In Memoriam: Mark Mahowald, MD (1937-2020)

Download the obituary from Sleep Medicine Journal May 2020 or read online.

March 25, 2020: It is with sadness we announce the passing of Dr. Mark Mahowald from complications following a brain stroke in January 2019. Dr. Mahowald was well-established as a member of the sleep medicine and research community in his work as a researcher, educator and physician.

Dr. Mark W. Mahowald made an impact in sleep medicine and research, especially in the area of parasomnias where he made strides in the diagnosis and treatment of the sleep disorder. Dr. Mahowald’s clinical research interests also included forensic sleep medicine and the importance of partnership between scientists and clinicians. View his full obituary in the Star Tribune.

Tributes from the Sleep Medicine Community
His colleague, Carlos Schenck, MD stated, “What a loss. But also what a blessing he was in my life, and in the lives of all RBD researchers and parasomnia researchers. In 1991, Mark was the first author of the great paper on Status Dissociatus. Just one example of his magnum opus.”

Meir Kryger MD, FRCP said of his passing, “Mark was an unbelievably generous friend, mentor and teacher. He was my go-to expert when some cases were over my head, such as the a neuromuscular patient that we published together (Kryger MH, Steljes DG, Yee WC, Mate E, Smith SA, Mahowald M. Central sleep apnoea in congenital muscular dystrophy. J Neurol Neurosurg Psychiatry. 1991;54(8):710–712). He helped shape the field of sleep medicine. My condolences to his family and to his colleagues and students who considered him family. Mark, I salute you!”

 

Tributes to Mark W. Mahowald received from colleagues by emails sent to Carlos H. Schenck, MD

Last week my friend and colleague Mark Mahowald died. He was a remarkable man on so many levels. He was a great clinician and scientist. He had a brilliant sense of humour and loved colourful language. He was a champion of basic science, and was one of the first clinicians to encourage my research in REM sleep and its involvement in neurodegeneration. But, his most memorable quality was his kindness. Mark, I owe you a debt of gratitude! He will be missed and fondly remembered.

John Peever, PhD
Professor – Department of Cell & Systems Biology
University of Toronto
VP Research – Canadian Sleep Society

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These are deeply saddening news. Such a giant to our field of neuroscience as a whole, and an inspiration. I remember when I participated in my very first APSS conference, still as a Research fellow in Argentina, I had a travel grant from the APSS and this was in 1996 I think. After an inspiring Symposium on RBD I went to the speakers podium and Mark attended me (great and unprecedented experience for me, that such a world famous researcher took the time to talk to a student he did not know and who had not published anything). had some specific question about scoring of sleep in PD, and how to proceed when the pattern in PSG would not fit to strictly follow all R&K and Mark said something like “ ….Oh, the rules do not work in PD Sleep” and “you have to make new rules for that.” This was extremely encouraging, to hear from him as the world expert, that my difficulties and doubts when working with these PSG studies were in a way justified and that I was not alone with them. And by saying this single short statement, Mark really helped to shape my whole future career, because a large part of my scientific work has been, and is still based on how to improve the accuracy of diagnosis of RBD, quantification of specific RBD-related PSG measures, and developing novel methods to detect/screen for RBD. And I know that Mark as a reviewer helped to improve our manuscripts so much that they could get published in Sleep and other journals, and certainly did so for many other researchers in the field. The great achievement the RBD group and field has now would have been impossible without him. I am glad that our [first RBD] book was published in time so he could hopefully enjoy the dedication.

Birgit Högl, MD
Professor of Neurology
Medical University of Innsbruck, Austria
President, World Sleep Society

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It is very sad news, Mark was a great man. I have always been impressed by his creativity and the strength of his science. Each of his presentations was thoughtful, innovative and provocative. His research has been seminal and had a major impact in the fields of neurology and sleep medicine. I would like to express my deepest condolences to his family and friends and especially to Carlos who has been so close to Mark throughout the years.

Jacques Montplaisir, MD, PhD, FRCP (C)
Professor, Department of Psychiatry, Université de Montréal
Director, Canadian Research Chair in Sleep Medicine
Center for Advanced Research in Sleep Medicine (CARSM)
Québec, Canada. H4J1C5
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Mark played such a major role in the lives of so many. His warmth, laughter, brilliance and pure love of medicine and people was infectious. He truly made the world a better place and I will miss him dearly.

Brad Vaughn, MD
University of North Carolina, Chapel Hill
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He was a giant in all ways; his impact on the field, his personality, and spirit….and will be greatly missed by all.

Erik K. St. Louis, MD, MS
Co-Director, Center for Sleep Medicine | Associate Professor of Neurology, Mayo Clinic College of Medicine | Departments of Neurology and Medicine
Director, Mayo Sleep Behavior and Neurophysiology Research Laboratory
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I so benefited from Mark’s experience early in my career and I have always deeply valued his insights. A real giant who will be sorely missed.

Michael H. Silber, MB, ChB
Mayo Clinic Department of Neurology and Sleep Disorders Center
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We are all so fortunate to have known him and benefited from his teaching, support and friendship. Mark has certainly left a deep enduring mark in our field.

Phyllis C. Zee, MD, PhD
Northwestern University Dept. of Neurology and Center for Circadian and Sleep Medicine
President-Elect, World Sleep Society

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A true giant in so many respects. This news is hitting of all us hard. One of Mark’s many endearing qualities was his honest comments. I had the great pleasure of working with Mark briefly during my Mayo sleep medicine fellowship 25 years ago in 1996, and I vividly recall some statements from that experience that I may share with a few others which were brutally honest yet excellent advice. I learned so much from him in many discussions with him since then, and in his erudite writings with Carlos and others. During our first meeting, Mark said something like, “So you think you know something about RBD? I’m sure you don’t, but I will try to guide you.” He sat me down and discussed states of being, status dissociatus and implications for RBD, reviewed some videos and PSGs of pts with RBD, etc. He gave me homework to read about parasomnias and related topics, including Jouvet’s work. His passion for teaching trainees was obvious, and his wry sense of humor made learning with him fun.

Bradley F. Boeve, M.D.
Mayo Clinic

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I have just got this sad news. I can only say that some people leave a trace for many generations and Mark Mahowald belongs to them. He was an exceptional clinician and researcher. His contribution to medicine and research will guide us in our work further.

Prof. MUDr. Karel Šonka, DrSc.
Department of Neurology and Center for Clinical Neuroscience
First Faculty of Medicine, Charles University and General University Hospital
Prague, Czech Republic
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It’s deeply sad news in so bad times. We will remember Mark for his outstanding scientific contribution given to Sleep Medicine and for his beautiful smile.

Federica Provini, MD, PhD
IRCCS Institute of Neurological Sciences
UOC NeuroMet, Bellaria Hospital
and Department of Biomedical and NeuroMotor Sciences,
University of Bologna
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Mark was an excellent clinician, curious and original researcher, excellent leader and an example for colleagues. I had the great pleasure of visiting Mark and Carlos in Minneapolis in 1990 at a time when there was little focus on sleep medicine and, in particular behavioral abnormalities during sleep. They gave us an understanding of the phenomena that seemed strange and incomprehensible to others. Mark was a unique person with whom we enjoyed his direct and friendly manner. The honor be his memory.

Poul Jørgen Jennum
Professor, chief physician, DMSc
Danish Center for Sleep Medicine
Department of Clinical Neurophysiology
University of Copenhagen Denmark
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Mark was a true original. He thought of things that others did not, and as a result he moved the field forward. That is a high complement, and his thoughtful iconoclasm will be missed.

Clifford B. Saper, MD, PhD
James Jackson Putnam Professor of Neurology and Neuroscience, Harvard Medical School
Chairman, Department of Neurology, Beth Israel Deaconess Medical Center
Editor-in-Chief, Annals of Neurology
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I had the unforgettable memory of Mark, when I met him, in front at my poster on RBD and MSA at the AAN probably in 1995. He was a nice, gentle and stimulating person. And I also remember his great talk on RBD when he came in Bologna in 2000 invited by Professor Lugaresi, and then came to visit our lab. He communicated his enthusiasm to shed light in original and unexplored fields of neurology.

Giuseppe Plazzi, MD
University of Bologna
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He was indeed an exceptional person- excellent, innovative, candid and so often with humour! He will be sorely missed!

Milena Pavlova, MD
Harvard Medical School
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Mark was really a great man and scientist. His research has been fundamental in the field of sleep in neurology.

Luigi Ferini-Strambi, MD, PhD
Full Professor of Neurology
Chair, Dept. of Neurology OSR-Turro
Director, Sleep Disorders Center
Università Vita-Salute San Raffaele
Milan, Italy
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Mark was an unbelievable and good man, always smiling and with encouraging words for all of us. He was a pioneering scientist for neurology in sleep medicine and with innovation and new theories in each talk he gave.
We sorely missed him!

Marco Zucconi, MD
Università Vita-Salute San Raffaele
Milan, Italy
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I am so saddened to learn of Mark’s passing. I don’t have to tell you what a kind, supportive and encouraging man he was, but that is exactly how he acted with me from the first time I met him as a young post-doc in the mid 1990s. And he remained that way ever since. As little as 2 years ago, he took the time to write to me to congratulate our team on one of our papers on EEG connectivity and sleepwalking. Few people ever take the time to do that. I have the feeling that Mark did these little, but very meaningful things all of the time.

Antonio Zadra, PhD
University of Montreal
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Mark’s concept of dissociated states of wakefulness/sleep with the three crossing circles is just brilliant. I always use his image to explain how he shaped our minds. I will remember his laughing voice and the pleasure I had to read his thoughts in your common papers, and to discuss with him (last time was in Prague, we had a long discussion at a table, just the two of us, that was great!)

Pr Isabelle ARNULF – cheffe de service, neurologue
Service des Pathologies du Sommeil
Hôpital Pitié-Salpêtrière
PARIS
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Mark was really inspiring for me. It is a terrible loss for the sleep field and for all of us. I am grateful for all I learnt with him. I had a wonderful time during my fellowship in MN, thanks to you and to him.

Rosana Alves, MD, PhD
Sao Paulo, SP, Brazil

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A seminal contribution was Mark Mahowald’s concept of the self as a constantly shifting set of states with multiple component elements. As a neurologist, he gave this idea clinical import in his work with Carlos Schenck on the REM sleep behavior disorder. Schenck and Mahowald recognized not just a new disease but an instructive condition.

Symptoms and normal psychophysiological features (such as muscle tone, mobility itself, hallucinatory perceptions and delusions) could all be better recognized by a quantitative statistical model rather than the linear model of traditional medicine. A person has one or more of the components some of the time whereas at others, he may have few or none of these manifestations. State dependence is the very essence of sleep medicine.

Mahowald’s unusual sensitivity enabled him to maintain contact with and appreciation of basic science at a time when sleep medicine was in danger of losing contact with its roots in neuroscience. All too often, clinicians and basic scientists were competing rather than cooperating as power politics increasingly separated two levels of discourse that had so much to say to each other. Related to his inclusive and warm personality was his genuine enthusiasm for fundamental phenomena rather than mere surface appearances. He moved effortlessly from the bench to the bedside, from Hennepin County, Minnesota to Palo Alto, California, and from brain to mind, and back again. Thus Mark Mahowald was a true pioneer of the new BRAINMIND science.

J. Allan Hobson, M.D.
Harvard Medical School
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I first met Mark at a 1987 or 1988 session of the Multi-site Training Program for Basic Sleep Research. This program was created and directed by the late Michael Chase and held at the Lake Arrowhead Conference Center. Mark participated as a member of the course faculty. Michael’s insight was to use the Arrowhead meeting as a vehicle to build community between established investigators, students, and junior investigators. I knew Mark via his published work but we had never met. When boarding a bus to be transported from one training venue to another, Mark passed many empty seats and asked if he could sit with me. We introduced ourselves and started a conversation the tone of which I will always remember. Mark was relaxed and natural and treated me as a colleague despite his being established and me being…far from established. This was the start of a dialog and friendship that continued for decades. Years after meeting Mark at Lake Arrowhead, an annual sleep meeting was held in Minneapolis. At that meeting I was invited to a dinner that included Michel Jouvet. I was honored to be included and when I thanked Mark for the invitation, he smiled and said he was not involved in creating the guest list. Mark Mahowald’s modesty and kindness were as enormous as his scientific contributions. I will always value the gift of Mark’s friendship.

Ralph Lydic, PhD
Professor of Psychology, University of Tennessee, Knoxville, TN

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Mark was a great neurologist and I enjoyed talking with him and participating in the several sessions where he was discussing different parasomnias, RBD and other bumps. He had also prepared many excellent videos. Mark was also very interested, and he knew a lot about different cultures. My condolences to his nearest people.

Markku Partinen, MD, PhD, FAAN
Helsinki Sleep Clinic, Vitalmed Research Center, Finland

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In my lectures on parasomnias, I used to use the phrase “state boundary.” When I discussed parasomnias with Mark, he used the phrase “state declaration.” So much better than mine.

Helene Sophrin Porte
Cornell University

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I first met Mark at one of the Summer Sleep Workshops organized by Michael Chase at the UCLA Conference Center in Lake Arrowhead, CA. Mark’s intelligence, knowledge, sense of humor, and enthusiasm for his work were traits that I instantly admired. Mark was a master at integrating his clinical expertise with his basic neuroscience knowledge, to the benefit of sleep research and sleep disorders medicine. Mark generously shared his insights with his trainees and colleagues. For many years I co-directed a course at the University of Michigan entitled “Sleep: Neurobiology, Medicine, and Society,” which was taught by basic science and clinical faculty. Mark participated as a guest lecturer, speaking on Narcolepsy and State Dissociations. His lectures were masterful, as he wove together dramatic stories of crimes committed during sleep with neurological data to propose possible underlying mechanisms and a conceptual model. Mark and I often discussed our shared interest in state dissociations , which I observed in preclinical models and he treated in his patients. I am grateful to have known him.

Helen A. Baghdoyan, PhD
Professor of Psychology
University of Tennessee Knoxville

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I first got to know Mark well at the first sleep meeting in India. There were only 3 speakers: Mark, Colin Sullivan and myself and we each have four presentations. Besides being confused that someone as junior as I was could mix in with two well known leaders in the field, it opened the door to a long term relationship with points we agreed on and some ( Eg the impact of alcohol on parasomnia ) but the key with ark it was always with an open mind and a desire to learn. My memories of him are of having a youthfulness in his approach and I am surprised to learn his age. He was always a gentleman in every sense of the word

Colin Shapiro, PhD, FRCPC
Professor of Psychiatry and Ophtalmology
University of Toronto

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I’ve known Mark Mahowald since the early 90’s and he gained my sincere admiration with his theories on interchanging states of being. Since then, I read all or most of his papers and used several of his concepts and figures in my lessons to medical students and neurology residents. Besides being an outstanding scientist, he was also and foremost an exceptional human being: shy, honest, and inherently enthusiastic. I feel privileged to have been his friend and student. He will be deeply missed in the Sleep community!

Rosalia Silvestri, MD
Professor of Neurology
University of Messina Sleep Medicine Center, Italy

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