R. Adams Cowley, MD (1917-1991)

Cowley was a pioneer in the field of open-heart surgery in the U.S., performing operations before the heart-lung machine was widely used. Despite his expertise and the success of the operations, patients were still dying from shock, not always immediately but sometimes within days or weeks. Cowley referred to shock as "a momentary pause in the act of death," a process that, once set in motion, was irreversible. Developing the concept of the "golden hour," Cowley recognized that if you could get a trauma victim to the appropriate care before that point, the patient was more likely to survive.

Starting with one trauma unit in 1960, the Baltimore Shock Trauma Center was born. Encouraging trauma patients everywhere to be transported to trauma centers, Cowley pushed the Maryland State Police's Aviation Division to become one of the first ALS medevac transport systems in the world; in 1973, he convinced Maryland's governor to issue an executive order establishing the Maryland Institute for Emergency Medicine, which later absorbed EMS and became the Maryland Institute for Emergency Medical Services Systems (MIEMSS), the first statewide EMS system. Cowley was appointed as its director. Over 30 years later, MIEMSS is still recognized as one of the world's best EMS oversight systems.