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Lessons from the DeadChris Hartlove

Lessons from the Dead

Why investigating deaths means saving lives

Carolyn Cumpsty-Fowler, PhD, MPH ’96, remembers five children who never had a chance to grow up—and how they changed her life.

At the time, she was in her 20s, a neurosurgical nurse at Groote Schurr hospital in Cape Town, South Africa, and part of a team researching clinical factors that could improve survival of children with traumatic brain injury. The most severely harmed were children struck by cars while crossing the road or playing in the streets. Roughly 70 percent of the victims who died never reached a hospital, while others were admitted with catastrophic injury. One of the young nurse’s duties was to counsel parents when a decision was made to terminate life support.

In September 1984, she reached her limit. After witnessing the anguish of five families in six days, she realized her research was chasing the wrong answers.

“I walked out of the intensive care unit that Friday night with the neurosurgery professor who was my adviser and told him, ‘Nothing we can do in the hospital is really going to make a difference for these children. We’ve got to stop these deaths. We’ve got to prevent them.’ And he basically said, ‘Do it.’”

Cumpsty-Fowler changed the focus of her study from injury recovery to injury prevention. Eventually her doctoral work became the basis of a successful, developmentally appropriate pedestrian safety program that she and traffic safety colleagues implemented throughout South Africa.

Now an assistant professor in the Johns Hopkins School of Nursing with a joint appointment in Health Policy and Management at the Bloomberg School, Cumpsty-Fowler serves on the Baltimore County Child Fatality Review Team, an interprofessional group she helped create. Her husband, David Fowler, MBChB, MMed, is the chief medical examiner for the state of Maryland.

Together, the couple developed a course at the University of Baltimore, Forensic Medicine and the Public’s Health, that illustrated the many ways that death investigation and public health professionals’ use of forensic data can impact health, including reducing preventable death in children.

A careful reading of individual deaths, they contend, can make life safer and healthier for all.

The Fowlers belong to several generations of researchers who have gained inspiration from the work of an injury prevention pioneer whose legendary career was launched in the break room of the medical examiner’s office.

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