Netflix's 'Bad Surgeon' documentary dives deep into the lies of Dr. Paolo Macchiarini

Dr. Paolo Macchiarini, whose looks have drawn comparisons to George Clooney, entered their lives like an answer to their most heartfelt prayers.

To his patients, the Italian surgeon embodied a second chance at life through a first-of-its-kind synthetic trachea transplant. To his ex-fiancée Benita Alexander, he promised a fairytale romance complete with trips to Russia, Greece, the Bahamas and an Italian wedding to be officiated by Pope Francis.

“He fooled his patients very much the same way he fooled me,” says Alexander, who met Macchiarini in 2013 when she was in her 40s. The former NBC News producer was working on a special about regenerative medicine. “They were convinced that he was the greatest hope of their loved ones surviving. He made them believe that he could help them the way he made me believe that he loved me and that he loved my daughter, and he was going to take care of us for the rest of our lives.”

Alexander’s relationship with Macchiarini, 65, and his surgeries are chronicled in Netflix's three-part documentary “Bad Surgeon: Love Under the Knife” (all streaming now). Macchiarini and Alexander are also the inspiration for Season 2 of Peacock’s anthology series “Dr. Death” debuting Dec. 21. Edgar Ramírez and Mandy Moore star.

“There's a lot of gaslighting and brainwashing,” Alexander says. “It's a slow, meticulous process. It's not like he hits you over the head with these lies all at once. It's a very cunning weaving of a web like a spider.”

Here are the revelations from “Bad Surgeon” and our interview with Alexander.

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Paolo Macchiarini used patients as 'human guinea pigs'

Thoracic surgeon Paolo Macchiarini and his patient Yulia Tuulik are seen in Netflix's docuseries "Bad Surgeon."
Thoracic surgeon Paolo Macchiarini and his patient Yulia Tuulik are seen in Netflix's docuseries "Bad Surgeon."

Beginning in 2011, Macchiarini transplanted plastic tracheas seeded with his patients’ stem cells in at least eight people. He was seen as a pioneer who could extend the lives of those with damaged windpipes or were born without one. But the only patient who survived had their transplant removed.

In an email shared in Netflix’s docuseries, patient Yulia Tuulik writes of “rotting” after the surgery and smelling so badly that “people shudder away.” She died in 2014. Yesim Cetir underwent 191 surgeries following her transplant, experienced two strokes, and had to have her throat cleared every four to six hours. Cetir died in 2017.

While innovative medicine comes without guarantees, Macchiarini lied about his credentials and misrepresented his research. Alexander acknowledges she can’t psychoanalyze her ex but does believe he was knowingly careless with his patients’ lives by forgoing animal trials.

“He was reckless, and he just used people as human guinea pigs,” she says. “He doesn't care about anybody else's life, and he doesn't care who he steps on or hurts or knocks over to get what he wants.”

The moment Benita Alexander knew her fiancé was a liar: Red flags 'exploded to the surface'

After getting engaged Christmas 2013, Macchiarini told Alexander he wanted to plan their wedding on his own, as a romantic surprise which aligned with the “giant, grandiose gestures” to which Alexander had grown accustomed. But as the wedding date approached, things began gnawing at the bride-to-be. “Every time I asked him a question about the wedding, he would get very tense and wouldn't give me answers,” says Alexander.

She had suspicions but lacked proof until a friend informed her the pope would be out of the country at the time of their nuptials.

“In that moment, I just knew,” Alexander says. “All those little red flags that had been nagging at me exploded to the surface.”

Benita Alexander kisses her former fiancé, disgraced surgeon Paolo Macchiarini.
Benita Alexander kisses her former fiancé, disgraced surgeon Paolo Macchiarini.

But Macchiarini’s lies continued: He told Alexander that being a surgeon was his cover, and he was actually a sniper for the CIA.

“Clearly, something was very seriously wrong, and he's a pathological liar,” says Alexander. “But when he told me that, I thought, ‘This man's crazy.’ I mean, legitimately crazy or so demented − and I didn't even know what to think.”

Paolo Macchiarini implicated in three patients' deaths but can still practice medicine

Macchiarini's colleagues at Sweden's Karolinska Institute expressed concern that the surgeon was misrepresenting the success of his procedures in 2014. Suspicion intensified in January 2016 when Vanity Fair published Alexander's account of their romance. That same month, a documentary, "The Experiments," revealed how Macchiarini's patients declined after surgery.

In 2022, Macchiarini was tried for causing bodily harm to three patients who received experimental transplants between 2011 and 2014. He was convicted on one count and received a suspended sentence.

In June, a Swedish appeals court increased his sentence to 2½ years, noting all three “could have lived for a not-insignificant amount of time without the interventions.”

Macchiarini protested, saying, “We did the transplant in good faith," according to The Associated Press. Filmmakers say Macchiarini declined comment on the allegations, and the documentary states he "has consistently denied any wrongdoing."

Acknowledging the brevity of the sentence, Alexander finds "some satisfaction" in the punishment. "It's very difficult to prove that he intentionally killed these people," she says. "He hid behind the fact that these are experimental procedures."

As the documentary points out, Macchiarini still has his medical license and can continue practicing.

Benita Alexander says she won't let Paolo Macchiarini's deceit make her bitter. "I just refuse to let him change me."
Benita Alexander says she won't let Paolo Macchiarini's deceit make her bitter. "I just refuse to let him change me."

Benita Alexander now: 'I still believe in love'

Alexander saw Macchiarini at the original trial in 2022 and again at the appeals trial where they came in close contact. “We brushed within inches of each other, and every time he tried to look at me, I just looked the other way,” she says. “That was my way of just saying, ‘Screw you. You don't have any hold over me. You don't mean anything to me, and I’m fine.’ ”

Alexander says she’s now “in a very serious relationship with a very lovely man.” She’s made conscious efforts to remain optimistic.

“I still believe in love,” she says. “I'm still a die-hard romantic, and that was very important to me because it was difficult enough to wrap my head around the fact that I had been fooled and duped. I just refuse to let him change me. I wasn't going to give him that power as well."

This article originally appeared on USA TODAY: Paolo Macchiarini's 'Bad Surgeon': Netflix series offers full exposé