that judgment did, it completely washed
Karolinska of all responsibility.
Which I think was the purpose of it.
ADAM: Prosecutors, though, were unhappy with the judgment.
ADAM: The case goes up on appeal.
And in June 2023, he's convicted...
of three counts of aggravated assault.
And he's been sentenced to two and a half years to prison.
Which seems remarkably light given the death toll.
However, in the Swedish legal system, I'm told,
this is a fairly typical sentence.
I lost my job.
I lost my reputation. I lost everything.
I even cannot [indistinct] my small children...
who asks me whether I'm really a killer.
[camera shutter clicks]
The big question is, what motivated Paolo Macchiarini
to engage in all this behavior?
I think that there's possibly a part of him
that just wanted this fame for himself
and to be acknowledged for his smarts.
And it took over what could have started
as a very noble pursuit,
which is to save lives and to make a difference.
BENITA: So much hope was attached,
so much promise attached to this man.
And I just got fooled.
I was so angry, and then at the same time,
I was so embarrassed and so humiliated.
I mean, I'm a journalist. I'm not supposed to get fooled.
Smart people can be taken in by cons
because they want to believe.
We wanna believe the story.
We wanna believe the narrative that's being delivered to us
by someone we like, by someone we respect.
JUDY: People wanna believe in a miracle.
And Paolo was selling a miracle.
MATTHIAS: He was selling something
that Karolinska wanted.
And Karolinska wanted their own Nobel Prize.
And you had a bunch of people in that institution
who were very, very hungry for it.
And without that, there wouldn't have been any Paolo.
ADAM: It's mind-blowing.
Karolinska sacrificed the whistleblowers
on the altar of Paolo Macchiarini.
I ask myself, how did he get away with it for so long?
And maybe the default is,
institutions fail over and over again
and that there's nothing special about Karolinska.
I think there's also, maybe the other answer is,
this is the power of mass delusion.
One newspaper puts him on the front page,
another puts him in prime time.
Then you're too big to fail.
I mean, this is going on all the time
in scientific research.
'Cause nobody's gonna go into the lab and say,
"Can I see your ethical approval?
"Can I see the windpipe from the patient?
"Can I see it?" Nobody's gonna do that.
And the system keeps churning.
[somber music]
***