# R Adams Cowley

R Adams Cowley (July 25, 1917 – October 27, 1991) was an American surgeon considered a key pioneer in emergency medicine and the treatment of life threatening Shock following severe traumatic injury. Physical trauma|trauma]]. Called the "Father of Trauma Medicine", he was the founder of the United States' first trauma center at the University of Maryland in 1958, after the United States Army awarded him $100,000 to study the effects of shock in wounded soldiers—the first award of its kind in the United States. The trauma unit at first consisted of two beds, and was later expanded to four beds. Many people called the four-bed unit the "death lab."
Cowley popularized the concept of the "Golden Hour" in trauma medicine: the period of 60 minutes or less following traumatic injury when immediate definitive care is crucial to a trauma patient's survival. He was a leader in the use of helicopters for medical evacuations of civilians, beginning in 1969, and founded the Society of Thoracic Surgeons.
He also founded the nation's first statewide EMS system, the Maryland Institute for Emergency Medical Services Systems (MIEMSS) by Executive Order of Maryland's then Governor Mandel in 1972, as well as the National Study Center for Trauma and EMS, enacted by Congress in 1986 and signed into law by President Ronald Reagan.
He is also known for being one of the first surgeons to perform open-heart surgery and invented both a surgical clamp that bears his name and the prototype pacemaker that was used by Dwight D. Eisenhower.

## Career

As a professor of thoracic surgery at the University of Maryland, Cowley was the organizer of the world's first and longest-running "shock trauma" center. After years of research that he conducted in the 1950s, "The Death lab" was officially opened at the University of Maryland Hospital in 1955. The center was renamed in May 1989 The R Adams Cowley Shock Trauma Center of the University of Maryland Hospital. In 1944 while still in the U.S. Army, Dr Cowley had pioneered the once controversial but now universally accepted concept of the "Golden Hour," which he defined as the sixty minutes from time of injury to receive multi system treatment at a hid Shock Trauma Unit " Shock a momentary pause in process of death. Since invention of automobile injured patients had been taken, by ambulance, to the nearest hospital to left to die. To accomplish his goal, Cowley delegated, and shared responsibility for, trauma medicine with hospitals throughout the state of Maryland -the Johns Hopkins Hospital's was named Marylands Pediatric Trauma Center, the Curtis Hand Center of Union Memorial Hospital cared for all injured hands and fingers.Cowley named the Bay View Hospital. Cowley as states burn trauma center. In 1969, Cowley accomplished the first injured "civilian" helicopter transport service in the world with the assistance of the Maryland State Police Aviation Division. With over 400 published professional articles, chapters, books, and white papers to his credit, Cowley was a pioneer in raising awareness of trauma prevention. Prior to 1966 Dr Cowley was on the Board of the National Sciences Commission as well The Presidents Commission of Highway Safety. He was member of group of scientists who worked to write thr famous White Paper - Accidental Death and Injury- The neglected American Disease. The paper was the turning point for EMS in the USA. President Lyndon
Johnson and the country were shocked by recommendations of the White paper and countless laws were enacted to address this crisis.
Dr Cowley accepted Dr David Boyd for the first fellowship at shock trauma. Dr Cowley mentored Dr Boyd who he treated like a son. Dr David Boyd
went forward to develop excellent Trauma system at the Illinois Trauma Center.Dr Cowley started The Maryland Institute for Emergency Medical
Service System which in 1975 which recognized over 20000 Firefighters, Md State Aviation crews, nurses and physicians who worked together to save accident victims. Dr Cowley developed the original designation for Trauma Centers Level 1 , 2 .. still in existence today. He designated state wide hospitals like Curtis Hand Center, Union Memorial to get all hand and finger injuries, Johns Hopkins as the statewide pediatric trauma center, Bay View Hospital as states burn trauma center.With MIEMSS , he divided state into regions and selected and accredited hospitals to
be the trauma center for that portion of the state. MIEMSS was formally adopted by state in 1993. All EMS and hospitals were delighted excluding University of Maryland Medical Hospital who might lose a portion of patient revenue. Dr Cowley fought his entire life for saving accident victims. The University
of Maryland finally won battle to close the trauma center in 1972 moving all patients to main hospital. Unbelievably In 1972, Governor Mandel was left of in maryland mountains and told they must pick up severely injured accident victim. Governor Mandel was furious. He vowed to fire Dr Cowley.
Within hours Governor Mandel was in Dr Cowley's office fuming and Dr Cowley said he need not worry about firing him because the University of Maryland had succeeded in permanently closing trauma unit at midnight. Governor Mandel learned identity of patient of accident victim who chief clerk of the house in Annapolis. Governor Mandel rushed to Annapolis to issue Executive Order that pulled the trauma unit out of University hospital to Md State Dept of Health. In 2015, Governor Mandel died and his major accomplishment was funding the trauma unit ,MIEMSS and saving lives in Maryland. Sadly, the disdain between Dr Cowley and UMMS continued until his death in 1991.
In 1986, at Cowley's request and with the support of Maryland Senator Mathias, Ronald Reagan, then President of the United States, signed the an act authorizing the establishment of "The National Center For The Study of Trauma and Emergency Medical Services" and appointed Dr Cowley as its founder and first director. This center, is still in operation today is located at the University of Maryland. The University of Utah, which honored Cowley as one of Utah's most famous legends, requested and received the collection of his personal and professional papers.

## Military awards

* Congressional Certificate of Merit, Congress of the United States of America, March 19, 1980.
* World War II Victory Medal.
* World War II Army Occupation Medal.
* Appreciation for services rendered from the FBI, United States Department of Justice, December 1983.
* House Bill, June 11, 2013, to award a Congressional Gold Medal to R Adams Cowley in recognition of lifelong commitment to the advancement of trauma care. Sponsored by Dutch Ruppersberger and all Maryland Congressional members.
* Senate Bill, June 11, 2013, to award Congressional Gold Medal to R Adams Cowley in recognition of lifelong commitment to the advancement of trauma care. Sponsored by Senator Barbara Mikulski and Senator Cardin.

## Titles

* Professor of Thoracic & Cardiovascular Surgery, University of Maryland, School of Medicine
* Clinical Professor of Medicine, Pennsylvania State University
* Founder/First Director, Maryland Institute for Emergency Medical Services Systems
* Director, Charles McC. Mathias Jr., National Study Center for Trauma & Emergency Medicine. Approved by US Senate and House and signed into law by President Ronald Reagan.

## Memberships

* National Highway Safety Advisory Committee (Presidential appointee)
* National Coalition for EMS (chairman)
* White House Conference on Emergency Medical Services
* Society of Thoracic Surgeons (founding member)
* American Trauma Society (founding member and past president)
* Atlantic EMS Council (founding member and past president)
* Maryland State Highway Safety Coordinating Committee
* Governors Commission of Fire Services
* National Research Council: Committees on Shock, Hyperbaric Oxygenation and blood components

## Publications

* More than 400 medical journal articles.
* Textbooks: Trauma Care: Surgical Management; Trauma Care: Medical Management; Shock Trauma/Critical Care Handbook; Terrorism, Mass Casualties, Crisis: A Lessons Learned Approach; Emergency Management at an Airport Catastrophe; Shock Trauma/Critical Care Manual; Initial Assessment and Management; Pathophysiology of Shock, Anoxia and Ischemia; and collected papers in Emergency Medical Services and Traumatology.
* Editorial boards: Disaster Medicine; Journal of World Association for Emergency & Disaster Medicine; American Journal of Emergency Medicine; Emergency Department News.

### White papers

* "Accidental Death and Disability: The Neglected Disease of Modern Society." (He was a member of the committee of the National Research Council that wrote the landmark document.)
* "The Need for a National Trauma Institute: Conquering Our Most Expensive Health Problem."
* "An Evaluation of the Utilization of Human Blood Resources in the United States."
Papers and memorabilia collected by the University of Utah.

## Education

Before he obtained his M.D. degree, Cowley studied in and graduated from the Layton Public Schools of Layton, Utah and Davis County High School in Kaysville, Utah; in 1940, Cowley graduated eighth in his class at the University of Utah. He attended medical school at the University of Maryland, from which he graduated in 1944. Cowley completed a fellowship at the University of Michigan in Ann Arbor, Michigan. In the late 1940s, while serving in the U.S. Army, he received extensive surgical training in Europe.

## Honors

* "American Men of Medicine", 1961 (biographical sketches of notable physicians and surgeons who contributed services and scientific skill to the welfare of mankind)
* "National Research Council"
** Committee on Hyperbaric Oxygenation, 1962-1966
** Committee on Shock, 1962-1971
** Committee on Blood Components, 1970
* Consultant to Senator A. Cranston (Chairman Senate Sub-committee on Health) and Senator J. Glenn Beall on Federal EMS Legislation, 1972-1976
* "Chairman, Mid-Atlantic EMS Council, Inc.", 1973-1989
* Mayor's Professional Advisory Committee, 1973-1977
* Credentials Committee, American College of Surgeons, 1974-19890
* "Advisory Panel on National Health Insurance", "Subcommittee on Health, Committee on Ways and Means, U.S.House of Representatives", 1975
* Participant, "White House Conference on Emergency Medical Services", January 6, 1976
* Speaker, Subcommittee on Health on the Emergency Medical Services Systems Act Extension, January 23, 1976
* "Governors Commission on Fire Services", 1974-1975
* "Chairman, American College of Surgeons Postgraduate Course", "Thoracic Trauma and Pulmonary Insufficiency," Boston, Massachusetts.April 1976
* "Sponsor, U.S.A." Bicentennial Emergency Medical Services and Traumatology Conference, May 9–12, 1976.
* Program Chairman, Traumatology Track, U.S.A. Bicentennial Traumatology Conference May 9–12, 1976
* "Project Director, Inner Harbor Disaster Exercise, U.S.A.", 1976
* "Mayors Citation", May 10, 1976
* "Official Citation, Maryland House of Delegates" (House Resolution 461)
* "Governors Citation", April 5, 1977
* Moderator, Thoracic Trauma Symposium, 63rd Clinical Congress, American College of Surgeons.1977
* Presiding Officer, Thoracic Surgery Symposium,63rd Annual American College of Surgeons Clinical Conference, Dallas, Texas, October 1977
* "Distinguished Marylander Award", Advertising Club of Maryland, May 1977
* "Certificate of Distinguished Citizenship", State of Maryland, 1977
* Speaker, House Subcommittee on Consumer Protection and Finance of the Committee on Interstate and Foreign Commerce, September 9, 1977
* "Certificate of Appreciation, Maryland State Firemens Association", 1977/1979
* "Program Director, Emergency Management at an Airport Catastrophe", May 12–13, 1978
* "Presidential Appointee", National Highway Safety Advisory Committee, 1978
* "Governor Appointee", Maryland State Highway Safety Coordinating Committee, 1978
* "William S. Stone Lectureship Award", American Trauma Society, 1978
* "Distinguished Alumni Award" University of Utah, 1979
* Editor, "Emergency Department News,".1980
* "Baltimore's Best Award", January 17, 1980
* "Citation, Maryland Chapter, American College of Emergency Physicians", March 17, 1980
* "Congressional Certificate of Merit, Congress of the United States of America", March 19, 1980
* "Special Award, Developing the Nation's Premier Emergency Medical Services System", Bell Helicopter Textron, March 1990
* "Award for Public Service, National Highway Traffic Safety Administration", March 1980
* "Citation, Outstanding Service", Safety Council of Maryland, June 18, 1980
* Honorary Member, University of Maryland Police Department at Baltimore, 1980
* Chairman, National Coalition for Emergency Medical Services,1980
* Disaster Planning Conference, American Hospital Association, 1981
* Emergency Management Advisory Council, State of Maryland, 1981
* "Honorary Diploma, La Cruz Roja Mexicana y la Association Mexicana de Medicina Critica y Terapia Intensiva", August 1981
* Board of Directors, International Society of Emergency Medical Services, 1981-1982
* "Program Chairman, First International Society Assembly on Emergency Medical Services," June 1982
* Associated Italian American Charities Award for Outstanding Service, November 1982
* Pima County," Arizona Award of Appreciation", April 1982
* "Robert F. Kennedy Lectureship Award", University Association of Emergency Medicine, 1982
* "President", American Trauma Society, 1982-1984
* Public Service Helicopter Technology Transfer Advisory Group, "National Aeronautics and Space Administration", 1983-1989
* Appreciation Award for Services Rendered, Department of Justice," Federal Bureau of Investigation", December 1983
* Editorial Board, "Disaster Medicine" Journal, 1983-1990
* Editorial Board, "The American Journal of Emergency Medicine" 1983-1990
* Certificate of Appreciation, National Committee for Employer Support of National Guard and Reserves, June 1984
* "Andrew White Medal, Loyola University," March 1984
* Award for Public Service, National Highway Traffic Safety Administration, May 1984
* Member, Advisory Board, National Spinal Cord Injury Hotline, 1984-1988
* Editorial Board, "Trauma Quarterly," 1984-1990
* "Honor Award and Gold Key Recipient", University of Maryland, School of Medicine, May 10, 1986
* Civic Achievement Award, Engineering Society of Baltimore, April 23, 1986
* Editor, "Journal of the World Association for Emergency and Disaster Medicine," 1986-1989
* AAMC Award, Group on Public Affairs, October 1986
* "Resolution, State Senate of Maryland, In Recognition of MIEMSS Performance in Amtrak-Conrail Train Accident," 1987
* "1987 Stanley W. Gustafson Leadership Award, Highway Users Federation", November 4, 1987
* Publication Design Award, "The System Saving Lives," Noble Steed Associates, Inc 1987
* Award for Increasing Public Awareness of Red Cross Response to Amtrak Disaster, "American Red Cross", January 4, 1987
* "Awarded Honorary Presidency, Pan American Trauma Society", 1988
* Honors Award, The Maryland Speech-Language-Hearing Association, 1988
* Cited as one of the "150 People Who Shape the Way We Live." Baltimore Sun, 1988
* "Marylander of the Year Award". The Maryland Colonial Society, 1988
* 1988 Powell Lecturer, University of Maryland Dental School, 1988
* Elected to the "Hall of Fame" and Honorary Membership, Eastern Association for the Surgery of Trauma, 1989
* "Public Service Award, The American Trauma Association", 1989
* Editorial Board, "Emergency Medicine News," 1989-1991
* Resolution in Appreciation, The Fire Chiefs Council, Regional Planning Council, 1989
* Plaque in Recognition of Exemplary Performance. The Fire Chief's Committee of the Regional Planning Council, 1989
* "Certificate of Appreciation, American Red Cross", 1989
* "Man of the Year Award" The Arlene Rosenbloom Wyman Guild, 1989
* Clinical Professor of Medicine, College of Medicine, The Pennsylvania State University, Hershey, Pennsylvania 1980- 1991
* Professor of Thoracic and Cardiovascular Surgery, University of Maryland School of Medicine, Baltimore, Maryland 1960 - 1991

## Personal life

He was born in Layton, Utah, on July 25, 1917. Cowley was the son of pharmacist William Wallace Cowley, his family's first college-educated member, who was the founder of Kowley Drugs, a drugstore on Main Street in Layton, Utah. Cowley's mother, Alta Louise Adams, was a self-taught painter and mother of five boys. Cowley was from the country, where he enjoyed riding horses, raising cows and farming.
Cowley quit medical school at the University of Maryland because of homesickness for family and country life. Upon hearing this, the medical school dean raced to the bus station, found young Cowley, and offered to let him live in his home if Cowley returned to his studies.
Cowley was married to Roberta Cowley, a speech–language pathologistfrom Univ of Va. who worked with him at Shock Trauma. Cowley had a son, R Adams Cowley II, who was born three weeks prior to his own death, and a daughter, Kay Cowley Pace, from prior marriage that ended in a 1960 divorce. Cowley's son R Adams Cowley II, an Eagle Scout, graduated from the Gilman School, Maryland, Vanderbilt University; Georgetown University, MS, Georgetown School of Medicine, 2020 , Georgetown residency in Orthopedic Spinal Cord Surgery, (2025) and Washington University St Louis, Fellowship Orthopedic Spine Surgery(2025-2026)
An amateur oil painter, Cowley donated one of his finest paintings, Winterscape,to raise funds for the first Shock Trauma Gala.
Spencer Adams, Cowley's uncle, played professional baseball with the New York Yankees.
Cowley was passionate about classical music, his favorite composer being Mozart.On weekends classical music starting blaring at 5AM.
Cowley collected Porsche's, Mercedes...
He was licensed pilot and enjoyed making many plastic helicopters while thinking of ways to get severely injured patients to him within his "Golden Hour" he discovered doing research at UMAB in the fifties. Cowley defined his Golden Hour as a momentary pause before death.
Though he could have afforded a home from his earnings as a doctor, Cowley lived in a modest efficiency apartment minutes from his beloved shock trauma. Apt was stacks of countless books piled everywhere even inside his stove and refrigerator.
Cowley worked sixteen-hour days, seven days a week, to bring his vision of creating trauma medicine to fruition; sometimes he even slept on hospital x-ray tables. One Christmas, University of Maryland carpenters presented Cowley with an eight-foot orange handmade bench so he would stop that practice.
Cowley joked that he missed seven sabbaticals. He refused to take vacations from 1944 till his passing in 1991.
Cowley loved his nurses. He regularly paid out of pocket for lunches, dinners and bonuses to thank them for passion and support of trauma center.
After Cowley's death, his personal and professional papers, awards, and memorabilia were requested by and donated to the University of Utah Marriott Library, where he was named one of "Utah's Heroes." He was a member of the Church of Jesus Christ of Latter-day Saints.
Cowley died suddenly on October 27, 1991 holding his 3 week old son. He is buried in the old section of Arlington National Cemetery.

### Cowley's first name

One of Cowley's grandfathers, Utah State Senator Rufus Adams, had yearned for years for a namesake grandson"Rufus" One of Senator Adams's daughters, Alta Louise, Cowleys mother half-heartedly agreed. However, after the birth of Cowley, his mother started to write "Rufus," but stopped after writing "R [with no period] Adams Cowley." Cowley's official first name became simply "R no period Adams Cowley and he insisted that name be used.ref>Franklin, Jon; Doelp, Alan (1980). Shocktrauma. New York: St. Martin's Press. ISBN 0-312-71741-5.</ref>

## Media portrayal

Cowley is the subject of the 1982 television movie film Shocktrauma, in which he is portrayed by William Conrad. This made for Public Broadcast Service TV was sponsored by General Foods.