Inside Mandy Moore and Edgar Ramírez’s Dangerous Romance in Dr. Death
The two Emmy-nominated actors take us inside Peacock’s harrowing tale of medical malpractice—and the twisted love affair at its center.
BY DAVID CANFIELD
NOVEMBER 15, 2023
For a few days while filming Dr. Death’s second season, Edgar Ramírez showed up to set visibly emotional. Production had reached the scenes in which Hannah Warren, a two-year-old girl born without a windpipe and nearing death, prepares to receive a synthetic-trachea transplant performed by Ramírez’s Dr. Paolo Macchiarini. A thoracic surgeon developing what the medical world began hyping as a groundbreaking procedure, Dr. Macchiarini was not, in truth, a miracle worker. His procedure worked off research that would later lead to a disgraced reputation and a conviction for gross assault against three of his patients. (He was sentenced to more than two years in prison.) His work proved the exact opposite of lifesaving.
“Edgar came onto set those days really upset, inhabiting a character that he knew had a life in his hands,” says showrunner Ashley Michel Hoban. Ramírez remembers that period too: “That was hard. It was hard to imagine that someone would go that far.”
Based on the Wondery podcast, the anthologized Dr. Death broke out as a critical hit in 2021 with the story of neurosurgeon Christopher Duntsch (Joshua Jackson). Both seasons of the series confront that gruesome question head-on: How can a doctor so dangerously deceive their own patients, and how can the medical system surrounding them let them get away with it? The first season, overseen by series creator Patrick Macmanus (who remains an EP on season two), introduced that question on a more intimate scale. The second, premiering on Peacock on December 21, thrillingly expands the inquiry, examining Dr. Macchiarini’s rise within the global medical world. We meet him in Stockholm circa 2011, where he’s a visiting professor at the Karolinska Institute; his first procedure in the show is completed in Illinois. He’s depicted less as a “mustache-twisty villain,” as Hoban puts it, and more as a nuanced antihero.
This comes through chiefly in the season’s unexpected anchor, the troubled new romance between Dr. Macchiarini and broadcast journalist Benita Alexander (Mandy Moore), which was previously documented in a 2016 Vanity Fair feature. Portrayed on the series as a divorced single mother thriving in her producing post at NBC, Alexander begins work on a story about Dr. Macchiarini and specifically his impending operation on Hannah Warren. In Ramírez’s canny portrayal, the doctor says all the right things and charms his way into the reporter’s heart, convincing her to break ethical codes and launch into an affair. The relationship’s undercurrents, of course, are darker than she could have imagined, and the series finds riveting momentum as she becomes determined to figure the man out—and realizes she’s being conned.
“The miracle—this is where we start off: This guy is doing things that no one else can do,” Hoban says. “Why wouldn’t you want that to be true?”
If Mandy Moore reintroduced herself as an actor with her devastating, Emmy-nominated turn in This Is Us, then she again charts new territory in Dr. Death, which marks her first onscreen role since saying goodbye to Rebecca Pearson. “This was just such a departure and a step in a different direction for me,” she says. She had a one-month-old baby when the offer came her way, and was told production needed to get going fast. “I remember thinking, I don’t know. I literally have a newborn, probably not going to be the thing to move my whole family to New York,” she says. “And of course I read the first two scripts and immediately was like, Yes, I have to do this.”
“She has this natural warmth, and there’s a trust to her and a vulnerability to her,” Hoban says of Moore. “[What’s new] is this sharp wit and cleverness to her, this cunning as she’s unraveling this mystery of this guy that she’s fallen in love with.”
Complicity is a major theme in this season, even as it extends to Dr. Macchiarini’s new medical peers in Stockholm, played by the likes of Luke Kirby, Ashley Madekwe, and Gustaf Hammarsten. “My personal goal from the first season [to the second] was to make it better, to make it bigger, to make it louder,” Macmanus says. “In our telling of this story, these people were a little bit more complicit in what was going on—and I think there’s a humanistic side to this story that is far more compelling, in my opinion, even than season one.” The season captures the thrill of discovery around Dr. Macchiarini’s supposed innovation, a kind of stem cell therapy that, he claims, eliminates the need for organ donors. “We’ve got these three doctors that were, just as Bonita was, sucked into Paolo’s orbit, and were excited by the future of this medicine,” Hoban says. “Altruistically, they were excited about what this could do for their patients.”
That so much could go wrong—patients dying, allegations of research misconduct—is a testament, perhaps, to Dr. Macchiarini’s powers of persuasion. His charm, masking a disturbing truth, is calibrated masterfully by Ramírez in a tricky performance that remains restrained and calculated throughout. “If the Wicked Witch knew that she was the Wicked Witch, she would never be the Wicked Witch—meaning that the challenge was more than portraying a lie,” the actor says. “I tried to portray a fantasy. I think that a lot of what he’d come up with were fantasies, that he strongly believed—to a pathological point—in the stories that he was telling.” Ramírez looked to films of the genre from the ’70s and ’80s, and stayed away from the convention of the “reveal”— the villain showing his cards once he gets found out. “He never admitted that he did anything wrong, so there is no shift,” he says. “He’s committed to his fantasy until the very end.”
Ramírez took the contents of Dr. Death personally. He’s had a heart condition since he was a kid; his mother has one too, as did his grandmother, he says. He’s experienced spending days at the hospital and knows how important it is to trust the professionals taking care of you. Add in the fact that, ever since his tour de force turn as the Venezuelan militant Carlos the Jackal in Olivier Assayas’s 2010 miniseries, he’s been on his own journey as an actor to avoid roles as unsettling as this one. “This is the darkest I’ve played ever since,” he says. “A lot of people offered me characters orbiting in that world, and I couldn’t. I’m very emotional in the way I choose my adventures, and I couldn’t go there.”
Accordingly, he knew what he needed to give to Dr. Macchiarini. He connected with one of the disgraced doctor’s surviving patients, who provided access to correspondence and other details that helped him unlock the man’s public persona. After that and some initial research, he put all the information away. “If you know so much, you just start judging the character,” he says. “It’s hard to portray it in a way that should be organic and fair to the objectives of the story.” This task extended to Moore as well, as she dug deep into the skin of a smart, headstrong woman who was manipulated and fooled—but never broken. “Making sure that she didn’t feel like too much of a victim, that people could really see themselves in her and understand how she got caught up in this whirlwind of what Paolo offered to her—that was the most challenging part,” she says. “I didn’t want this to feel so far-fetched.”
This is the goal of Dr. Death as a whole—communicating the idea that it could happen to you. In this iteration, Alexander acts as a compelling, complex audience surrogate, with the urgent message going hand in hand with the rich character arc. Hoban, who started as Macmanus’s assistant and wrote on several of his series (including the debut season of Dr. Death), steps into the showrunning role for the first time here. “No one can understand what the role of showrunner is like until they do it,” Macmanus says. “I had lunch with one of [Hoban’s] writers yesterday, and they said that they’d been in the business for seven years, and they had never been a part of an experience that was as fulfilling and as kind as the experience that they had under her leadership.”
For her part, Hoban stays focused on the mission of the show. “Even in places with what is supposed to be the greatest social health care system in the world, these things can still happen, and people can find loopholes and take advantage of them,” she says. “And then the question is, when we see that maybe something isn’t as good as we thought it was, how do we stand up?” The answer, of course, is anything but straightforward—and makes for damn good drama.