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One Good Thing: This true crime podcast about a murderous doctor is even scarier during a pandemic

Dr. Death season 1 is a story about nightmarish systemic collapse disguised as a story about a sociopath.

Amanda Northrop/Vox
Aja Romano writes about pop culture, media, and ethics. Before joining Vox in 2016, they were a staff reporter at the Daily Dot. A 2019 fellow of the National Critics Institute, they’re considered an authority on fandom, the internet, and the culture wars.

One Good Thing is Vox’s recommendations feature. In each edition, find one more thing from the world of culture that we highly recommend.

I listen to a metric ton of true crime podcasts — so many that murder starts to seem run-of-the-mill. In that context, it’s hard to overstate the eagerness I felt when I sat down to marathon the new, six-episode second season of Wondery’s Dr. Death, the terrifying hit series about real doctors who knowingly inflict harm on their patients. I loved season one, and although both seasons of Dr. Death star host and medical journalist Laura Beil and have the same production team, the second season feels in many ways like a different, and weaker, series altogether.

But season two’s change in direction has renewed my appreciation for season one and its combination of taut, gripping storytelling and an unforgettable close-up look at systemic failure. Dr. Death season one explored how institutional blind spots enabled a truly macabre central character to maim his patients over an 18-month surgical spree. In retrospect, it feels like a tale ready-made for a pandemic era, one of individual hubris married to society’s tendency to reward unearned entitlement.

And while it might be a little perverse to find pleasure in a story of medical malpractice during such a pandemic, Dr. Death’s first season stays fresh.

Season one of Dr. Death looks at a chilling case of medical malpractice

The first season of Dr. Death, which launched in 2018 and ran for seven episodes, examined the life and horrific crimes of Christopher Duntsch. Duntsch is a former Dallas neurosurgeon who, through a staggering combination of personal incompetence and sociopathy mixed with institutional indifference, managed to leave a string of mangled patients in his wake.

Among these patients — victims — were two people who died as a result of injuries Duntsch knowingly inflicted. Over 18 months between 2011 and 2013, Duntsch bounced around Dallas-area surgical practices, botching the surgeries of at least 33 of his patients while evincing an air of arrogant expertise that fooled multiple hospitals into hiring him. This was despite his shaky track record and a string of alarmed surgeons who tried to sound warning bells.

The entire time, Duntsch, who grew up rich and entitled, seemed to be aware he was making mistakes; he falsified information on his CV and seemed to steamroll his critics on his way to the top. “Anyone close to me thinks that I likely am something between god, Einstein and the antichrist,” he wrote in an email at one point while he was practicing surgery, “because how can I do anything I want and cross every discipline boundary like its a playground and never ever lose[?]”

A 2016 long-form article about Duntsch served as the basis for the 2018 podcast, which became a critically acclaimed hit and is currently being turned into a TV series for Peacock, with Joshua Jackson (The Affair) playing Duntsch. Although the podcast’s first season ran just seven episodes, it left a striking impression: It was all I and most other true crime buffs I knew could talk about for weeks. Because I’m a true crime nerd and perhaps a bit of a masochist, I’ve listened to many a jaw-dropping yarn about murder. But the structured narrative, Beil’s way of incrementally revealing Duntsch’s history, and the sheer monumental scale of this story’s tragedies, audacities, and systemic failures made Dr. Death unlike any other series for me.

Beil takes you through a nightmare that unfolds at multiple levels. There’s the actual gory surgical horror Duntsch inflicted — grueling and sometimes difficult even to listen to, with details about incisions and nerve damage and, um, screws that most people never, ever want to hear in any setting, let alone this one. She also charts Duntsch’s unbelievable progress through Dallas’s medical scene and all of the moments when he could, and should, have been held accountable for botched surgeries and malpractice, only to get pats on the back and his prior mishaps hand-waved away — all for the sake of convenience.

Above all, Beil focuses on Duntsch himself, with his confidence and his completely unwarranted arrogance about his own expertise. Dr. Death season one devotes much of its time to close-reading Duntsch’s behavior and psychology. By straightforwardly walking us through his college exploits, his drug-fueled residency days, and his complicated relationship with women, Beil delivers an unforgettable portrait of an entitled misogynist who joined toxic masculinity with narcissism and spent years passing off both traits as charisma.

For Dr. Death season two, Beil takes a different approach — and not one that entirely worked for me. It’s a funny thing to realize that what I’m missing most from a true crime series is what I usually complain about getting too much of: a closer look at the villain. But season one put its villain in the foreground with a vengeance, and that made all the difference.

Dr. Death’s first season feels like a necessary exploration of how an entire system enables an incompetent narcissist

It’s possible that I had set too high a bar for season two because of my love for season one, but the differences between the seasons are obvious. Season two of Dr. Death examines the equally horrific story of Dr. Farid Fata, a Lebanese American doctor who ran a renowned cancer clinic franchise in Michigan until whistleblowers who worked with him revealed that he’d been wrongfully diagnosing patients with cancer. Apparently driven by greed, Fata had even put hundreds of his trusting patients on chemotherapy treatments they didn’t need.

The scale of Fata’s crimes is much bigger than Duntsch’s: He conducted his malpractice with less oversight because he ran a private practice, and carried out his horrors over a longer period of time, all while his patients raved about him and he gained tremendous local acclaim as a caring and nurturing practitioner. His nurses and staff saw a different side of him, however. To them, Fata was the pinnacle of a megalomaniacal micromanager, a penny-pincher who deliberately eschewed established medical practice without ever being held accountable for it.

Season two of Dr. Death also scales outward. Perhaps because Fata had so little professional oversight, Beil’s reporting turns away from examining his psychology or the system that produced him and toward dramatizing the process of exposing his crimes. Instead of focusing on Fata as the perpetrator, season two spends more time on several people who reported him, ultimately building to the climactic moment of exposure: a full-fledged FBI raid on Fata’s entire staff.

We do hear from a few of the victims and their families, and these are heart-wrenching tales of people duped by Fata’s outward show of kindness and veneer of authority. But season two feels, overall, far more like a chase thriller than season one — and I’m not sure a story about medical malpractice, especially one released during the pandemic, should feel this much like a thriller.

To be fair, some critics had similar complaints about season one; the New Yorker noted that Wondery has made “lurid” true crime part of its milieu with series like Dr. Death and the equally popular Dirty John, another short-form true crime thriller. But season one of Dr. Death is, to me, much different from the typical true crime podcast. In the way it chooses to drill down into its subject, it’s closer to the stellar second season of In The Dark, which my colleague Emily VanDerWerff called “process-oriented storytelling.”

One of the stories from season one that people remember the most involves that of Jerry Summers, a lifelong friend of Duntsch’s who entrusted him with what should have been routine neck surgery only to wake up paralyzed — permanently. That’s the kind of nightmare scenario you can only understand if you know both sides of Duntsch: the sociopath he really was, and the upstanding model doctor people believed him to be.

Beil frames Duntsch within both contexts, letting a story of one sociopath become a much larger story about societal failure. Summers and the other victims fell prey to the medical institutions that hired Duntsch and let him continue practicing despite botched surgeries, but they also fell prey to the social systems that reward confident men for their confidence, their swagger, and their gumption — regardless of whether those traits are earned.

I‘ve written about this tendency before — specifically, how true crime narratives perpetuate this mystique of the confident man rather than working to demystify it. The mythos of serial killer Ted Bundy continues to be one of the best examples of this, but other recent examples have sprung up, too.

The recent Netflix documentary American Murder worked hard to demystify family annihilator Chris Watts, who friends described as the perfect husband, and who was so popular he received a deluge of fan mail after he was imprisoned for murdering his wife and two young daughters. Even Duntsch was originally slated to be played on the Peacock show by the hunky Jamie Dornan, of Fifty Shades of Grey — a glamorous casting for an unglamorous guy who reportedly used to do his medical rounds while still high after all-nighters doing cocaine and LSD.

Dr. Death’s portrait of Duntsch works because Beil never stops reminding you how ordinary Duntsch’s brand of arrogant incompetence is, nor of the systems that allowed him to flourish. She and her team of reporters hammer away at specific institutions for answers, especially Baylor, where Duntsch first received his surgical privileges.

By contrast, season two hardly teaches us about Fata himself, his training, and the institutions that failed to check him. One whistleblower carefully filed a report against Fata to her medical licensing organization through the internet, yet we learn nothing about the process by which that claim was investigated and ultimately closed — not even whether the organization that failed to act against Fata was subsequently investigated, or whether the claim was ever even seen by a pair of human eyes.

There’s a world of difference in the broad overview beats of season one and the relentless drill-down of season two. Season two’s “Dr. Death” comes off as a disturbingly distant caricature, as opposed to the uncomfortable close-up we’re forced to endure of Duntsch. The racial implications here are uncomfortable as well; that the podcast makes so little effort to unpack the psyche of a man who ultimately pleaded guilty to knowingly misdiagnosing or mistreating 553 patients seems to be a fraught choice.

Instead, season two focuses on the moral quandaries faced by whistleblowers. Yet season one also had its whistleblowers, a pair of Dallas surgeons who teamed up to stop Duntsch after realizing no one else would. Their ethical dilemmas have stuck with me, feeling weightier because we glimpse so much of the complicated world of high-powered Dallas medical politics that they’re navigating.

It’s easy to see why the second season’s creative team might have chosen, in this time of the pandemic, to place the emphasis on regular people taking accountability and taking risks to ensure medical safety. Beil even says as much in her final season two wrap-up interview.

But ironically, the disastrous way many authorities have dealt with the Covid-19 pandemic in the USwith a combination of hubris, arrogance, unearned confidence, and a lack of accountability for their decision-making — makes me value even more the lessons season one tried to teach us. These earlier episodes now seem almost like a pandemic playbook — a way of understanding systems of incompetence and how they sometimes manifest in unthinkable ways.