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Bad Surgeon's Benita Alexander Talks Being 'Brainwashed' by Dr. Paolo Macchiarini

The journalist explains why she ignored the "red flags" in their relationship and the outrageous lie she still "can't wrap her head around."
  • Paolo Macchiarini and Benita Alexander (Photo: Netflix)
    Paolo Macchiarini and Benita Alexander (Photo: Netflix)

    Former NBC News producer Benita Alexander made a career out of trusting her gut, but when she met Dr. Paolo Macchiarini, a thoracic surgeon considered a pioneer in the field of regenerative medicine, her instincts went out the window.

    What started as a flirtation between a producer and her interview subject quickly blossomed into something more, and despite the ethical concerns about their relationship and Macchiarini's suspicious behavior, Alexander found herself falling in love with the "super-surgeon" who claimed to have developed a groundbreaking synthetic-trachea procedure. Caught up in their fairy-tale romance, Alexander failed to recognize that Macchiarini, who proposed in December 2013, was a fraud in nearly every sense of the word: Not only did he have a secret family in Barcelona, but he misrepresented his research and failed to properly test his plastic tracheas, resulting in the deaths of seven patients.

    Alexander's story serves as the centerpiece of Netflix's Bad Surgeon: Love Under the Knife, a new docuseries about Macchiarini's years-long con premiering Wednesday, November 29. Directed by Ben Steele, the three-part series combines in-depth interviews with Alexander, Macchiarini's colleagues at the Karolinska Institutet who blew the whistle on his alleged research fraud, and the team of Swedish investigative journalists who uncovered evidence that Macchiarini knowingly transplanted a faulty airway into a patient (she died two years later).

    Together, they paint a damning portrait of a man who used his charm to cut corners, and a medical institution that prioritized the prestige and money that Macchiarini's procedure could generate over the health of their patients.

    Though reports of Macchiarini's medical malpractice first surfaced in November 2014, when Alexander and Macchiarini were still engaged, Alexander stuck by him until she discovered that their "fantasy wedding" — which Macchiarini claimed would be officiated by Pope Francis and attended by the Clintons and Obamas — was a lie. "My whole life was upended," she tells Primetimer. "It's honestly almost debilitating. On top of everything else and the betrayal, you're just wracked with shame and guilt."

    In a lengthy interview, Alexander explains why she was "brainwashed" into ignoring her journalistic instincts, reveals which of Macchiarini's many lies she found the most "absurd," and opens up about the "nerve-wracking" experience of watching her story play out in Dr. Death Season 2.

    You describe feeling a "spark" with Paolo during your first research meeting for NBC News special A Leap of Faith. What was it about him that drew you in so quickly?

    He's one of these people that walks into a room and kind of commands the room. He's got a very — at least he had — a very commanding presence. He's charming, he's intelligent, he's worldly, he dresses in these expensive Italian suits. He's got an air about him. Add to the fact that he was intriguing by sheer virtue of what he was doing. He was a medical pioneer; he was a rebel taking risks that nobody else in the world was willing to take, and seemed to be, at the time, devoted to giving hope to people who had no other hope. So, I think there was this whole sort of aura about him, and there's a reason he was called the "super-surgeon" and the "miracle man."

    So, I was intrigued before I even met him. But not intrigued in any kind of romantic way — he's just an intriguing person. But the second we met, and I talk about it in the Netflix special, there was just something that happened. He's very flirtatious with everybody, men and women. Our eyes locked when he came around the corner, and he gave me this flirtatious smile.

    I felt like a silly, giddy schoolgirl. I felt utterly stupid. In my head I was like, "What the hell was that?" and "Whatever the hell that was, just let it go." Not that I'd really felt that before, but I dismissed it as almost like a celebrity crush. I was enamored with him. At the time, I didn't think anything more of it than that.

    Do you think you would've had that same reaction to him if you met him in a more casual setting, without knowing of his reputation in the medical field?

    That's hard to answer. I just think his reputation preceded him. Obviously, I had read a lot about him, I had watched interviews with him. We were all intrigued by him, and people were joking in the office that he's a George Clooney lookalike. He just has that thing, that appeal. So how much that impacted how I reacted, I'm not really sure — I just know that he was interesting and intriguing.

    You explain that you ignored early warning signs in your relationship, including Paolo's many cell phones and his evasiveness, but did you uncover any red flags about his artificial tracheas or his medical background while working on the documentary?

    No. You have to remember, at the time, although the whistleblowers were quietly working in Sweden, they were quiet. Nobody knew what they were doing yet; they hadn't gone public. As far as the world knew, Paolo was doing these experimental, groundbreaking procedures. Yes, some of his patients had died, but he always explained that the way he still explains it: by dismissing it in a quite cavalier way, really, by saying that when you're doing something experimental, patients will die. It happened with the first lung transplants, heart transplants, et cetera.

    That's true, actually, and we need people in medicine who are willing to push barriers and take chances, otherwise we'll never move medicine forward, right? But the huge difference is the fact that you're supposed to stop once you realize it's not working. You don't misrepresent the results to the public and have press conferences saying the patient is doing glowingly well, and you sure as hell don't use people as human guinea pigs and skip all the preliminary steps and not do all the research and everything.

    But at the time, we didn't know that. I didn't know that. When I found out that he was lying to me at such an extreme, egregious, almost incomprehensible level, I was obviously devastated and heartbroken — my whole life was upended. I was embarrassed, I felt ashamed, I felt guilty. We had all these guests coming to this fantasy wedding that were all on this train with me because they were following me: I believed it, so they believed it. It's honestly almost debilitating. On top of everything else and the betrayal, you're just wracked with shame and guilt.

    But my immediate thought — and it was after I found the other family and the house in Barcelona, which was sort of the last piece of the puzzle for me — and my immediate thought was, "Oh my god. If he's lying to me like this, there's just no way he's not lying in his medical and professional arena." I had no direct evidence of that, but I was terrified. He's called the "super-surgeon." This is a man who has people's lives in his hands. And that's why I decided to go public. It wasn't about revenge; it wasn't out of spite; it wasn't even about telling my story. I just felt an urgency to go public.

    And I thought at the time, because I didn't know about the whistleblowers, that I might be the only person who had the information to expose him, and I wanted to put it out there and just tell the world, "Look, this guy is not who you think he is." And then of course, once I went public, almost immediately all the information came out in Sweden and tragically, my worst fears were true. It was the double-whammy of the personal and medical lies that just brought the house of cards tumbling down.

    That's something the docuseries does very well — convey the idea that there were puzzle pieces people all over the world were putting together: you in the U.S., the Swedish journalists, his colleagues in Sweden. It's surprising that no one realized, "There's more going on beyond what I can see in this particular moment."

    I think it's important to remember though, and I talk about it in my case, my story, but it's what happened to everybody. The reason he was able to pull the wool over so many people's eyes — not just mine, but respected, famous doctors, surgeons, institutions, people who were giving him money, giving him grants — is he's an extraordinarily skilled liar. He lulls you in very slowly, and he's extremely adept at squashing any doubts that you have. He's rapid-fire with his responses. He is so good at it, and this is what a clever, compulsive, pathological liar does. It becomes like gaslighting because you start to doubt yourself.

    I also think what happened, less in my story but with the medical people, is here you have this famous doctor who's bringing all kinds of money into Karolinska, the place that awards the Nobel Prize in Medicine, and there are grants attached to him; they're talking about building a whole facility around him. This is a big deal. And I think when there were first inklings that something might be wrong — which is why the whistleblowers were attacked — it was a whole lot easier, as big institutions unfortunately often do, to try and sweep it under the rug. It was a very, very inconvenient truth, and I don't think people wanted to deal with it.

    After the New York Times published allegations of Paolo's scientific misconduct in November 2014, you "jumped in the trenches to help him" because at the time, you "believed that he was being unfairly maligned." Did any journalistic alarm bells go off when you read the report?

    Yes. We had fights about it, and I grilled him. I asked him so many questions, and I'd never seen him like that — he got very angry with me because he couldn't come back at me so quickly with the answers. And then I was helping him write emails because– at the time, it was just allegations of scientific misconduct, but we're not talking about criminal allegations yet. To this day his argument is that he was being unfairly maligned and attacked and that people are jealous and always try to take pioneers down.

    But when I got into the nitty-gritty with him and started writing emails, there were things that weren't making sense to me, and we did argue about it. That was the beginning — because it was the last six months or so [of the relationship] — where little red flags were starting to really nag at me and eat at me. They weren't over though. They weren't big enough for me to go, "Oh my god, he's a con man" or "Oh my god, he's lying to me."

    Somebody wasn't waving a giant warning flag, but there were definitely things, both medically and personally, that were starting to eat at me. Which is why when that simple email came [about the Pope being unable to officiate their wedding], I just knew. The lightbulb went off and all these little flags that I'd been trying to suppress, actually, [became clear.]

    Why do you think you ignored those instincts for a couple of months?

    It's very hard to understand what happens in a situation like this. I remember doing stories about cult members and thinking, "How does somebody get people to believe this stuff?" But I can actually understand now because it is a kind of brainwashing, and there's gaslighting, and there's kind of a fog. You feel almost a little bit confused. You start to doubt yourself — I think that's the important thing, and that's where the gaslighting is so powerful. I had always, always trusted my gut implicitly, but now I'm kind of doubting myself, and I'm in love with the man, right? So it's complicated. There's a reason they have that saying that love is blind because it is, a little bit.

    And so much was at stake: I was giving up everything. I thought I was riding off into the sunset with him to Barcelona. Sure, there was a part of me that didn't want it to be true. I don't think that was the predominant reason; I think it was more that he had an answer for everything.

    Many of his colleagues speak about his "god complex" as a surgeon. Was that something you also saw throughout your relationship?

    I saw it, yeah. He could be extremely arrogant, and off-puttingly so. But I think everybody, my friends included, just kind of dismissed that as, "He's a super-surgeon. He's this world-renowned surgeon and works at the place that gives the Nobel Prize in Medicine." In hindsight, a lot of little things started to flash back to me. Just the way he treated people sometimes– people in restaurants, wait staff, people like that. He definitely thought he was better than everybody else.

    And of course, in his comments, when I did start to really grill him, he's just adamant that he did nothing wrong. He just can't even see it. He either can't see it or simply doesn't care — I believe it's probably the latter. And he's reckless. So, yeah. I 100% think he has a god complex.

    One of the Swedish journalists who investigated the medical malpractice condemns the "orchestrated media campaign" to prop up Paolo as a "super-surgeon." Do you feel any responsibility for furthering his con via the NBC documentary?

    Look, I wish we'd known then, but the unfortunate truth is that we didn't. We did our due diligence — it wasn't a completely glowing documentary, either. We talked about the problems; we had somebody in there that was criticizing him; we were open about that. I wish we had known the appalling, horrifying extent of it, but we just didn't at the time. When that thing aired, it wasn't public yet. The whistleblowers and Bo [Bosse Lindquist], the Swedish documentary producer, and I were all working in parallel, but none of us knew about each other. If there had been a way for us to share information, this could have been exposed a lot faster. Yeah, I wish that had happened.

    Looking back, which of the many lies Paolo told you now scans as the least credible?

    [Laughs] I mean, the whole thing's absurd, right? You make up a fantasy wedding that you know the entire time is never going to happen. You allow people to book plane tickets and hotels and you allow me to buy wedding dresses and send out invitations. You sit at dinners with 20 people and talk about this castle that you've rented out for them. These detailed texts that he would send me, hundreds and hundreds of them, thousands of them, going into minute detail about the food we were having and meetings he had at the Vatican or with the Swiss Guard. I mean, he's living in some sort of twisted fantasy world. To this day, I can't wrap my head around it.

    So, that part is just appalling. And then there are things, of course, like when he told me he was a sniper, that was just laughably ridiculous. And I actually thought, "He's nuts. He's completely nuts." I didn't believe him for a second. I don't even know why he said that — I don't know why he thought I would believe him. I don't know what he was doing when he did that.

    But the thing that bothers me the most to this day is my daughter. My daughter just lost her father to brain cancer. She was a vulnerable little girl. And you sit in front of this little girl and you talk to her about the house she's going to live in in Barcelona, and the life she's going to have in Barcelona, and the school you've enrolled her in in Barcelona. That's just unforgivable. That still infuriates me. It's one thing to do it to me, but to do it to a child? It's sick.

    You participated in the Dr. Death podcast season about Paolo's con, but have you been involved in Peacock's scripted series that's premiering in a few weeks?

    I am not involved in that. I was not consulted about that, no.

    How do you feel about seeing your story play out in a more dramatized manner?

    I'm sort of waiting with bated breath to see what they get right and what they get wrong. That's the difficult part about a fictionalized series, right? They can take creative liberties, and that becomes more complicated because they're using my real name. I don't know how they're portraying it; I don't know what they got right and what they got wrong. And that's nerve-wracking.

    But I've told my story plenty of times. I'm public enough that if you want to find out the truth– I hope there's nothing egregiously wrong or misrepresented. It sounds like they've been very meticulous about it and they're taking a deep dive into the medical lies. It's good. It's more exposure. All of it is good. This story needs to be public.

    Paolo was recently sentenced to 30 months in prison in Sweden. In your mind, is that sentence sufficient? And on a greater level, what does justice look like in a case that also implicates a medical system that's hungry for profit?

    A lot of people ask me, "Why so little time?" Unfortunately, this was a complicated case. Sweden worked very, very hard to get these charges to stick. They first tried to try him back in 2017 and they dropped the charges. It's complicated because this was a groundbreaking procedure — how do you prove that he intentionally killed somebody? And then a very tenacious second prosecutor, because Sweden was so furious, came along and said, "No, we're going to do this again." And I was very happy about that.

    One of the reasons that I've continued to talk about this so relentlessly is because there has been no justice. He's been walking around all this time with absolutely no accountability, claiming he did nothing wrong, claiming all he did was want to help his patients. He has not had to face responsibility for what he's done. His feet have not been held to the fire. So this is some semblance of justice for his patients and their families, and there is some satisfaction in that. They deserve that. This is not about me — this is about his patients and the fact that you played with people's lives. You used people as human guinea pigs. And there cannot be no consequences for that.

    I do think, institutionally, places need to take a hard look at themselves. The parallels are very similar. He kind of sauntered in and nobody really checked his CV or did background checks on him because he walks the walk and talks the talk, and everybody just believed him. This is why people like him are so dangerous. They're so cunning and manipulative. They have an agenda from Day 1. You've got to have checks and balances. You can never cut corners. You've got to check everything, and you can't believe something just because somebody says it's true.

    This interview has been edited for clarity and length.

    Claire Spellberg Lustig is the Senior Editor at Primetimer and a scholar of The View. Follow her on Twitter at @c_spellberg.

    TOPICS: Bad Surgeon: Love Under the Knife, Netflix, Benita Alexander, Paolo Macchiarini