This was, of course, completely fabricated, but Alexander likens hearing it all to being a frog in boiling water. If she ever questioned him, he would concoct another story – and while in the documentary she can sometimes appear confusingly naive, on Zoom she comes across as highly intelligent.
As to why he bothered with such outlandish lies, Alexander believes it gave him a thrill. “Nobody understands this type of mind because people like him don’t have therapy; they don’t feel guilt or remorse or empathy but they do enjoy the high of getting away with something.”
The wedding was planned for July 2015 and as the date approached, Alexander started to worry. Why could she not speak to the wedding planner or the venue? And why – despite criss-crossing Europe and America with her fiancé – had she still not been able to visit the house in Barcelona that was his main residence?
By this point, Alexander had agreed to quit her job and move to Spain with her teenage daughter to live with her future husband. But the day after her NBC leaving drinks in May 2015, a colleague sent her an email showing that the Pope would be in South America at the time of her wedding.
“Suddenly all the red flags made sense,” she says. “He was such an adept manipulator and so skilled at dismissing my concerns, but in that one moment I saw the truth.”
When she confronted him, he cut off contact and so she went in secret to Barcelona where – sitting in the back of a hot taxi wearing a blonde wig – she watched the man she thought was the love of her life walk down the steps of his house with a woman and two children. Later she would realise that they had never been engaged, as he was already married.
“I was consumed with rage and that got me through it in a way,” she says. “But there was profound sadness, and humiliation and embarrassment that I had fallen for this. It was very complicated.”
A year earlier, Corbascio, Grinnemo and Simonson had started gathering evidence. They had learnt about patients in Russia – one of whom, like Cetir, had mild tracheal damage and normal life expectancy but who then went on to die in agony after Macchiarini’s interventions. “Like lambs being led to slaughter,” says Grinnemo.
Once their case was prepared, they took it to the Karolinska board, but in a parallel of the Lucy Letby tragedy here in Britain, senior management not only refused to listen to their concerns, but disciplined the three surgeons – ordering them to apologise and punishing them by slowly cutting them off from funding and any promotional opportunities. Macchiarini, by contrast, was vindicated by his employers in an in-house investigation and continued to take on new patients.
It would take until 2016 before his fall from grace. Within the space of two months, an interview with Alexander was published by Vanity Fair and a Swedish documentary was released about Macchiarini’s medical failings. Finally, the Karolinska bowed to pressure and announced it would not be renewing its star surgeon’s contract. In 2018, the Lancet journal retracted two papers by Macchiarini.
And in 2022, he was found guilty of bodily harm in a Swedish district court and handed a suspended sentence.
But for Alexander, the three whistleblowers and the relatives of his patients, relief only came in June this year, when prosecutors appealed that verdict and Macchiarini was sentenced to two-and-a-half years in jail for causing the deaths of three people between 2011 and 2014. The Svea Court of Appeal concluded that there were no emergency situations among two of the three patients who later died, while the procedure on the third could not be justified. “The patients have been caused bodily harm and suffering,” the appeals court said of the two men and one woman. The patients, it concluded, “could have lived for a not insignificant amount of time without the interventions.”
