Patience and Sarah is a 1969 historical fiction novel with strong lesbian themes by Alma Routsong, using the pen name Isabel Miller.

[1][2] Routsong's novel is based on a real-life painter named Mary Ann Willson who lived with her companion Miss Brundage as a "farmerette" in the early 19th century in Greene County, New York.

[2] It tells the story of two women in Connecticut in 1816 who fall in love and decide to leave their homes to buy a farm in another state or territory and live in a Boston marriage.

The story addresses the limited opportunities and roles of women in early America, gender expression, and the interpretation of religion in everyday life.

Sarah Waters, author of Tipping the Velvet and other historical novels with lesbian themes,[3] has said that this book was an influence on her writing.

The narrative switches to Sarah's perspective as she cuts off all her hair, renames herself "Sam", takes an axe and walks west alone, healing from the beatings her father gave her (no harm meant, he says).

They meet up with Parson again and decide that Greene County in upstate New York will be their destination, where land is cheap and they can live in peace.

Routsong originally published 1,000 copies of the book using her own money, selling them on street corners in New York City and at meetings of the Daughters of Bilitis.

Alma Routsong gave her approval to the project shortly before her death, but did not survive to hear more than a few songs from the score performed privately.

[10] Concerning the 1996 pre-premiere of the semi-staged final draft, with piano accompaniment, The New York Times claimed it had "an accessible, attractively lyrical score" and that, "Sarah has a gorgeous, Ravelian aria at the start of the second act.