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- I read this piece
in "The Times"

about this little girl
who needs a new windpipe.

Name's Hannah Warren.

Her family's working with
this doctor in Europe.

- Dr. Paolo Macchiarini.

- The focus of my research
is tracheal transplants

with the help of stem cells

by developing
biosynthetic tracheas.

- So you're basically
tricking the body

into thinking the implant's
already a part of you.

- Will you be
interested in assisting?

- Yes. Yes.

- I was wondering if
you would be interested

in collaborating on rat
trials to test our tracheas.

- Absolutely.
- Welcome to the team.

- So this is the first
artificial-trachea transplant

in the U.S.,

and I want Hannah's journey
to be the focus of the piece.

- Surgery went well.

- I have watched
you for a while now.

What you did, it was a miracle.

Paolo, I shouldn't.

- The science
doesn't seem sound.

- It's not exactly
your kind of science.

- I will admit I don't get it.

- Knife.

After the operation,
she's healthy and happy

with her donor trachea.

- Hannah Warren will
be the youngest patient

ever to receive a biosynthetic
tracheal transplant.

- Okay, stop right there.

Let's swap this out to play
over Dr. Macchiarini talking

about the initial diagnosis.

I think we still
need a little more B-roll

with the parents, but
we are close to locking.

Ow.

- You okay?
- Yeah, I'm okay.

Hi.

I was just talking about you.

- Uh, Benita.

- Daryl?

- I called to, um...

I called to tell you she, uh...

she's gone.

What?

- Hannah's gone.

- What... what do
you mean she's gone?

- It was... There
were complications.

Her... her lungs, after all
the time in the hospital,

she just... her
body couldn't, um...

Hannah's gone.

We were with her, and she
just kept getting worse.

We thought maybe
she was gonna...

that it would pass, but, uh...

- Mom, your phone.

Is it work?
- No, it's not work.

What's up with
the braids, kiddo?

I haven't seen you
repeat a hairstyle twice,

let alone three
times, in a week.

- Dad liked my hair this way.

- I miss him, too.

But I think you look great.

You ready for school?

What are you doing here?

- I wanted to make
sure that you're okay.

You're not answering my
phone calls, my texts.

- You shouldn't be here.

- I know you heard about Hannah.

I just wanted to make sure
that you're okay, Benita.

- I thought she
was getting better.

- There were complications.
- "Complications.

"Fragile native tissue.

Weakening of the lungs."

I-I read the reports,
Paolo. I know the medicine.

But you told me she
was getting better.

- She was very sick.

And she was going to die.

I tried.

You think that I'm not upset?

But I won't give up.

I don't have the
right to give up.

- No, Paolo, don't.
I-I can't do this.

Let's just call it
what it is, okay?

- What is it?

- A mistake.

- Colleagues, board members,

we are so glad to have you here

for this momentous occasion.

Tomorrow we will perform the
first-ever human transplant

using a bioartificial scaffold.

Our patient is
Andemariam Beyene,

a 36-year-old
Eritrean PhD student

living in Iceland.

Two years ago, he
developed a malignant tumor

in his windpipe.

They have tried radiation
and surgical intervention.

All failed.

So his doctors
referred him to us.

As you all know, we
only have approval

to perform this procedure
as compassionate use,

a last resort.

We have designed a
biosynthetic trachea

tailor-made to
Mr. Beyene's anatomy,

down to the last micrometer.

- And this truly
is the breakthrough

that will launch us as
a global destination

for this kind of medicine.

- Ladies and gentlemen,

I present to you the future
of regenerative medicine.

Within weeks, it
will grow tissue,

transforming into an
actual, living trachea.

Dr. Macchiarini, I am sorry.

I no longer wish to
have the surgery.

We feel it is too risky.

- It is completely natural
to have concerns, Mr. Beyene.

- The trachea, it's plastic.

How can you be sure it
will work inside my body?

- There you misunderstand.

It is not plastic.

The trachea is medical-grade

polymeric
nano-composite material.

- If I may.
- Yeah, of course.

- Mr. Beyene, you're studying
lava tubes in Iceland.

Is that right?
- Yes.

- I believe the
recellularization process

is just like that.

When a volcano erupts,

underground lava
rivers create tubes.

When the lava drains,
the tubes remain,

but now they're rock solid.

They become a part of the Earth.

And that means
they last forever.

That's what your
stem cells will do

to the synthetic trachea

to make it last forever
as a part of you.

- You're asking my
husband to be the first

but offer no guarantee
the procedure will work.

- No, we cannot offer guarantees

because it would be
irresponsible to do so.

Nothing is guaranteed
in medicine.

Even just a year ago,

your options would have
been much more limited.

You are very lucky
to be the first.

Your doctors referred you to us

because the other
treatments failed you.

You could have as little
as six months to live.

This is your best chance
to see your son grow up.

- Okay.

- Okay.

I think it's very difficult
to keep an emotional distance,

especially if it is a child.

Hey.

How you holding up?

- I wish I felt numb.

I just feel...

everything.

- Give yourself a break, B.

You're not on a schedule here.

- It's gonna take what it takes.

- You know, with Hannah
Warren and John...

it's just a whole lot of death.

- How's Lizzi?

- She's really quiet.

I think she's pretending
to be okay for me,

which makes me feel guilty,
which makes me feel worse.

She's just such a daddy's girl.

And that breaks my heart.

- At least you still
have a heart to break.

- Yeah, the pain
reminds us we're alive.

It's awesome.

- Work is good?
- Work is good.

Work is good.

- Hey, how's that
piece coming along?

- Hey, it's not.

It's...

a special about the
future of medicine.

It's supposed to be hopeful.

And now I don't
have a story at all.

- What about him?
- What about him?

- Shift the focus
to him, you know?

"Dr. Macchiarini,
Miracle Man"...

a look at the pioneer of
generational medicine.

- Regenerative.
- Exactly.

- But then what about Hannah?

- She'd still be part
of the main story.

Medical breakthroughs are
always paved with setbacks.

It doesn't mean that
Macchiarini's work

isn't worth believing in.

- Hold on to the hopeful.

- If anybody can make
it happen, it's you.

When did the pain start?

- Um, off and on for
the last few weeks.

I just thought it was
stress or something.

- Would you describe the pain
as sharp, dull, or burning?

Sharp, like... Aah!

Like someone's
stabbing me. Ow.

- Let's get a CBC,
liver enzymes,

urine test, and a CT of
the abdomen and pelvis,

plus 30 milligrams of
Toradol for the pain.

- So it's my appendix?
- It's not your appendix.

- What? No, no, no, no, no.

I have a daughter.
She's nine years old.

She just lost her father.

I can't have something
wrong with me.

- We just need to run some
tests to see what's going on.

- Doctor, they're waiting.

- Is there anyone
you want to call?

- Hi, excuse me.

Hi.
- Hi.

Thank you for
coming. I'm sorry.

- No, no, I'm glad you called.

Has the pain subsided?
- No.

I think it's worse, actually.

- What did the doctor say?
- Nothing.

They just ran a bunch of tests,
and no one's told me anything.

I've just been sitting
here by myself.

- You CT scan shows
uterine fibroids.

- What? What is
that? Is that cancer?

- Not at all.
They're very common.

Is it okay if I take a look?
- Yeah.

- Yeah?
- Okay.

- This might hurt a little bit.
- Okay. All right.

Okay.

Yeah, I can feel two.

They're about the
size of grapefruits.

- What?

- It sounds much
worse than what it is.

Don't worry. They will
have them removed.

- So I have to have surgery?

- Yeah, but it's a
very common procedure.

I'm sure your doctor will
walk you through everything.

You're gonna be fine.

Trust me.

- He's got you
working late already?

- I'm preparing.

It's something doctors do.

You should try it.
- Noted.

- I'll sleep when I'm published.

- Why don't you like him?

- I don't really like anybody.

- That's true.

Still, so few surgeons want to
operate on the throat at all,

and he throws in
stem-cell regeneration.

Aren't you interested
in his work?

- Yes, yes, I find
it all very...

interesting.

- You're an ass.

Look at this.

He has to identify the surgical
planes bordering the trachea,

avoid tumor dissemination,

all without exposing the larynx,

the thyroid, the esophagus.

Say what you want.

Dr. Macchiarini's
got some balls.

- I guess that's what it takes,
huh... some nice big balls?

- Sorry, I didn't
mean to offend you.

- Yes, I have tiny balls.

You know, a good surgeon
knows when not to cut.

- Fuck that. I'm tired of being
on the verge of something.

Too afraid to make the cut...
this is groundbreaking work.

I'm getting in.

- Just watch your back.

- I always do.

- Dr. Svensson.

- Dr. Macchiarini? Uh...

- Oh, the trials seem
to be proceeding nicely.

- Uh, yes.

Um, we're on schedule.

- Good.

Any exciting conclusions so far?

- Well, nothing...
you know, nothing

really determinable yet.

Of course, I won't be
able to truly discern

any results until...

- Yeah, until you completed
the trials, of course.

As you can imagine,
I'm... I'm very anxious

to see any results...
positive or otherwise.

- Well, on the test rats

that have received
synthetic tracheas,

so far none have
responded negatively.

- Well, that...
that is excellent.

- But as you said, we're
still gathering data.

Uh...

the purpose of this trial

is to witness objective
results, of course.

- Of course, of course.

- May I ask, is there
anything in particular

that is concerning you?
- Oh, no, not at all.

I have complete faith in
your research, Doctor,

as well as my own.

I'll just leave
you to your work.

- Okay.

Yeah.

- Thank you.
- Yeah, no problem.

Oh, thank you, thank
you, thank you.

Oh, my God, please.

- Wow, I wish I had
that effect on you.

- 48 hours without caffeine?

Who am I today?

- I spelled your name for them.

You're feeling better?
- Mm-hmm.

I am. Like two
grapefruits lighter.

Thank you, really.

- Pleasure.

- Paolo...

we've both been through a lot
of loss the past few months.

And I know I wasn't
dying in there, but I...

I was really scared, and it...

It just...

it put things in
perspective for me.

Us together, it could cost
me my job, my reputation,

but I think this thing we
have, it's worth the risk.

- For me, too.

- You've heard the criticism...

that you're really taking a
chance with these patients.

What do you say to that?

- I was raised to
believe that if you...

if have even one chance,
you need to take it,

because either that
patient will die,

or we try to do something,
even if it's new.

As a doctor and... and
as a human being, I...

I ask myself, are we
allowed to say no?

I don't think we are.

- And when you got
that call later

that... that she had passed...
- Mm.

- It had to be
devastating for you.

- I couldn't stop thinking...

did I make the right decision?

Did I do everything to save her?

There are so many patients
all around the world

who need this procedure.

We should really
try to achieve this

for all of them,

because even in the
face of failure,

we should keep hope alive.

- Great job today, guys.

Dr. Macchiarini, do
you mind staying behind

for a few minutes to
go over the schedule?

- Good night.

- Of course.

So?

- So...

Well, I have some
follow-up questions for you

that are gonna happen...

- Really?
- Behind closed doors, yeah.

- I'm so sorry you had
to go through this.

- It's okay.

It's just gonna be a scar.

- One day we will
live in a world

where we won't have to cut
people open to fix them.

You'll see.

- Do you ever have any doubts?

- Of course I do.

- Really?
- Mm-hmm.

- 'Cause you seem so
sure of all of it.

Even the things
that could go wrong,

that have gone wrong...

you just keep moving forward.

- I think a lot about the
ones who came before me.

Like Thomas Starzl...

he started the first
liver transplants.

His first patients died.
- Hmm.

- Or Christiaan Barnard...

he performed the first
heart transplant.

People threw rocks at him.

Everybody thought he was crazy.

- I'm sure people looked
at him the same way

that you're looking
at me right now.

When Hannah died,
I did lose faith.

But these doctors, they...

they believed, they
worked, they persevered

until they found their way.

Being the one to
try something new,

no matter the personal cost,

is vital to move
medicine forward.

It's vital.

And I believe that the
work that we're doing

is going to save many lives.

- I believe it will, too.

- Hi, my love. I'm here,
missing you in Barcelona.

The lemon trees
are ready for you.

- Oh, there is a sushi
roll with my name on it.

Benita?
- Hmm? Oh, yeah, lunch.

- You ready?
- Sorry. Yeah.

- Good.

- Mm.
- Come on, come on...

No, I hear you. The
information is great.

But I'm going to need
another source on it

to confirm her account.

Sure. Could you
email that to me?

Wow, that sounds good.

Yeah.

- It's Lizzi. Okay.
- I'll miss you.

- Yeah. Sure.

It's okay with me.

If it's okay with Aubrey's
mom, you can sleep over.

Okay. I love you, too. Bye.

- Did you say "sleep over"?
- Yeah.

- Maybe I could
change my flight.

- Oh, I didn't know
that was an option.

- Mm-hmm.

- What?
- The Stones are sexier.

- No, no, no.
- That's it.

- How can you even compare them?

- I've always thought this,
and I'm not going to apologize.

- "Blackbird," um...

"Martha My Dear,"

"While My Guitar Gently
Weeps," "Rocky Raccoon."

- Okay, now we're listing songs?

- Yeah.
- "Satisfaction"...

- Oh.
- "Gimme Shelter,"

"Sympathy for the Devil."
- No.

No, we can't have
this conversation.

This is terrible. Now
I have to leave you.

- Are you gonna leave me?
- I'm gonna leave you.

- Are you gonna leave
me for The Beatles?

- This is a very, very...
- They're almost...

All of them are dead, almost.
- Important distinction.

- Italian "Vogue," nice touch.

- For Lizzi.
- Ah.

Hey, Lizzi? My
friend Paolo is here.

- Your "friend"?
- My friend.

- "Cacio" means "cheese,"

and "pepe" means "pepper."

So it's like Italian
mac and cheese.

And pepper, you know, "pepe."

- It's delicious, right?

What do you think, kiddo?

- I don't like it.

- Your mom tells me that
you play the violin.

- She does, yeah.
- Yeah?

- She practices every day.

Sometimes I don't even have
to ask her to practice.

- Oh, wow. That's impressive.

It's impressive,

'cause I used to play the
piano when I was your age,

but I hated to practice.

Well, maybe we
can play together.

You... you play the violin,
and I play the piano.

We make a concert for your mom.

Mm.

Did you hear what happened
when Johann Sebastian Bach

dropped his violin?

It Baroque.

It Ba-roque.

- Ba-roque, that's funny.

- Can I go to my room?
- Lizzi, come on, please.

No, it's okay.

But, Lizzi...

I know that you're feeling
a thousand things right now,

all at once.

And I'm ready to wait
for as long as it takes

for you to figure out
how you feel about me.

But I'll make you a deal.

If you let me show you

how much I care about your mom,

I promise you I will
never make you eat

my cacio e pepe again.

Accordo?

- Accordo.

- Good night.

She'll get there.

It takes time.

It's really good.

- But you got it,
right, Baroque?

- I got Baroque.
- Okay.

- Yeah, it's a cute joke.

Hey, three more pages, then
jammies and lights out, okay?

- Okay.

- I love you.
- I love you, too.

- Good night.

- Hey, Mom?

I like his accent.

- What? Are you
kidding me? You cooked.

Get out of here.

- What?

- I have bad news.

Our trip to Barcelona...
- No!

- I have to cancel.
- Oh.

- Uh, there's...
there's a new patient

I need to meet in Moscow.

- I was so looking forward
to finally seeing your place.

- I know, my love,
and I'm so sorry,

but if she agrees to surgery,

this could launch funding
for the entire lab.

- No, I-I get it, I get it.

I just, um...

have to figure out what to
tell Kim and everybody else,

'cause I already took time off.

And I have Laura coming
to stay with Lizzi and...

- Why don't you come with me?

- To Russia?
- To Moscow.

I can show you off in Moscow.

I don't know.

- Oh, come on, Benita, I
want to spend time with you

without having to
hide... please.

- We have to wait
until the special airs

before we tell anybody anything.

- I'm sure our secret
will be safe in Russia.

Please come with me.

Please, come with me.
- Okay.

I mean, who...

who am I to say no to the
great Dr. Macchiarini.

- Accessing the cricoid ring.

I see severe infection,
most likely caused

by the excessive radiation
treatments on the patient.

The cartilage is necrotic.

If the tumor hadn't killed him,

it would have been
only a matter of time

before he succumbed
to infection.

Knife.

Starting resection.

The biosynthetic trachea
will fit perfectly

in the resected area.

Metzenbaum.

Okay.

Okay, switch the oxygen input.

Saline.

Any leaks in the trachea will
produce bubbles in the saline.

Pulse ox?

- Holding steady.

- No signs of leaking.

- Oxygen holding, 98%.

- It's working.

- Congratulations, Doctor.

- Okay, let's close him up.

Doctor?

- BP's dropping.

- He's bleeding.
- Vitals are weakening.

- No, it can't be. The
implant is working.

Where is this blood coming from?

Doctor?

The left carotid's
most likely ruptured.

- No, I didn't touch it.
I wasn't even near it.

- You said there was
radiation damage.

- Losing OX.

- It must have weakened
the vascular wall.

- Doctor.
- Blood pressure is dropping.

- Doctor, we need
to do something.

- Doctor?
- Losing oxygen.

- Doctor?

Paolo!

I can fix this.

- He needs to be stabilized.

- Suction?
- Blood pressure is dropping.

- Found it. Cautery.

BP is on the rise.

- He's stable.

Sutures for Dr. Macchiarini.

- You should close him.

All right, my love, this way.

- I was texting with Lizzi

about setting up our Skype call.

- Mm-hmm?

- And she specifically
asked for you to jump on.

- Oh, she did?
- Yeah.

You charmed her,
you big charmer.

- Pardon me.

Uh, compliments of the
gentleman at the bar.

- Thank you.

- To you, to me, and
to ice buckets, always.

Cheers.

So who is our
benefactor this evening?

- I shouldn't say.
- Paolo, come on.

I protect sources for a living.

- He's a Russian
oligarch, very connected.

No, don't look.

There is a network of
high-profile patients,

celebrities, clergy, presidents

that are treated in secret,
that I treat in secret.

Because of who they are,

I have to keep our
arrangement quiet.

- Presidents, like
U.S. presidents?

- Paolo Macchiarini,
surgeon to the stars?

Okay.

I... Somebody's got
to do it, right?

- Shh, they're coming.
- Oh.

- Yulia, this is
Benita Alexander.

- Paolo, good to see you.
- It's nice to meet you.

If you're trying
to impress me, Doctor,

it's... it's working.

- Yulia, my dear, for
you, only the best.

- Uh, Paolo tells
me you're a dancer.

The best in Russia.

- I met Andrej not long
after I joined the Bolshoi.

- I saw her perform
in "Swan Lake."

She was magnificent.

- I was only part of the corps
de ballet, not the soloist.

- Still, I could not
take my eyes off of her.

- While I was on tour in
London a few years ago,

I was involved in a
horrible car accident.

- It's a miracle
she's even alive.

- My windpipe
was broken. My...

Everything was broken.

And it left me with
this hole in my neck.

- I'm so sorry.

- The past is a
lighthouse, not a port.

I found
Dr. Macchiarini.

- Up until now,
we have implanted

only patients for
compassionate use,

those who otherwise would die.

But you have shown me
that quality of life

is nearly as important
as life itself.

- So this is an
elective surgery?

- Yeah.
- Mm.

A part of me

hopes it will allow me to
dance again, but, mostly...

we have a two-year-old
son, Sasha.

I want to play with
him...

Sing him a lullaby.

- And you're the
perfect candidate.

You're young, healthy,

no other medical issues that
would complicate matters.

You... you're ready.

- Mm. I really don't
want to go to Sweden.

I wish you were set up
to operate in Russia.

- Then I have
great news for you.

Our colleague, Dr. Lasbrey,
is setting up facilities

in Krasnodar as we speak.

Your procedure will launch our
work here in Russia, Yulia.

You will have your
operation here.

- To Dr. Paolo Macchiarini...
- Ah.

- Our rock-star surgeon.

- Mm.

- You okay?
- Mm-hmm.

- Yeah?
- Yeah, I'm okay.

- This ballet was first
performed in 1871.

You know...

Are you okay?

Hey. Hey, hey, hey, my love.

Hey, are you okay?

- I'm sorry. I
don't think I can...

- No, no, no, we'll go home.
No, we'll go. I text you.

No, she's... I'll
text you, okay?

Let's go.
- Are you sure? Should I...

- Yes. Yeah, yeah.

- You're getting worse.

You should have let me
take you to the hospital.

- No, I just want to lie down.

- You're burning up.
- Mm. I feel sick.

- Let me check something.

The surgical site is infected.

- What? There's no way.
That was months ago.

It's got to be healed by now.
- No, it's not.

- So... so what,
antibiotics or something?

- No, it's too late for that.

You're in sepsis. I need
to debride your wound.

Otherwise, you
will go into shock.

- "Debride"? What
does that mean?

You're gonna be okay.

Do you trust me?

- Mm-hmm.

- "Two months after
transplantation,

"the patient is asymptomatic,

"breathes normally,
and is tumor free.

"These results are evidence

"that a successful
organ-regeneration strategy

has been accomplished."

"And the procedure's
success provides proof

of the viability
of this approach."

To Dr. Macchiarini, who
dared to make the cut.

Cheers.

- To Andemariam Beyene,

who bravely risked
his life for science.

Cheers.

And last but not least,

to The motherfucking "Lancet"

for publishing our
research article.

Cheers!
- Skol, Anders.

- Nathan, tack.

- So published in
"The Lancet"...

you're halfway to a Nobel.

This is shit.

You'd think they would have
sprung for better bubbly.

- Then feel free to
steal someone else's.

- Fantastic.
- Cheers.

- I'm surprised to see you here,

knowing how you feel
about Dr. Macchiarini.

- Well, free champagne
is free champagne...

or whatever this is.
- Of course.

- You must all be on cloud nine.

- I'm excited, of course,

though I also have
the feeling of...

What do you call it?
Impostor's syndrome.

- Why?

You're running
Macchiarini's rat trials.

- Which are still in progress.

Macchiarini included
my name in the byline,

but I have yet to
submit my results.

- Welcome to the world
of scientific publishing.

As I recall someone once saying,

"Competition fuels progress."

- Okay.
- Here we go.

Watch out for the chair.

Yeah, but
I can't watch anything.

Okay.

- Okay, you can open your eyes.
- No.

- You said you wanted
to start playing again.

- We can do a duet.
- Wow.

Yeah, we can do a duet.

This is incredible. Thank you.

Careful with your stitches.
- Aw.

- Love, come here.

Thank you so much.
Wow, this is so cool.

But first, I have to
remember how to play.

- Oh, let me get my phone.
- This is so cool.

Thank you.

- ♪ Knowing I'll be missing ♪

♪ Christmas Eve in my hometown ♪

- Thank you.
- Mm.

- Are you okay?

- Yeah. Christmas, family...

holidays, you know?

- It makes you sad?

- Not really, not this year.

We feel like a family.

- You read my mind.

Lizzi.

- Wait. Hold on.

What... what is going on?
This feels like collusion.

♪ Through dreams and
just pretending ♪

♪ I'm there, and
I'll be spending ♪

♪ Christmas Eve in my hometown ♪

- What do you say, Mom?

- What do you say?

- ♪ In my hometown ♪

- Hey, come in.
- Hello.

- Hi. Please come in.

Look...

Mr. Beyene sent it.

- Oh.

- It's nice, isn't it?
- Yeah.

- I wish our work
always ended like that.

- Yes.

Thank you for
sharing that with me.

- Sometimes it's nice
to be reminded why we...

- Sacrifice.

- So you, too?

- Oh, you know, nothing big...
just girlfriends, children,

probably a few
years off my life.

- Well, maybe we can
build something together

that will make it
all worthwhile.

- I think we can.

- The funding for our
transplant research

is about to run out.

- I'm sure "The Lancet" article
garnered some attention.

- Yes, we can capitalize
on that momentum

to secure a new grant,

which will lead
to more surgeries

and to more money.

- Around and around.

- Until we can expand...

globally.

The goal is six operations
within the next three months.

- You can produce that many
custom tracheas in that time?

- Yes, it can be done.

But we need more patients.

- Then let's find more patients.

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