Dr. Susan LaFlesche Picotte: tradition, assimilation, and healing

Mariel Tishma
Chicago, Illinois, United States

 

Susan LaFlesche Picotte

Fig 1. Susan La Flesche Picotte. 1889. Drexel University College of Medicine Legacy Center Archives & Special Collections. Published with permission.

“My office hours are any and all hours of the day and night.”

-Susan LaFlesche Picotte1

 

It was August of 1889 and Dr. Susan LaFlesche Picotte was suffering a sleepless night. She had just treated her first patient and she doubted her diagnosis. She was a new doctor after all, and at only twenty-four she was the first Native American physician practicing clinical medicine in the US. When Dr. LaFlesche rose to visit the eight-year-old boy the next morning, she found her patient playing in the river, healthy once more.2 Her life story, however, is not as simple. Susan LaFlesche Picotte stood at a complicated intersection of her culture and assimilation.

Susan LaFlesche was born in 1865, one of the last years of traditional life for the Omaha tribe. She participated in buffalo hunts as a child, but the herds vanished as she grew.3 Susan’s father, Joseph LaFlesche (Iron Eyes), hoped the Omaha could survive changes like these.

Joseph LaFlesche was the last recognized chief of the Omaha tribe.4 He decided that rather than struggling to remain entirely separate from the coming wave of white society, it was better to integrate select parts to survive. Not all agreed with this tactic. Some in the tribe referred to Joseph and his followers as “The Village of the Make-Believe White Men.”5

During her childhood, eight-year-old Susan witnessed the death of an Omaha woman from neglect by the white doctor assigned to their reservation. She remained with this woman while they waited for the doctor but he never came, despite four separate messages being sent to him.6 This would be the catalyst for her interest in medicine.

Her early education was in mission schools on the reservation. Here Susan learned to read, write, and speak in English, as well as the basics of arithmetic, history, and geography.7 She completed school at age fourteen. At age seventeen, Susan and her sister Margueritte traveled to New Jersey to attend the Elizabeth Institute for Young Ladies. She finished in 1882 and returned to the reservation where she taught at the Quaker mission school.8

While teaching, Susan was introduced to Alice Fletcher, an anthropologist and advocate for Native Americans. When Fletcher became ill, Susan helped nurse her back to health. Fletcher recommended that Susan return to the East, attend the Hampton Institute, and eventually earn a medical degree.9

The Hampton Institute was “one of the nation’s first and finest schools of higher education for non-white students.”10 It opened its doors first to Black students and later expanded to include Native Americans.11 As Susan already spoke English, she was assigned the normal course of study, which was more difficult and included tutoring other students who had less formal education.12 Susan studied government, history, politics, physics, and biology and furthered her studies in English.13 She completed the three-year course in just two and graduated in 1886.14 As salutatorian, Susan gave an address at graduation, sharing experiences and insights from her childhood on the reservation.15

Susan now set her sights on medical school. Hampton’s resident physician, Martha Waldron, had suggested her alma mater, the Women’s Medical College of Pennsylvania (WMCP).16 At that time, WMCP was at the forefront of medical education and the first medical school open to women in the US.17 This made it a sound choice. One roadblock, though, was cost. Then as now, medical school tuition was often out of reach for underrepresented students. Susan connected once again with Alice Fletcher for help.

Fletcher secured the help of the Connecticut Indian Association, which wanted to support Native Americans in their pursuit of “civilized” professions and culture.18 Susan was immensely grateful to the women in this group and continued to work with them throughout her career. The women of the Connecticut Indian Association also solicited funding from the Office of Indian Affairs (OIA). However, there was some controversy around Susan’s education, and the amount of aid she received was less than what the OIA had promised.19

WMCP covered the major medical disciplines but maintained a special focus on obstetrics and gynecology. It was assumed that most women physicians would serve women.20 Susan’s other courses covered chemistry, anatomy, physiology, histology, materia medica, and therapeutics. More advanced courses included pathology and surgery. Students attended regular clinics at the Woman’s Hospital, sometimes working alongside male medical students. While observing a surgery during one of these clinics, a male medical student fainted. Susan wrote in a letter that neither she nor the other female students were “even thinking of fainting.”21,22

Susan wrote her family often, and when they shared their medical troubles with her, she provided advice and suggested treatments.23,24 On the few occasions Susan went home for the summer, she cared for her aging parents25 and the rest of the tribe, including during a measles epidemic.26

Susan graduated in 1889 as valedictorian of her class.27,28 Following a rigorous exam for highly coveted spots, she was selected as one of six women for a four-month internship at the Woman’s Hospital. When her internship was complete, she returned to the Omaha reservation where she would live and work for the remainder of her life. Susan was appointed physician at a government boarding school in August of 1889. She requested to treat adults in the tribe and was allowed to do so. She became so popular with those on the reservation that she treated most of the OIA physician’s patients. He eventually left, and Susan became responsible for over 1,200 tribal members on the Omaha and Winnebago Indian Reservation, as well as a few white patients who lived nearby.29

At the school Susan served as both physician and health teacher to students. She educated them on hygiene, physiology, English, and math,30 and treated their cholera, dysentery, and influenza, among other illnesses.31 Adults in the tribe came to her for treatment of tuberculosis, cholera, dysentery, and eye disorders such as trachoma.32,33

Susan fought to earn the trust of her patients. Many questioned her unfamiliar and nontraditional methods.34 However, Susan spoke the Omaha language and knew their culture. Women especially trusted her over a white male physician. Eventually, many conceded as they “felt [she] was one of them.”35

When Susan had arrived, her office at the school was not properly equipped. Many OIA physicians could not rely on supplies from the office that employed them. When supplies did arrive, they were often broken or outdated.36 So Susan reached out to her connections in the East and received donations of clothing, supplies, and money.37 When these donations ran dry, she financed supplies with her own salary.38

Outside her office, Susan traveled the nearly 1,350-square-mile reservation to meet her patients at home.39 Most of the roads were challenging to navigate while carrying fragile vials of medicine and delicate instruments. After several years in practice, she could afford to buy her own buggy and team. Still, Susan’s days were long, often starting at 8 am and continuing until 10 pm, regardless of the weather. The freezing Nebraska winter did not slow her down, and she attended to patients even when the temperature hit twenty degrees below zero.40

Four years of hard work and conditions took a toll on her health. Susan resigned as the OIA physician for the Omaha tribe in October of 1893. By January, she had an earache and neck and back pain so severe she was bedridden. Her illness would return periodically, rendering her unable to work.41

Susan eventually recovered and then announced her intention to marry Henry Picotte, a Sioux man, which shocked her friends and family.42 At the start of medical school, Susan had promised the Connecticut Indian Association that she would not marry until a few years after her graduation.43 She had fulfilled that promise by 1894, but some believed she would never marry.

The couple moved to Susan’s allotment near Bancroft, Nebraska and had two sons—Caryl and Pierre. Susan then returned to work. Now in private practice, she cared both for members of the Omaha tribe, as she had before, and white patients from Bancroft. Occasionally, Susan would bring one of her sons with her when she went on house calls. To facilitate her medical career, her husband took on a supporting role, tending their land and caring for their children.44

However, the peace would not last. Susan nursed her husband through a serious case of tuberculosis and general decline from alcoholism, and he died in 1905.45 His death may have pushed her to further her political involvement, particularly in the temperance movement.

Susan served as the trusted political consultant, lawyer, and translator for the Omaha.46 The US government had decided Native American tribes were unable to manage their own land, and so held it “in trust.”47 When members wanted to sell or rent the land, all money had to pass through the government—sluggishly at best, if the funds ever returned at all. The process was intentionally complicated, and some tribe members did not know English. Susan wrote and spoke on their behalf. This red tape would prevent some tribe members from receiving medical care, as they could not get the money to pay for it.48

After the death of her husband, Susan’s sons were entitled to land in South Dakota. However, because Susan was a woman and not a resident of South Dakota, the money from the land’s sale was withheld. The agency assumed she was not competent enough to manage the money for her sons, despite being an educated physician.49

Susan also advocated for temperance, believing that alcohol was a tool of white settlers to weaken the Omaha, leaving them vulnerable to both manipulation and disease.50,51 Susan and her allies leveraged a law to prohibit the sale of alcohol on the reservation in 1892 and to any Native American whose land was in trust in 1897.52

Susan LaFlesche Picotte Memorial Hospital
Front-left angle photograph of the Dr. Susan LaFlesche Picotte Memorial Hospital in Walthill, Nebraska, United States. Photo by Joelwnelson. 2009. Via Wikimedia. CC BY 3.0.

In public health more generally, she fought to rid the reservation of tuberculosis. She took a multi-pronged approach, focusing on preventing infection from the house fly and common drinking cups53 and emphasizing education and inspection for symptoms. In 1912, she designed a poster about the dangers of the house fly—considered a serious spreader of disease at the time. In 1914, she wrote to the Commissioner of Indian Affairs asking for materials to speak on tuberculosis to the tribe, hoping that education would shape behavior.54 As part of this same letter, she asked that all children in reservation schools be inspected for symptoms of tuberculosis. Many children had come to her with the disease after several months at these schools without any treatment.55

Her final project was to found a hospital on the Omaha reservation that could operate without government funding.56 Susan campaigned for the money herself, soliciting grants and donations. Thanks to her efforts, the building was funded and constructed on time. However, Susan was ill for much of 1912, and so the hospital’s opening was delayed until 1913. Initially only open to Native Americans, the hospital would quickly reverse this policy and welcome both non-white and white patients. It had two general wards, five private wards, a maternity ward, and an operating room. Two years after its opening, the hospital had admitted 448 patients, 126 of them Native Americans.57 Susan worked in the hospital for a short time but was often bedridden. She had been ill for much of her life. In college, she reported difficulty breathing and numbness. She was diagnosed with neurasthenia, manifesting in physical and mental exhaustion along with headaches, insomnia, palpations, and spinal irritation. She likely had cancer, possibly of the ear or bone. She was operated on twice in the year of her death, but neither was curative.58,59

Dr. Susan LaFlesche Picotte died in 1915 and the hospital was renamed in her honor. It continued to treat patients until it was closed in the 1940s. The building was later restored and designated a National Historic Landmark.60

 

End Notes

  1. “Susan La Flesche Picotte: The First American Indian Doctor,” Unladylike2020: The Changemakers, Video by PBS, American Masters, WNET, July 2020, https://www.pbs.org/wnet/americanmasters/meet-first-american-indian-woman-physician-ienwy3/14818/.
  2. Ibid.
  3. Benson Tong, Susan La Flesche Picotte, M.D.: Omaha Indian leader and reformer, (Norman, Oklahoma: University of Oklahoma Press, 1999), 5, https://archive.org/details/susanlafleschepi0000tong/page/n7/mode/1up.
  4. “Susan La Flesche Picotte,” Nebraska Public Media Foundation, n.d., http://www.nebraskastudies.org/en/1875-1899/susan-la-flesche-picotte-first-na-female-physician/.
  5. Carson Vaughan, “The Incredible Legacy of Susan La Flesche, the First Native American to Earn a Medical Degree,” SMITHSONIANMAG.COM, March 1, 2017, https://www.smithsonianmag.com/history/incredible-legacy-susan-la-flesche-first-native-american-earn-medical-degree-180962332/.
  6. Lisa Spellman, “Honoring Dr. Susan La Flesche Picotte,” University of Nebraska Medical Center, November 19, 2020, https://www.unmc.edu/news.cfm?match=26551.
  7. Bernita L. Krumm, “Women in History–Dr. Susan LaFlesche Picotte: American Physician and Heroine,” Journal of Women in Educational Leadership, Vol. 3, No. 4 (October 2005): 3, https://digitalcommons.unl.edu/jwel/166/.
  8. Bernita L. Krumm, “Women in History–Dr. Susan LaFlesche Picotte” 4.
  9. “Susan La Flesche Picotte,” Nebraska Public Media Foundation.
  10. “Changing the face of medicine: Dr. Susan La Flesche Picotte,” U.S. National Library of Medicine, Last modified June 3, 2015, https://cfmedicine.nlm.nih.gov/physicians/biography_253.html.
  11. Valerie Sherer Mathes, “Susan LaFlesche Picotte: Nebraska’s Indian Physician, 1865-1915,” Nebraska History 63 (1982): 503, https://www.nebraskahistory.org/publish/publicat/history/full-text/NH1982SLaFPicotte.pdf.
  12. Valerie Sherer Mathes, “Susan LaFlesche Picotte, MD: Nineteenth-Century Physician and Reformer,” Great Plains Quarterly Vol. 13, No. 3 (Summer1993): 173, https://www.jstor.org/stable/23531722.
  13. Benson Tong, Susan La Flesche Picotte, M.D., 64.
  14. Joseph Agonito, “The La Flesche Sisters: Walking in Two Worlds” in Brave Hearts: Indian Women of the Plains, (Guilford, Conneticut: Twodot, 2017), 178.
  15. Valerie Sherer Mathes, “Susan LaFlesche Picotte” Nebraska History, 604.
  16. “Changing the face of medicine” U.S. National Library of Medicine.
  17. Carson Vaughan, “The Incredible Legacy of Susan La Flesche.”
  18. Bernita L. Krumm, “Women in History–Dr. Susan LaFlesche Picotte” 4.
  19. Sarah Pripas-Kapit, “”We Have Lived on Broken Promises”: Charles A. Eastman, Susan La Flesche Picotte, and the Politics of American Indian Assimilation during the Progressive Era,” Great Plains Quarterly Vol. 35, No. 1 (Winter 2015): 56-57. https://www.jstor.org/stable/24465561.
  20. Joseph Agonito, “The La Flesche Sisters” 179.
  21. Benson Tong, Susan La Flesche Picotte, M.D.,71-72.
  22. Valerie Sherer Mathes, “Susan LaFlesche Picotte,” Nebraska History, 508.
  23. Benson Tong, Susan La Flesche Picotte, M.D., 77.
  24. Valerie Sherer Mathes, “Susan LaFlesche Picotte” Nebraska History, 509.
  25. Valerie Sherer Mathes, “Susan LaFlesche Picotte, MD,” Great Plains Quarterly, 176.
  26. Benson Tong, Susan La Flesche Picotte, M.D., 81.
  27. “Changing the face of medicine,” U.S. National Library of Medicine.
  28. Carson Vaughan, “The Incredible Legacy of Susan La Flesche.”
  29. Valerie Sherer Mathes, “Susan LaFlesche Picotte” Nebraska History 512.
  30. Benson Tong, Susan La Flesche Picotte, M.D., 89.
  31. Bernita L. Krumm, “Women in History–Dr. Susan LaFlesche Picotte” 4.
  32. Carson Vaughan, “The Incredible Legacy of Susan La Flesche.”
  33. Benson Tong, Susan La Flesche Picotte, M.D., 96.
  34. Lisa Spellman, “Honoring Dr. Susan La Flesche Picotte.”
  35. Benson Tong, Susan La Flesche Picotte, M.D., 91-92.
  36. Benson Tong, Susan La Flesche Picotte, M.D., 88-89, 95.
  37. Valerie Sherer Mathes, “Susan LaFlesche Picotte, MD” Great Plains Quarterly 178.
  38. Benson Tong, Susan La Flesche Picotte, M.D., 95.
  39. Carson Vaughan, “The Incredible Legacy of Susan La Flesche.”
  40. Benson Tong, Susan La Flesche Picotte, M.D., 94-95.
  41. Valerie Sherer Mathes, “Susan LaFlesche Picotte, MD,” Great Plains Quarterly, 178- 179.
  42. Valerie Sherer Mathes, “Susan LaFlesche Picotte” Nebraska History, 516-517.
  43. Joseph Agonito, “The La Flesche Sisters” 179.
  44. Joseph Agonito, “The La Flesche Sisters” 182.
  45. Bernita L. Krumm, “Women in History–Dr. Susan LaFlesche Picotte” 121-122.
  46. Bernita L. Krumm, “Women in History–Dr. Susan LaFlesche Picotte” 5.
  47. Valerie Sherer Mathes, “Susan LaFlesche Picotte, MD,” Great Plains Quarterly, 180.
  48. Benson Tong, Susan La Flesche Picotte, M.D.,165, 170.
  49. Sarah Pripas-Kapit, “”We Have Lived on Broken Promises”” 67.
  50. Benson Tong, Susan La Flesche Picotte, M.D., 132.
  51. Benson Tong, “Allotment, Alcohol, and the Omahas,” Great Plains Quarterly Vol. 17, No. 1 (Winter1997): 23, https://www.jstor.org/stable/23531946.
  52. Sarah Pripas-Kapit, “”We Have Lived on Broken Promises”” 66.
  53. Valerie Sherer Mathes, “Susan LaFlesche Picotte, MD,” Great Plains Quarterly, 179.
  54. Benson Tong, Susan La Flesche Picotte, M.D., 180, 184.
  55. Picotte to the Commissioner of Indian Affairs, April 29, 1914, Nebraska State Historical Society, RG2026-LETTER-1914.
  56. “Susan La Flesche Picotte,” Nebraska Public Media Foundation.
  57. Benson Tong, Susan La Flesche Picotte, M.D., 180, 188-190.
  58. Benson Tong, Susan La Flesche Picotte, M.D., 168.
  59. Valerie Sherer Mathes, “Susan LaFlesche Picotte” Nebraska History 516, 524.
  60. Bernita L. Krumm, “Women in History–Dr. Susan LaFlesche Picotte,” 5.

 

Bibliography

  • Agonito, Joseph. “The La Flesche Sisters: Walking in Two Worlds in Brave Hearts: Indian Women of the Plains. Guilford, Conneticut: Twodot, 2017.
  • “Changing the face of medicine: Dr. Susan La Flesche Picotte.” U.S. National Library of Medicine. Last modified June 3, 2015. https://cfmedicine.nlm.nih.gov/physicians/biography_253.html.
  • Ferris, Jeri. Native American Doctor: The Story of Susan LaFlesche Picotte. Minneapolis, Minnesota: Carolrhoda Books, 1991.
  • Krumm, Bernita L. “Women in History–Dr. Susan LaFlesche Picotte: American Physician and Heroine.” Journal of Women in Educational Leadership, Vol. 3, No. 4 (October 2005): 3-6. https://digitalcommons.unl.edu/jwel/166/.
  • Mathes, Valerie Sherer. “Susan LaFlesche Picotte, MD: Nineteenth-Century Physician and Reformer.” Great Plains Quarterly Vol. 13, No. 3 (Summer1993): 172-186. https://www.jstor.org/stable/23531722.
  • ______. “Susan LaFlesche Picotte: Nebraska’s Indian Physician, 1865-1915.” Nebraska History v 63 (1982): 502-530. https://www.nebraskahistory.org/publish/publicat/history/full-text/NH1982SLaFPicotte.pdf.
  • Picotte, Susan. Letter to the Commissioner of Indian Affairs. Concerning Liquor Traffic on the Reservation and the Health Condition of the Omaha. Nebraska State Historical Society. RG2026-LETTER-1914. April 29, 1914.
  • Pripas-Kapit, Sarah. “”We Have Lived on Broken Promises”: Charles A. Eastman, Susan La Flesche Picotte, and the Politics of American Indian Assimilation during the Progressive Era.” Great Plains Quarterly Vol. 35, No. 1 (Winter 2015): 51-78. https://www.jstor.org/stable/24465561.
  • “Susan La Flesche Picotte.” Nebraska Public Media Foundation. N.d. http://www.nebraskastudies.org/en/1875-1899/susan-la-flesche-picotte-first-na-female-physician/.
  • “Susan La Flesche Picotte: The First American Indian Doctor.” Unladylike2020: The Changemakers. Video by PBS American Masters. WNET. July 2020. https://www.pbs.org/wnet/americanmasters/meet-first-american-indian-woman-physician-ienwy3/14818/.
  • Spellman, Lisa. “Honoring Dr. Susan La Flesche Picotte.” University of Nebraska Medical Center. Publication month/day/year. November 19, 2020. https://www.unmc.edu/news.cfm?match=26551.
  • Tong, Benson. “Allotment, Alcohol, and the Omahas.” Great Plains Quarterly. Vol. 17, No. 1 (Winter1997): 19-33. https://www.jstor.org/stable/23531946.
  • ______. Susan La Flesche Picotte, M.D.: Omaha Indian leader and reformer. Norman, Oklahoma: University of Oklahoma Press, 1999. https://archive.org/details/susanlafleschepi0000tong/page/n7/mode/1up.
  • Vaughan, Carson. “The Incredible Legacy of Susan La Flesche, the First Native American to Earn a Medical Degree.” SMITHSONIANMAG.COM. https://www.smithsonianmag.com/history/incredible-legacy-susan-la-flesche-first-native-american-earn-medical-degree-180962332/.

 


 

MARIEL TISHMA is an Assistant Editor at Hektoen International. She has been published in Hektoen International, Bloodbond, Argot Magazine, Syntax and Salt, The Artifice, and Fickle Muses. She graduated from Columbia College Chicago with a BA in creative writing and a minor in biology. Learn more at marieltishma.com.

 

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