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.

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