The nightmare at the center of Dr. Death, a new Peacock drama inspired by the 2018 true crime podcast of the same name from Wondery, involves a surgeon who seems intent on using his scalpel to destroy the lives of his patients—and a medical system content to let him skate by. Out July 15, Dr. Death introduces viewers to Christopher Duntsch, a real-life Texas-based surgeon who in 2017 was sentenced to life in prison after maiming and even killing almost all of the nearly 40 patients he operated on between 2011 and 2013.
The series, a lightly fictionalized version of the podcast, stars Joshua Jackson as the slick and overconfident Duntsch. Alec Baldwin and Christian Slater join the cast as two doctors who try to stop Duntsch from causing further harm. Their efforts to stop him, as documented both in the podcast and show, take a long time, as Duntsch moves between hospitals and continues injuring patients.
How does a doctor get away with something like this? Of the 37 patients Duntsch operated on in Dallas over about two years, 33 were hurt or harmed in the process. Some people woke up paralyzed; others emerged from anesthesia to permanent pain from nerve damage. Two patients died, one from significant blood loss after the operation and the other from a stroke caused by a cut vertebral artery. One patient, a childhood friend of Duntsch’s, went in for a spinal operation with someone he trusted and woke up a quadriplegic after the doctor damaged his vertebral artery. Such significant injuries should have been “never events”—something that should never occur in an operating room, a surgeon told D Magazine, which covers the Dallas-Fort Worth area, in a 2016 piece that inspired the eventual Dr. Death podcast.
The question of how Duntsch was able to operate with impunity for so long—when surrounded by many people who tried to raise the alarm and failed—drives Dr. Death, which jumps across time in each episode to show what the doctor was like as a young man, friend and medical student, and then later as a surgeon, a partner and a father. One conversation in Peacock’s first episode of Dr. Death sums up the confusion many felt at watching Duntsch work: “It was like he knew what he was supposed to do … and he did the exact opposite.”
Here’s what to know about Duntsch, what he did and how he was eventually stopped.
Confident to a fault
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Duntsch took careful steps to put across the image of a hardworking, competent and caring person and doctor. The son of a physical therapist and teacher, he was known even before pursuing his medical aspirations as a person who didn’t give up—even when letting go would have been the right choice. Determined to play football for a Division I college team, Duntsch dedicated himself to training while in high school. While he did make it on to a couple of college teams—one in Mississippi and one in Colorado—former teammates said he had trouble keeping up in practice but would plead with coaches to let him keep trying. “I gathered very quickly that everything that he had accomplished in sports had come with the sweat equity,” one old teammate told ProPublica in 2018. “When people said, ‘You weren’t going to be good enough,’ he outworked that and he made it happen.”
This attitude and outlook stuck with Duntsch as he set out to achieve something beyond football and landed on surgery. He decided he’d be a neurosurgeon and was not going to let anything, including lack of skill or training, stop him in his quest. And at first, Duntsch appeared to have what it took: He enrolled in an M.D./Ph.D program at the University of Tennessee at Memphis College of Medicine and put in dozens of hours in cancer and stem cell research. He was even part of a group that founded the biopharmaceutical company Discgenics—which focuses on developing regenerative cell-based therapies to help with pain—and brought on two of his mentors in surgery as investors. (He was later let go from the company over money issues).
Things seemed to be moving along smoothly. But depositions from Duntsch’s peers who knew him around that time period, between 2006 and 2008, point to cracks in the facade. One woman remembered Duntsch taking LSD and cocaine throughout one night, before leaving the next morning for his hospital shift. “After you’ve spent a night using cocaine, most people become paranoid and want to stay in the house,” the woman said in the deposition, according to D Magazine. “They don’t want to go participate in any extraneous activities, and he was totally fine going to work.”
Duntsch’s substance abuse was brought to the attention of the University of Tennessee following an anonymous complaint that he was doing drugs before work. The podcast series and ProPublica report that Duntsch was ordered by the university to take a drug test, but managed to avoid it. He was then sent to a program for impaired physicians and still allowed to complete his surgical training—though how thorough the training was is unclear. Only years later would the Dallas district attorney’s office discover through a search of hospital records that although a typical neurosurgery resident completes about 1,000 operations during their training, Duntsch had actually done fewer than 100.
Patients waking up worse than they went in
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On paper, Duntsch was a star pick for any hospital system once he completed his residency, thanks to years of research and study of the use of stem cells and several strong recommendations from his prior supervisors. Following training, Duntsch settled in the Dallas area in 2011, joining the Minimally Invasive Spine Institute in Plano as a practicing physician. This position also granted him operating privileges at Baylor Regional Medical Center (Baylor-Plano). There, other surgeons quickly realized their new colleague was not just arrogant about his abilities but an actual danger to his patients as the casualties began adding up. A former coworker, Dr. Randall Kirby (played by Christian Slater in the Peacock series), said he watched Duntsch botch a relatively simple procedure by refusing to use a scalpel to remove a disk, instead using a different instrument that ended up causing more damage. The patient Duntsch operated on continues to walk with a cane and lives with chronic pain.
And that was just one case from Baylor-Plano. Other patients who went to Duntsch had similar experiences: entering the operating room with the expectation of relieving a great burden and waking up to an even worse reality.
Later, following another accusation that he was abusing drugs before doing surgeries, Duntsch was relegated to mostly minor surgical procedures at the hospital. The first operation he conducted in this capacity was to fix a woman’s compressed nerve—during the surgery, he cut an important vessel in the woman’s spinal cord and she bled to death. And what happened after shows how Duntsch was able to continue working as a surgeon in Texas, despite the trail of broken trust, chronic pain and death he left behind.
While Baylor-Plano conducted an investigation of Duntsch and his cases, and found that he would need to be let go, Duntsch was not technically fired from the hospital. ProPublica reports that Duntsch resigned voluntarily in April 2012. Crucially, as is recounted in careful detail in the podcast, in part because of the voluntary exit, Baylor-Plano was not required to report Duntsch’s actions to the National Practitioner Data Bank, a resource medical professionals and hospital administrators use to track which doctors have been fired, suspended, had their licenses revoked or have had to make malpractice payments. Duntsch was not reported to either the data bank or the Texas Medical Board, preventing him from being tracked as he continued his career elsewhere in the state.
Duntsch moved on fairly quickly, to the Dallas Medical Center, where officials allowed him to begin operating while they conducted his reference checks—which ended in disaster. In July, he performed an operation on a woman who lost a tremendous amount of blood and lost consciousness upon waking up after surgery. She was transferred to another hospital and died. At the same time, Duntsch was operating on another woman, and the staff in the room said they were unsure whether he “was putting hardware … in the right places and noticed he kept drilling and removing screws.” That woman woke up in pain, unable to move.
The complaints add up
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The Texas Medical Board began receiving official reports about Duntsch following the botched procedures at Dallas Medical Center, as multiple doctors began sending in complaints. Kirby, along with Dr. Robert Henderson (played in the series by Alec Baldwin), a spine surgeon who had been called in to fix Duntsch’s mistakes, were among the physicians who reported and attempted to stop him. For months, they stopped getting reports about messed up operations and thought they’d found success. But at the end of 2012, Kirby was called to help yet another patient who’d had her vocal cords and an artery cut during a neck surgery—a surgery he discovered had been done by Duntsch at another clinic.
In 2013, things came to a tragic head. Despite being known in Texas as a doctor to avoid (at least among professional peers), and despite a report to the data bank and an investigation into his cases by the state medical board, Duntsch continued to be hired. The last hospital to employ Duntsch was the now-shuttered University General, where he botched another surgery after he mistook a patient’s neck muscle for a tumor. Kirby, who called the operation “an attempted murder,” and Henderson, both annoyed by the slow pace of the state’s investigation, ramped up their efforts to strip Duntsch of his practicing rights. In June 2013, Duntsch’s medical license was suspended and fully revoked later that December.
After this, life for Duntsch fell apart. As is shown in the series, he drank too much and shoplifted hundreds of dollars worth of items, among other erratic behaviors. In the meantime, prosecutors were working with Kirby and Henderson to find a way to indict Duntsch—a challenge, considering Texas had never previously handled such a case. Eventually, they indicted Duntsch on five counts of aggravated assault and one count of causing harm to an elderly person.
To establish that Duntsch’s disastrous work had been a part of a longtime pattern, prosecutors brought several of his former patients on the stand to testify about their experiences. “You had people in walkers. You had people on crutches. You had people that could barely move. You had people that had lost loved ones,” one of Duntsch’s defense attorneys told ProPublica. But some of the most important testimony came from Kimberly Morgan, Duntsch’s former assistant and ex-girlfriend, who shared parts of a 2011 email from Duntsch that appeared to lay out his true aims: “Unfortunately, you cannot understand that I am building an empire and I am so far outside the box that the Earth is small and the sun is bright. I am ready to leave the love and kindness and goodness and patience that I mix with everything else that I am and become a cold blooded killer.” Duntsch was found guilty and sentenced to life in prison.
Coverage of Duntsch’s case, the podcast series and the now-streaming Peacock series all make sure to underscore that his story is part of a major systemic failure—a common theme in true crime stories. In this case, Duntsch remained a popular hire in part because neurosurgeons bring more revenue to the hospitals they work for than nearly any other medical specialty, and officials are unlikely to second-guess a candidate with stellar credentials and recommendations. Coupled with the slow pace of the investigation the Texas Medical Board conducted, Duntsch was basically allowed to wreak havoc wherever he went until he was brought to a final stop.
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Write to Mahita Gajanan at mahita.gajanan@time.com