Doctor and reformer of the late 19th century, Susan La Flesche Picotte is widely regarded as one of the first indigenous people of what is now America to earn a medical degree, but she was more than a doctor and a reformer. She was a potent activist and achieved so much as an indigenous woman in a time when indigenous people, and especially indigenous women, had so few rights and so few opportunities. She left behind an incredible legacy for her Omaha tribe but also for all indigenous tribes. Today, few will have heard of Susan but her invaluable work has left a profound impact. This is her remarkable story…
The Chief
1837. Chief Big Elk was summoned to Washington. He returned to his Omaha people with a stark warning: “There is a coming flood which will soon reach us, and I advise you to prepare for it.” It was not literal. In Washington he had seen a different world, the bustling streets of a capital city showing Chief Big Elk a future of which the Omaha, he knew, had to adapt to survive, otherwise their traditional ways would be wiped out. Shortly before his death in 1853, he chose a man with a similar vision to succeed him as the chief of the Omaha – that man was Joseph La Flesch. A man of indigenous and French descent.
Decade after decade, La Flesche struggled to keep threading an elusive bicultural needle, one that he believed would ensure the success of his children, the survival of his people.
– Joe Starita (author).
Joseph’s push was bold, his ambition remarkable. He wanted total assimilation. “It is either civilization or extermination,” he often said. The Omaha were far from keen. The tribe splintered between the ‘Young Men’s Party’, open to the incorporation of the coming flood of the white world, and the ‘Chief’s Party’, loyal to the traditional ways. It wasn’t long before the Young Men’s Party started to build log cabins and roads, laying out modern towns. The Chief’s Party dubbed this settlement, ‘The Village of the Make-Believe White Men’.
It was in this world where Susan La Flesche Picotte grew up. Born on the Omaha reservation on June 17th, 1865. She grew up with her three older sisters in the log cabins, walking a tightrope between her heritage and the oncoming storm. Her father, Joseph, also known as Iron Eye, identified as Omaha but he was of Ponca and French Canadian ancestry, educated in St. Louis but returning to the tribe. He became its controversial leader in 1855, but his belief in partial assimilation brought friction, something Susan was all too aware of.
These were choices made to venture into the new world that confronted Omahas. The La Flesche family was adept at learning and adopting languages, religions, and cultures. They never forgot their Omaha culture; they, we might say, enriched it with greater knowledge of their new neighbours.
– John Wunder (professor).
It was here, in the Village of the Make-Believe White Men, where a young Susan would meet a Harvard anthropologist who would change not only her life forever, but also the lives of her tribe…
The Face of Prejudice
Alice Cunningham Fletcher was not only an anthropologist, but also a women’s rights advocate who acted as teacher and guide to the young Susan. Alice inspired Susan. When she was only eight years of age, she heard of an elderly woman in the tribe suffering immeasurable pain. Susan had her eyes opened to the world outside of the tribe by Alice and, without a second thought, she ran to the bedside of the elderly woman.
She sat with her and held her hand, waiting for the white doctor to arrive. The white people, however, cared little for the indigenous peoples. Four times a messenger was sent, four times the white doctor said he would arrive soon, but he never did. And the elderly woman died shortly before sunrise. It was a harrowing experience for young Susan. Why did the doctor not come? It was the first time she realised the white people were never going to accept the indigenous peoples unless something changed. Rather than anger, Susan felt a call to action. It would be the making of her.
It was only an Indian and it [did] not matter.
– Susan.
Susan’s family was in a unique position having mixed heritage but Susan certainly felt a stronger pull toward the Omaha. She learnt many of her tribe’s traditions and stories, but her parents felt as if these rituals would be detrimental in a white world. Susan was never given an Omaha name, all a part of the assimilation efforts, and she was forbidden from receiving traditional Omaha forehead tattoos, much to her dismay. She did, however, speak fluent Omaha, but her father encouraged her to speak English. All of this had a profound impact on young Susan.
Our culture is being supressed. Who we are is being lost. And lives are not being saved because of our race. No wonder she felt drawn to becoming a doctor herself, but as an indigenous woman, it would be far harder than I think anyone today could possibly imagine.
Regardless, the loss of the elderly woman undoubtedly motivated Susan to pursue a career in medicine.
The Medicine Woman
Susan felt her culture and traditions vanishing around her. President Ulysses Grant’s ‘Peace Policy’ saw children of reservations taught in boarding schools where they were encouraged to assimilate into white society. No wonder Susan was growing frustrated and disillusioned. She came and went from the reservation for various education reasons, leaving in 1884 to study at the Hampton Institute in Virginia. It was a black college after the American Civil War but became a place for indigenous peoples to study.
Susan attended the college with her sister Marguerite, her stepbrother Cary, and 10 other Omaha children. The girls, predictably, learnt how to be ‘good housewives’ whilst the boys learnt useful skills. Susan graduated in 1886 as class salutatorian and winner of the Demorest price, given to any graduating senior who receives the highest examination scores. Female graduates were encouraged to teach or return to their reservations and become ‘Christian wives and mothers’. Not Susan, no. In 1886, she decided to do something no indigenous woman had ever done before: she applied for medical school.
In 1886, some 1,300 miles from where she was born, Susan debarked from a train in Philadelphia. She was just 21 but incredibly learned. She loved Shakespeare and spent her free time painting and playing the piano. She was exhausted, her journey long. Before her, however, a new challenge. She had done the impossible. She had got into medical school. She was driven by something her father once told her:
Do you always want to be simply called ‘those Indians’ or do you want to go to school and be somebody in the world?
Within days, she would attend her first classes at the Women’s Medical College of Pennsylvania, far removed from the wild plains of her homeland and the tipis of her childhood. She stood at the vanguard of medical education. But she was in good hands. This school was the first of its kind established for women in America. It was a difficult but rewarding three years. Susan never forgot the elderly woman or the indifference of the white man to her care. Maybe if she could become a doctor, just maybe she could make a real, tangible difference. And you know what? After three years, she did it.
Susan La Flesche Picotte became the first female indigenous person of what is now America to earn a medical degree. Susan was now a qualified doctor.
Valedictorian
It only takes one person to shake the boat to shatter another barrier. Susan had done that when she graduated valedictorian in 1889. She could suture wounds, deliver babies and treat tuberculosis. Yet because of her gender and race, she could not vote nor was she a recognised citizen of America as indigenous people were not entitled to that right. Never mind becoming a doctor of indigenous heritage, Susan was one of the handful of American women, indigenous or not, to go to medical school. She was the definition of vanguard.
Susan applied for the position of government physician at the Omaha Agency Indian School in 1889 and two months later, she was offered the position. During her medical studies, she had appealed to the Connecticut Indian Association, a local auxiliary of the Women’s National Indian Association, their aim to ‘civilize the Indians by forcing Victorian values of domesticity among Indian women’.
The Association not only paid for Susan’s medical school expenses but paid for her housing, books and other supplies. In doing so, she became the first person in America, of any gender or race, to receive aid for professional education. After she graduated, the Association appointed her as a medical missionary to the Omaha and they funded the purchase of medical instruments and books for her practice.
She returned to the Omaha in 1889. She was now their chief physician, a role she took up at the government boarding school. Her responsibility was to teach students about hygiene and to keep them healthy. But nothing could prepare her for what she encountered when she returned to the Omaha. The sick were everywhere.
And they needed Susan.
The Saint
On the first day Susan opened her doors, the sick flooded in. The numbers were astonishing. They had been sick for months and nobody came to help them. Suddenly, here was Susan, one of the Omaha, ready and willing to help however she could but it was overwhelming. Nothing prepared her for this. Tuberculosis and cholera were rife among many. Others were looking for a clean place to rest. Susan was not just a doctor to her people. She was their lawyer, accountant, priest and political liaison, not to mention someone you could confide in. This was more than what she trained for.
Susan was not on her own but the only other doctor there was white. However, entirely understandably, the Omaha did not want to be treated by white people. Dr Susan, as the Omaha called her, was called upon so much that her white counterpart grew frustrated and quit. Susan was now on her own. She was now the only physician on a reservation covering 1,350 square miles or 3,496 square kilometres.
Susan was not obliged to care for people who were not students but she did. She cared for as many people as she could. She worked 20 hour days and directly under her care were 1,200 people. If you want proof how little the white people cared for the indigenous people, there you go. Nobody was coming to help Susan. She was completely on her own.
Her only ally was the Association who provided medical equipment. Susan took on a saintly figure. From her office in the school’s courtyard, she started to help the Omaha with more mundane tasks, as well as their healthcare. She wrote letters for them and educated them, also helping them to translate official documents. The American government was hellbent on making their lives as miserable as possible, wrapping the Omaha up in complex legalities they, understandably so, didn’t understand or comprehend. Now here was Susan. She wasn’t just a doctor, she was fighting for the Omaha.
She was their protector.
The Healing Hand
Susan’s fondest hope for the Omaha was to build a hospital. But such dreams were hard to realise. In the meantime, she spent most of her 20 hour days making house calls, on foot, walking tens and tens of miles. She’s a hero. But she saw it as a duty. She did it come rain or shine, but when the snow came, she had to rely on a horse. Despite the weather or circumstances, she never missed a house call. She once travelled for six hours, on foot, to check up on a single patient. Under the burning Sun, her life was in danger. But that didn’t matter to her.
Although a few Omaha rejected her diagnosis, the vast majority trusted her implicitly. She was treating patients with tuberculosis, influenza, cholera, dysentery and trachoma, many from her tiny office, just 12 by 16 feet in size. For her efforts, she was paid $500 a year, plus $250 from the Association as a missionary. That’s around $21,000 in today’s money, but much of that went into supplies. She was forced to take a temporary leave in 1893 to take care of her dying mother, and in 1894, she met and became engaged to Henry Picotte, a member of the Sioux tribe. The couple had two sons, Caryl and Pierre.
Susan returned to medicine after the birth of her children, completely unheard of in the Victorian era as women were expected to give up their careers and become full time mothers. Not Susan, no, she was the definition of unconventional. She loved to care for people and, as time went on, she started to treat white people, too. And when she couldn’t get childcare, she sometimes took her children on house calls.
She was a fighter. There’s no doubt about that.
The New Firm
Susan opened a private practice in Bancroft treating white people and indigenous people. She persuaded the Office of Indian Affairs to ban liquor sales in towns created within reservations and became a potent advocate of proper hygiene and the use of screen doors to keep out flies carrying disease. She also waged a war on communal drinking cups and the mescal used in new religious ceremonies. But she was not invulnerable to illness herself.
She suffered most of her adult life from chronic illness. She offered suffered from breathing troubles and chronic pain in her neck, head and ears. Almost certainly to do with how hard she pushed herself, walking those incredible distances in the worst of weather. Things got worse for her in 1893 when she fell from her horse, causing significant internal injuries. Over time, she also went deaf. But you know what? None of that stopped her.
Susan, somehow, summoning superhuman strength, just kept going. She was spurred on by the desire to help the Omaha. She fought battle after battle including taking on temperance in 1897. Alcohol had affected indigenous people horribly. Susan sought to educate her community about preventive medicine and other public health issues. Alcoholism was a personal battle for Susan. Her own husband was alcoholic.
As a prominent member of the community, Susan used her power to support measures such as coercion and punishment to dissuade individuals from alcohol and oversaw the creation of a secret police to enforce corporal punishment to discipline those who consumed alcohol. It might seem harsh but you have no idea what alcohol did to the indigenous peoples. It was out of control. Something had to be done, no matter how harsh it may appear. She fought against alcohol her entire life. Yet, despite her tireless efforts to drive others away from alcohol, her husband could not escape the vice.
His habit led to him contracting tuberculosis and very sadly, he died.
Public Health, Unlimited
Even after such tragedies Susan kept going. School hygiene, food sanitation and efforts to curb the spread of tuberculosis were all battles she fought. She believed the key in fighting disease was education and in 1913 she finally realised her fondest ambition: her own hospital for the Omaha people. It was the first privately funded hospital on the reservation.
Her most important crusade was against tuberculosis, which had killed hundreds of Omaha, including her husband. She suffered a lack of funding and because there was yet no cure, she advocated cleanliness, fresh air and eradication of houseflies. She also engaged in political action, becoming increasingly active in the campaigns against extending the trust period for the Omaha after her husband’s death. She also became a delegate to the Secretary of the Interior, protesting for changes in the supervision of the Omaha.
Over time, Susan became something of a community leader. She often fiercely defended the Omaha’s interests and tried to help resolve situations where white people took advantage of indigenous peoples. But as she grew older and fought land battles even in Washington itself, Susan’s health began to deteriorate. By the time her beloved hospital in Walthill was completed, remarkably still there to this day, albeit not a hospital anymore, Susan was too frail to be its sole administrator.
She continued to care for people even as she grew frail. But by 1915, she was suffering greatly and on September 18th, she died of bone cancer. She was buried near her husband, father, mother, sisters and half-brother. Tragically, Susan was just 50-years-old.
But my God, what a legacy she left behind…
The Healer
After Susan’s death, her son Caryl went on to become a soldier in the United States Army and served in World War II. He died in 1978. His brother, Pierre, lived in Walthill where he married and raised three children. What a mother they had. A woman I think very few if anyone outside of America has ever heard of. You can only compare her to Mother Teresa and Florence Nightingale, but she was very much her own person. In her life, she served over 1,000 patients and, at one point, on her own, she was serving 1,300 over a vast area, making house calls predominantly on foot. Even after her health failed, even after she fell off a horse, she just kept going. And her life culminated in a hospital she lived just long enough to see completed. I cannot believe she is not a household name. She is a superhero. She saw injustice and she decided to do something about it. And boy, she did make a difference.
Yet, unlike so many chiefs and warriors of indigenous tribes, Susan is virtually unknown outside of the Omaha tribe. For all the good she did, today the Omaha tribe still face many health challenges. Allegations of tribal corruption and poor patient care have dogged the Omaha and Winnebago tribes. Susan’s hospital closed in the 1940s and is now a small museum, leaving the people of Walthill stranded. Alcoholism still plagues the tribes of the area as do amphetamines, suicide and crime. It doesn’t mean Susan’s fight was in vein. She started a rebellion against how the indigenous tribes were being treated and she decided to do something about it. And she certainly did.
Better health care is coming for the Omaha and the reservation hospital in Walthill is now a community centre named after Susan, but is in desperate need for funds to keep it open. Susan today is remembered, certainly among the Omaha. Schools named in her honour, statues and in 2017, a Google Doodle alerting the world to the incredible work of Susan. Her story is now being told while the fight she started is still being fought, in her name.
Susan La Flesche Picotte watched a sick, elderly indigenous woman die because the local white doctor didn’t care. It inspired her to be the change she wanted to see in this world. You can’t get much more inspiring than that. She never stopped working and she never stopped caring. You may not have heard of her, but you have now.
So don’t forget it.
We who are educated have to be pioneers of Indian civilisation. The white people have reached a high standard of civilisation, but how many years has it taken them? We are only beginning; so do not try to put us down, but help us to climb higher. Give us a chance.
– Susan.
Toodle-Pip :}{:
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Images (click on them to enlarge): 1) Susan La Flesche Picotte - I think she looks so kind and intelligent, 2) Susan's hospital, now a museum and community centre. Image Credits: https://philadelphiaencyclopedia.org/archive/womans-medical-college-of-pennsylvania/dr-picotte-2-sm/, https://en.wikipedia.org/wiki/File:Picotte_Hospital_from_SE_2.JPG
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