The Woman in Charge
A Profile of Dr. Joye M. Carter, Chief Medical Examiner of Harris County

Dr. Joye Maureen Carter, the current chief medical examiner for Harris County, Texas, is full of "firsts." She's honored with being named the first female to head a medical examiner's office in the state of Texas, and the first black female to become a chief medical examiner in the United States.

From the time she was in the third grade, Dr. Carter knew that she wanted to become a doctor, but wasn't sure in what field. Then in the ninth grade, she had an opportunity to do some career sampling, and the decision was made - she'd become a forensic pathologist - an investigator who determines the medical/legal reason why a person has died.

"As a 14-year-old ninth grader in Indianapolis, I found myself in a hospital setting," she said. "Through a school-based career sampling program, I found myself in the hospital kitchen, preparing breakfasts. I wasn't very good at that, so they shooed me out the door."

Dr. Carter said back in the early 1970s, the kitchen and the morgue were in close relationship in a lot of hospitals.

"As I was sitting outside, I watched a body being rolled into the morgue, and I wondered what went on behind that door. I asked if I could step in one day to watch an autopsy being done. I was able to watch it, and it was fascinating to me. I knew then I was going to do pathology and I wanted to do forensic pathology."

"When you study how people have died, you can help people live better," Dr. Carter continued.

In 1979, after graduating from Wittenberg University in Springfield, Ohio, Dr. Carter was on to medical school at Howard University College of Medicine in Washington, D.C. To pay for school, she considered taking out loans or a public health scholarship, but some of these types of funds require students to focus on one particular area of medicine, like primary care. This wasn't for the doctor-to-be. She knew she wanted to do forensics.

"I went with one of my classmates to a job fair while we were still undergraduates," she said. "I already knew I was going to medical school at Howard; I just hadn't thought about the pay issue. While at the fair, I happened to run across the Air Force. The recruiters were talking about scholarships, and I thought, `Hmmm ... I could go to medical school, I would be an officer, I'll accrue time, and they will pay my way through school, buy all my necessary equipment, plus pay me a stipend to attend. That's not a bad deal.' So that's what I did."

Dr. Carter received a United States Air Force Health Professions Scholarship in 1979, and graduated from Howard in 1983. She stayed with the Air Force until 1992, where she last held the post of Major, U.S. Air Force Medical Corps, and was the chief physician and a forensic pathologist.

Dr. Carter prematurely left the Air Force in 1992 to take a job as the chief medical examiner for the District of Columbia. She was the first female to have held this position, and consequently became the first black female to become a chief medical examiner in the United States.

After four years on the job, Dr. Carter decided she needed a change of scenery. The Washington, D.C. infrastructure was in disarray. As her office environment declined, Dr. Carter said it put a strain on the employees. For example, the office didn't have hot water, and employees were using their own money to pay for gas and the changing of tires on city vehicles.

"I just finally said, `If I can't do quality work, I need to go somewhere where I can.' The information about Harris County had come around, and I thought `Now here's a "Law and Order" place. Let's head down there.' So I threw my hat in the ring, and as it turned out, I was selected and I came in 1996."

In 1995, just before Dr. Carter came to Houston, a consulting firm evaluated the Harris County Medical Examiner's Office and found many inefficient procedures in place. Armed with this information, upon her arrival she was able to propose some much-needed changes. Dr. Carter just recently celebrated her fifth anniversary with the office, and many actions have been taken on her proposed changes. For example, when she came to the job, the office had 72 employees and a budget of just over $4 million. Today, the office has 102 employees with a budget of $7.7 million.

"When I first came to work here, the commissioners allowed me the opportunity to present my ideas for early, mid-range and late goals," she said. "So far, they've gone along with each and every one."

In fact, Dr. Carter said they surpassed all of the set 5-year office goals, well in advance of her 5-year anniversary, and are at the point now to be able to start planning for the future.

"I'm hoping in the future - maybe five years down the line - we will be able to have some satellite centers in outlying areas, because Harris County is so big."

As the chief medical examiner, Dr. Carter is always on call. Some weeks require her to work 80 or more hours, depending on the day-to-day happenings in her office. But she believes in making herself rest, because she feels that in order to do her job effectively, she must be rested and rejuvenated.

"I credit my lack of burnout to making myself go home. I tell the doctors who work here, `It's OK to go home and rest. Leave things here. Be refreshed, live your life - then come back.' If they need me, my staff knows they can reach me anytime, and I'll be right back. But until that pager goes off, I'm living a normal life at home," she said.

A lot of responsibility comes with the job, and there are times when she's traveling, for business or pleasure, and gets a call or a page.

"I just hired a wonderful deputy chief, Dr. Louis Sanchez. I have not taken too much time for personal trips, since I have not had a deputy for the past three years, or so," Dr. Carter said. "Now I feel a little more comfortable about leaving town - but I still take my pager and phone."

Dr. Carter has just booked a cruise, the first in her life, and will embark next month.

"I am really looking forward to it, having spirit and body heal while I am away for the week," she said. "My wonderful administrative staff will keep things together. They have really jelled and are comfortable working together."

In addition to all of her job-related activities, the good doctor is also an aspiring writer. She authors a monthly column on general health issues for the local, weekly African-American News & Issues newspaper. Topics range from the importance of organ donation, to self-esteem issues.

"I cover a lot of different health-related topics. So many issues involve health, and when people think well of themselves, they treat themselves better."

Dr. Carter said she hopes this column will become syndicated later this year.

She has also written two books.

In her first book, "My Strength Comes from Within," she writes about when she developed her "sense of self" as a fifth grader, how she's used it to spur herself on, how she got into forensics in ninth grade, how she loves her career, and her spiritual side.

"I deal with death every day, so I have an intense appreciation for life. I am also a very devout Christian," Dr. Carter said. "That is key to helping me cope, day in and day out."

She credits her family for giving her a strong background and a positive upbringing. In turn, she tries to inspire young people, in particular, to pursue their goals and dreams.

"It doesn't have to be my career path - they can be whatever they choose," Dr. Carter said. "They should feel good about themselves. Everyone has their own sense of strength - and for those who don't, perhaps this book can help them find it."

The second book, "I Speak for the Dead," will be published in the coming months, and deals with both the public and medical community perceptions of death, and how people can help themselves and help others cope. Dr. Carter urges dialog between family members on organ and tissue donation, wills, and sharing personal wishes such as advanced directives, should a person need these items later on in life.

"I encourage people to share their questions and concerns with their loved ones. If you make a decision about your health care in your mind and don't tell anyone, it doesn't do any good. If tragedy strikes, your loved ones need to know your wishes. I think many times our fear of this topic keeps us from moving forward on this issue."

She also details her role as a medical examiner versus the public's perception of what a medical examiner does.

"People don't like to talk about death, but that's what I talk about all the time," she said. "To me, it's part of life. And when you're talking about things that are unpleasant, people don't like to hear what you have to say sometimes. This is a difficult job - it's not for everyone. But I have a talent for doing it. I have survived tremendous controversy by always keeping my head high and speaking through my work. I hope people realize that the medical examiner can be a community asset. This job is my calling from God."

Both of Dr. Carter's books are available through Barnes & Noble.

To help keep her energy up and her mind focused, Dr. Carter has taken up the sport of tennis, and it has quickly become her favorite stress reliever. She plays three times a week and is "coached" by state Rep. Al Edwards.

"My mother spent thousands of dollars getting me trained to play tennis when I was younger, and I never caught on," she said. "It was because I was left handed, and they were teaching me to play as a righty. I never believed I could actually hit a ball across the net, but I am really enjoying it. I can see my progress every time I play."

Dr. Carter said her favorite aspect of the job is the community service she provides through her office.

"I was in a restaurant at a recent breakfast meeting, and a family stopped me to compliment the office on our services. I spent about 15 minutes talking to them about their experience - the death of their loved one, their sharing of memories of that loved one, and how they were coping now. As the "coach" of the team here, that makes me happy."

Dr. Carter said she loves using her skills as a forensic pathologist, but the nature of her job is administrative and she doesn't get to investigate cases nearly as often as she would like. She reviews every homicide that comes out of the office, as well as special cases, such as those involving children, the recent flood victims, and a recent string of Houston deaths due to lethal drug overdoses.

"Since 95 percent of my job is administrative," she said, "I am slowly trying to build up to actually doing more cases, because it is really what I love to do."

Dr. Carter said it hasn't really bothered her to excel in a traditionally male-dominated field.

"I don't try to hide the fact that I am a woman, or hide my knowledge and capabilities. I sometimes have had to deal with sexism, but it doesn't bother me. When I am asked, `How do you do this?' I reply, `Stand back and watch me work.'"

Dr. Carter said in order to succeed as a medical examiner, a person must be detail oriented.

"Notice I said person," she said. "People need to remove gender biases from job descriptions. If you are a professional on the job, you should be treated as such. My business card says "Dr.," and I expect to be treated with as much respect. People are not always going to like you, but they will respect you for being yourself."

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©2006 Texas Medical Center

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