Susan La Flesche Picotte

Susan La Flesche Picotte was the first Native American woman to become a physician in the United States. A member of the Omaha Reservation, she worked tirelessly for her people.


Susan La Flesche Picotte, the first Native American woman to become a doctor in the United States, was born in 1865 and grew up on the Omaha Reservation. She left in 1884 to attend the Hampton Institute in Virginia and later earned a medical degree at the Women's Medical College of Pennsylvania. She returned to the reservation and worked as a physician there until 1894. Working in private practice, she treated tribal and white people, advocating for better health care for all. In 1913 she founded a reservation hospital, which was later named in her honor. La Flesche Picotte died in 1915.

Early Life

Susan La Flesche was born on the Omaha Indian Reservation, in northeast Nebraska, on June 17, 1865. She was the youngest of four daughters of Chief Joseph La Flesche (known as "Iron Eyes") of the Omaha tribe and his wife, Mary Gale (One Woman). Both parents were of mixed race and wanted their children to live in the white and Native American worlds. After attending a mission school on the reservation, young Susan attended the Elizabeth Institute for Young Ladies and later the Hampton Institute in Virginia, from which she graduated in 1886.

While growing up on the Omaha reservation, several experiences led La Flesche to consider a medical education. She had experienced the poor living conditions of the Omaha people and once watched a sick Native American woman die because a white doctor refused to give her care. La Flesche knew she had to do something to change the predicament of her people.

Advanced Education

While at the Hampton Institute, Susan La Flesche was encouraged by one of her mentors, Martha Waldron, to acquire a scholarship from the U.S. Office of Indian Affairs. When that scholarship was granted, La Flesche became the first person to receive federal aid for a professional education. In 1886 she began to attend the Women's Medical College of Pennsylvania, one of only a few medical schools at that time that accepted women.

While pursuing her education, La Flesche continued to experience life in both the white and Native American worlds. During her schooling in Philadelphia, she was in awe of the lavish dresses she saw in the department stores. When she was fitted for a dress, she wrote to one of her sisters that it made her “become a lady of fashion.” In the same letter, she paradoxically told her sister that she yearned for a pair of moccasins.

Medical Doctor on the Reservation 

In 1889, Susan La Flesche completed the three-year medical program at the top of her class of 36, and following a one-year internship, she became the first Native American woman physician in the country. She returned home to work at the government boarding school, caring for 1,200 white and Native American patients. While there, she strove for major changes in the health care of all patients, promoting the importance of cleanliness and ventilation. She especially counseled tribal people on the benefits of fresh air, discarding trash and killing flies, which were known to be transmitters of tuberculosis and other diseases.

Serving as a reservation doctor proved to be very challenging for La Flesche. She was paid only $500 a year, which was ten times less than an Army or Navy doctor, and whenever the Bureau of Indian Affairs ran out of supplies for the tribe, La Flesche would be forced to use her own money to pay for them. During the severe winter of 1891, she would see more than 100 patients a month, making many house calls in sub-zero weather. Over time, the 20-hour workdays took a toll on her health, and in 1893, she was bed-ridden for two months.

Marriage and Private Practice    

In 1894, Susan La Flesche married Henry Picotte, a Sioux Indian from South Dakota. The couple moved to Bancroft, Nebraska, where she set up a private practice and they raised two children. In a time of Victorian values, when women were generally expected to be full-time mothers and housekeepers after marriage, La Flesche Picotte worked full-time as a professional.

For most of his adult life, Henry Picotte suffered from alcoholism, and often La Flesche Picotte had to take care of him while simultaneously running her medical practice. The experience would eventually lead her to the Temperance Movement, and when Henry died in 1905, La Flesche Picotte became determined to eliminate the scourge of alcohol on reservations. In 1906, she led a delegation to Washington, D.C., to lobby for the prohibition of alcohol on Indian lands.

Her opposition to alcohol on the reservations led her to fight for other causes and to attract some controversy. She supported a new Native American religious movement, the Peyote Religion, a pro-temperance Christian denomination that sought to introduce the hallucinogenic drug peyote into Native American spiritual traditions. This put her in opposition with many of her white medical colleagues. She also became an activist for the tribal people’s legal status and citizenship and fought against land fraud perpetrated on the Omaha people. Her activism hit home when she confronted the Bureau of Indian Affairs bureaucracy to prove she was more competent than a male relative to oversee her husband’s estate after his death.

Final Years and Legacy

Susan La Flesche Picotte also pushed for modern hygiene and disease prevention standards among the Omaha people. In 1913, she fulfilled a lifelong dream by opening a hospital on the Omaha reservation town of Walthill, Nebraska. Despite these accomplishments, La Flesche Picotte suffered from chronic pain and respiratory problems, and as she grew older and her health declined, she became unable to carry on her many causes. In March 1915, she became debilitated, and she died on September 18, 1915, of what was believed to be bone cancer.

Susan La Flesche Picotte’s legacy extends beyond being the first Native American female physician. She championed many causes of Native Americans in the late-19th and early-20th centuries, and she is considered to be an early trailblazer of the women’s movement. La Flesche Picotte was ahead of her time in pursuing causes many considered unimportant. She never shied away from speaking truth to power, even when it meant facing criticism from both white and tribal people. Her courage and compassion made her a unique and effective leader. 

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