Susan La Flesche Picotte

Physician

• Born: June 17, 1865
• Birthplace: Omaha Indian Reservation, Nebraska
• Died: September 18, 1915
• Place of death: Walthill, Nebraska

Native American physician

As the first female Native American physician, Picotte served her tribe as medical missionary and community leader for twenty-five years.

Area of achievement Medicine

Early Life

Susan La Flesche Picotte (lah-flehsh pee-koh) was born to chief Joseph La Flesche (also known as Iron Eye), the son of a French fur trader, and Mary Gale La Flesche (also known as One Woman), the daughter of a white army surgeon and his Omaha wife. Adopted by Omaha chief Big Elk, Iron Eye succeeded him as one of the two principal chiefs of the tribe in 1853. The La Flesches believed that some accommodation to the ever-advancing white world was essential if their tribe were to survive. Susan, the youngest of Iron Eye’s four remarkable daughters, grew up in a family much influenced by assimilation-oriented missionaries. Her parents converted to Christianity, adopted the white man’s lifestyle, and encouraged their children to seek formal education. Picotte’s oldest sister, Susette (Bright Eyes), ultimately gained fame as a speaker, journalist, and Native American rights advocate; Rosalie enjoyed a successful business career in the livestock industry; and Marguerite became a teacher among the Omaha tribe.

Reared on the reservation, Picotte attended agency day schools run by Quaker and Presbyterian missionaries. At the age of fourteen, she and seventeen-year-old Marguerite traveled to New Jersey to attend boarding school at the Elizabeth Institute for Young Ladies, returning home to Nebraska two and a half years later. From 1882 to 1884, Picotte taught at the mission school before continuing her education at the Hampton Normal and Agricultural Institute in Virginia. Established in 1868 to educate freed enslaved people (and later, American Indians as well), Hampton emphasized vocational training; however, the sisters could read and write English fluently and were encouraged to pursue an academic program. Picotte was graduated second in her class in 1886. Urged to study medicine by the school physician, Dr. Martha Waldron, she eagerly accepted a scholarship to Woman’s Medical College of Pennsylvania. On March 14, 1889, Picotte was graduated at the head of her class of thirty-six women, becoming the first female Native American to acquire a medical degree.

Life’s Work

Following a four-month internship at Women’s Hospital in Philadelphia, Picotte accepted the position of government physician to the Omaha agency school. Of all the Nebraska tribes, the Omahas were considered the most successful in trying to accommodate to white ideas of “progress.” The Omaha Allotment Act of 1882 had divided much of the reservation into individual farms, and more and more American Indian families were sending their children to the agency school. Despite this seeming progress, drought, grasshoppers, unscrupulous white neighbors, and inept government agents all combined to create desperate poverty among the Omahas. With this social upheaval and deprivation came malnutrition and disease. Influenza, dysentery, and tuberculosis were endemic on the reservation, as were periodic outbreaks of cholera, smallpox, diphtheria, and typhoid fever. Within weeks of her arrival, the twenty-four-year-old Picotte also took on the arduous task of treating the entire adult population, giving her a patient load of more than twelve hundred.

The size of the reservation thirty by forty-five miles and the absence of paved roads forced Picotte to travel huge distances by horse and buggy or on horseback, often in severe weather. In 1891, the Women’s National Indian Association, which had financed her medical training, asked her to take on additional duties as their medical missionary to the tribe. That same year, she gained membership in the Nebraska State Medical Society. Soon she experienced the first of several bouts with osteomyelitis, a painful infection of her facial bones that later caused deafness and eventually led to her premature death. Exhausted and temporarily bedridden by the disease, she resigned as agency doctor in October of 1893.

Despite her frail health and enormous professional responsibilities, Picotte became increasingly involved in tribal and family affairs during the 1890’s. Ever the missionary, she taught Sunday school at the Presbyterian church, acted as interpreter for non-English-speaking Omahas, and worked closely with Marguerite to upgrade sanitary conditions on the reservation. To everyone’s surprise, on June 30, 1894, she married Henry Picotte, an uneducated French-Sioux from the Yankton Agency and a brother of Marguerite’s late husband, Charles. The Picottes settled for a time in Bancroft, on the southern edge of the reservation, where Henry farmed the La Flesche allotment and Picotte had two sons: Caryl, born in 1895, and Pierre, born in 1898. While rearing her children and caring for her ailing mother, she continued to practice medicine, treating both Native American and non-Native American patients. Before long she was also nursing Henry, whose excessive drinking undermined his health and ultimately caused his death in 1905.

For Picotte, the scourge of alcoholism went beyond the boundaries of a personal family tragedy. Her father had waged a successful campaign against whiskey peddlers and liquor consumption on the Omaha reservation. After Iron Eye’s death in 1888, however, the situation deteriorated. Picotte eventually came to regard “demon rum” as the principal health hazard threatening her people. In temperance lectures, newspaper articles, and letters to government officials, she argued that alcohol abuse not only increased violence and crime but also made her tribespeople easy prey for all sorts of deadly diseases, especially tuberculosis and pneumonia. Moreover, she charged, local politicians and bootleggers routinely used whiskey to cheat tribal members out of their allotments. She lobbied the Bureau of Indian Affairs (BIA) for stricter enforcement of the 1897 congressional ban on selling liquor to American Indians. By 1906, she had convinced the secretary of the interior to ban all liquor sales in any new town carved out of the Omaha reservation.

Picotte and her sister Marguerite (who had remarried) bought property in the new town of Walthill, where, in 1906, they each built modern homes. Over the next nine years, Picotte actively participated in the civic and professional life of the community, despite her own failing health. The Presbyterian Board of Home Missions hired her as their missionary to the Omahas, the first nonwhite to hold such a post. She served several terms on the Walthill Board of Health, during which time she led campaigns to eradicate the communal drinking cup and the household fly as agents of disease. She organized the Thurston County Medical Association, served a three-year term as state chair of the Nebraska Federation of Women’s Clubs’ public health committee, and began an intensive study of tuberculosis.

In 1909, the Omaha tribe sought Picotte’s help in solving serious problems arising out of the allotment system. By law, individual allotments were to be held in trust by the government for twenty-five years, until Native American owners were deemed sufficiently “assimilated” to handle their own financial affairs. Meanwhile, government red tape and dictatorial agency control deprived tribal members of desperately needed trust funds. Making matters worse, the BIA instituted new restrictions in 1909; consolidated the Omaha and Winnebago agencies; and announced plans to extend the trust period an additional ten years, despite the Omahas’ high literacy rate and well-educated leadership. Picotte wrote a series of blistering newspaper articles protesting the BIA’s conduct. In February of 1910, barely recovered from a near-fatal attack of neurasthenia, she headed up a tribal delegation sent to Washington, D.C., to fight the new policies. Unsuccessful in getting the old agency restored, Picotte did persuade the secretary of the interior to cancel the ten-year trust extension, thus granting most Omahas control over their own property.

Picotte’s main dream was to erect a centrally located hospital where she could provide better medical care for her American Indian patients. Through her efforts, the Presbyterian Church provided $8,000, and Quakers gave an additional $500. Marguerite and her husband donated the land, and various other friends agreed to purchase the equipment. After Walthill Hospital opened in January of 1913, Picotte was able to practice there for only two years. The bone disease in her face and neck spread, taking her life on September 18, 1915. Her funeral was conducted jointly by Presbyterian clergy and a tribal elder; the medical facility she built was renamed the Dr. Susan Picotte Memorial Hospital.

Significance

As practicing physician, missionary, social reformer, and political leader, Susan La Flesche Picotte had a profound effect on the lives of her people. By 1915, there was scarcely an Omaha alive who had not been treated by her; even those who did not embrace all of her reformist ideals trusted her. As the Omahas’ unofficial but clearly recognized spokesperson, Picotte defended their interests in the white world, even as she devoted her energies to their physical well-being at home. Beyond modern medical care, public health improvements, and vigorous leadership, she provided her tribe and the larger world with a vibrant example of what late nineteenth century reformers hoped to accomplish with their assimilationist policies. Like her father, Picotte believed that education, Christian principles, and legal rights were the key to her tribe’s advancement. That she and her non-American Indian mentors underestimated the difficulties facing American Indians and overestimated the virtues of forced acculturation does not detract from her achievement. Susan Picotte walked with grace in two worlds; assimilated into middle-class mainstream American culture, she never abandoned her tribal roots or her overriding concern for her people. Few women, Native American or white, have left such an indelible mark on their communities. In 2023, Time magazine named her to their "11 Native American Historymakers to Know" list.

Bibliography

Clark, Jerry E., and Martha Ellen Webb. “Susette and Susan La Flesche: Reformer and Missionary.” In Being and Becoming Indian: Biographical Studies of North American Frontiers, edited by James A. Clifton. Chicago: Dorsey Press, 1989. Contrasting the lives of the two best-known La Flesche sisters, the authors conclude that both women were thoroughly assimilated into white culture; Susan, however, participated more directly in tribal life and harbored less bitterness toward non-Indians.

Green, Norma Kidd. Iron Eye’s Family: The Children of Joseph La Flesche. Lincoln, Neb.: Johnsen, 1969. The pioneering work on the La Flesche family, and still the best source of detailed information on Picotte’s life. Green explores the achievements of three generations of this large and fascinating clan. Included are the children of Iron Eye’s secondary wife, Ta-in-ne, as well as a glimpse of the adult lives led by Picotte’s two sons, Caryl and Pierre.

Hauptman, Laurence M. “Medicine Woman: Susan La Flesche, 1865-1915.” New York State Medical Journal 78 (September, 1978): 1783-1788. Focuses on Picotte’s experiences in medical school, emphasizing her enthusiasm and scientific curiosity. Hauptman makes good use of her correspondence to convey the image of a supremely self-confident young woman who also possessed a wry sense of humor.

Mathes, Valerie Sherer. “Dr. Susan La Flesche Picotte: The Reformed and the Reformer.” In Indian Lives: Essays on Nineteenth- and Twentieth-Century Native American Leaders, edited by L. G. Moses and Raymond Wilson. Albuquerque: University of New Mexico Press, 1985. Mathes portrays Picotte’s life and work as a manifestation of the late nineteenth century female reform tradition. This article also gives the most up-to-date diagnosis of the physician’s own perplexing health problems.

Milner, Clyde A. With Good Intentions: Quaker Work Among the Pawnees, Otos, and Omahas in the 1870’s. Lincoln: University of Nebraska Press, 1982. Places the La Flesche family’s advocacy of accommodation in the larger context of the Quaker-inspired “Peace Policy” adopted by the government in 1869. For the Omahas’ role within this framework, Milner relies heavily on a landmark study of the tribe published in 1911 by Picotte’s half brother, ethnologist Francis La Flesche.

Tong, Benson. Susan La Flesche Picotte, M.D.: Omaha Indian Leader and Reformer. Norman: University of Oklahoma Press, 1999. Interpretive biography focusing on Picotte’s ability to move between two disparate cultures her Omaha Indian life in the West and the world of college, medical school, and politics in the East.

Waxman, Olivia B. "11 Native American Historymakers to Know." Time, 5 Oct. 2023, time.com/6317481/native-american-history-makers/. Accessed 21 Nov. 2023.

Wilson, Dorothy Clarke. Bright Eyes: The Story of Susette La Flesche, an Omaha Indian. New York: McGraw-Hill, 1974. Romanticized biography of Picotte’s older, more famous sister. There is little material here on Susan herself, but more on her mother, Mary Gale, than is available elsewhere.

Related Articles in Great Events from History: The Twentieth Century

1901-1940: January 5, 1903: Lone Wolf v. Hitchcock; August 14, 1912: U.S. Public Health Service Is Established; October 12, 1912: First Conference of the Society of American Indians; June 2, 1924: Indian Citizenship Act; June 18, 1934: Indian Reorganization Act.