Nearly four decades ago, Baltimore's fledgling shock trauma center saved the life of a 29-year-old prosecutor. The young lawyer returned months later to ask the medical staff how he could repay their effort.
"Run for office," center founder Dr. R Adams Cowley told C.A. Dutch Ruppersberger. "We need all the help we can get."
The exchange would alter the course of both of their careers. Ruppersberger would win election to the Baltimore County Council, rise to county executive and eventually become a member of Congress. And Cowley would gain a powerful and persistent ally for his innovative new center.
On Monday, Ruppersberger and two other members of Maryland's congressional delegation announced legislation to honor Cowley posthumously with the Congressional Gold Medal — the highest civilian award Congress can bestow.
Cowley, who died in 1991, founded the nation's first trauma center at the University of Maryland in 1958 with a grant from the Army. He conceived of the "golden hour," the idea that the care a patient receives in the first 60 minutes after a trauma is critical to survival.
A thoracic surgeon, Cowley was one of the first doctors to perform open-heart surgery. He invented a surgical clamp that bears his name. And he developed a pacemaker used by President Dwight D. Eisenhower.
He began the trauma unit with two beds. Today, the Maryland Shock Trauma Center is a free-standing hospital within the University of Maryland Medical Center, with 160 beds and 10 operating rooms.
Ruppersberger's car accident left him with dozens of broken bones, torn lungs and head injuries that led to brain swelling. He required 47 pints of blood and spent a month in the hospital.
"As a result of this institution, I'm here now," the Baltimore County Democrat said Monday at a small gathering at the medical center in Baltimore. "I think you would be an advocate, too, if you were involved in an institution that saved your life."
Congressional rules require two-thirds of the House and Senate to cosponsor legislation to award the medal — 290 House members and 67 senators. Congress has bestowed the award 155 times since the American Revolution; recipients include George Washington, Winston Churchill and George and Ira Gershwin.
"Anybody who's in the field of medicine — and especially in Maryland — knows exactly who Dr. Cowley is," said Rep. Andy Harris, a Baltimore County Republican and an anesthesiologist who is co-sponsoring the legislation along with the rest of Maryland's delegation. "Dr. Cowley led the world."
Rep. John Sarbanes, a Democrat from Baltimore County, described how Cowley pushed lawmakers in Annapolis and Washington to embrace his ideas, including the use of helicopters to speed the transportation of injured patients and the development of the first statewide EMS system in the nation.
Ruppersberger helped shepherd many of those initiatives through the political process. A member of Shock Trauma's board of visitors, Ruppersberger has also secured millions in federal grants for the center over the years.
Dr. Thomas M. Scalea, Shock Trauma's current director, said countless people have been saved by the procedures and systems Cowley championed.
"It's all because Dr. Cowley had that vision … and was stubborn enough to drive it through and not take 'no' for an answer," Scalea said. "Saving that many people's lives seems to me to merit this congressional medal."