Part 16: Taking Flight

Beginning with a two-room “death lab” in 1961, R Adams Cowley built a trauma care empire that stretched from the University of Maryland Hospital to ambulances and first responders in every corner of the state.

Through the Maryland Institute of Emergency Medical Services Systems (MIEMSS), of which he was also director, Cowley controlled every facet of EMS in the state: training standards and educational curriculum, ambulance inspection and regulation, protocols for field care, and communications. The statewide EMS radio switchboard, called SysCom, was located in an office within Shock Trauma.

Through its collaboration with the Maryland State Police, MIEMSS had its own helicopter fleet that could transport a patient from an accident scene to a trauma center within 30 minutes from anywhere in the state. Wall-to-wall coverage. Maryland is still the only state able to deliver that level of care to its residents.

Cowley fought countless battles to develop his vision of an integrated statewide EMS system, using the weight of a growing body of clinical data and the persuasion of his powerful personality.

During his lifetime, Cowley fought to keep the university hospital’s clinical services from interfering with the revolutionary and sometimes controversial treatment developed at Shock Trauma – particularly the Department of Surgery.

Shock Trauma’s clinical center was a hospital within a hospital, with its own operating rooms, its own dedicated staff of surgeons and nurses, its own clinical lab and radiology, and its own anesthesiologists.

Shock Trauma even had its own color scheme – Pepto-Bismol pink scrubs. Pink is also used in prisons for its reputed soothing and calming effect.

One immovable object Cowley's nearly irresistible force could not overcome was the Federal Aviation Administration, which forbid helicopters from landing on the roof of University Hospital. Cowley’s vision for an ideal trauma center had helicopters land on the roof and patients taken by dedicated elevator directly into operating rooms on the hospital’s upper floor.

Out of the question, the FAA said. You can’t land a helicopter on top of patient rooms.

So Cowley commandeered the upper deck of the Penn Street parking garage across the street from Shock Trauma and had it made into a helicopter landing pad.

Shock Trauma had its own ambulance, the sole job of which was to transport patients from the roof, down six flights on the parking garage’s ramps, cross the street and back into the loading dock behind University Hospital, next to the dumpster.

Inside a set of swinging double doors, a broad orange stripe on the floor led down the hall and around the corner through the hospital’s basement to a dedicated elevator that took patients up to Shock Trauma’s clinical center on the second floor.