Outrunning Death
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Outrunning Death
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About this listen
In the late 1960s, trauma surgeon R. Adams Cowley became obsessed with a question that refused to leave him alone: why were patients still dying even when everything seemed to be done “right”?
By tracking cases minute by minute, Cowley uncovered a brutal truth. The most lethal enemy in trauma care wasn’t always the injury itself, but the time lost before definitive treatment. Quiet injuries were being missed. Patients were waiting. And once shock took hold, even perfect care often came too late.
In this episode, we follow Cowley from his early years in thoracic surgery to the bedside patterns that led him to define the Golden Hour. Along the way, we trace how highways replaced battlefields as the primary source of trauma, how Maryland built the first true shock trauma network, and how helicopters, dispatch, and paramedics were reorganized around one ruthless priority: speed.
We also meet Peter Safar, whose work on CPR and airway management tackled the minutes before the hospital, proving that the Golden Hour could only be won if someone kept patients alive long enough to reach it.
This is the story of how emergency medicine stopped reacting to injuries and started racing the clock.