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[Jenelle Centeno]

It was my first day on the complex care service during my clerkship. Not long after introducing myself to the team, I was assigned my first patient. She was in the hospital for the third time that summer with clots in her lungs. I nodded and took notes as she described how doctors had been unsuccessful in identifying a cause of her clots. Then she paused, laughed, and said, "They should put me on one of those medical mystery shows." The intern pursed her lips and replied, "We're doing all the same things here."

At first blush, the show has an extremely effective way of depicting various diseases; as a third-year medical student, I only wish that my preclinical curriculum had more of those 3D models... Sanders is often able to describe complex biological processes in accessible language while combatting things like the misinformation and stigma surrounding functional neurological disorders. As a medical student watching the show, Diagnosis reminds me how important it is to explain and normalize medical conditions in a way that is effective for those who are not in the medical field.

Where Diagnosis becomes problematic, however, is in its portrayal of the inner workings of the medical system. The show claims to garner suggestions from a global audience to arrive at a more accurate diagnosis. By presenting itself as an opportunity for patients with chronic medical conditions to receive a new diagnosis that previous doctors did not suggest, Diagnosis implicitly conveys an image of medical practitioners as incompetent. And yet, according to my research, most cases ultimately arrive at a diagnosis that had been suggested by previous providers (Figure).

Furthermore, by operating under the premise that patients with previously undiagnosed conditions can receive a new diagnosis that might enable treatment, the show may also offer false hope to viewers with incurable medical conditions.

Diagnosis also focuses on a limited range of conditions. Human behavior, function, and consciousness are naturally interesting topics. However, the systems that underlie such conditions are also among the least understood and most limited in treatment options. Diagnosis episodes gravitate towards these less-understood conditions. In focusing on these, the program depicts an image that does not represent what the medical field is typically capable of and neglects the progress that has been made in treating conditions that were previously not understood, undiagnosable, or untreatable.

The major potential harm of Diagnosis is in instilling distrust in the healthcare system. Even as a medical student, I have already seen multiple cases in which a patient's care was limited by skepticism toward or lack of trust in medicine and medical practitioners. By overlooking prior workups and focusing on cases that are difficult to characterize given the limits of medical knowledge, Diagnosis inherently supports misconceptions of healthcare providers as untrustworthy or potentially lacking in knowledge; this may have broader detrimental effects.

With rising distrust of the medical system, patients have become less likely to seek medical care, adhere to care plans or heed medical advice, and participate in health maintenance interventions such as vaccinations. Fortunately, the show has the opportunity to address these potential pitfalls in future seasons by doing the following:

Dedicate more time to outlining the previous diagnostic workup, including what tests had been done in the past, why those tests were conducted, and how the results were interpreted. This way, the conclusions of those providers could be better justified, rather than portraying them as poor or inattentive diagnosticians.

Involve consulting providers more in the show so that they can communicate their thought processes. Although the audience may not immediately understand the content of these discussions, witnessing the degree of knowledge and training involved in the traditional diagnostic process could instill a greater appreciation for and trust in medical providers.

Diagnosis appears to have established itself as a hit among viewers, but given the impact that the media can have on the public's perception of medicine and the relationships that patients have with their own personal providers, the show may be harmful overall. With a greater emphasis on the diagnostic process and the mechanics of medicine, Diagnosis has an opportunity to simultaneously engage viewers in the medical process while also promoting a positive image of medicine that facilitates more productive conversation between patients and their providers.

Ramie Fathy is a third-year medical student and curriculum representative at the Perelman School of Medicine at the University of Pennsylvania. He is interested in the interaction between medicine, the media, and the public. The opinions expressed in this perspective are his own.

When Bad Surgeon: Love Under the Knife debuted on Netflix at the end of November, it quickly catapulted into the streaming service's Top 10 series. That shouldn't surprise anyone who caught the sordid, three-part docuseries about Dr. Paolo Macchiarini.

Bad Surgeon has it all: a sweeping romance, a wild con, and a true crime story with a subject whose charisma fooled some of the world's brightest surgeons. Told through the perspective of Benita Alexander, a former NBC news producer who covered and then fell in love with the man, there are plenty of jaw-dropping twists.

So, is it any wonder that Bad Surgeon is just the beginning of new projects devoted to this surreal story? Read on to learn more about the trending docuseries and where you can watch similar projects, including a new TV drama starring Mandy Moore.

Dr. Paolo Macchiarini is a 65-year-old Italian thoracic surgeon and regenerative medicine researcher who shot to fame for his reported lifesaving research with synthetic windpipe implants. He created polymer windpipes and soaked them in a solution of a patient's own stem cells before transplanting them.

He also speaks six languages and has claimed to be the doctor of famous public figures such as the Pope, Barack Obama, and Bill and Hillary Clinton. For years, he worked at the Karolinska Institute in Sweden, whose professors select the Nobel prize winner in physiology or medicine.

While the doctor's methods were reported as groundbreaking in 2011, they were eventually revealed to be completely unfounded. Macchiarini had never properly tested the trachea implants and was accused of fudging the research. Some claimed he used humans as Guinea pigs.

Macchiarini performed eight such transplants between 2011 and 2014. Seven of the people he performed surgeries on died shortly after receiving their transplants, including a two-year-old girl and a single father.

A woman named Yesim Cetir initially survived her transplant but had to undergo 191 surgeries, including one to remove the plastic tube. She also experienced two strokes and had to have her throat cleared every four to six hours. Eventually, in 2017, she also died.

In addition to all of the horrifying medical things that Macchiarini was accused of, Bad Surgeon peels back the layers of his personal deceits. Benita Alexander is the leading voice of the docuseries, and she doesn't pull any punches regarding the effects this man had on her life.

Alexander first realized not all was what it seemed when her fianc (yup, they were engaged) couldn't explain why the Pope was traveling the same month he had reportedly agreed to wed the couple. A whack of lies subsequently emerged, including a whole other secret family.

With the spell broken, Alexander went public with a 2016 Vanity Fair article. Others questioning the doctors' methods followed suit, exposing the reality of the situation. Macchiarini was eventually fired from the Karolinska Institute and went to court for his accused crimes.

Once word got out about this doctor, he was the subject of several news reports, documentaries, and podcasts. One of those podcasts was the Wondery podcast, which serves as inspiration for the second season of Peacock's Dr. Death, with the season titled Dr. Death: Miracle Man.

In the dramatized version of events, Mandy Moore plays Benita Alexander, and the show traces her love story with Macchiarini, played by dgar Ramrez. As anyone who has seen the Netflix doc or followed along with the real-life events knows, there is a lot to dramatize. However, the series takes some liberties, so even the most well-versed true crime lovers may be surprised at how some things play out.

The second season also has nothing to do with the first season of Dr. Death, which starred Joshua Jackson as surgeon Christopher Duntsch. That doctor was accused of routinely performing surgery while under the influence, paralyzing and killing some of his patients in the process.

Once you've finished watching Bad Surgeon: Love Under the Knife and Dr. Death: Miracle Man, you might want to stay on Peacock to check out Dr. Death: Cutthroat Conman. That doc drops the same day as the scripted series and goes even more in-depth via interviews with people who worked alongside Macchiarini.

It was a long journey for the families of those who died after a Macchiarini surgery. The doctor was the subject of a yearlong investigation by Swedish police in 2016. At the time, they found that the doctor was negligent in four of the five cases they looked at because the devices and procedures he used were unfounded.

Finally, in 2022, new evidence coupled with support from people in more than five countries, resulted in Macchiarini's conviction of causing bodily harm. However, he was also acquitted on two similar charges.

This past summer, Macchiarini was sentenced to 2.5 years in prison, having been found guilty of aggravated assault against three former patients. Today, three of his research papers have been corrected, four are now marked with an expression of concern, and 11 have been retracted.

Going to the hospital is rarely a good thing and seldom a treat. However, when it comes to these medical dramas, the chance to go to the hospital is the most exciting part of our weeks. With a plethora of intricate medical cases, high-octane surgeries, and panicked casualties providing constant drama, it's clear why millions flock to stream these medical dramas every day. That's without mentioning the romances, break-ups, and family drama, with some of the most detailed character development in all of modern media coming inside the walls of a hospital. To help you figure out the best medical dramas on Netflix, here is a helpful guide.

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