A single 1895 photograph of two Black women labeled as mother and daughter has led historians to uncover what they believe was a secret medical practice and a hidden romantic partnership that lasted more than two decades in Jim Crow Atlanta. Dr. Sarah Chen, a historian researching Black female physicians in the post-Reconstruction South, found the portrait in the archive of photographer James Baldwin, who documented Atlanta’s Black community from 1890 to 1920. The notation on the back read: “Mrs.
Josephine Carter and her daughter, Dr. Elizabeth Carter, Atlanta, Georgia, November 1895. ”
The existence of a Black female physician in 1895 was extraordinary, only 30 years after the end of slavery and amid the brutal consolidation of Jim Crow laws. Chen confirmed that Elizabeth Carter graduated from the Women’s Medical College of Pennsylvania in 1894, one of only two Black women in her class.
Then the public record went silent: no hospital affiliation, no practice listing, no medical society membership, no advertisement for services. Official records showed that Elizabeth lived continuously with Josephine, listed in the 1900 census as her daughter. But Chen found no birth record connecting them, no death record for a Mr. Carter, and no evidence of an official medical practice.
Josephine, a former enslaved woman born around 1856, purchased a house at 847 Auburn Avenue in 1893 as a single woman, paying $800 cash. She operated a respectable boarding house for women, repeatedly described in Black newspapers with words like “discreet” and “private. ”
Newspaper references hinted at quiet charitable work. Death notices from the late 1890s showed Josephine arranging burial for unnamed women who died of childbirth complications.
Elizabeth’s academic file revealed honors in obstetrics and gynecology, and a senior thesis on maternal mortality among Black women. A letter from Elizabeth to her professor, dated March 1895, explained that no hospital would grant her privileges and the medical society refused her membership. She wrote that she was not deterred and would serve her community “through whatever means become available,” adding, “My mother has secured us a suitable location. ”
Historians who reviewed the evidence concluded that Josephine and Elizabeth were not mother and daughter but partners who used the cover story to protect themselves and their work.
A church historian recalled that his grandmother called them “devoted to each other” and said community members protected the Carters through silence because they loved them. A diary kept by a nurse who worked with Elizabeth documented decades of secret medical care, including a 1901 arrest of Josephine on charges of running a disorderly house, which were dismissed after prominent community members testified on her behalf. Elizabeth finally practiced medicine openly during the 1917 influenza pandemic, volunteering at Grady Hospital. She contracted influenza and died on November 18, 1917, at age 45.
Her death certificate listed her occupation as physician. Josephine died six months later, in May 1918, reportedly of a broken heart. They are buried together at Oakland Cemetery under a headstone reading, “devoted to each other and to serving their community. ”
The fullest confirmation came decades later when Josephine’s trunk, kept sealed through generations by family instructions to protect her privacy, was opened.
It contained journals spanning 1893 to 1918, in which Josephine wrote explicitly of her love for Elizabeth, their decision to present themselves as mother and daughter, and the years of work, fear, and joy they shared. Elizabeth died, Josephine wrote, “My Elizabeth is gone. 23 years together. I don’t know how to exist without her.
”
Chen’s findings were published in the Journal of African-American History and gained national attention. The 1895 photograph is now displayed at the National Museum of African-American History and Culture. The Carter-Carter Foundation, named for both women, funds scholarships for LGBTQ students of color pursuing medicine and supports free clinics for marginalized communities. The house on Auburn Avenue has been restored as a museum and community health center.
Researchers have since identified 37 similar portraits by Baldwin depicting Black queer women living as relatives in Atlanta between 1890 and 1920. Chen published a book on the subject, and at a ceremony marking the discovery, a new monument at the Carter grave described the two women as “partners in life, love, and service,” noting that they ran a secret medical practice for over 20 years and saved countless lives. A young Black queer medical student who read Chen’s book later told her she planned to open a practice serving low-income and LGBTQ women, inspired by Elizabeth. At the restored health center, staff continue the work Elizabeth performed in secret.
The stories of patients she treated still surface, passed down through generations of families who credit their survival to the doctor on Auburn Avenue.