The Nursing Pin That Was Never Supposed to Survive: How a Forgotten Photograph Exposed a Buried Medical Institution

The photograph should not have mattered.

That was Karen Ashby’s first thought when she lifted it from the bottom of a water-damaged cardboard box in the basement archive of a church on Auburn Avenue. The box had been sealed for decades, forgotten beneath hymnals, broken chairs, and the quiet accumulation of time. It smelled of mildew, dust, and something older—an odor archivists recognize as history that has been neglected, not preserved.

Inside were dozens of curled black-and-white photographs. Most were familiar and easily categorized: church picnics, choir groups, graduation portraits, brick buildings long since demolished. Faces posed stiffly for cameras that demanded stillness and obedience.

This photograph almost blended in.

Two women stood side by side outside what appeared to be a hospital entrance. Both wore crisp white nursing uniforms. Their aprons were sharply pressed. Their posture was exact. They stood close enough that their shoulders nearly touched, hands folded neatly at their waists. Their expressions were restrained but unmistakably proud—the look of people who had earned something hard, and knew it.

Karen had worked as an archivist on the Grady Memorial Hospital history project for more than a decade. Before that, she had trained as a nurse. She knew uniforms the way other people knew faces. She could usually date a photograph within a few years by the cut of a sleeve or the angle of a collar.

This one placed itself immediately.

Post–World War I. Likely 1919.

She was about to file it away when something stopped her.

The pins.

Both women wore nursing pins on their left shoulders. At first glance, they appeared similar—small metal emblems meant to signify professional training. But Karen had learned that institutional history often hides in details others overlook.

She reached for the magnifying lamp.

The woman on the left wore a Grady Hospital nursing crest. Karen recognized it instantly: a shield-shaped enamel pin featuring a caduceus and interlocking initials. The design dated back to the late nineteenth century and had changed very little.

The woman on the right wore something else entirely.

Her pin was oval, slightly larger, and centered around an oil lamp—the symbol long associated with Florence Nightingale and early professional nursing education. Beneath the lamp were faint initials, barely visible even under magnification.

Karen felt a tightening in her chest.

She turned the photograph over.

On the back, written in careful but fading pencil, were two names:

R. Simmons
E. Pace

Below them, a date: June 1919.

And beneath that, almost lost to the paper’s grain, a third line:

McVicker, Class of 1918.

Karen leaned back in her chair.

McVicker.

The name was not new to her. It had appeared before—rarely, briefly, and always without explanation. A ledger entry with no supporting documents. A passing mention in a church bulletin. A footnote with no photograph attached.

Until now.

Grady Hospital’s nursing programs in the early twentieth century were strictly segregated. White nurses and Black nurses trained separately, wore different uniforms, received different credentials, and were never photographed together. The policy was explicit. The record was clear.

And yet here were two women, standing shoulder to shoulder, wearing pins from two different institutions.

The photograph was wrong.

Karen began pulling records.

Graduation rosters from 1918 to 1920. Nursing registries. Internal correspondence. Personnel files. There was no record of R. Simmons or E. Pace graduating from Grady.

State nursing registries offered fragments. Simmons appeared later in Alabama. Pace surfaced briefly in Illinois. Neither was officially credited to Grady.

The oval pin became an obsession.

Karen searched every catalog she had compiled over eleven years. Georgia nursing schools. Southern training programs. Hospital insignia. Nothing matched.

Late one night, long after the archive had closed, she found a brittle newspaper clipping tucked inside an unrelated folder.

The Atlanta Independent, 1906.

“McVicker Training School for Colored Nurses Opens on Houston Street.”

The article described a small institution founded by a coalition of Black Baptist churches. It trained young Black women in anatomy, hygiene, obstetrics, wound care—at a time when most hospitals refused to admit them at all. The school operated quietly, largely ignored by white newspapers.

Karen dug deeper.

McVicker appeared again and again, always faintly: fundraising notices, graduation announcements, church minutes. Fifteen to twenty students per year. Modest. Legitimate.

Then, suddenly, it vanished.

In late 1918, McVicker closed. Official explanations cited financial strain from the influenza pandemic. Faculty deaths. A deteriorating building.

But something else stood out.

In January 1919—weeks after McVicker’s closure—Grady Hospital announced a new initiative: An Auxiliary Training Program for Negro Nurses. Newspapers praised it as progressive and generous.

Yet Karen could find no evidence that anyone ever graduated from it.

No diplomas.
No class photographs.
No pins.

Only that photograph.

She contacted Dr. Loren Whitfield, a medical historian at Spelman College.

Whitfield studied the image in silence.

“I’ve seen the name McVicker twice in my career,” she said. “Both times, the trail ended abruptly.”

“What do you think happened?” Karen asked.

Whitfield tapped the photograph. “I think McVicker produced something valuable. And someone else decided to claim it.”

The breakthrough came unexpectedly.

Karen posted a summary of her findings on a medical history forum. Weeks later, an email arrived from Chicago.

Subject line: That’s my great-grandmother.

Denise Pace Robinson was seventy-four. Her great-grandmother, Ethel Pace, had trained as a nurse in Atlanta before moving north. Denise possessed a few inherited documents, including a scanned page from a hospital logbook.

Karen stared at it.

March 1919.
Auxiliary Nursing Staff – Colored Ward.

Twelve names.

Next to several entries: McVicker 1917 or McVicker 1918.

Beside each, written later in red ink:

Credentials pending review.

At the bottom, another red-ink note froze her.

All auxiliary staff to wear Grady insignia during ward rotations. McVicker pins to be collected and held until status determination.

The auxiliary program had not been a school.

It had been a holding system.

Fully trained Black nurses were absorbed into Grady’s workforce without recognition, without equal pay, and without credentials. Their pins were confiscated. Their school erased. Their labor rebranded as institutional generosity.

Karen traveled to Chicago.

Denise opened her great-grandmother’s Bible. Inside the cover, written decades earlier:

McVicker Training School. Graduated with honors. May 1918.

“She never stopped calling herself a McVicker nurse,” Denise said.

Back in Atlanta, Karen presented the evidence to the hospital history committee.

The photograph.
The logbook.
The testimonies.

Questions followed—but not the right ones.

That night, alone in the archive, Karen returned to the photograph.

One detail still troubled her.

The order said McVicker pins were to be collected.

But in June 1919, Ethel Pace was still wearing hers.

Karen enlarged the image again.

R. Simmons’ right hand was clenched tightly.

Near her palm, a thin sliver of metal caught the light.

Another pin.

Not worn.

Hidden.

This photograph was not a keepsake.

It was a record of defiance.

A signal left behind.

And as Karen locked the archive, one thought stayed with her:

If this photograph survived by accident…

What else had been destroyed on purpose?

And who decided that this one—against all odds—would remain?