by Aparna Nathan

Susan La Flesche Picotte

In 1873, an eight-year-old girl sat by the bedside of an elderly Omaha woman, waiting for the white doctor she had called for four times. But the doctor never arrived and the woman died in pain. 

That girl, Susan La Flesche Picotte, would go on to credit that moment as the catalyst for her barrier-breaking career in medicine, public health, and advocacy for indigenous rights. She became the the first Native American person to earn a medical degree, the sole doctor on the Omaha reservation during a flurry of epidemics, and an advocate for the rights of her people. This list of accomplishments would be impressive at any time, but especially during the turn of the century, when women were relegated to domestic duties and Native Americans were not considered citizens.

La Flesche was born in June 1865 on the lands of the Omaha Nation, in what is now called Nebraska. Her father was the last recognized Omaha head chief and led the tribe through an era of disruption and adaptation as they signed a treaty ceding most of their land to the United States government and moved to a reservation. His perspective was that, for the Omaha to persist, they had to be educated in both their own culture and the ways of the white Americans encroaching on their sovereignty. This was reflected in La Flesche’s childhood: She spoke not only Omaha and Otoe, but also French and English; and she learned Omaha traditions and then attended boarding schools off the reservation. For college, she went to the Hampton Institute, a historically black college that opened its doors to Native American students around the time that La Flesche attended. Throughout her life, she recognized that her dual cultures enhanced her ability to heal and advocate for those in need. At graduation, she gave a speech as salutatorian in which she described her unique qualifications to help her tribe as a doctor: “I shall have an advantage over a white physician in that I know the language, customs, habits, and manners of living among the Indians.” Buoyed by this confidence, she attended the Women’s Medical College of Pennsylvania, from which she graduated in 1889 at the top of her class. 

In the late 19th century, when La Flesche was training in medical school, female doctors were still rare and fighting to be accepted by the medical establishment. Back among the Omaha, however, women were respected as healers. Armed with her new medical degree, La Flesche petitioned the Commissioner of Indian Affairs and, in 1889, was appointed as a government doctor for the Omaha Reservation. While La Flesche’s role has also been described as an example of white medical practices supplanting indigenous practices, La Flesche nevertheless nursed hundreds of people through multiple epidemics—tuberculosis, cholera, flu—and became an integral part of the community. Each day, she traversed the 1,350-square-mile reservation to make house calls from 8am to 10pm. Even her home, which doubled as an office, became a community hub where she doled out advice on everything from health to law.

As she had predicted in her graduation speech, her Omaha and female identities made her an even better doctor than any degree alone could. In a report to the WNIA in 1891, she wrote, “I have had more medical work among the women than I expected… and I have been called in to attend some cases where a white physician was never called before.” She was also respected by the surrounding white communities and opened a private practice that served everyone, regardless of race.

As La Flesche saw infectious diseases and other scourges like alcoholism—fueled by opportunistic white traders—ravage the community (and her own family, losing her husband to a combination of tuberculosis and alcoholism), she realized that medical care alone wasn’t enough. She became a tireless advocate for public hygiene measures like screens for doors and windows, fly traps, and abandoning shared drinking cups. In her letters to the Commissioner of Indian Affairs, she made impassioned pleas to ban liquor sales on the reservation. And even as La Flesche’s rigorous activism began taking a toll on her own physical health, she continued lobbying the government for Omaha rights, specifically land rights. The government had wrested control of the communal Omaha lands away from them and repeatedly delayed the full return of the lands, instead allotting parcels to individual Omaha without making them the legal landowners unless they were deemed “competent.” La Flesche advocated to the Secretary of the Interior, and subsequently, most Omaha were granted deeds to their land. Although this still left them vulnerable to the predatory machinations of prospective white landowners, the ability to use their land as they wanted was one step closer to being able to exercise the full rights of a citizen.

Even in the final years before her death in 1915, La Flesche continued to work toward her goal of improving health and economic conditions for the Omaha. In 1913, she fundraised for and built the county’s first modern hospital, the first privately funded hospital on a reservation. The issues that La Flesche fought for—public health, land rights, tribal sovereignty—are still critical areas of inequity for indigenous people in the United States. La Flesche’s work has been continued by present-day activists, and she has inspired generations of female and indigenous physicians.


Aparna Nathan is a fourth-year Ph.D. student in the Bioinformatics and Integrative Genomics Ph.D. program at Harvard University. You can find her on Twitter as @aparnanathan.

Photograph of Susan La Flesche Picotte, courtesy of the Nebraska State Historical Society Photograph Collections, is licensed under the public domain.

Cover image by Gordon Johnson from Pixabay.

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