Blood: While moonlighting as charge nurse on labor and delivery at the Baltimore City Hospital, a woman bled to death post-op from what I figured out years later was coagulopathy due to acute fatty liver of pregnancy. From then on, I was on a quest to change the outcome of pregnancy due to abnormalities of bleeding and clotting. This is not the actual picture of the Chux pad from that day, but this is exactly what it looked like.
With the late Dr. Hohler. Having learned that childbirth was not always normal or natural, when my beloved husband, Chuck Hohler, died, I took the life insurance money and went to medical school at the University of Virginia.
Graduation. I had secretly fantasized about doing my OB/GYN residency at the University of North Carolina, but my dream came true when my new husband, David James, was transferred to Research Triangle Park, NC.
Gil White and Harold Roberts - Episiotomy. I was the chief resident on OB when Dr. Harold Roberts and Dr. Gil White had a pregnant patient with FII, FVII, FIX and FX deficiency who needed to be delivered. They left a recipe for the management of possible postpartum hemorrhage. After the patient was delivered of a 9 lb 12 oz infant, she did not bleed from her uterus, but tried to exsanguinate from her episiotomy. This was an eye-opening experience for me. The recipe from the hemostasis experts worked to magically stop her bleeding. I thought how I would like to be a magician, too.
Mascots. Some were sad to see me leave UNC, but I was welcomed at Duke for my fellowship in Maternal-Fetal Medicine.
Russell Ware. During my fellowship, when my research mentor for a project on gestational diabetes turned out to be a jerk, my fellowship director asked me if I had any other ideas for a project. I said yes – vascular disruptions in unborn babies. Joanne Kurzberg had the insight that Russell Ware would be a good mentor since he was interested in vascular disruptions in children with sickle cell disease. I spent 3 years in Russell Ware’s lab. This is a picture of me with Russell and Thad Howard, who has been the lab director for 25 years.
Jeanne Lusher. On a trip to the ASH annual meeting with Russell Ware’s lab, I attended a satellite symposium on women with bleeding disorders and heard Jeanne Lusher say that every woman with menorrhagia should be tested for an underlying bleeding disorder. That statement led me to a series of investigations that has kept me busy for years. The bottom line is some women with menorrhagia should be tested and others shouldn’t.
Tom Ortel. During this time, I also developed a collaboration with Tom Ortel, who was Medical Director of the Coagulation Laboratory and the Anticoagulation Clinic at the time. We submitted a grant to the CDC Blood Division and were subsequently designated a Thrombosis and Hemostasis Center.
In the clinic. When I finished my fellowship, my Maternal-Fetal Medicine Division Director, Phil Heine, allowed me to establish a clinic for women and girls with blood disorders.
Phil Heine, Andi, and Elizabeth Livingston. Here is Dr. Heine with my former fellowship director, Elizabeth Livingston, presenting me with a graduation gift 15 years after I finished my fellowship.
Betty Thames. Tom Ortel introduced me to Betty Thames, who became my Project Manager and allowed me to be a successful clinical researcher.
Women's International Group. Tom Ortel also encouraged me to attend the ISTH meeting in Washington DC in 1999, which led to my joining the Women’s Interest Group and ultimately chairing the Women’s Health SSC.
Sally McCallister, et al. Sally Crudder Owens McAllister, who had met me through the CDC, recruited me to the Women’s Task Force of the National Hemophilia Foundation. I don’t know what Steve Humes is doing in this picture, but Maggie Ragni wrote the music and lyrics as well as provided the accompaniment for this serenade Sally and I performed.
Ann Marie and Bruce Evatt. At NHF, I began a long partnership with Ann-Marie Nazzaro, who, at that time, was their vice president for Education.
Peter, Claire, and Barb. Our relationship with the CDC led to collaborations with Peter Kouides, Claire Phillip, and multiple others to define the role of underlying bleeding disorders, and VWD in particular, in obstetric and gynecologic bleeding.
Chad Grotegut, MD. BIRCWH (Building Interdisciplinary Research Careers in Women’s Health) grant funding from the NIH allowed me to pursue epidemiological studies of women and girls with blood disorders. One of our former fellows in Maternal-Fetal Medicine, Chad Grotegut, has continued these studies and also continued his laboratory work on uterine contractility, enriching my understanding of uterine hemostasis. He is one of many trainees who have educated me over the years.
Keith Hoots and Donna DiMichele. Perhaps the most exciting year of my career was the year I spent as a special advisor on Women’s Issues to the Division of Blood Diseases and Resources at the NHLBI – working closely with Keith Hoots and Donna DiMichele. At the NHLBI, I highlighted the issues associated with women’s hemostasis –issues that underpin preeclampsia, postpartum hemorrhage and hormone-induced thrombosis.
VWD Expert Panel 2008. I have worked on Guidelines Committees for VWD, Thromboembolism and Sickle Cell Disease, but I only have the picture from the NIH VWD Expert Panel.
FWGBD Formed in 2009. In 2009, at the ISTH meeting in Boston, Barb Konkle, Roshni Kulkarni and I formed the nucleus of a Board of Directors for FWGBD.
Faculty at FSS at ASH 2016. FWGBD has come a long way. We have a dedicated staff, a committed Board and a robust medical advisory committee educating health care providers about the unique needs of women and girls with blood disorders.