 Franklin Delano Roosevelt brought us through the Great Depression and World War II. Who knows how history would have been different had he not died, in his fourth term as president, from a massive stroke. In the following days and months, we learned that Roosevelt had suffered from severe high blood pressure for years. In spite of this, he was on no medications or other treatments. The reason for the lack of treatment is stark and simple. There were none. The state of the art at the time was death. Death from so-called malignant hypertension out of control high blood pressure, for which it was thought there was no remedy. But they were wrong. There was Walter Kempner and his rice-fruit diet. Physician-scientists trained with the best fled Nazi-Germanian setup shop at Duke. We began treating malignant hypertension patients with a radical diet consisting of only white rice and fruit, with strikingly favorable results. A rapid reduction in blood pressure, rapid improvement in kidney failure, eye pressure, heart failure, and other manifestations of this previously fatal illness. He figured that if a low-salt diet helped with blood pressure, a low-protein diet helped with kidney function, and a low-fat and cholesterol diet helped the heart, why not take it to its logical conclusion and design a no-salt, no-cholesterol diet of almost pure carbohydrate. So he designed a diet with less sodium than any low-sodium diet, less protein than any low-protein diet, and less cholesterol and fat than any other low-fat diet. His hope was that it would just stop the progression of the disease. Instead, something miraculous happened. In about two-thirds of cases, the disease reversed. Reversal of heart failure, reversal of eye damage, reversal of kidney failure. Remember, this was effectively a terminal disease. People just had a few months to live, but if they went on the diet, most got better. Before and after. The round pictures at the bottom are photos, photographs taken of the back of people's eyes, starting out swollen, bloody, and leaking, and then nearly normal in a matter of months. Kidney disease cured. A striking fact is that in some patients, after being effectively cured by the diet over many months, they could then relax the diet to a more conventional plant-based diet and go on and live a normal, active life. The rice diet may actually drop blood pressures too low, so you have to modify it, add back other foods to bring the pressures back up to normal. An editorial in the New England Journal of Medicine described Kempner's results as little short of miraculous. Practically speaking, there's probably no more effective diet for obese, decompensated cardiac patients. The problem, though, is that most physicians lack the extraordinary persuasive powers required to keep the patient eating such a restricted diet. When Dr. Caldwell Esselstyn presented his study results, demonstrating in some cases a reversal of near end-stage heart disease with a whole-food plant-based diet, the chair of Cleveland Clinic's cardiology department asked, how can we expect patients to stay on a strict diet like this when we can't even get them to quit smoking? Just like penicillin drugs don't work at all, unless you take them. Plant-based diets don't work unless you actually eat them. I think the answer is that the physician must have a zealous belief in the diet and must convey that passion to the patients. For Kempner to keep his patients on the rice diet, Kempner browbeat yelled at and castigated them when he caught them straying, and he didn't just browbeat them. He sometimes actually beat them. It came out in a lawsuit, in which a former patient sued Dr. Kempner, that he had literally whipped her with a whip and other patients to motivate them to stick to the diet. Reminds me of the famous diabetes physician Arnoldo Cantini back in the 1800s, who knew that the remedy for diabetes is not at the drugstore, but in the kitchen to ensure compliance if necessary, he would lock a patient up for six weeks. Thankfully, in terms of personality, Dr. Esselstyn is the opposite of Dr. Kempner, polite, soft, smoky, and gentle, able to keep his patients on track without whipping them. And last but not least, Esselstyn walks to talk following the diet himself, whereas Kempner died of a heart attack, though at the age of 94. His work continues on in Durham, where they continue a relaxed version of the diet, allowing actual vegetables. A year before Roosevelt died, Kempner had already published his miraculous results. It seems highly likely that, had the rice diet been provided to President Roosevelt a year before his death, his disease might have been controlled before his fatal stroke, and that this fatal event could have been averted.