Against the Current: The Legacy of Susan LaFleshe Picotte

Written by Thaddeus Tague
Apr 9, 2020

The woman trudging through a snow bank was the only doctor for 1,350 square miles of Nebraska land. The below-zero winds pierced through her layers of clothing as she led her two mares toward the house of a patient. When she returned home, at the end of an almost 20-hour day, a line of patients waited at her door. She took a deep breath. She remembered, as a young child, what had launched her onto a medical path.

As an eight-year-old, she watched an elderly Omaha woman die a painful and drawn-out death because a white doctor had failed to arrive after four urgent summons. She would later savagely recall, “It was only an Indian and it did not matter […] The doctor preferred hunting for prairie chickens rather than visiting poor, suffering humanity.”

Susan LaFleshe Picotte was not only the first female Native American doctor in history, but the sole doctor to over 1,200 residents of the Omaha territory. Her office never closed, and her lantern shone in the window as a beacon of hope at all hours.

Joe Starita, a professor at University of Nebraska-Lincoln, said of Picotte: “What you see in its totality, on the medical front, the political front, the social front, the spiritual front, you see a woman whose foremost contribution to her people was giving them hope, in places where hope was often so hard to find.”

1865 was a harrowing time for the Omaha people. Over six decades the Omaha tribe had been reduced by almost half due to war and sickness. They were trapped between the expanding western America and the well-armed Sioux tribe, who actively raided along their territory. That year marked the culmination of five separate land lease treaties that relegated them to a single reservation. For a tribe who moved every 8-15 years, the reservation represented massive cultural losses.

It was into this tumultuous time that Susan LaFleshe Picotte was born. Knowing that the future of the Omaha tribe lay at the behest of western American expansion, Susan’s father Joseph raised all seven of his children to act as advocates for their people, and sent them to school on the Eastern seaboard. Susan studied at the Elizabeth Institute for Young Ladies in Elizabeth, New Jersey before attending the Women’s Medical College of Pennsylvania. In 1889, she became the first female physician to graduate from the school.

 

Credit: Smithsonian National Anthropological Archives

Picotte returned to the Omaha people in Nebraska, occasionally traveling east for business or family visits. Eventually she was appointed missionary and spokeswoman for the tribe, and settled in Nebraska year-round.

During Susan’s lifetime, she witnessed the predatory nature of indifferent medical care upon the Omaha tribe. The lack of education surrounding basic hygiene had wreaked havoc upon her tribe ever since large-scale western trade had begun. Alcoholism and new illnesses killed several members of her family and loved ones. The white doctor charged with caring for the reservation was appointed to the position with little regard to his medical competency. Racial tensions, combined with the relative isolation of the reservation, made good medical care a far-flung hope. The more Picotte traveled to and from the reservation, the more obvious this injustice became.

It was at this point that she began working as an intermediary with the Office of Indian Affairs. Through an appointment from the Omaha Blackbird Hills Presbyterian Church and some small funding, she began her work as the bearer of hope to her community. In 1891, a massive influenza outbreak struck. Of the 130 patients she cared for during this time, one in particular stayed with her.

One late night, she received word that a young girl had taken ill. The next morning, in 20-below-zero-degree weather, Picotte wrapped her scarf around her face and drove her buggy and team six miles to the family’s house. The girl’s severe flu was compounded by existing tuberculosis. Picotte left medicine and promised to return. Over the course of two weeks, Susan visited the girl constantly. She cooked meals for the family, lightened the house with her warmth, and even spent long nights awake at the girl’s bedside as her condition worsened.

Each night, as she tried to help the girl draw labored breaths and hold down food, she thought of the old woman who had died decades earlier while the reservation doctor played deaf. Not only did Picotte preach the message of love to those around her, she modeled it to. When the young girl died, Picotte was at her side.

 

“Her faith was a practical one: her priority was to help those in need, to show love, and to speak up for those who couldn’t speak for themselves. “

A child of two cultures, she could pass easily between the Omaha reservation and the rest of the United States. Over the course of her life, she was many things. In addition to her physician work, she helped run, interpret, and lead worship at the local missionary church. She translated legal documents, and helped settle affairs for families on the reservation. She served as a local missionary, an occasional preacher, and helped officiate weddings, ceremonies, and translate sermons.

In her later life, Picotte wrote about how Christ’s teaching spurred her on to continual advocacy for Omaha’s mental, physical, and spiritual well-being. Her faith was a practical one: her priority was to help those in need, to show love, and to speak up for those who couldn’t speak for themselves. Whether through legal matters or medical ones, she stood as an advocate between her Omaha tribe and the world. In 1892 she traveled to Washington D.C. to bear witness to the widespread devastation that alcoholism was causing in her tribe, and to speak out against the traders flooding reservations with alcohol. Even during years where she was not physically living on the reservation, she carried the plight of the Omaha with her.

 

In Picotte’s letters, still preserved today, we see a fully human person. She fell deeply in love. She struggled with her calling and ministry. In 1905 she lost her husband Henry Picotte to complications related to alcoholism. Compelled by her grief and her own diminishing health, she resolved to see an actual hospital built on the reservation.

In 1910, the federal government again began changing the terms of land usage, stripping the Omaha people of their livelihoods, economic opportunities, and homes. The tribe elected Susan to go to Washington D.C. and plead their case before the director of Indian Affairs and the U.S. Attorney General. Sick with what we now know as cancer and unable to keep down food, Susan left the reservation one last time to advocate for the people she loved. Her work over the past 20 years, combined with her passionate defense of the Omaha, led to a stunning victory. Her tribe was not only allowed to keep and lease their lands, but also to keep all the land’s related proceeds.

Credit: Smithsonian National Anthropological Archives

By 1913, her dream of a hospital had become an actuality. Without a single federal dollar, she personally funded, built, and staffed a hospital—the first hospital on a reservation not funded by the government. “A single widowed woman built a modern hospital without a single tax dollar on an Indian reservation in 1913,” writes Starita. “That was unheard of then. That’s unheard of now.”

Picotte died shortly after, and the hospital was named the Dr. Susan LaFlesche Picotte Memorial Hospital in her honor.

“Sick with what we now know as cancer and unable to keep down food, Susan left the reservation one last time to advocate for the people she loved.”

Omaha Tribe historian Dennis Hastings claims Picotte as one of the most notable heroines in American history. She cared for her people with an embodied and multi-faceted love. She healed their physical ailments, evangelized to the spiritually hurting, and served as an advocate and shield to the whole tribe. Her faith was largely unburdened by many theological trappings. Every day, she seized the opportunity to treat others as better than herself.

Omaha means “against the current.” Picotte’s life embodied the road of the advocate, pushing forward against the currents of injustice and neglect. In a nation focused on expansion and advancement, she followed the calling to be a conduit of Christ’s love in her little corner of the world.