On February 5, 2020, Bernard L. Madoff, the mastermind of the largest Ponzi scheme in history, filed a court brief asking to be released from his 150-year prison sentence because his doctors said that he had less than a year and a half to live due to end-stage kidney disease (New York Times, February 5, 2020). In his brief, he stated that he also had serious heart disease, high blood pressure, and such severe back pain that he had to use a wheelchair and a back brace just to get around. His request was denied, and on April 14, 2021, he died in prison, apparently from heart failure brought on by his chronic kidney failure and a previous heart attack.
Madoff was a prominent New York financier and former chairman of NASDAQ who was sentenced in 2009 for fraud, money laundering, perjury and theft. Instead of investing his clients’ money, he used it to support his lavish lifestyle and got away with the deception by using money from newer investors to pay the earlier ones. On December 10, 2008, Madoff told his two sons about his incredible fraud, and the sons immediately called their lawyer, who contacted federal authorities. FBI agents arrested Madoff the next day. The Securities Investor Protection Corporation (SIPC) trustee estimated the loss at $65 billion, with an actual loss to investors of $18 billion.
Early Life of the Fraudster
Madoff was born in 1938 in Queens, New York to a father who was both a plumber and a stockbroker. After high school, he attended the University of Alabama for one year, transferred to and was graduated from Hofstra University, and attended Brooklyn Law school for one year. He left law school to start his Wall Street firm, Bernard L. Madoff Investment Securities. He hired his brother as senior managing director and also employed his two sons and a niece. The technology that the firm used became the NASDAQ. In 2001, after 41 years of being the sole owner of his firm, he incorporated Madoff Securities and was its sole shareholder.
Arrest, Conviction, Prison Life and Death
On March 12, 2009, Madoff pleaded guilty to securities fraud, wire fraud, mail fraud, money laundering, making false statements, perjury, theft from an employee benefit plan, and making false filings with the SEC. He pleaded guilty to being solely responsible for all charges, most likely to try to protect other people who were involved in the fraud. On June 29, 2009, Madoff was sentenced to the maximum sentence of 150 years in federal prison. The judge noted that none of his friends had submitted letters requesting a lighter sentence.
Madoff was incarcerated at the Federal Correctional Institution near Butner, North Carolina. On December 18, 2009, he was treated for facial fractures, broken ribs and a collapsed lung inflicted by another inmate. In December 2013 he suffered a heart attack. In December 2019, he was hospitalized for kidney failure. He was admitted to palliative care for terminal patients, and he died on April 14, 2021 at age 82, reportedly of “natural causes,” which would be used to describe heart failure and kidney failure.
When most people break the rules of society, they suffer guilt and regret, if only because they have to worry about getting caught and suffering the punishment. People who feel no guilt and do not worry about getting caught are called sociopaths. As long as sociopaths do not get caught, they can continue to benefit from their crimes. Madoff kept on stealing money as long as he could, but claimed that none of his family or co-workers were aware of any of his criminal activities. When his scheme was revealed, the investigators and the bilked investors found that hard to believe that no one but Madoff knew that he was doing anything wrong.
Fifteen percent of older North Americans suffer from chronic kidney disease, permanent damage to their kidneys, which is usually diagnosed by a blood test called glomerular filtration rate (GFR). Most cases of kidney disease cause no symptoms until there is severe kidney damage, so a regular physical exam includes the GFR blood tests. Kidney failure can eventually require dialysis or kidney transplants.
Diabetes and high blood pressure are the leading causes of kidney failure. We know that Madoff had high blood pressure, and while I have found no mention of diabetes in the reports on his medical condition, photographs show that he had a very large belly that often accompanies type II diabetes or at least pre-diabetes. As many as 30 percent of diabetics are not diagnosed correctly because they have normal fasting blood sugar levels (Atherosclerosis, Jan 2017;256:15-20). Anyone who has a blood sugar greater than 145 mg/dL one hour after eating a meal is suffering from diabetic cell damage (Diabet Med, March 21, 2016), so a normal fasting blood sugar level does not rule out diabetes. These people do not necessarily need to take drugs, but they must follow all of the dietary rules to prevent a high rise in blood sugar after meals. Other causes of kidney failure include certain medications such as non-steroidal anti-inflammatory drugs or diseases such as Lupus.
Preventing or Slowing Kidney Failure
Anyone whose GFR tests are below 60, which usually indicates early stages of kidney failure, should immediately adopt an anti-inflammatory lifestyle and be checked for diabetes.
• Eat a diet that is high in anti-inflammatory foods and low in pro-inflammatory foods. Eat lots of fruits, vegetables, whole grains (not ground into flour). beans, coffee, tea, and fish such as salmon. Severely restrict sweetened beverages and sugar-added foods, foods made with flour and other refined carbohydrates, red meat (meat from mammals), processed meats and fried foods (BMC Medicine, January 8, 2015;13(3)).
• Excess salt intake can cause high blood pressure, and all people with kidney damage are advised to limit salt. Canned foods and other processed foods often contain a lot of salt.
• Get enough vitamin D. Vitamin D deficiency blocks insulin receptors to raise blood sugar levels and increase risk for diabetes.
• Avoid tobacco and second-hand smoke
• Avoid alcohol
• Avoid being overweight
• Try to exercise every day. Exercise helps to reduce excess weight, high blood pressure, high LDL cholesterol, and high triglycerides. Exercise also helps to increase healthy HDL cholesterol and strengthens muscles and bones.
• Check with your doctor about medication to control high blood pressure
• Limit intake of NSAIDS (non-steroidal anti-inflammatory medications), and check with your doctor on other medications that may affect your kidney function.
April 29, 1938 – April 14, 2021