Original subtitles

[dramatic music plays]

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 tumour

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 theatre,

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 enamoured 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 specialised 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 realised

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 tumour 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 Magazine or,

you know, Vanity Fair or 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 realise

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 behaviour 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 tumour in the first patient.

Paolo described that the tumour

was a golf ball size and unresectable.

But when we actually looked at the medical files,

the tumour 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 realising

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 realised.

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 instil 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 Times came 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 realise

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 Fair article 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 defence

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 behaviour?

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]

♪