Dr. Death executive producer explains how Christopher Duntsch could have avoided prison

Talk about a TV writer's dream: a story about a handsome, charismatic doctor with a killer bedside manner. Creator/Executive Producer Patrick Macmanus (Homecoming, Happy) knew he had a ready-made hit in Dr. Death when he first learned the story of Christopher Duntsch, the Texas neurosurgeon who permanently maimed and killed patients during routine procedures. Here, Macmanus talks about how he first discovered the ghastly true story behind Dr. Death—which stars Joshua Jackson and drops today on Peacock—and whether he thinks Duntsch is truly crazy.

ENTERTAINMENT WEEKLY What is Dr. Death's origin story? Were you in the car listening to the podcast on the way to the grocery store and you said, 'Oh my God, I've got to make a limited series out of this?'

PATRICK MACMANUS I didn't hear the podcast first. I was working on a show called Happy [for SyFy] and I was sent the first three episodes of the podcast that hadn't come out yet. It was a gold mine. You can't ask for a story that is so ready-made. I will not insult our writers when I say that because they elevated everything, but it's one of those stories that you have to be particularly bad to mess up, right? I was gifted the opportunity to tell it. I will say I'm a hundred percent hypochondriac. My wife laughs at me all the time about it. I say to her 'someday, I'm going to be right and you're going to feel bad about this.' This was a very dangerous story for somebody like me to delve into. I felt sick for most of the last three years in the best possible way.

Did you feel a need to go talk to Christopher Duntsch in prison?

I had an urge to do that very early in the process. So while I was writing in August and September of 2018, I had asked to reach out. And at that time, Christopher's case was actually on appeal. And so there was no world where they were going to let him speak to me. And even after he eventually lost that appeal, the train had already left the station. The good news is, is we had thousands of pages of research, thousands of pages of court documents, tons of hours of interviews. And we did have full access to doctors as well as Laura Beil, who did the original Dr. Death podcast. So we had all of the tools at our disposal.

So what do you think, is he just crazy? Do you think at some point he came to the conclusion that he really was a horrible surgeon, or do you think to this day he thinks everybody else is wrong?

That is a wonderful question. I'm going to answer it in a couple of different ways. From the very start, before there were any writers and before I'd even written the pilot episode, I had said to the studio that if you are asking me to answer the question of why Christopher Duntsch is the way that he is, I will never give you that answer. I don't think anybody but Christopher Duntsch can answer that question. I think that it would do a disservice to the story to try to find the pretty pink bow to tie on the story, to let people know how this creature could possibly be. I can tell you that, with the intention of allowing audiences to come to their own conclusions, my conclusion is that Christopher is an extraordinarily complex and tragic figure. He is absolutely a narcissistic sociopath. I believe that he's a product of nurture. I think his upbringing fanned the flames of that sociopathy and that narcissism. And then on top of that, you have the systemic side of the medical system that ultimately failed in stopping him. It sort of just blew that flame into a full-fledged conflagration—not because the hospitals were necessarily to blame, but his education. The system was attracted to his very real charms. He was intelligent. He was charming. He was affable. Had he explored his research and stayed in that lane and never gone to operate, we'd be talking about him in an entirely different fashion today. We would be lauding him for what he was doing because to this day, several of his patents are still being used in the use of stem cells and neurosurgery. But everyone around him, not wittingly or willingly, ended up sort of encouraging all of his worst attributes.

I can't think of a more enormous responsibility than trying to find an actor to play that role.

Jamie Dornan was originally attached to play Christopher in the beginning. He was a phenomenal partner right up until the pandemic hit and we got shut down. He stayed in New York while everyone else went home. Scheduling just got in the way there. We went into a mode of trying to figure out how to fill those shoes. I had seen Josh in When They See Us. He had a very small but vitally important role. I had never seen him like that. I realized what he really had to offer. When Josh and I had our first conversation, he said to me from the beginning, 'I've got to figure out how to approach this character without any judgment. I have to figure out how to humanize this guy.'

Did you talk a lot about how gory to make the surgeries?

It was a conscious choice from the very beginning to not show the surgeries until the finale. I am somebody who adores the genre of horror. We went out of our way to let your imagination do the work. We definitely amped up the sound effects. But in reality, you don't see a whole lot until the finale.

Dr. Death begins streaming today on Peacock.

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