Dr. Mary Fowkes, a neuropathologist at Mount Sinai Hospital in Manhattan, whose autopsies of Covid-19 victims found serious damage to multiple organs at the start of the pandemic – a finding that led to the successful use of higher doses of blood thinners to treat patients – died on Nov. 15 at her home in Katonah, NY, in Westchester County. She was 66 years old.
Her daughter Jackie Treatman said the cause was a heart attack.
When Dr. Fowkes (rhymes with “bumps”) and her team began their autopsies, little was known about the novel coronavirus, which was believed to be largely a respiratory disease. The first few dozen autopsies showed that Covid-19 affected the lungs and other vital organs, and that the virus likely traveled around the body in the endothelial cells that line the inside of blood vessels.
“We have seen very small and very microscopic blood clots in the lungs, heart, liver, and significant blood clots in the brain,” said Dr. Fowkes in an interview on the CBS newscast “60 Minutes” for a segment that aired Nov. 22 about the long-term effects of Covid-19. She had been interviewed by correspondent Anderson Cooper on October 30, a little over two weeks before her death.
The clots in the brain suggested there had been strokes, she told Mr. Cooper.
Mr. Cooper asked if she expected to see the breadth of damage in so many organs.
“No, not at all,” said Dr. Fowkes. “Nobody saw it that way.”
Dr. Fowkes “had a curious scientific mind and an uncompromising attitude to do as many autopsies as possible to produce something unique,” said Dr. Carlos Cordon-Cardo, chairman of the Department of Pathology, Molecular and Cell-Based Medicine at the Icahn School of Medicine on Mount Sinai, said in a telephone interview.
Dr. Cordon-Cardo said the results of the autopsies of Covid patients carried out by Dr. Fowkes’ team lead to an aggressive increase in the use of blood thinners, which has led to a marked improvement in the health of some patients. The drugs have been adjusted to take into account the patient’s increased immune system response to Covid, he said.
Dr. Fowkes and others involved in the Covid autopsies wrote a paper about their results and published it in May, but it has not been peer-reviewed and published.
Mary Elizabeth Fowkes was born on November 1, 1954 in Clayton, a village in north New York, and grew up in Syracuse. Her mother, Isabel (Walroth) Fowkes, was a social worker. Her father, Glen, wrote insurance policies.
Dr. Fowkes graduated from SUNY College of Environmental Sciences and Forestry in Syracuse in 1977 and then worked as a medical assistant.
To improve her chances of studying medicine, she became a technician in a cell and developmental biology laboratory and then enrolled in a doctoral program in anatomy and cell biology at SUNY Upstate Medical University, also in Syracuse. She eventually enrolled in a combined Ph.D.-MD program at the school, graduating with both degrees in 1999.
Dr. Fowkes graduated from Beth Israel Deaconess Medical Center in Boston with a degree in pathology in 2003. She then received fellowships in neuropathology at New York University Medical Center and in forensic pathology in the chief physician’s office in New York City, where she was mentored by Dr. Barbara Sampson, who was on the staff at the time in 2006 and is now the city’s chief physician.
“What she really learned from us is what can be learned from an autopsy, the importance of closing families, and how important an autopsy is to public health and understanding of disease,” said Dr. Sampson in a telephone interview.
After her city scholarship, Dr. Fowkes entered the Icahn School as an assistant professor of pathology and stayed with the faculty until her death. In 2012 she was appointed Director of Neuropathology on Mount Sinai and two years later Director of Autopsy Services. She encouraged the hospital to do more autopsies, relying on her educational value, and pushed for an expansion of the hospital’s brain bank.
Her extensive research recently included an emphasis on recurrent meningiomas, slow-growing benign brain tumors.
She also looked after many young doctors, including Nadia Tsankova, a neuropathologist.
“I was very excited about the combination of research and clinical service,” said Dr. Tsankova in an interview. “And Mary was very passionate about research. Sometimes you take a job and strive for something and your boss says, “No, you have to do this.” But she would say, “I understand what you have to do and we will make it work.”
Dr. Fowkes viewed autopsies as essential to understanding disease and felt compelled to perform them on Covid victims even though she was in an at-risk age group.
When performing autopsies, which are done on the first floor of the hospital, she used an oscillating saw to open the cranial cavity to remove the brain, potentially exposing her to the virus through aerosolized pieces of bone and blood.
“There were only four pathologists willing to risk their lives to perform autopsies on these cases,” said Dr. Fowkes the BBC in June. But she added, “I felt it was extremely important to do this job so that we could get some answers so that we could know how to properly treat patients. So we used all the protective gear, but we were still very scared, to be completely honest. “
Since protective equipment was scarce in late winter and early spring, Dr. Fowkes used an N95 mask for a week at a time.
Alongside her daughter, she is survived by her mother; one son, Derek Treatman; and her brothers Mark (her twin) and John. Her marriage to Scott Treatman ended in divorce.
During the 60 minute section, Dr. Fowkes held a slice of the cerebellum of a Covid victim in his left hand. Mr. Cooper pointed to a brown depression in the brain.
“Is that a stroke?” he asked.
“It’s a stroke,” she said.
At the end of the report, Mr. Cooper announced to the audience that Dr. Fowkes died.