The story of Susan La Flesche’s calling begins on an evening in 1873 on the Omaha Native American Reservation in Nebraska. She was just eight years old then, a child. But that night, she sat amongst others at the bedside of a gravely ill woman who desperately needed medical attention.
Everyone waited as a messenger rushed out to get the U.S. government-appointed doctor who served the reservation. There were no Native American physicians in the country at the time. The night passed, but the physician never came. Apparently, he would later remark that he simply didn’t want to. The woman died before morning.
That memory stayed with Susan and shaped a promise she would keep long after she understood its significance. No one should die for lack of care. This belief would lead her to become the first Native American woman to earn a medical degree, and then to a career practicing on the same reservation where she grew up.
—
The Omaha Nation had lived for generations along the broad sweep of the Missouri River. Their lives there followed the seasons, an old and steady rhythm of summers spent in agricultural villages where they tended corn, beans, and squash, and the colder months on the plains in pursuit of the buffalo. In cultural practice, they maintained a carefully ordered clan system and a diplomatic tradition that placed great value on consensus and balance, reflecting their broader belief in maintaining harmony both within the tribe and with their neighbors.
But by the mid-19th century, U.S. westward expansion had brought immense pressure on the tribe to cede their homelands. In 1854, the Omaha signed a treaty giving up most of their territory and establishing a reservation along the Missouri River in northeast Nebraska. This area would be reduced again in subsequent agreements. Life as they had known it was profoundly altered, with decisions about their governance now under the authority of the U.S. Indian Agency, and often in competition with the long-held tradition of rule by chiefs.
Susan was born into this context in 1865, as the Omaha people were still adjusting to this new chapter in their history. She was the youngest daughter of Iron Eye, one of the last formally recognized chiefs, and his wife, Mary Gale. Iron Eye believed that America was rapidly changing and that Native Americans needed to integrate into the more dominant society around them; that the tribe’s future would depend on education and adaptability. So he made sure that Susan and her siblings learned English, attended school, and understood the American world. Yet at home, the family remained firmly rooted in their own culture. They spoke the Omaha language, attended tribal gatherings, and told their ancestral stories.
By her teens, Susan had shown a remarkable intelligence. Her teachers saw it, and so did the leaders of the Presbyterian missionary organizations that supported the education of Native students. With their help, she left the reservation to attend school in New Jersey, where she was the only Native student in her class. Which wasn’t easy. There she encountered “praise” for her supposedly “civilized” manners. Still, she excelled in her studies.
In 1886, Susan applied and received admission to the Women’s Medical College of Pennsylvania, one of the few medical schools in the country that accepted women. She arrived in Philadelphia with the dream of becoming a physician for her people. When she graduated with top honors in 1889, she became the first Native American woman in the United States to earn a medical degree. After completing a year-long internship at the Woman’s Hospital of Philadelphia, she returned to the Omaha Reservation to begin her practice.
—
Returning home was a triumph, though it came with many challenges. Illnesses spread quickly on the reservation, worsened by poverty and inadequate federal support. Homes were drafty in a land of brutal winters. Food was often scarce. And trust in doctors thin. Susan understood these hardships poignantly.
The Omaha had long relied on their own medicine people, who cared for the tribe through plants, ceremony, and spiritual balance. Their role remained vital. But the diseases that swept through the reservation in the 19th century were new, devastating illnesses brought by contact and confinement. Traditional remedies could only do so much. The government-appointed doctor was supposed to fill that void, yet he was often unreliable. As the need for dependable care grew, Susan’s ability to move between both worlds became all the more essential.
She became the reservation physician at a salary less than half that of a doctor outside the reservation. But the salary mattered little to her. What she wanted was to care for the families on the Omaha lands. And that’s what she did, often riding miles on horseback at all hours and through every kind of weather. She treated fevers, set broken bones, delivered babies, counseled grieving parents, and advocated relentlessly for sanitary reforms. She even assisted families with financial decisions and paperwork. Beyond the community, she pressed the federal government for better funding, sometimes receiving little more than promises. But Susan kept treating and advocating.
By the early 1910s, Susan had set her heart on building a hospital on the reservation so that everyone could receive dignified, modern medical care close to home. She fundraised tirelessly, speaking to women’s clubs, church groups, and philanthropic organizations, and writing to reformers who supported Native causes. Donations arrived from across the country, many of them modest contributions gathered by club members and church societies, slowly bringing her vision to life.
In 1913 her vision became real. The Dr. Susan La Flesche Picotte Memorial Hospital opened in Walthill, Nebraska, on the Omaha Reservation. It was the first hospital on an American Indian reservation built without federal government funding, and the first reservation hospital founded by a Native American woman. Susan served as its head physician.
Sadly, she did not have long to enjoy it. Years of exhausting work had taken a toll in numerous ailments. Susan passed away at just fifty years old in 1915.
—
Notes
Read a snapshot of Chief Joseph.
Sources
- “Dr. Susan La Flesche Picotte, First Native American Woman Physician.” Nebraska State Historical Society, https://history.nebraska.gov/dr-susan-la-flesche-picotte-first-native-american-woman-physician/
- “Dr. Susan La Flesche Picotte.” National Institute of Health, https://cfmedicine.nlm.nih.gov/physicians/biography_253.html
- Herbison, Matt. “Native American Heritage Month: Dr. Susan La Flesche Picotte and Dr. Lillie Rosa Minoka-Hill.” Drexel University College of Medicine, https://drexel.edu/medicine/about/community-health-and-inclusive-excellence/ochie-blog/native-american-heritage-month-dr-la-flesche-picotte-and-dr-minoka-hill/
- Malea D. Powell. “Down by the River, or How Susan La Flesche Picotte Can Teach Us about Alliance as a Practice of Survivance.” College English, vol. 67, no. 1, 2004, pp. 38–60. JSTOR, https://doi.org/10.2307/4140724. Accessed 23 Nov. 2025.
- Tong, Benson. Susan La Flesche Picotte, M.D.: Omaha Indian Leader and Reformer. University of Oklahoma Press, 1999.
- Wikimedia Commons, Wikimedia Foundation, https://commons.wikimedia.org/wiki/File:Doctor.susan.la.flesche.picotte.jpg
Discover more from Historical Snapshots
Subscribe to get the latest posts sent to your email.
