Exclusive: Bernie Madoff’s Heartbreaking Final Days: Hallucinations, Disastrous Medical Conditions & Waiting For The End

It was just before midnight on April 6 when the nursing station at the Federal Correctional Hospital in Butner, North Carolina, received a call about an inmate crying for help.

When a nurse arrived at cell 5420D, she looked inside and saw Bernie Madoff sitting on the side of her bed, staring at the floor and wagging her left foot. He then shouted: “Help! I hate this fucking place!

The nurse told him to stop yelling because he was disturbing the other inmates, to which the man behind the biggest Ponzi scheme in history replied, “F ** k them!”

“I never sleep and I am always tired”


– Bernie Madoff, according to medical records provided to MarketWatch by the Bureau of Prisons

The nurse told her to stop swearing and asked her what was going on. Madoff, confused and agitated, apologized and said, “I gave them a pass and no one respects me or does anything! I can’t believe they’re doing this to me!”

He couldn’t explain who he was talking about. Then he completely stopped answering questions. He refused to lie down or turn off the light and resumed sitting silently on the edge of the bed, his face buried in his hands.

Eight days later, he would have died at the age of 82.

The story of Madoff’s erratic behavior and details of his long failing health inside Federal Prison where he lived for nearly the last 11 years of his life are based on more than 4,000 pages of medical records published on MarketWatch by the Bureau of Prisons in response to a request under the Freedom of Information Act.

A dark and rapid decline

They describe a grim decline in Madoff’s physical and cognitive abilities as he spent the last 17 months of his life in hospice care in the prison hospital, waiting to die of kidney failure.

Madoff also suffered from severe coronary artery disease that left him breathless while crossing a room, records show. In 2020, he developed gangrene on the fourth toe of his left foot, which is not uncommon in people with end-stage kidney disease. He would end up having that toe and the one next to it amputated to keep the gangrene from spreading.

For much of his senior year, Madoff relied on a wheelchair and oxygen tanks to get around. He underwent dialysis three times a week, although he often stopped or refused treatment altogether because he found it too debilitating. He was placed on low doses of methadone for pain because other prescription pain relievers were deemed inappropriate given his kidney problems, records show. Madoff was considered a “high risk for falls” and had lost eight of his teeth.

Madoff was among the first people in the country to be vaccinated against COVID-19, getting his first injection of the Pfizer-BioNTech vaccine on December 18, 2020.

Due to his perilous health situation, Madoff was among the first people in the country to be vaccinated against COVID-19, getting his first injection of the Pfizer-BioNTech vaccine on December 18, 2020, just a week after its approval. emergency use by the FDA. Madoff received his second stroke on Jan.9, according to records.

A spokesperson for the Bureau of Prisons declined to comment on any aspect of Madoff’s treatment behind bars.

In mid-2019, Madoff began seeking early release from his 150-year sentence, given he was terminally ill. Madoff told prison officials he plans to move to Baltimore to live with a person whose name has been redacted on the record and undergo treatment at Johns Hopkins Hospital, according to the records.

He told a prison social worker that the cost of hiring an aide for his care would not be an issue because “he has several people. [redacted] who can help him and some who are “in debt” “, according to the records.

Records showed Madoff’s request was blocked more than once by the prison director and the attorney general, on the grounds that Madoff’s offense had been so serious and that he refused to undergo a dialysis as recommended by staff.

Medical staff ultimately said Madoff met the criteria for compassionate release and the director agreed to take the request to the judge in the Madoff case, even though he recommended not to do so. In June 2020, Judge Denny Chin dismissed Madoff’s claim, stating that he believed, “Mr. Madoff never really had any remorse and that he was only sorry that his life as he knew it was ‘collapses around him.

‘Sir. Madoff never really had any remorse and he was only sorry that his life as he knew it was falling apart around him.


– Judge Denny Chin, in June 2020, dismissed Madoff’s request for release on compassionate grounds

When Madoff was first arrested, losses from his scam were estimated to be $ 65 billion. That figure was then drastically reduced to around $ 18 billion when the false paper profits were deducted from the total. At the time of Madoff’s death, investigators said they managed to recover $ 14.4 billion.

Last January, Madoff appealed to the director again in a handwritten note, saying he was at high risk due to the COVID-19 outbreak and was at risk of losing his footing due to gangrene. The prefect again rejected the request, according to a letter in the file.

Brandon Sample, the lawyer who handled Madoff’s early release request, said details of his client’s deteriorating health were well known to officials reviewing his case.

“It was well documented that Mr. Madoff was elderly and ill. The BOP, the government, and Madoff’s sentencing judge were all aware of the same thing. Nonetheless, his declining health was insufficient for the judge to show Madoff some pity. That remains the real story here. There is no point in being released for compassion if there is no compassion, ”Sample said in a statement.

A long history of ailments

Madoff’s medical records also detailed the intensive treatment he received during his more than a decade behind bars. He was 71 when he entered prison in 2009 after pleading guilty to securities fraud, money laundering and perjury, and his kidney and heart problems were already known. Upon arrival, Madoff’s condition was monitored regularly – his medical records showed that he had undergone hundreds of doctor’s appointments and tests during his incarceration by cardiologists, nephrologists, psychiatrists, doctors, doctors and doctors. dentists and ophthalmologists.

Madoff has proven to be a difficult patient, routinely refusing treatment for a variety of ailments, skipping appointments, and stopping and starting his medications at will, the records show. Madoff refused for years to begin kidney dialysis against doctors’ insistence, and only began treatment after his case was deemed terminal in 2019. At one point, it was suggested that he ‘he requests a kidney transplant, but Madoff refused.

Madoff has proven to be a difficult patient, regularly refusing treatment for a variety of ailments, skipping appointments, and stopping and starting his medication at will.

Upon entering prison – given the notoriety of his case – he took regular mental health counseling and was put on Prozac and later Celexa for depression and anxiety, according to records.

Years later, Madoff was put on trazadone to help him overcome his anxiety and sleep, records show. “I never sleep and I’m always tired,” Madoff reportedly told a doctor.

In late 2009, just months after being transferred to the minimum security prison in Butner, North Carolina, Madoff passed out on his way back from the bathroom and hit his head against a water fountain, leaving him with a broken nose, a fractured rib, a cut above his eye that required seven stitches and an intracranial hemorrhage. Prison guards, who found him lying in a pool of blood and unable to explain what had happened, initially thought he had been assaulted. But Madoff later explained that he felt dizzy after stopping his blood pressure medication because he thought it made him feel itchy, records show.

In 2013, Madoff was rushed to Duke Regional Hospital with chest pain. Doctors determined that he had suffered a small heart attack and underwent angioplasty and a stent was inserted. He will undergo another angioplasty in 2020.

In 2014, he underwent surgery to remove part of his prostate, which was enlarged and had caused him difficulty urinating.

Reach the “terminal cliff”

In his final weeks, Madoff began to hallucinate as his mental state declined, records show. Just before he was sent to Duke University Hospital on March 23 to have his toes removed, he reported to prison medical staff that he was seeing people in his room at night. Madoff was also due to have a heart valve replacement that day, but surgeons didn’t think he would survive the operation, so they opted out.

When Madoff returned to prison from the hospital, he told a corrections officer he saw a bird in the officer’s jacket pocket. Madoff admitted to “feeling crazy” to doctors and said nothing mattered anymore, according to the records. He said the methadone he was taking left his head cloudy.

Just before he was sent to Duke University Hospital on March 23 to have his toes removed, he reported to prison medical staff that he was seeing people in his room at night.

In the days that followed, Madoff became more and more agitated and confused, unable to say what day it was or remember the things that just happened. His speech became more and more incoherent.

On the morning of April 12, just two days before his death, Madoff was found on his cell floor, having fallen out of bed, according to medical records. He was able to respond to his name but nothing else. Doctors noted in the records that Madoff appeared to have reached the “terminal cliff.”

Later that day, the prison rabbi was called in to see Madoff, who had signed a do not resuscitate order, and whose breathing was becoming increasingly difficult. Medics then put Madoff on a morphine drip and moved him to a room closer to the nurses’ station. He never opened his eyes again.

On April 13, medics attempted to contact Madoff’s emergency contact, whose name was redacted from the records, but were unable to reach them at the two numbers in the records.

At 3:10 a.m. on April 14, Madoff was found dead in room 5308, according to the doctor’s notes. He was pronounced dead at 3:29 a.m. – the cause: end-stage kidney disease.


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