Remembering Dr. R Adams Cowley: A Revolutionary & Pioneer of Trauma Medicine

Dr. Cowley in the old CCRU

Dr. Cowley (center) instructing in the old CCRU

Dr. R Adams Cowley passed away 25 years ago today, but his contributions will live on forever in the form of thousands of lives saved.

R Adams Cowley, MD, a cardiothoracic surgeon, was the founder of United States’ first trauma center, University of Maryland R Adams Cowley Shock Trauma Center, and the Maryland EMS System. He revolutionized trauma medicine and is responsible for the development of the “Golden Hour” concept. As Dr. Cowley explained in an interview: “There is a golden hour between life and death. If you are critically injured you have less than 60 minutes to survive. You might not die right then; it may be three days or two weeks later — but something has happened in your body that is irreparable.”

Drs. Gens and Cowley

Dr. Cowley (left) with fellow trauma surgeon Dr. Gens in 1983

“R Adams Cowley was a pioneer, a man of immense vision and the father of American trauma care systems,” Dr. Thomas Scalea, Shock Trauma Physician-in-Chief, said. “At a time when we take organized trauma care for granted, it is important to remember that none of this would have happened without him and a few others who refused to take no for an answer. They fought the political and medical battles to demonstrate that organized trauma care saves lives. I am privileged to continue his legacy.”

Open Heart Surgery

A Baltimore Sun photo shows Dr. Cowley performing open-heart surgery on a 2-year-old boy

After many years of research and discussion, in 1958, the Army awarded Dr. Cowley a contract for $100,000 to study shock in people. He developed the first clinical shock trauma unit in the nation; the unit consisted of two beds (later four beds). By 1960, staff was trained and equipment was in place.

In 1968, Dr. Cowley negotiated to have patients brought in by military helicopter to get them to the shock trauma unit more quickly. After much discussion with the Maryland State Police, the first med-evac transport occurred in 1969 after the opening of the five-story, 32-bed Center for the Study of Trauma.

In 1970, Dr. Cowley expanded his dream, feeling that not a single patient should be denied the state-of-the-art treatment available at his trauma center in Baltimore. He envisioned a statewide system of care funded by the state of Maryland available to anyone who needed it.

Airport Drill

Dr. Cowley leads a drill at the airport

His dream became a reality with the intervention of former Governor Marvin Mandel. Governor Mandel became interested in Dr. Cowley’s program when a close friend was severely injured in a car crash. In 1973, the Governor issued an executive order establishing the Center for the Study of Trauma as the Maryland Institute for Emergency Medicine. The order simultaneously created the Division of Emergency Medical Services. Dr. Cowley was appointed as director.

Maryland had the first statewide EMS system, and it, like the Shock Trauma Center, has become a model worldwide. Countless lives have been saved due to Dr. Cowley’s vision.

r-adams-cowley-studentsWe thank you, Dr. Cowley, and will always remember your legacy.





6 thoughts on “Remembering Dr. R Adams Cowley: A Revolutionary & Pioneer of Trauma Medicine

  1. I started volunteering on 4C in 1977 then started working as a FT RN in 1978. I remember Dr. Cowley as a very humble and compassionate man. He was always very approachable and available to talk. He thought highly of “his” nurses and would not hesitate to inform new Attendings, Fellows and Residents to listen to the nurses since “they were highly trained”.
    I was very saddened to know of his death and can hardly believe it has been this long. I admired and respected him and am very proud that I was a small part in his vision.

  2. I worked in Trauma years ago, and on a busy night Dr. Cowley offered to get me a coffee. A nice guy!

  3. I visited with dr. Cowley in the eighties and enjoyed a wonderful hospitality !
    Dr Cowley’s work was a great inspiration for the trauma care in my Emergency Department in the University Hospital of Leuven, Belgium.
    I remember how Dr. Cowley took me to the market for lunch: oysters, roastbeef and yogurt ice cream ! What a plaisure !
    Dr. Cowley visited my department, but unfortunately he was then telling me this would be his last trip to Europe because his health was declining. He unfortunately passed away soon after his visit.
    What a great man and what a previlege to have been a friend !

  4. Without medical pioneers like Dr. Cowley, we definitely would not be advancing medicine at the rate we currently are.

  5. I first me Dr.Cowley in 1960 because we had Utah connections, and visited with him as a lonely Western Friend. Our friendship was very intense and he inspired me to never give up. Due to my own inadequacies I was asked to leave Medical School during my Junior Year in School. During three years of soul searching, his inspiration pushed me to try again. In 1970 I graduated with honors from medical school in the Philippines and developed a small town Medical Practice in Idaho. As a member of the Idaho Academy of Family Practice I attended a Safety Meeting in Washington and was able to visit again with Dr.Cowley as director of the Trauma Unit. He resurrected my dreams and it was my privilege to thank him for always being a true friend. I also thank this website for reviving these precious memories.

  6. I am honored to have served in our University of Maryland SHOCK-TRAUMA Unit and in our University of Maryland Cardiovascular Surgery O.R. learning from our most highly distinguished Professor of Surgery R. Adams Cowley, M.D., M.A.C.S. I put what I learned under his tutledge during my Active Army Military Deployment in the Far East where I served as Chief of Medicine 121st Evacuation Hospital APO SF 96220 and as Commanding Officer 548th General Dispensary APO SF 96301.

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