Susan La Flesche Picotte

Susan La Flesche Picotte (June 17, 1865 – September 18, 1915) was a Native American medical doctor and reformer and member of the Omaha tribe. She is widely acknowledged as one of the first Indigenous people, and the first Indigenous woman, to earn a medical degree. She campaigned for public health and for the formal, legal allotment of land to members of the Omaha tribe.

Picotte was an active social reformer as well as a physician. She worked to discourage the consumption of alcohol on the reservation where she worked as the physician, as part of the temperance movement. Picotte also campaigned for the prevention and treatment of tuberculosis, which then had no cure, as part of a public health campaign. She also worked to help other Omaha navigate the bureaucracy of the Office of Indian Affairs and receive the money owed to them for the sale of their land.

Early life

Susan La Flesche was born in June 1865 on the Omaha Reservation in Eastern Nebraska. Her parents were culturally Omaha, had both European and Indigenous ancestry, and had lived for periods of time beyond the borders of the reservation. They married in either 1845 or 1846.

La Flesche's father, Joseph La Flesche (also called Iron Eye), was of Ponca and some French Canadian ancestry. He was educated in St. Louis, Missouri, but returned to the reservation as a young man. He identified culturally as Omaha. In 1853, he was adopted by Chief Big Elk, who chose him as his successor, and La Flesche became the principal leader of the Omaha tribe around 1855. Iron Eye encouraged a certain amount of assimilation, particularly through the policy of land allotment, which caused some friction among the Omaha.

La Flesche's mother, Mary Gale, was the daughter of Dr. John Gale, a white United States Army surgeon stationed at Fort Atkinson, and Nicomi, a woman of Omaha, Otoe, and Iowa heritage. Gale was also the stepdaughter of prominent Nebraska fur trader and statesman Peter A. Sarpy. Like her husband, Mary Gale identified as Omaha. Although she understood French and English, she reportedly refused to speak any language other than Omaha.

La Flesche was the youngest of four girls, including her sisters Susette (1854–1903), Rosalie (1861–1900), and Marguerite (1862–1945). Her older half-brother Francis La Flesche, born in 1857 to her father's second wife, later became a renowned ethnologist, anthropologist and musicologist (or ethnomusicologist), who specialized in the study of the Omaha and Osage cultures. As she grew, La Flesche learned the traditions of her heritage, but her parents felt certain rituals would be detrimental in the white world. They did not give La Flesche an Omaha name and prevented her from receiving traditional tattoos across her forehead. She spoke Omaha with her parents (especially her mother), but her father and oldest sister Susette encouraged her to speak English with her sisters, so that she would be fluent in both languages.

As a child, La Flesche witnessed a sick Indian woman die after a white doctor refused to treat her. She later credited this tragedy as her inspiration to train as a physician, so she could provide care for the people with whom she lived on the Omaha Reservation.

Education

Early education

As a child, La Flesche was educated at the mission school on the Omaha reservation. It was run first by Presbyterians and then by Quakers, after the enactment of President Ulysses S. Grant's Peace Policy in 1869. The reservation school was a boarding school where Native children were taught the practices of European Americans to assimilate them into white society.

After several years at the mission school, La Flesche left the reservation for Elizabeth, New Jersey, where she studied at the Elizabeth Institute for two and a half years. She returned to the reservation in 1882 and taught at the agency school. She left again to study at the Hampton Institute in Hampton, Virginia, from 1884 to 1886. It had been established as an historically black college after the American Civil War, but also educated Native American students.

La Flesche attended Hampton with her sister Marguerite, her stepbrother Cary, and ten other Omaha children. The girls learned housewifery skills and the boys learned vocational skills as part of the practical skills promoted at the school. While La Flesche was a student at the Hampton Institute, she became romantically involved with a young Sioux man named Thomas Ikinicapi. She referred to him affectionately as "T.I.", but broke off her relationship with him before graduating from Hampton. La Flesche graduated from Hampton on May 20, 1886, as the salutatorian of her class. She was also awarded the Demorest prize, which is given to the graduating senior who receives the highest examination scores during the junior year.

La Flesche decided in 1886 to apply to medical school.

Medical school

Though women were often healers in Omaha Indian society, it was uncommon for women in the United States to go to medical school, and in the late 19th century, only a few medical schools accepted women. La Flesche applied to medical school in 1886 and was accepted to the Woman's Medical College of Pennsylvania (WMCP), in Philadelphia, which had been established in 1850 as one of the few medical schools on the east coast for the education of women.

La Flesche asked for financial assistance from family friend Alice Fletcher, an ethnographer from Massachusetts who had a broad network of contacts within women's reform organizations. La Flesche had previously helped nurse Fletcher back to health following a flareup of inflammatory rheumatism. Fletcher encouraged La Flesche to appeal to the Connecticut Indian Association, a local auxiliary of the Women's National Indian Association (WNIA). The WNIA sought to "civilize" Native women by encouraging Victorian values of domesticity, and sponsored field matrons whose task was to teach Native American women "cleanliness" and "godliness".

La Flesche, in writing to the Connecticut Indian Association, had described her desire to enter the homes of her people as a physician and teach them hygiene as well as curing their ills, a mission in line with the Victorian virtues of domesticity that the Association wanted to encourage. The Association sponsored La Flesche's medical school tuition, and also paid for her housing, books and other supplies. She is considered the first person to receive aid for professional education in the United States. The Association requested that she remain single during her time at medical school and for several years after her graduation in order to focus on her practice.

At the WMCP, La Flesche studied chemistry, anatomy, physiology, histology, pharmaceutical science, obstetrics, and general medicine, and, like her peers, did clinical work at facilities in Philadelphia alongside students from other colleges, both male and female. While attending medical school, La Flesche began to dress like her white classmates and wore her hair in a bun as they did.

After La Flesche's second year in medical school, she returned home to help her family, many of whom had fallen ill due to a measles outbreak. During the rest of her schooling, she would write letters back home giving medical advice.

On March 14, 1889, La Flesche graduated from medical as valedictorian of her class after three years of study.

In June 1889, La Flesche applied for the position of government physician at the Omaha Agency Indian School; she was offered the position less than two months later. After her graduation, she went on a speaking tour at the request of the Connecticut Indian Association, assuring white audiences that Native Americans could benefit from white civilization. She maintained her ties with the Association after medical school. They appointed her as a medical missionary to the Omaha after graduation, and the Association funded purchase of medical instruments and books for her during her early years of practicing medicine in Nebraska.

Medical practice

La Flesche returned to the Omaha reservation in 1889 to work as the physician at the government boarding school on the reservation, run by the Office of Indian Affairs. There, she was responsible for teaching the students about hygiene and keeping them healthy.

Though she was not obligated to care for the broader community, the school was closer to many people than the official reservation agency, and La Flesche cared for many members of the community as well as for the children of the school. La Flesche often had 20-hour workdays and was responsible for the care of over 1,200 people. From her office in a corner of the schoolyard, with the supplies provided by the Connecticut Indian Association, she helped people with their health but also with more mundane tasks, such as writing letters and translating official documents.

La Flesche was widely trusted in the community, making house calls and caring for patients sick with tuberculosis, influenza, cholera, dysentery, and trachoma. Her first office, which measured 12 by 16 feet, doubled as a community meeting place.

For several years, she traveled the reservation caring for patients, on a government salary of $500.00 per year, in addition to the $250 from the Women's National Indian Association for her work as a medical missionary.

In December 1892, La Flesche became very sick, and was bedridden for several weeks. In 1893, she took time off to care for her ailing mother and also to restore her own health. She resigned later that year to take care of her dying mother.