Von Willebrand Disease

True Crime and VWD: The Staircase Saga

Laurie Kelley October 6, 2024

Crime stories—whether fiction or nonfiction—have always fascinated but seem even more popular than ever. Murder mysteries and whodunnits. Organized crime or the kid next door. True crime—often about murder—ironically has new life recently, with smash-hits on Netflix like Lover Stalker Killer, The Menendez Brothers and Dahmer.

Our amazing archivist from North Carolina, Richard Atwood, researcher and reader extraordinaire, has a particularly interesting true crime story—the Staircase saga.

He writes: “This true crime event has maintained a bizarre fascination over two decades of debate. On the night of December 9, 2001, author Michael Peterson found his wife, Kathleen, dead at the bottom of a back staircase in their Durham, North Carolina home, surrounded by blood spatter. The police suspected murder and arrested Michael, who was the last person to see Kathleen alive. During the 2003 nationally televised trial, the prosecution introduced evidence that, sixteen years earlier, Michael was the last person to see a certain Elizabeth Ratliff alive before she was found dead—surrounded by blood spatter—at the bottom of a staircase in Germany. It was revealed that Elizabeth Ratliff had von Willebrand disease, a condition that complicated the determination of her official cause of death. There were too many coincidences between the two deaths involving staircases.

“This Staircase saga has personal connections. The murder and trial were a big deal here in North Carolina, as well as nationally. My son and his family live a half mile from the Peterson house. After Michael’s murder conviction was overturned and he returned to Durham, my son reported that friends of his would see Michael working out in the gym—a practice picked up in prison—then add slyly that it was on the step machine. This black humor is prevalent in Durham where many, but not all, consider Michael guilty of murder. I should also add that the psychologist named Margie Fargo, who was the jury consultant for Michael’s legal defense team, was my date to our high school senior prom in Atlanta back in 1968. Margie continues to profess Michael’s innocence.

“The body of work under the name ‘The Staircase’ keeps expanding. The 2003 murder trial was broadcast live and thoroughly discussed on Court TV, the former cable television network. The author Diane Fanning wrote Written in Blood: A true story of a murder and a deadly 16-year-old secret that tore a family apart (2005). The French filmmaker Jean-Xavier de Lestrade released his almost seven-hour documentary The Staircase (2005) on Sundance (and later on DVD). To provide updates, R.J. Parker wrote The Staircase: murder of Kathleen Peterson (2018) and Aphrodite Jones wrote A Perfect Husband (2019). As an author, Michael Peterson wrote Beyond the Staircase (2020), a slightly biased version of events that describe his prison experience. There may be other books about the murder trial, the overturned conviction after eight years imprisonment, and the subsequent plea deal. Then filmmaker Antonio Campos released the HBO series The Staircase: limited series (2022), The eight episodes, lasting eight hours, first shown on HBO, then released on DVD, star Colin Firth and Toni Collett, both accomplished actors. This fictionalized account of true events (filmed in Atlanta, not Durham) provides alternative explanations without stating a definitive explanation. It’s good entertainment.

“While I admire the acting skills of Firth and Collett, I don’t feel that they accurately portray Michael and Kathleen Peterson—he is not sour enough. I’m also a fan of Juliette Binoche, who plays the documentary film editor.

“But my biggest complaint about all the Staircase contributions is that von Willebrand disease does not get enough attention. Dr. Henry Lee had an excellent expert witness explanation of blood spatter during the trial. And then there is the ‘owl theory.’ I have an owl that perches on a branch overhanging my Winston-Salem yard most days. He is peaceful, unlike the alleged ‘killer owl’ in Durham, 75 miles away. Michael sold the house in Durham to pay his legal bills – the new owners spent a fortune fixing up the house on four acres. Margie Fargo lives in Charlotte; I saw her at a high school reunion in Atlanta. Michael continues to live in Durham, though I haven’t heard whether he still works out at the gym; he is close to 80 now.

“If you want some good true-crime reading, or wish instead to binge watch, then consider something from The Staircase saga – and be like me, complaining that von Willebrand disease should get more attention.”

Remembering Our Veterans: Renée Paper

Laurie Kelley November 12, 2023

This past week we honored our veterans for their service to our country. This past week I also received a message from someone in the von Willebrand disease community, surprised and saddened that no one seems to remember one of our great veterans—Renée Paper, RN. Her date of passing was November 7, 2007, at age 49. So young, but she made a huge impact. She was a pioneer in VWD care for all. She should be and needs to be remembered. So much of the care we receive today for VWD we owe to Renée. This includes my book on VWD, A Guide to Living with von Willebrand Disease, which I originally wrote with Renée.

Renée had von Willbrand disease, and was an emergency room nurse in Nevada. She traveled and lectured frequently. She was a powerhouse when lecturing. I saw her absolutely command a room full of nurses and doctors with her photographic memory, brilliant knowledge of VWD and her deep-seated passion. She spoke with authority, compassion and a call to arms, for everyone to find unidentified VWD patients, get them the treatment they deserve and need, to stop the silent suffering of women. She herself had had a hysterectomy in her early 20s, rendering her unable to have children, when doctors did not correctly diagnose her with VWD and sought to end her uncontrollable bleeding. I think in part her burning dedication and fiery style of lecturing was fueled by the embers of what was left of her ability to control her life, to have children. She didn’t want this to happen to any other woman.

Renée Paper and Laurie Kelley at national meeting

If you never heard a Renée Paper speech, you missed some great speeches. One of my favorite lines by her was when she blamed the medical community for misdiagnosing women who had VWD as being “hysterical,” or “imagining” their illnesses. “You know why this happens?” she would bark out. “Because men dominate the medical scene! And you know why they don’t take us seriously? Because men don’t have uteri!” Leave it to Renée to always use the correct Latin plural of uterus.

She traveled with me to Puerto Rico and the Dominican Republic on lecturing tours together, and she and I presented in places as close as Connecticut and far away as Australia. She was brilliant; she was fun-loving. She could be irreverent yet compassionate. She loved animals, and one of her favorite gifts to her friends was to send a photo of herself each New Year’s with a different animal from different parts of the world: kissing a dolphin in the Caribbean; draping a boa constrictor around her neck in Mexico; nuzzling an alligator in New Orleans; atop a camel in the Canary Islands. Renée knew how to grab life by the horns and tame it, and she wanted others to do that, too, regardless of whether they had a disorder or disability.

Renée was a visionary leader. As an emergency room nurse in Nevada, she saw the need for a patient-based hemophilia organization and an HTC. Nevada had neither when she first lived there. Typical of Renée, she saw the need and figured out how to meet it. She founded Nevada’s first patient organization and HTC, both of which continue to this day. In fact, November 1 is Renée Paper Day in Nevada! How many people can claim such an honor?

So we remember an inspiring and action-oriented leader as one of our veterans. As if she knew the clock was ticking, she made incredible accomplishments that continue to benefit patients to this day. A legacy like that is the mark of a true leader.

VWD in the Land of Fire and Ice

Laurie Kelley August 28, 2022

Being in the Nordic regions of the world made me think about the origins of von Willebrand disease (VWD), how it was identified. Why?

VWD was named after the doctor who first identified it: Dr. Erik Adolf von Willebrand, a Finnish physician who first described VWD in 1926. He began to study an unusual bleeding disorder in the local communities, called Ålandic hemorrhagic disease. In 1925, Dr. von Willebrand evaluated a five-year-old girl named Hjördis. She lived on the remote island of Föglö, which belongs to Åland, a group of islands in the Baltic Sea between Sweden and Finland.Hjördis was bleeding excessively from her lip following an injury. She had a history of nosebleeds and bleeding following tooth extraction. She was one of 12 children, 10 of whom showed bleeding symptoms. Sadly, four of her siblings died of uncontrollable bleeding between the ages of two and four. Hjördis herself later bled to death during her fourth menstrual period. When Dr. von Willebrand studied the extended family, he discovered that 23 of 66 family members (16 females and 7 males) also had bleeding problems. The history of the original Finnish family has now been traced back to 1750, identifying over 1,000 members, with 125 known to be affected, and 12 who died from bleeding.

According to the website of the Icelandic Hemophilia Society, Iceland has about 127 registered people with VWD. Of these, 60 are mild (Type I) and 67 are severe. We know there are three main types of VWD, and numerous subtypes, so this information isn’t very clear on how many have what type. But we can be assured they are getting excellent care. And we mentioned last week that Icelanders have kept excellent genealogies of their families, meaning we can trace back family lineages for, in some cases, thousands of years, like the Finnish VWD family first recognized as having VWD.

I hope to return to Iceland and meet some of these friendly people who belong to our global family, in the land of fire and ice!

You can read all about VWD in our book, A Guide to Living with von Willebrand Disease, free to patients! Order here.

Don’t Forget VWD This Month!

Laurie Kelley March 14, 2022

I’m in Egypt on vacation, and to visit Tamer Hanna, a very special hemophilia patient, and one couple in the group of tourists I am with mentioned they have visited the Äland Islands in Finland. My ears picked up; that’s where VWD was discovered! It was a great opportunity to educate them about the most common inherited bleeding disorder.

March is Bleeding Disorder Awareness Month, and I think it’s a great time to remember those with the most common inherited bleeding disorder in the world.

When did this bleeding disorder get identified?

Von Willebrand Disease was named after the doctor who first identified it: Dr. Erik Adolf von Willebrand, a Finnish physician who first described VWD in 1926. He had been studying an unusual bleeding disorder in the local communities, called Älandic hemorrhagic disease.

In 1925, while in Helsinki, Dr. von Willebrand evaluated a five-year-old girl named Hjördis. She lived on the remote island in the Baltic Sea, between Sweden and Finland.

Hjördis was bleeding excessively from her lip following an injury. She had a history of nosebleeds and bleeding following tooth extraction. She was one of 12 children, 10 of whom showed bleeding symptoms. Sadly, four of her siblings died of uncontrollable bleeding between the ages of two and four. Hjördis herself later bled to death during her fourth menstrual period.

When Dr. von Willebrand discovered that 23 of 66 family members (16 females and 7 males) also had bleeding problems. The history of the original Finnish family has now been traced back to 1750! Over 1,000 members, with 125 known to be affected, and 12 who died from bleeding.

Dr. von Willebrand concluded that this was a previously unknown type of hemophilia, characterized by prolonged bleeding time and mucocutaneous bleeding. The disorder affected both males and females. Dr. von Willebrand called this new disorder “pseudohemophilia.” But because he believed platelets were involved, he later renamed the disorder “constitutional thrombopathy.” In 1928, four American doctors described a similar disorder, but it wasn’t until decades later that the actual blood-clotting protein involved was identified. The protein—von Willebrand factor (VWF)—and the disorder were named after the doctor who first described the unusual symptoms.

It’s estimated that VWD affects up to 1% of the world’s population, which dropped the jaws of my fellow tourists. Overlooked for too long in favor of focusing on hemophilia, I think VWD is now getting the recognition, and help, it deserves. But women in countries like Egypt still suffer and need education and medication. We can all help with that!

Visit the World Federation of Hemophilia and Save One Life to learn more.

Excerpted from A Guide to Living with von Willebrand Disease by Laureen A. Kelley and Paul Clement.

Remembering Renée

Laurie Kelley November 6, 2017

This past week I’ve been working diligently on updating my book, A Guide to Living with von Willebrand Disease. I feel guilty saying it’s my book—it was actually “our” book, my and Renée Paper’s. It’s been out of print a while, and we truly need this resource. While thinking of Renée as I edited it, I realized that tomorrow marks the 10th anniversary of her passing, and working on this book made me realize again what a valuable leader, friend and advocate she was.

She was only 49 when she died, after an eight-week hospital stay following a fall. She had dealt with multiple health challenges: von Willebrand disease, diabetes, hepatitis C. Compounding this was obesity. After she lost her sister Michelle, who suffered from similar health concerns, she decided to have gastric bypass surgery, in an attempt to improve her health. She lost a remarkable amount of weight, but the years of illness had taken their toll on her body. What’s truly amazing is that nothing, nothing, seemed to slow Renée down!

She traveled and lectured frequently. She was a powerhouse when lecturing. I saw her absolutely command a room full of nurses and doctors with her photographic memory, brilliant knowledge of VWD and her deep-seated passion. She spoke with authority, compassion and a call to arms, for everyone to find unidentified VWD patients, get them the treatment they deserve and need, to stop the silent suffering of women. She herself had had a hysterectomy in her early 20s, rendering her unable to have children, when doctors did not correctly diagnose her with VWD and sought to end her uncontrollable bleeding. I think in part her burning dedication and fiery style of lecturing was fueled by the embers of what was left of her ability to control her life, to have children. She didn’t want this to happen to any other woman.

Fiery style of lecturing? If you never heard a Renée Paper speech, you missed some great and shocking speeches. One of my favorite lines by her was when she blamed the medical community for misdiagnosing women who had VWD as being “hysterical,” or “imagining” their illnesses. “You know why this happens?” she would bark out. “Because men dominate the medical scene! And you know why they don’t take us seriously? Because men don’t have uteri!” Leave it to Renée to always use the correct Latin plural of uterus.

Renée traveled with me to Puerto Rico and the Dominican Republic on business together, and she and I presented in places as close as Connecticut and far away as Australia. She was brilliant; she was fun-loving. She was could be irreverent yet compassionate. She loved animals, and one of her favorite gifts to her friends was to send a photo of herself each New Year’s with a different animal from different parts of the world: kissing a dolphin in the Caribbean; draping a boa constrictor around her neck in Mexico; nuzzling an alligator in New Orleans; atop a camel in the Canary Islands. Renée knew how to grab life by the horns and tame it, and she wanted others to do that, too, regardless if they had a disorder or disability.

Renée walked the talk: her message was always to get educated about VWD. Don’t let it keep you from enjoying life. Play the hand you were dealt. (Yes, she was from the Las Vegas area!) Play it and win.
Renée was a visionary leader. As an emergency room nurse in Nevada, she saw the need for a patient-based hemophilia organization and an HTC. Nevada had neither when she first lived there. Typical of Renée, she saw the need and figured out how to meet it. She founded Nevada’s first patient organization and HTC, both of which continue to this day. In fact, November 1 is Renée Paper Day in Nevada! How many people can claim such an honor?

So we remember an inspiring and action-oriented leader, who was warm and loving, and also at times, a pain! And she knew it, and didn’t care. She had places to go and things to do, and a higher calling. As if she knew the clock was ticking, she made incredible accomplishments that continue to benefit patients to this day—including the world’s first book on VWD, which will be re-released in 2018. A legacy like that is the mark of a true leader.