Why you should care
Because she was fighting for universal health care more than 100 years before the concept existed.
As the sun slipped past the horizon, the young girl watched with growing anxiety as an elderly woman struggled to breathe. It was 1873, and they lived on the Omaha Reservation in the northeast corner of Nebraska. The old woman’s condition was worsening, but the White doctor — sent for four times — refused to come. The hours ticked by, and eventually, the woman died before the girl’s eyes. As she would later describe in her journal, Susan La Flesche Picotte vowed that night to do whatever it took to become a doctor.
It took her nearly two decades, but in 1889, La Flesche became the first Native American to graduate from medical school — 35 years before the U.S. government recognized Native Americans as citizens and 31 years before American women could vote. “Whether it was a 2-year-old or a 92-year-old, she took care of everybody,” says Joe Starita, a journalism professor at the University of Nebraska and author of A Warrior of the People, a biography of La Flesche. “There was nobody like her in the history of America — not before, and not since.”
La Flesche was born on the Omaha Reservation to Chief Joseph La Flesche (also called Iron Eye) and Mary Gale (called One Woman). Her father was an unconventional chief: He was a prohibitionist who taught his four daughters Native customs, but he insisted that only English be spoken at home and that adapting to the White world was essential for survival. At 14, La Flesche left home to attend the Elizabeth Institute for Young Ladies in New Jersey and then earned a degree at Hampton Institute (now Hampton University) in Virginia, graduating second in her class.
Both schools brought La Flesche into contact with well-connected White women who were impressed by her drive and intellect, Starita says. Cognizant that gender and racial bias were deeply embedded in the fabric of their era, this circle of supporters used their status to propel La Flesche into spaces she couldn’t otherwise access. With their help, she earned a spot at the Woman’s Medical College of Pennsylvania and graduated as class valedictorian.
At a time when few women, let alone Native Americans, were encouraged to pursue careers, La Flesche was determined to work on behalf of her Native community. Turning down more lucrative job opportunities in New York and Boston, she packed up and headed home to the Omaha Reservation.
She was 24 and had her work cut out for her. The only physician for more than 1,200 patients spread across 1,350 square miles, she used a horse and buggy to make house calls. She delivered babies and treated diseases like cholera, influenza and tuberculosis on the reservation and in the surrounding White towns. Seeing an urgent need for more centralized care, she set to work on her ultimate dream of building a hospital where everyone could be treated. In 1913, with $9,000 — raised primarily from her East Coast connections, and without a single taxpayer dollar — La Flesche opened the first-of-its-kind modern reservation hospital in Walthill, Nebraska.
Yet, in spite of her achievements, La Flesche and her family sparked controversy back home. Many tribe members resented Chief Joseph’s eagerness to assimilate White and Native American culture, Starita says, chiding him for what they called his “Village of the Make-Believe White Men.” For her part, La Flesche, raised on the reservation by mixed-race parents but educated in White schools, was trapped in a catch-22: “She wasn’t Indian enough to satisfy some members of her tribe,” explains Starita, “and she wasn’t White enough to gain the full respect of some people she would later meet in New Jersey, Virginia and Philadelphia.”
[La Flesche was] leaning in a century before Sheryl Sandberg was in high school.
Joe Starita, University of Nebraska
U.S. history textbooks have overlooked La Flesche, who died of bone cancer in 1915 at the age of 50, even though her story and the obstacles she faced are arguably more timely than ever. More than a hundred years ago, she journaled about the societal pressures she endured as a Victorian-era working mother of two sons. As Starita puts it, she was “leaning in a century before Sheryl Sandberg was in high school.”
Today, the Susan La Flesche Picotte Memorial Hospital still stands, a national historic landmark honoring the country’s first Native American doctor. The facility stopped treating patients in the 1940s and fell into disrepair, but last year the Nebraska Commission on Indian Affairs launched a campaign to repurpose it as a museum and offices for the Omaha tribe and other organizations.
Far beyond a physical structure, however, La Flesche’s legacy rests on the belief that health care should be a fundamental right afforded to all, regardless of race, class or gender. And her journey reflects one woman’s desire to forge an identity from separate, often clashing cultures — on her own terms.
“Ultimately, the genius of Susan La Flesche,” Starita says, “is that she was able to thread this very elusive bicultural needle from 500 feet above the ground with no safety net.”