Maull's methods were his undoing Shock Trauma was reined in, but at great cost

February 28, 1993|By This article was reported and written by Michael Ollove, Jonathan Bor and Douglas Birch.

They knew what they didn't want. They didn't want another Adams Cowley.

They didn't want the new head of Shock Trauma to be anything like the original. They had had enough of uncompromising and uncontrollable, of bull-headed and autocratic.

For 28 years, University of Maryland Hospital officials had suffered through the iconoclastic reign of of R Adams Cowley because of the renown he had brought them. They had endured him with toasts and tight smiles. But now that he was gone, they didn't want another of his kind.

In Kimball I. Maull, that's exactly what they got.

"We did hire a person who was in some respects just like Dr. Cowley," said Morton Rapoport, the head of University of Maryland Medical System, who was instrumental in hiring Dr. Maull and is leading the effort to oust him.

It's not as though university officials went looking for a caretaker. They wanted an aggressive administrator who could control Shock Trauma's warlords and tear down the walls Dr. Cowley built between his center and the hospital. But they wanted a conciliator, someone who could use tact and persuasion to force wrenching, unpopular changes.

Instead, they got someone with Dr. Cowley's disdain for diplomacy.

Dr. Maull angered the staff by firing doctors and cutting physician salaries. He slighted William Donald Schaefer by saying that he didn't care what the governor thought. He frightened doctors in other emergency rooms, who feared he would grab the most lucrative trauma patients. He angered some volunteer firefighters by demanding they use new, unfamiliar techniques.

Worst of all, he committed the heresy of attacking Shock Trauma's cherished reputation as the standard by which all other trauma centers are measured.

No one is asserting that Dr. Maull wasn't doing the job he was brought in a year ago to perform. University officials, though, did not have the stomach for the mess he was creating on their behalf.

"Absolutely he was carrying out the mission," Dr. Rapoport said in an interview Thursday. "I think it was the process of how it was being done that became the issue."

His supporters -- and there don't appear to be many of them -- believe he was a scapegoat.

"I knew five months ago that this was going to happen," said Aizik Wolfe, a highly regarded neurosurgeon and one of Dr. Maull's admirers. "I warned Dr. Maull about the leadership at the university. I told him that once they used him for their purposes, he was going to be dog meat, and there was going to be no support."

Dr. Maull defended himself before the University Board of Regents Thursday night and is now awaiting its decision on whether to fire him. Friday afternoon, he sat in his lawyer's Towson office and described himself as a "hatchet man" who had been hired to do Dr. Rapoport's "dirty work," only to be cast aside.

"I feel I have been unfairly dismissed," he said. "I did my job as they expected. And as soon as it got too hot, they bailed out."

"You can't touch us"

Dr. Maull was hired in December 1991 to bring control to a rogue institution and force it to act like part of the University of Maryland system.

The edifice that Dr. Cowley had erected bore the stamp of his personality, prejudices and suspicions. He was a visionary whose influence on medical science was far-reaching, but he was also a my-way-or-the-highway administrator, a man with a Kevlar ego whose devotion to Shock Trauma made him intolerant of dissent from below and indifferent to sensitivities above.

Dr. Cowley turned Shock Trauma into a fortress, jealously guarding its independence from the University of Maryland Hospital, of which it was ostensibly a part. He despised academia, its vanities and its politics. He prized surgery, not research, and he expected his doctors and nurses to feel the same.

"Cowley demanded absolute loyalty," said Dr. Clayton Shatney, a surgeon who resigned from Shock Trauma in 1982 in a disagreement with Dr. Cowley, who was known as "The Boss" to his subordinates. "If you were loyal you got to keep your job. But if you crossed him he'd fire your ass in a second."

Although Dr. Cowley inspired fierce loyalty, as his health declined even his devotees became disturbed by his increasingly arbitrary behavior in the late 1980s and they spearheaded his removal in 1989.

With Dr. Cowley gone -- he died in 1991 -- University Hospital officials saw the chance to rein in Shock Trauma. Those were the marching orders given to Dr. Maull, to force Shock Trauma "to work in a collaborative way with the entire medical center," in the words of Dr. Rapoport.

Dr. Maull, 50 and movie star handsome, was chief of surgery at the University of Tennessee Medical Center in Knoxville, where he demonstrated that he was not one to shrink from an ugly fight. He battled other hospitals to make his institution the cornerstone of a regional trauma network. Along the way, he antagonized some doctors and endured the censure of a local surgical society after criticizing a private hospital.

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