Ep 73-The Killer Surgeon with a Plastic Windpipe: Paolo Macchiarini (Part 1)

A plastic windpipe. A world-famous surgeon. One of the most prestigious medical institutions on earth. What could possibly go wrong when hope, headlines, and reputation move faster than evidence? We’re in Stockholm at Karolinska University Hospital, where Paolo Macchiarini convinces patients and the public that he has created a “synthetic organ” transplant that can save lives and change medicine forever. 

If you care about medical ethics, patient safety, whistleblower protection, and why “prestige” is not the same as proof, this story will stick with you. Subscribe, share the episode with a friend, and leave a rating or review so more listeners can find the show, then tell us: what red flag should have ended this much sooner?

Resources: 

1. Wikipedia — Paolo Macchiarini. https://en.wikipedia.org/wiki/Paolo_Macchiarini 

2. BBC Magazine — "The Surgeon Who Reinvented Himself" (September 2016). https://www.bbc.com/news/magazine-37311038 

3. Vanity Fair — "The Celebrity Surgeon Who Used Love, Money, and the Pope to Scam an NBC News Producer" (January 2016). https://www.vanityfair.com/news/2016/01/celebrity-surgeon-nbc-news-producer-scam 

4. Karolinska Institute — The Macchiarini Case Timeline. https://news.ki.se/news-archive/the-macchiarini-case-timeline 

5. STAT News — "A Stain Mars Karolinska Institute as It Awards the Nobel in Medicine" (October 2021). https://www.statnews.com/2021/10/04/stain-mars-karolinska-institute-awards-nobel-medicine/ 

6. For Better Science — Macchiarini's Trachea Transplant Patients: The Full List. https://forbetterscience.com/2017/06/16/macchiarinis-trachea-transplant-patients-the-full-list/ 

7. For Better Science — Claudia's Trachea. https://forbetterscience.com/2016/11/02/claudias-trachea/ 

8. For Better Science — Macchiarini's Victim's Family Sues Trachea Makers for Wrongful Death. https://forbetterscience.com/2018/05/09/macchiarinis-victims-family-sues-trachea-makers-for-wrongful-death/ 

9. LeapsMag / KU Leuven — Whistleblower Account (PDF). https://gbiomed.kuleuven.be/english/research/50000698/50489035/attachementsebook2/167-leapsmag.pdf 

10. KU Leuven — Case for Retraction (PDF). https://gbiomed.kuleuven.be/english/research/50000698/50489035/attachementsebook2/170-peter-wilmshurst-2018-case-for-retraction-of.pdf 

11. Science — "Karolinska Institute Vice-Chancellor Resigns in Wake of Macchiarini Scandal." https://www.science.org/content/article/karolinska-institute-vice-chancellor-resigns-wake-macchiarini-scandal 

12. Science — "Top Nobel Prize Administrator Resigns in Wake of Macchiarini Scandal." https://www.science.org/content/article/top-nobel-prize-administrator-resigns-wake-macchiarini-scandal 

13. Science — "Disgraced Surgeon Paolo Macchiarini, Whose Crimes Inspired an Opera, Headed to Prison." https://www.science.org/content/article/disgraced-surgeon-paolo-macchiarini-whose-crimes-inspired-opera-headed-prison 

14. BBC — "Karolinska Institute: Nobel Judges Fired Over Surgeon Scandal" (September 2016). https://www.bbc.com/news/world-europe-37286980 

15. BBC — "Italian Surgeon Found Guilty in Sweden" (June 2022). https://www.bbc.com/news/world-europe-61836856 

16. Reuters — "Italian Surgeon Found Guilty in Sweden Over Patients' Deaths" (June 2023). https://www.reuters.com/world/europe/italian-surgeon-found-guilty-sweden-over-patients-deaths-2023-06-21/ 

17. KSAT — "Swedish Appeals Court Ups Surgeon's Sentence" (June 2023). https://www.ksat.com/news/world/2023/06/21/swedish-appeals-court-ups-surgeons-sentence-for-harm-during-experimental-windpipe-transplants/ 

Transcript

SPEAKER_01 0:52

It's like Tim the Tool Man.

SPEAKER_03 0:54

Oh no. Yeah, that's problematic. Anyway, how are you?

SPEAKER_01 1:01

Hi, Jenna. Hi. Hi, I'm good. How are you? Good, good, good. Y'all just missed it.

SPEAKER_00 1:12

I was just like, Raven, you cannot be nesting at the beginning of this episode because no one wants to hear that. And Jenna doesn't have the time to edit all your scritchy scratchies on my blanket note.

SPEAKER_02 1:26

But this baby was so sad. She had to go hide under the bed.

SPEAKER_03 1:30

And all I could see was her little beady her little beady eyes glinting

Dog Drama And Nail Trim Shock

SPEAKER_03 1:34

in the camera. And she was so sad. She's like, I mean, first of all, I had you all to myself for how many years, six, seven years. And now there's somebody that takes all your time and attention and smells and makes noise, and I can't even nest on your freaking bed.

SPEAKER_00 1:51

Poor right then. She's like, lady, recording night is our time. I can't even nest properly anymore. She did. She threw a big under the bed. I had to coax her out.

SPEAKER_03 2:04

I said, She needs to come onto Jenna's house. I'll let you nest away, baby. Although the beds are super high, but oh, okay.

SPEAKER_00 2:11

Well, yeah, the reason I usually just let her nest away, right? But the reason I made her stop was because she just got a nail trim. And I could hear those little suckers, scritchy scratch, and I'm a comforter, and I didn't want it to snap.

SPEAKER_03 2:29

I get that. And good for you for taking your dog for a pedicure. Like, I can't afford that stuff. I just tell them, listen, let's go on the pavement and scratch your paw a bunch of times.

SPEAKER_00 2:42

Listen. Let me tell you about her little poticure really fast. So I took her to the vet for just an appointment, and I was like, oh hey, we have to get these ratchet nails to take care of. And they were like, Yeah, okay, sounds good. You know, and I was like, okay, do you guys use a Dremel there? It's a new vet, right? And so I've never been there. And I'm like, Do you guys Dremel? And they're like, Well, we do, but you know, it's a it's extra cost. I'm like, oh, okay, no, I've never been there. How much is a nail trim anyway? They're like, well, it starts at $30. What? And I was like, oh, starts. Starts. And they're like, Starts? Okay. I so I I'm listening, okay, and and she goes, That's if your dog is behaving, if your animal's behaving. I I said, Oh, oh. Um she said, if it's a difficult animal, then it's an extra fee. And I was like, incredible. Okay, so how about the how about the Dremel? She was like, Well, that's 55 for one that is behaving. I was like, Girl, your human could get a mani petty for that. Are you kidding me? I'm not kidding. So needless to say, I did not do the Dremel for my sweet, sweet princess. And normally she does get a Dremel, she usually gets her nails done at daycare, but I'm home for the summer, so I had her do it at the vet. And you know what? That might seem to that.

SPEAKER_03 4:17

She's gonna get a Dremel when she goes back to daycare. I oh my god, and imagine, okay, so you have to pay extra for a dog that misbehaves. It's hard to hard to test or treat, right? I just I can't stop thinking about our jobs and the kids that go through like I had a I had a two-year-old today just tear it apart. Like, we used every single toy on the premises, and everything got thrown. You broke two pieces of equipment.

SPEAKER_00 4:48

I was literally picturing kids pulling the boards out of the wall in the booth.

SPEAKER_03 4:53

Yeah, he broke the clip off the one of our pieces of equipment that does admittance annoyes. Yeah, and then he broke the VRA remote and was like, I get it. You you're too, you have feelings like you you don't have enough language to really express it, so I get it. I get how you felt about the whole thing. But imagine I charged extra. I actually have to charge less because I didn't get enough results, like I got one ear but not the other, you know?

SPEAKER_00 5:23

And and then you actually cost us more because the stuff's broken.

SPEAKER_02 5:27

And when you don't have an assistant, you have to clean all the toys.

SPEAKER_01 5:33

Yeah, been there and done that, spent a lot of hours of my life cleaning toys.

SPEAKER_04 5:40

Yep.

SPEAKER_00 5:41

Um, yeah, so sorry, sister. Yeah. In other news, I have squash stuck in my hair from my kid.

SPEAKER_03 5:49

So I thought it was a fancy, like, you know, conditioning treatment or something.

SPEAKER_00 5:56

Nope. It's uh not as bad as uh something about Mary situation, but it is squash.

SPEAKER_03 6:03

Well, thank goodness it's not about Mary situation, but I will say, you know, like there are plenty of cultures that put henna in their hair to to give it that reddish hue. Oh, do you think maybe squash might give you a little nice little little orange highlight going on?

SPEAKER_00 6:20

I think it was a little heavy on the butternut, so I might just be like a golden girl.

SPEAKER_03 6:25

Listen, if you get hungry during the episode, you can just have a little snack.

SPEAKER_01 6:31

Just start sucking on my hair. Oh boy. I look as disheveled as I am advertising, y'all.

SPEAKER_03 6:39

You look like a busy mama and you look gorgeous. Gorgeous, darling, gorgeous.

SPEAKER_00 6:44

Oh, old girl's flags. Okay, so welcome to episode 73. Everybody, happy to have you here. We don't really have a correction section, I don't think, do we?

SPEAKER_03 6:57

I mean, I'm sure I did some stuff wrong, but I didn't hear anything.

SPEAKER_00 7:02

I have something to say, but it's not a correction. But I didn't, I don't know.

SPEAKER_03 7:06

Well, nobody's clamoring loudly. So Allie Cats.

SPEAKER_01 7:10

Well, I might have a I might have an unread message from Rich. I don't know.

unknown 7:14

Listen.

SPEAKER_03 7:15

Rich I have squash in my hair right now. I can't check. Your squeaky wheel, you'll get the attention. Otherwise, you know, don't don't hit. Just let us know. Oh funny. I think we're good.

SPEAKER_00 7:25

I'll uncheck later, Rich. Okay. So, not a correction, but information from a previous episode, I think like two or three ago, where I was like talking about pre-eclampsia and mortality rates. So I did say I was going to look that up, and I did. So globally, the top three causes of maternal death are hemorrhage, pre-eclampsia, and or eclampsia, and sepsis. So isn't that wild? Top three. And preeclampsia claims 70,000 maternal lives and 500,000 fetal lives each year.

SPEAKER_03 8:04

Oh my gosh, that is huge. I know it's the whole world, but seriously, that many babies die every year

Squash Hair And New-Mom Chaos

SPEAKER_03 8:10

still in this day and age.

SPEAKER_00 8:12

Yeah, it's a lot. And of course, in like it's tragic, you know, areas that they don't have quick access to medical care, medical wastelands. Of course, it's happening more there, but it is very severe and scary, and it does still claim, like you said, a lot of lives annually, even in 2026.

SPEAKER_02 8:33

I hope we can do something about that and soon.

SPEAKER_00 8:36

Yeah. I agree. Because also, once you have preocclampsia, I don't remember if we said this in that episode or not, but if you go on to have another child, your likelihood of having it again is increased. That's scary. No.

SPEAKER_03 8:51

I honestly feel like it's a miracle that anyone gets born and survives birth and mothers survive. I mean, it's just such such a crucial time, you know. Imagine 500,000 babies in a room, like in an auditorium or stadium. You wouldn't even be able to fit them in the stadium, and that's how many babies die from pre-glampsia. Why aren't we hearing about this more?

SPEAKER_00 9:15

Yeah, just one thing.

SPEAKER_03 9:16

Why aren't we hearing more about this?

SPEAKER_00 9:19

I don't know. I never really heard about it until I had it.

SPEAKER_03 9:23

How scary. Okay. Maybe future episode, future research topic.

Maternal Death Facts On Preeclampsia

SPEAKER_00 9:30

Yeah. Yeah. Well, uh, no time like the present to hop into sponsor numero numero Uno. Numero Uno. If you've been looking for something to give your skin a little extra love, not squash, you have to hear about products from Love Indus. We've have featured previously their luminosity dewdrops on our show, which are basically like having a facial in a bottle. It is a lightweight serum that deeply hydrates while helping your skin look firmer, smoother, and more radiant. And what makes it so unique are the ingredients, which feature mug of silk from India, known for its strength and longevity, along

Sponsor Break: Love Indus Skincare

SPEAKER_00 10:15

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SPEAKER_03 10:33

I want to hear more about fatigue. How does that differ to the fatigue differ from fatigue?

SPEAKER_01 10:40

It's in the garden by the It does sound like a flower. Yeah, it's in the garden. Oh bless.

SPEAKER_00 10:49

By the fun guy. Okay, but what I actually came here to share about this company is they have a product that I just learned about. It's called Freedom of Expression Line Limiter. And let me tell you, it caught my attention as a new mama because it is designed to smooth the appearance of expression lines, and it is often compared to, and I quote, a Botox alternative in a tube. Mm-hmm. So since I recently had a baby, I am taking a break from all neurotoxin treatments. So sadly, I miss Botox so much. If you're against Botox, sorry, but I love a smooth forehead. Okay. And I also love in the meantime finding skincare options that help me feel like I'm still taking care of my skin. So probably gonna have to get that. Same. Does that sound nice?

SPEAKER_03 11:42

I'm worried you're worried about like baby lines. I'm worried about my frown lines.

SPEAKER_00 11:47

Are you joking? Have you seen my forehead? It looks like people could plant rows of corn.

SPEAKER_03 11:54

Oh, okay. A little hyperbole really can kind of hurt the soul. Stop it. Don't talk about my friend that way. But seriously, you know, if you want to feel good about yourself, you have your little hang-ups like you think you got, even though you don't. Cornrows across your forehead. You might have a little rinky rinky-doo, but not in my hair, but my forehead.

SPEAKER_01 12:16

Boy, I think rose for nose.

SPEAKER_03 12:21

Oh, you okay. Well, but I mean, nobody likes even the faintest of wrinkles, though. This sounds like a good alternative to paralyzing your forehead with Botox.

SPEAKER_01 12:35

L-O-L. I mean, you won't look I had a very qualified ENT provider doing my Botox. Oh man. Was that a little quid pro quote? I take it. You've never had No, I haven't.

SPEAKER_03 12:50

And I'm not against it either. I just want to be able to have expressions.

SPEAKER_00 12:55

Well, okay. If they do it right, you you can still move your face. Did you ever know I had it? No. We'll see. If they do it right, you don't know.

SPEAKER_03 13:07

Well, I need I need the phone number of your person.

SPEAKER_00 13:12

Yeah, she she good.

SPEAKER_01 13:14

Okay, Shannon.

SPEAKER_00 13:15

So sorry.

SPEAKER_01 13:17

This is so off the tone. No, but Shannon. Oh, you're too far away. Okay. Love Indus products work beautifully across all skin types, tones, and ages.

SPEAKER_00 13:33

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SPEAKER_01 13:39

And don't forget to use our promo code stay suspicious at checkout for 21% off your order. Get that smooth forehead girl or guy who uh whatever.

SPEAKER_03 13:49

Listen, I want to try it. Does it work on tech neck like turkey neck? I might try that.

SPEAKER_01 13:54

I don't know, but let me know.

SPEAKER_03 13:57

Apparently you're the expert because you're the one doing the promo.

SPEAKER_01 14:01

Oh, listen.

SPEAKER_03 14:02

Well, I can't. Listeners, this 21% off.

SPEAKER_00 14:05

It's worth trying it on your tech neck if you yeah, and so I did look at the website, right? Because I'm well, I'm not lying. I'm seriously considering getting this. And so I think it's like $88. But after our discount calls, it was like $68. That is, I would say, very good for a Botox in a tube.

SPEAKER_03 14:22

You could take your dog to get her nails done. Sorry, sweetheart. Goodbye. Mama needs a food for it. Who's more important at this juncture, right? Come on. No, this this tired mom with squashing her hair deserves Botox in a tube. You do. Listen, Raven will understand. Yeah.

SPEAKER_01 14:41

Mm-hmm.

SPEAKER_03 14:42

Yeah. If not, she'll hide under the bed. Right? She lets you know. She has her own language. Okay. Not to change the subject, but to change the subject. Can I just say I am so excited about today's topic? And I find this case fascinating. And I'm really, really excited because I know you're gonna bring a little a little you to the story and a little more information because I only know like a handful of things about it.

SPEAKER_00 15:10

Okay. Well, I guess I don't know if we're burying a lead here. Do we know what we're talking about? Paolo Macchiarini. If anybody's heard about him. I guess no time like the present to just get right in. Trigger warnings. Yeah, I didn't do well with that again. I put question mark, question mark, question mark, question mark mark with uh I don't know, killer surgeon.

The Synthetic Trachea Operation Begins

SPEAKER_01 15:34

I'm so numb to them now.

SPEAKER_00 15:39

So I guess if killer surgeons are, you know, a trigger for you, then here we go.

SPEAKER_03 15:48

Okay. If the killer surgeon is a trigger, you probably aren't listening to our podcast to begin with.

SPEAKER_00 15:53

So yeah. You got here by mistake, but welcome. We welcome everybody. And you know what? You wouldn't probably still be here to hear that because it's been 16 minutes of me clamoring about cornrows on my head.

SPEAKER_03 16:07

Listen, this is all very good information so far.

SPEAKER_00 16:11

I just hope that people that are like, holy goodness gracious, me on my please shut up, are like finding that skip 30 button. Because you can hit it, it's fine. Okay. We're in Stockholm, guys. It's June 9th, 2011, and a man lies on an operating table inside one of the most prestigious hospitals on earth. The Karolinska University Hospital, home of the Nobel Prize in Medicine.

SPEAKER_03 16:41

Never heard of it. Where is it? Sorry. I haven't heard of that. Really? Maybe that makes me a bit.

SPEAKER_01 16:49

H have you? Well, I guess like I know until now about it. Sorry, did I just put you on the It's in Sweden. Okay. But I guess Okay, that's all I need to know.

SPEAKER_00 17:01

So anyway, I feel like that's gonna be a correction section. Okay. I'm so sorry. Let's get back to this patient. He's on the table in the operating room. His chest is open. He has a diseased windpipe that has been cut away, and now a surgeon is about to do something no one has ever done before. Dun dun dun. Oh my god.

SPEAKER_03 17:26

That's not good. That's scary.

SPEAKER_00 17:27

The patient's name is Anda Mariam Bayena. Yeah. You guys, I tried to do all of us a favor by putting pronunciation keys after every single name. I'm just stammered at myself that I froze at the first one because I did this to avoid this. Here we are. The patient's name is Andamariam. Nope. Andriam. Bayene. Yeah, you got it. Oh boy. Yeah, this is gonna be great. He's 36 years old and he's a doctoral student in geology at the University of Iceland. He's a husband and a father who's been diagnosed with late-stage tracheal cancer. He has been told that without the surgery, he will die. The surgeon lifts a white, Y-shaped scaffold from a sterile tray that is made of plastic, and it has been seeded with stem cells harvested from his own bone marrow. And according to the surgeon, the world's first fully synthetic organ. It was a windpipe grown in a laboratory, a miracle of regenerative medicine. The surgeon's name is Paolo Macchiarini. He is handsome, multilingual, and breathtakingly confident. Okay, this is by all accounts, not my own accord.

SPEAKER_03 18:59

But I've seen the I've seen the documentary. Oh, I haven't.

SPEAKER_01 19:05

What? Okay, yeah. Oh, yeah. I've only seen like his naughty like mug shoddy naughty picture.

SPEAKER_00 19:14

Okay. Okay. He gives press conferences in five languages. He is published in the Lancet. He has been profiled on the front page of the New York Times and has been whispered about for a Nobel Prize. And he works at the very institution that awards it, the Karolinska University. He has told Bayonet and his family that this plastic scaffold will integrate within his body and that his own cells will then regenerate around it, allowing him to breathe again. Sounds great. But here's what actually happened. The scaffold did not integrate, and it never could. So within months, the plastic began to degrade inside BNA's airway, and his body attacked it as a foreign object, and then the infection set in. So the graft first collapsed, and BNA went under emergency surgery. After emergency surgery, after emergency surgery, just basically interventions to keep the disintegrating plastic from killing him. His left lung was eventually destroyed by chronic infection, and for two and a half years he suffered. And a Moranium BNA died on January 7th, 2014, at only 38 years old. And here's the part that is enough to keep you up at night. BNA was not the first, and he wouldn't be the last. He was only one of 20 patients who received trachea implants from Paolo Macchiarini. 20 patients, and only three of them survived. The others, men, women, and even a two-year-old baby, were told that they were receiving cutting-edge life-saving treatment from a genius surgeon at the world's best hospitals. What they actually received was plastic tubes implanted by a man who had fabricated his credentials, falsified his research data, and never conducted adequate animal trials. A man whose procedures had no scientific basis, and a man whose institutions knew and looked the other way. Isn't that a tale as old as time?

SPEAKER_02 21:24

Unfortunately, yes. Mm-hmm.

SPEAKER_00 21:27

So this is the story of Paolo Machiavini, the miracle maker who wasn't. The surgeon who charmed the world, seduced a television producer with fake papal wedding, and left a trail of bodies across three continents. It's a story about what happens when charisma is mistaken for competence, when prestige is mistaken for proof, and when the institutions built to protect all of us decide instead to protect themselves. Paolo Macchiarini was born on August 22nd, 1958 in Basel, Switzerland, to Italian parents. He grew up between Switzerland and Italy, earning his medical degree from the University of Pisa in 1986, and completed a Master of Surgery there in 1991. He later obtained advanced degrees from the University of Franc Franc Comte. I looked this up, but I forgot the pull design. On paper, his credentials were

The Patient Harm Behind The Headlines

SPEAKER_00 22:38

impeccable, and let me emphasize the on paper part because. Because here is what Paolo understood, perhaps better than anyone in modern medicine, is this in the world of elite academia, credentials are rarely checked. They are merely assured. If you are at the right institution with the right title, given the right press conferences, people will believe you are who you say you are. And Machiarini said that he was extraordinary.

SPEAKER_03 23:11

He was extraordinary at something.

SPEAKER_00 23:14

Uh-huh. Uh-huh.

SPEAKER_03 23:15

Yeah.

SPEAKER_00 23:16

He claimed a two-year fellowship in thoracic surgery at the University of Alabama at Birmingham. The university later confirmed he had completed only a six-month fellowship in hematology and oncology, not actually surgery.

SPEAKER_03 23:30

Vastly different. That's like saying you can speak Mandarin Chinese, but you got like rudimentary Spanish conversational abilities. Yeah.

SPEAKER_00 23:42

Yeah. Yeah. The thoracic surgery department he claimed to have been trained in didn't even exist at the time, actually. He also claimed a master's degree in biostatistics from the same university, and shocker, no record of that was ever found. He listed research positions and affiliations that could never be verified, and he padded that old CV with phantom accomplishments, each one just plausible enough to go unquestioned, and it worked just as planned because nobody questioned them. That is the first lesson of this story. The higher you climb, the less that anyone checks. In Italy, a commission at the University of Florence discovered that Paolo had fabricated credentials when he applied for a full professorship. They blocked his appointment, but the findings were never made public. He simply moved on, and next to Spain, and then to Germany, and finally to Sweden, carrying his false CV with him like a passport. He moved through the great hospitals of Europe, the hospital clinic in Barcelona, the University of Hanover, Great Ormond Street Hospital in London, and at each stop he accumulated prestige. At each stop, he also left behind whispers about inflated results, about corners cut, and about a man who promised more than he delivered. But the whispers never caught up to him because he was, by every count, extraordinarily charismatic. Colleagues described him as magnetic. He was tall, well-dressed, fluent in Italian, French, German, English, and Spanish. He gave press conferences with the ease of a head of state, and he name-dropped shamelessly. Popes, presidents, noble laureates, laureates, excuse me, laureates. He spent lavishly and he radiated the kind of supreme confidence that makes people want to believe. In 2010, the Karolinska Institute in Stockholm came a collin, the institution whose faculty awards the Nobel Prize in Physiology or Medicine, the crown jewel of European medical research. They wanted a star in Paolo with his five languages and his Lancet papers and his promises of a revolution in regenerative medicine was exactly what they were looking for. They hired him as a visiting professor. And they did this despite receiving, according to a later investigation led by former Supreme Court Justice Sten Heckscher, quote, remarkably negative references, including information that he had been blocked from a professorship in Italy, that there were doubts surrounding his research, and that his CV contained falsehoods.

SPEAKER_02 26:26

Wow.

SPEAKER_00 26:28

Just a bouquet of red legs.

SPEAKER_03 26:38

Must have been pretty bad.

SPEAKER_00 26:40

Yeah.

SPEAKER_03 26:40

Yeah.

SPEAKER_00 26:41

Yeah. Uh huh. So they hired him anyway, and at Karolinska, a phenomenon took hold that investigators would later call the bandwagon effect. Regenerative medicine was the most exciting frontier in science. Paolo was its most visible champion. Questioning him felt like opposing progress itself. And so the question stopped and the red flags were filed away. The stage was set for what one former president of the Swedish Medical Association would later call the biggest research scandal Sweden has experienced in modern times.

SPEAKER_03 27:15

Listen, never file those red flags away, people. No matter what the situation.

SPEAKER_00 27:20

Don't file those flags away. Don't do it. Raise them high. So now it's November 2008 and we're in Barcelona, Spain, and Paolo Macchiarini stands before a wall of cameras and announces that he has done something unprecedented. He has transplanted a trachea into a 30-year-old Colombian woman named Claudia Castillo. But not just any trachea, no, no, no. He has taken a donor trachea, stripped it of its cells using a chemical process, reseeded it with Castillo's own stem cells, and implanted it into her body. No anti-rejection drugs needed. A new organ rebuilt from the patient's own biology, and the world went bananas. Obviously. What? Yeah. Incredible. Yeah. The Lancet, which is one of the most prestigious medical journals on the planet, published his results. Headlines declared a new era in medicine, and Paolo was hailed as a visionary. The procedure was called the first successful tissue-engineered trachea transplant, and it seemed to promise a future in which organs could be grown to order, essentially, eliminating

The CV Lies And Star Power

SPEAKER_00 28:38

transplant waiting lists forever. So, like, super promising, super hopeful, super exciting. We are terribly excited by these results, Macchiarini told reporters. Just four days after transplantation, the graft was almost indistinguishable from adjacent normal bronchi. Yeah, however, that wasn't true. What the Lancet paper did not say, what Macchiarini did not tell the cameras, was that the graft actually began collapsing within three weeks. Castillo needed a stent almost immediately to keep her airway open, and over the following year she underwent dozens of additional procedures. And by 2016, her graft had failed entirely and her left lung was removed. The quote unquote revolutionary transplant had cost her a lung. But in 2008, none of this was known. The story that reached the public was the story that Paolo told. It was a miracle. And on the strength of that miracle, he began to dream bigger. What if you didn't need a donor trachea at all? And what if you could build one from scratch, a fully synthetic organ, a plastic scaffold seated with the patient's own stem cells, no donor, no waiting list, no rejection, simply a windpipe made in a lab. The idea itself was revolutionary, and it was also, according to experts in the field, biologically impossible. Pierre Delera, a professor of experimental surgery at Kuleuven in Belgium, who had spent his career studying tracheal replacement, would later call it, quote, one of the biggest lies in medical history, because you are doing something that is impossible from a theoretical point of view, end quote. The trachea is not like a bone in that it does not regenerate. A plastic scaffold cannot become a living airway simply by adding stem cells to it, which makes sense when you put it that way. The blood supply alone, the vascularization problem, had never been solved. But Paolo was not deterred by biology. He was propelled by ambition. In June 2011, Karolinska University Hospital and a Moranium BNA, the surgery that we described at the top of the episode. So Paolo and his team implanted a Y-shaped plastic scaffold manufactured by Harvard Bioscience, a publicly traded medical device company, into BNA's chest. It had been seated with stem cells in a custom bioretractor for just 36 hours. There had been no large animal studies completed, no long-term trials, no ethical board review. The surgery was classified as a compassionate emergency procedure, a vital indication, they called it, even though BNA's cancer, while serious, was not immediately life-threatening. The New York Times put it on the front page with the headline calling it the world's first synthetic organ transplant. Paola was photographed, smiling, looking triumphant, and noble whispers began to grow louder. What the papers didn't report was that within months the scaffold was disintegrating. BNA's body was rejecting the plastic, granulation tissue was growing over it, blocking his airway, and emergency procedures followed as I had mentioned, one after the other after the other, and the left lung was destroyed by chronic infection. The published Lancet papers reported that he had a normal functioning airway, but that was actually a lie. Whistleblower Mateus Karbasho, a cardiac surgeon at Karolinska, would later testify quote, it said he had a normal functioning airway. That wasn't true. They said that the patient was doing fine, and that's not true. One of his lungs was completely obliterated from a chronic infection, end quote. In November 2011, Paolo operated again, and this time on an American patient named Christopher Lyles. In July 2012, he implanted a third synthetic trachea into Ishim Chitir, a young Turkish woman. The pattern repeated each time. Brief publicity, then silence, and then suffering. The machine kept on building, though. The Lancet would publish and the media celebrated. Harvard Biosciences stock price responded to each headline. The grants flowed, and the patients behind closed doors, out of the spotlight, were dying. So let us stop here and do something that Paolo Macchiarini and the media never did, and let us talk about the patients because we find it equally important, if not more important, to highlight what we know about their lives as much as we can and not just chat around about the villain and the story.

SPEAKER_03 33:23

Amen.

SPEAKER_00 33:25

So Mr. Bienne, we've mentioned him a couple times now in the opening and just moments ago, but he was 36, doctoral student in geology at geology, geology at the University of Iceland. And more importantly, he was a husband and a dad. Unfortunately, he was diagnosed with the tracheal cancer. And as we know, he was told by Paolo that the synthetic trachea would save his life. I was very scared, very scared about the operation, he told BBC a month after surgery, but it was live or die. But it was not live or die. The Sveya Court of Appeals would later determine that BNA, quote, could have lived for a not insignificant amount of time, end quote, without the intervention. But Paolo told him otherwise, and Bienna believed the most famous surgeon in the world because why wouldn't he? I would.

SPEAKER_03 34:19

For sure. Yeah.

SPEAKER_00 34:20

After surgery, the plastic scaffold degraded inside his chest and he subsequently suffered the chronic infections, ultimately losing the left lung despite every additional emergency surgery he had. And unfortunately, sadly, he died on January 7th, 2014, at just 38 years old. Christopher Lyles was born in Baltimore in a former Marine. He was diagnosed with tracheal cancer and was told his only hope was Paolo's synthetic trachea. So he did what I'm sure everyone would do if it was within their means. He traveled to Stockholm in November 2011. Unfortunately, the graph failed and he suffered the same cascade of complications: the degradation, infections, airway collapse, and sadly, he died on March 6, 2012, less than four months after the surgery at only 30 years old.

SPEAKER_03 35:14

So young.

SPEAKER_00 35:23

She wasn't dying by any means, and she didn't need the experimental synthetic organ, but Paolo persuaded

The First Trachea Miracle Unravels

SPEAKER_00 35:29

her that this procedure would give her a better quality of life, so she opted to move forward. She received her synthetic trachea in July 2012 at Karolinska. What followed was nearly four years of unimaginable suffering. The graph literally rotted inside of her, and she underwent close to 200 additional surgeries, which included corrective procedures, stent placements, and emergency interventions. All attempts at trying to keep her alive as her body fought the foreign object in her throat. She was in and out of the hospital for years until she sadly passed away in 2017 at only 36 years old. She had been a healthy young woman before she met Paolo Macchiarini. Her family later sued the makers of the synthetic trachea scaffold for wrongful death. Yulia Tulik. Like Ashim, Yulia had a condition that was not life-threatening before she opted for surgery. She did not need to be on the operating table, but Paolo convinced her otherwise. After the transplant, the synthetic trachea began to oout inside of her chest, and the smell was so overpowering that, according to documentary footage that I had read about, people around her shuddered away. She described before she died the experience of her own body decomposing from the inside out. She died from complications of the graft. Just another patient who was not dying until he intervened. Hannah Warren, a two-year-old who was born in South Korea without a trachea, a rare congenital condition called tracheal agenesis. She had spent her entire life in a hospital in Seoul, breathing through a tube. Her parents, understandably desperate, found Paolo, and he told them that he could give their daughter a windpipe, that she would, quote, go from being a virtual prisoner in a hospital bed to running around and playing with her sister and enjoying a normal life, end quote. The surgery was performed at the Children's Hospital of Illinois in Peoria on April 9th, 2013. The FDA had approved it based on Machiarini's published data, the same data that was fabricated, the same successes that were actually failures. Hannah Warren died on July 6, 2013, less than three months after surgery, and she was only two years old. Her parents had been promised a miracle, and all they got was a coffin.

SPEAKER_03 37:59

I can't.

SPEAKER_00 38:01

And these are only the most documented cases. In total, at least 20 patients received tracheal transplants from Paolo with donor tissue. Others were fully synthetic scaffolds, and seven of the eight patients who received tracheas died. So of all the 20 patients, only three are confirmed alive. So that's a big 15% success rate.

SPEAKER_03 38:25

Yeah, basically 15% survived in spite of him trying to kill them, is how I read that.

SPEAKER_00 38:32

Yeah. By emergency measures, I am sure. Yeah. But despite what all of the um data, research data said.

SPEAKER_03 38:43

Well, it doesn't seem like there were any peer review studies like challenging these because, you know, he decided he had something special that only he could do, and nobody else obviously was able to study it.

SPEAKER_00 38:56

And throughout this period of time, he continued to publish papers in the Lancet and other journals reporting successful outcomes. He continued to give press conferences while still accepting grants and awards. The published record said his patients were thriving. The hospital record said that they were dying. And the gap between those two realities is the gap at the center of this crime. In 2013, four doctors, Carl Grenamo, Mateus Corbasho, Thomas Fuchs, and Oscar Simonson at Karolinska began to notice that something was very wrong. They worked at the same hospital where Machiarini was performing his surgeries, and they could see in the hallways, in the patient wards, in the medical records that they had access to, that the published results did not exactly match reality. We saw that patients who received an artificial trachea weren't faring well after the procedure, Grinamo later told Retraction Watch. So we started to investigate if there were animal studies or other data to support that the graphs worked in patients. What they found was devastating. Carbascio began reading Macchiarini's published papers carefully, comparing them against the actual patient records. When I started reading specifically the papers that Paolo himself had written, he later told APC's 2020, then we could quite quickly come to the conclusion that what was written in the papers was not what was going on in reality. End quote. The papers said that the patients were doing well, but as we know now, they were dying. The papers said that the graphs were functioning, but they were actually disintegrating. The papers said that there was a scientific basis for the procedures, but there was none. No adequate animal studies had ever been conducted. Ever, ever, ever, ever. Bo Risberg, a former president of the Swedish Medical Association, would later call the failure to perform preclinical animal tests the worst crime you can commit. Those four doctors compiled their findings into an extraordinary report, and I mean extraordinary, okay? It was over 500 pages of documentation, clinical records, imaging studies, and paper-by-paper analysis of Machiarini's published claims versus the medical reality. They estimated they invested more than 10,000 hours of labor, which I bet, yeah. This was not a casual complaint. This was a prosecution file built by doctors who believed that they had a moral obligation to stop a colleague from killing patients. In the summer of 2014, Grinamo brought the findings to Anders Hampston, the vice-chancellor of Karolinska Institute. I basically forced them to agree to an investigation, Grinamo later recalled. But it was a very tough meeting. The feeling I got was that they wanted to silence everything. Karolinska did commission an external investigation, which I guess is better than an internal, but yeah. They appointed Bengt Yeardin, a professor of surgery at Uppsala University, to examine the allegations. In May 2015, Yeardin delivered his verdict. He surmised that Machiarini was guilty of scientific misconduct in seven seven published papers. The findings described, quote, a systemic misrepresentation of the truth that leads the reader to have a false impression of the success of the technique, end quote.

Patients Suffer While Papers Claim Success

SPEAKER_03 42:21

Amen.

SPEAKER_00 42:22

This should have been the end of him. Hello, again, tale as old as time. A formal finding of scientific misconduct delivered by an independent expert should have triggered his dismissal, the retraction of his papers, and a criminal referral. Vice Chancellor Hamston overruled Eardin, unfortunately. He commissioned a second review, and this time by an internal committee, which reached a different conclusion. No misconduct. Macchiarini was cleared and his contract was extended, which is bananas to me. Bananas. The whistleblowers were told that they were wrong, but it was worse than being told that they were wrong. They were treated as a problem. And here enters the retaliation. I know. Over the next two years, those four doctors who had tried to save lives by telling the truth had their own lives systematically destroyed. Macchiarini filed police reports against them, accusing them of violating patient confidentiality by accessing records that ultimately proved patients were suffering. Regardless of what they had proved or not, they had no reason to be looking at their records. They were subjected to misconduct investigations, and their careers at Karolinska were damaged or derailed. So, like, let's think about that for a second. These four doctors discovered a colleague is implanting plastic tubes into patients based on fabricated data, and then those patients are dying, and you know, that's being published that they are not dying, and it's all a lie. So they spend tens of thousands of hours documenting the truth and bring it to the institution, and then the institution turns on them. Like, ugh, it's just disgusting. In a later letter, the whistleblowers wrote directly to Hamston that read, Prof. Grinimo of the state of the patients operated on at Karolinska and the gross and serial misrepresentation of their clinical outcomes in the articles published by Prof. Machiarini. At this time, it should have immediately been initiated an investigation, but instead, nothing was done. After this first meeting, at least nine attempts on our part were initiated to bring attention to these circumstances. Nine! There were nine attempts, and of all of those nine. Times institution chose silence. The whistleblowers would eventually be vindicated, but the vindication came years too late, at enormous personal costs, and only after forces outside Karolinska forced the truth into the open. The crack that broke Karolinska open did not come from the inside, but actually from television producer and a magazine journalist. In January 2016, two things happened almost simultaneously. Vanity Fair published a devastating article by Adam Sarelski titled The Celebrity Surgeon Who Used Love, Money, and the Pope to scam an NBC news producer, which we would normally get to shortly, but you guys, this is getting really long. So I don't know if we're going to get to that shortly. You might hear about that next week. We'll see. And in Sweden, filmmaker Basa Lindquist aired a three-part documentary on SBT called The Experiments, that with clinical precision laid bare the full scope of Machiarini's scientific fraud. Lindquist had spent years investigating, and he had the patient records, the whistleblower's testimony, and the gap between what Machiarini published and what actually happened. And he put all of it into paper and on Swedish national television. Boo ya. Within weeks of the documentary's broadcast, the carefully constructed wall of institutional protection around Machiarini began to slowly collapse. Yeeha! On February 13th, 2016, Vice Chancellor Anders Hamston, the man who overruled the Yardin report, resigned. In his resignation letter, he wrote, It seems very likely that my decision in this case was wrong. I completely misjudged the surgeon. Yeah. Yeah. Remember your first external review investigation? Yeah. Uh-huh. Shouldn't have done it internal after that. But he was not the last to fall. Urban Lendahl, the Secretary General of the Nobel Assembly, the man who had personally recruited Machiarini to Karolinska, resigned from its Nobel Assembly position. Lendah had been instrumental in bringing Machiarini to Stockholm, and his departure exposed the uncomfortable truth that the Nobel Prize institution itself had been entangled in the scandal. Harriet Wahlberg, the former vice-chancellor who had first approved Machiarini's hiring, despite the negative references uncovered, was removed from her subsequent government appoint as the Chancellor of Swedish universities. In September 2016, Sten Heckscher, a former president of Sweden's Supreme Administrative Court, delivered his independent investigation report, and it was damning. He found that Karolinska had received remarkable negative references about Machiarini before hiring him, including evidence of credential fabrication and blocked appointments in Italy. Wow!

unknown 47:32

Oh my god.

SPEAKER_00 47:33

The institution had hired him anyway because they were dazzled by his star power. And then the Swedish government took the most dramatic step of all. It sacked the entire board of the Karolinska Institute.

SPEAKER_03 47:45

Oh my god. Go for them! Tootaloo.

SPEAKER_00 47:51

Yeah. Not a resignation or a quiet restructuring, just the government fired them. I love it. The man who had once been whispered about for the Nobel Prize had instead triggered the worst institutional crisis in Karolinska history. The institution that decides who receives medicine's highest honor had been unable to recognize a fraud operating under its own roof, or worse, had recognized him and chose to look away. So yeah, guys, I I think I made this one a little long. So if it's okay with everyone, not that you can answer me because we're gonna decide here anyway. We're gonna make this a part two, a two pada.

SPEAKER_03 48:31

This is fascinating. You've done it, you've done a fantastic job. There's so much about this guy. The bloody cheek. I mean, that's that's an understatement of the year. I mean, this guy was a narcissist to the nth degree, and he didn't care who who he took in his bath as a result of his negligence. He just wanted to be seen as something he never was, which was a revolutionary, you know, somebody who was creating and solving something that had never done been done before. I don't understand how he could continue this for so many cases before it got highlighted.

SPEAKER_00 49:08

Well, and then the poor four that tried to bring it to light, the retaliation, I just cannot with retaliation. I cannot.

SPEAKER_03 49:16

No.

SPEAKER_00 49:17

Especially, and we can talk more about this next week, but all of the time and effort that they put forth to comb through the records and to actually compare like real life versus what was put on paper, and then just to get retaliated against after that. No, no point, no.

SPEAKER_03 49:37

But then the same sort of thing happened in the Leppy case, you know? Yeah, those physicians presented concerns and they were brought to the carpet and like you need to learn to get along and the sandbox and penalized and humiliated, and yet the whole time they were bringing up these legitimate concerns. So is it time for sponsor number two?

SPEAKER_00 49:58

Yeah, okay. Well,

Whistleblowers Investigate And Get Punished

SPEAKER_00 50:01

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SPEAKER_03 51:39

Oh needs a little treat.

SPEAKER_00 51:41

Yeah, girl. Head to Mollybee's.com and use our promo code stay suspicious for 10% off your order. And trust us, your future self will thank you. Your taste buds at least.

SPEAKER_03 51:52

Speaking of treats, it's time for our medical mishap. Wow, wow, wow. The subject line of this email is bananas nearly sent me to urgent care. Oh boy. Hi, Jenna, Amanda, and the Whittle baby. It says why, why, why, why, double exclamation point. First of all, congratulations on your sweet little one. I felt compelled to send this in because I have a feeling Amanda, especially Amanda, will appreciate it. I'm also a first-time mom, and I think our babies were born around the same time. Oh, and tiny. If that's true, solidarity, sister. We're all just out here trying to keep tiny humans alive while simultaneously questioning every decision we make. I feel that hard.

SPEAKER_04 52:42

Yep, yep.

SPEAKER_03 52:42

I may not have a newborn baby now, but I remember that feeling when I did have one. So this isn't really a medical mishap that happened to me or a family member. It's more of a parenting mishap. Or or maybe a my anxiety got the best of me mishap. Either way, I hope you both get a laugh out of it because I certainly can now. My daughter had recently been cleared by her pediatrician to start purees. As a first-time mom, I spent way too much time reading parenting blogs, watching videos, and convincing myself that every decision I made was somehow gonna shape her future forever. Ugh, I feel that hard. Yep. You know the advice I'm talking about, like, quote, start with vegetables first, or they'll only ever want fruit, end quote. Quote, don't introduce foods too quickly, end quote. Watch for allergies, do this, don't that. Oh my gosh, whatever. It's enough to make your head spin. Yep. So naturally I played it safe and I started with sweet potatoes. I mean, honestly, it was equal parts fear of trying something new and the fact that sweet potatoes happen to be what I had in the house. After a while, I decided it was time to branch out. I mean, bananas. Bananas seem harmless enough, right? I mashed one up, froze a little for her sore gums. Oh, her little sore gummies. Sorry, that's me. Okay, the writer says, for her sore gums, since she was working on some tiny little teeth, and she absolutely loved it. She devoured every bite, and I walked away feeling light. I completely nailed it. This whole introducing solids thing. But that confidence lasted exactly until the next diaper change. I opened the diaper. Oh no. I opened the diaper. I looked down and I immediately I immediately thought, my child has worms. Okay. Oh no. Well, not maybe worms, not possibly worms, but definitely worms. There were these black, stringy things throughout her diaper that looked exactly like little worms. My heart absolutely dropped into my stomach. Oh my god. Mine would have too.

SPEAKER_04 55:00

Yeah.

SPEAKER_03 55:01

I immediately started mentally retracing. What has she done over the last few days? How could she have gotten worms? She barely leaves the house. We don't have pets. She can't even crawl yet. My brain was doing Olympic level mental gymnastics, trying to figure out how my infant pick up a parasite. So I did whatever the anxious parent does. I took pictures, I sent a frantic message to the patient portal to her pediatrician, and I spent the next 20 minutes convincing myself I was going to be packing a diaper bag for an urgent care visit. I should also mention I have pretty significant medical anxieties. So while I was waiting for a response, I'd already progressed into imagining stool samples, medications, and explaining to my husband how our baby ended up with intestinal worms before she'd even had her first birthday. The message simply said, Well, bananas commonly leave behind little black fibers that look remarkably similar to worms in a baby's diaper. It's completely normal. Nothing to worry about. Well, I wasn't going to accept that. So naturally I Googled it immediately and discovered that, quote, banana poop looks like worms, quote, is apparently such a common panic that there's countless articles and forum posts about it. Evidently, I joined a very large club of first-time parents who experienced the exact same moment of sheer terror. So, to any other new parents listening who are about to introduce bananas, let me save you a mild cardiac event. If you see little black worm-looking streaks in your baby's diaper after bananas, don't panic. They're almost certainly just banana fibers doing what banana fibers be doing. I hope this saves another sleep-deprived ferret from spiraling the way that I did. Stay cool, Alley Cats. Betsy.

SPEAKER_00 57:04

Betsy, thank you for saving me from the banana scares.

SPEAKER_01 57:09

Because we have not introduced bananas because I read the same thing. Don't do fruit or all the wanted fruit.

SPEAKER_00 57:18

Okay, he's had like he had this had like apple in like a like there's these pouches, right? It was like pork and apple with

Documentary Exposes The Institution

SPEAKER_00 57:25

mini beans and whatever. So like he, I guess he's having that, but yeah. Yeah. Betsy, thank you. And now that I'm like thinking about it, I can totally picture the little squeals you're talking about. Because when you make banana bread, it has those little like squeaks in it.

SPEAKER_03 57:39

Yeah, those little black is that where the seeds are though, right? I have no idea. The banana seeds are black inside, they're tiny little things inside the core of the banana. But they when you slice it. Yeah. Because when you slice it, yeah, because they're connected together in like this little minuscule little gel. Yeah. Anyway, I will say, listen, you guys have a you new moms now. I sound like an old lady, but you knew moms now have such a quagma of scrutiny and judgment and rules going on that I never had to deal with. So I can only imagine the panic. Y'all are good moms. Listen, have confidence in yourself. A little fresh banana, never hurt anybody. And you know what? So what if your poop is stringy? Go for it. I didn't know what else to say, but listen, this is informative.

unknown 58:41

Yeah.

SPEAKER_03 58:42

I don't think I scrutinize my kids' poop that much. So I think that happens with a lot of detailed judgment on social media. So yeah, I you guys, I I don't envy you the amount of stress that that brings to light, but I feel like my mom's like my parents' generation also were glad they didn't have the scrutiny because it was like, oh, smoking, drinking, who cares? Like that doesn't affect the city. Well, they were told to do that. Exactly. It'll relax you, it'll be better for the baby. So you'd be a better mom if you relax. Right. Go pop a eater.

SPEAKER_00 59:19

The advice has changed. Oh man. Wait. Well, you know, normally I would ask you here what should we expect next week, but I guess I outdid myself with this one. I hope it's gonna be long enough for next week.

SPEAKER_03 59:33

You will, because I've got some other insight for you that you might want to look into. I think it will be. I think it's gonna be great. But meanwhile, I'm not I think I know it's gonna be great. I didn't mean to sound like I think and I'm not sure. It's gonna be awesome. Yeah, because this guy is a topic in and to himself. He could have a whole series. Anyway, don't miss, don't me, don't meet or don't miss a beat. Subscribe or follow Doctoring the Truth wherever you enjoy your podcast for stories that shock, intrigue, and educate. Trust, after all, is a delicate thing. You can text us directly on our website at doctoringtruth at buzzsprout.com or email us your story ideas and comments at Doctoringthe Truth at Gmail. Be sure to follow us on Instagram at Doctoring the Truth Podcast and on Facebook at Doctoring the Truth. We're on TikTok at Doctoring the Truth and ed oddpod e-d-a-ud. Don't forget to download, rate, and review so we can be sure to bring you more content next week. And until then, stay safe

Sponsor Break: Molly Bee’s Cookies

SPEAKER_03 1:00:37

and stay suspicious. Bye.

SPEAKER_00 1:00:52

Bye.