Joshua Jackson Dissects the Psychology of ‘Dr. Death’ and Ponders a ‘Dawson’s Creek’ Revival

Joshua Jackson started his career playing some of the sweetest and therefore most beloved characters in pop culture, from Charlie Conway in “The Mighty Ducks” to Pacey Witter on “Dawson’s Creek.” Even as he matured into more adult roles, such as Peter Bishop on “Fringe,” he leaned on likable, even when they became increasingly complex characters. That’s why his work in Peacock’s “Dr. Death” is so notable.

Jackson stars as Christopher Duntsch, the titular nicknamed neurosurgeon, in Peacock’s limited series based on the Wondery podcast of the same name (and of course the real-life former doctor’s story). It is a role he stepped into amid the COVID-19 pandemic when Jamie Dornan vacated the project, and it is one that required nuanced acting. The real-life Duntsch was convicted of and sentenced to life in prison for maiming a patient, while also being accused of injuring almost three dozen patients others in less than two years in his career. But Jackson couldn’t just play the man as a monster.

“He has all of the book knowledge and he is actually a very, very, very intelligent man. So, he’s capable of deluding himself and fooling other people,” Jackson tells Variety. “When you look at his surgical attack — what he said he wanted to do — it’s exactly perfect. He knew exactly where he wanted to be, how he wanted to do it, what he wanted the practice and the outcome to be. It’s just that when he got to the practical application because he hadn’t done that work — he’d been allowed to escape doing that work — he didn’t have the actual skills to apply that. Now, most every other human being would have one disastrous outcome, maybe two, and go, ‘Oh shit I don’t know what I’m doing here, I should stop doing this.’ But this is where that narcissistic personality that frankly you have to have to be a surgeon [comes in].”

At first, Jackson admits he “wasn’t prepared to grapple with the idea that [the doctor] was anything other than a monster because what he did is so outrageously spectacularly bad and so evil.” But he pushed himself to “walk a mile in his shoes” and understand much about the system (or “toxic soup,” as Jackson calls it) built up around Duntsch that allowed him to continue to work and even thrive, despite doing so much harm.

“Once I did that [I could] accept at face value that he believes himself to be the hero of his own story. That concept, both in surgery and out, of consciousness of guilt is a huge one for him. And ultimately where I came out is that he does not have consciousness of guilt. And once I accepted that, everything else kind of flowed out of that,” Jackson says about getting into the psychology of the character.

The series from showrunner Patrick Macmanus which showcases some of the botched surgeries the real-life Duntsch performed, along with the case two other Texas-based doctors (Robert Henderson, played by Alec Baldwin, and Randall Kirby, played by Christian Slater) tried to bring against him with the medical board. It doesn’t shy away from the fact that he completed less than 10% of the usual surgeries required during residency, nor the fact that he was allowed to continue to operate even after causing irreparable harm to former patients.

“Dunstch is an outlier in his specific combination of evils that make him very destructive, but he is right in the pocket of what the system is designed to promote to support itself,” Jackson says. “Patients are dependent upon the doctor themselves to be a good and decent person who’s not going to do 10,000 tests you don’t need, who is going to put your care over and above whatever quota they need to make or mortgage payment they feel pressure to get to, or the kid they’re trying to put through college. There’s just so many pieces that are broken in the profit motive inside of the American medical system that get us to outcomes like Duntsch.

“If he meant to do this it’s much less scary: he’s just a psychopath and all we got to do is weed out the psychopaths. But if he didn’t mean to do it and he was supported in continuing to do it, it’s much scarier and much more dangerous,” Jackson continues. “The system around him achieved exactly what it’s designed to do, which is to protect the system itself and the ability for the system to make profit. And so, when you look at it from that perspective, the whole thing becomes much more nefarious to me [and] much more terrifying.”

“Dr. Death” also explores how Duntsch became a doctor, let alone one who would be so comfortable with and willing to fail and refuse to admit it.

It follows Duntsch as he struggles with an estranged marriage and shifts his practice, lying to patients about why he closed up his old shop and joined a new hospital. But it also flashes back to his college years, to show his strained relationship with his parents and knee-jerk tendency to deflect and blame others and his situation.

“There are clearly these things that are like time bombs in his personality, but they can only be set off in a really specific environment, and everything in his life led him to exactly the wrong place so that all of those little time bombs — those those ugly pieces inside of him — detonated at exactly the same time and created this monstrous human being. That, to me, was fascinating,” Jackson says.

“The world around him that created him is also fascinating because if any little piece of history changes, I don’t think that we’re sitting here having this conversation. He may have had the ability, but he wouldn’t have had the opportunity to do the awful things that he did.”

While Jackson was initially concerned about playing flash-back scenes as the younger version Duntsch, he wanted to do it because “I had, I thought, a pretty strong take on who he was then,” he says.

While VFX did a “digital wipe — the ‘Benjamin Button’ thing” on his face, Jackson says, most of the transformation to play Duntsch was done practically.

To travel back in time with him, Jackson dropped 20 pounds, changed the register of his voice and adopted a new way of walking, as well as interacting with those around him. “He was 19-years-old and you’re like Bambi, in my opinion, at that age. Particularly boys, we haven’t kind of grown into ourselves yet,” he explains.

As Duntsch ages during the course of the story, Jackson shifted his gait, mannerisms and voice, and eventually prosthetics begin to take over. “We spent a lot of time getting the gradations of the prosthetic so that you don’t really notice it through the first couple of steps and then and then at the very end it’s quite a significant leap that’s happened [because] he’s internalized all of this angst and chaos and he’s literally, physically wearing it on his body,” Jackson says.

Jackson’s recent roles, from Netflix’s limited series “When They See Us” and Hulu’s adaptation of “Little Fires Everywhere” and now “Dr. Death,” have dealt with darker themes than the “beautifully innocent” stories from his own youth, as he describes “The Mighty Ducks.”

He thinks “it’s great that  a bunch of the guys did cameos” on the recent Disney Plus “Mighty Ducks” series “because that’s fun for the parents who are introducing that story to their kid. But mostly, that show should be for the kids — it should be for the next generation to find their own version of that story,” Jackson says.

Rebooting “Dawson’s Creek” with a whole new crop of kids could work, he says, because teenage stories are timeless and universal. However, “I don’t know that we need to see Pacey and Joey in their mid-40s. The story was told about a group of people at a time and frankly, you probably could have cut the last two seasons out and just kept it in high school because it’s such a particularly beautiful moment — and specific moment — in a bunch of people’s lives.

“I know what their story is there: it’s beautiful and it’s self-contained and it’s a moment and it’s all those great things,” he says. “No one needs to see the gritty drama about Pacey and Joey and their marriage 20 years later. I don’t know that you service that old story by telling the story of us getting old and gray and wrinkly and going through a midlife crisis together. I don’t think that adds to the original story.”

“Dr. Death” streams July 15 on Peacock.

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