The First American Indian Doctor

Susan La Flesche was the first female American Indian doctor in the history of the United States.

This one person changed the health equation for an entire tribe.

1889, Omaha reservation, Nebraska.

24-year-old Dr. Susan La Flesche treated her very first patient.

Susan diagnoses the eight-year-old boy and gives medicine in front of the mother.

And after they go, she starts fretting over, "Is there any chance that I misdiagnosed that?"

So the next morning she saddles up her horse and she starts riding ten miles towards where his family lived.

She gets closer and she sees that one of the boys playing in the creek was her patient of yesterday.

So she turns around knowing that now that family would trust her.

"This rapid recovery won for me no end of fame among the Indians.

They fairly flocked to me after that."

Susan La Flesche was born in 1865, the youngest daughter in a mixed Omaha and French family.

Her father Joseph was one of the seven Omaha chiefs who signed treaties ceding over 90% of the tribe's land to the U.S. government.

"The ones who go against the current."

So "Omaha" - that's what it means.

Throughout my lifetime when I heard about the La Flesche family, I heard two varying accounts.

One that they had sold us out, and the other that they had helped to save us.

During this time of upheaval and forced assimilation, they were foreseeing a future where we had to live amongst white people.

We were going to be overtaken and the Le Flesche family wanted to see the tribe adapt and survive what was coming.

After attending reservation schools run by missionaries, La Flesche left in 1879 to attend school in New Jersey.

There weren't many 14-year-old girls on the Great Plains boarding trains headed 1,300 miles away to fend for themselves in a classroom.

Susan was very unique.

"Ever since I was a small girl, I saw the need of my people for a good physician...

I determined to make something useful of my life."

La Flesche obtained a scholarship to attend Hampton Institute in Virginia, a leading trade school for African Americans and American Indians.

She graduated in 1886, and gave a speech at the commencement.

"We who are educated have to be pioneers of Indian civilization... Do not try and put us down, but help us to climb higher."

In 1889, La Flesche graduated top of her class from one of the first medical schools for women, becoming the country's first American Indian woman doctor.

Her colleagues encouraged her to stay and practice medicine on the East Coast, but she returned home to Nebraska.

I remember being in medical school and one of my advisors said, "You're a great student.

It's such a shame to waste this education, to just work on an Indian reservation."

That happens a lot to American Indian students.

People don't understand why they want to go back and work in their communities.

I'm Dr. Yvette Roubideaux and I'm a member of the Rosebud Sioux Tribe, and I'm also Standing Rock Sioux.

I am known as the first woman director of the Indian Health Service, a healthcare system that provides services to over 2 million American Indians and Alaska Natives, mostly on or near Indian reservations.

But it is significantly underfunded and under-resourced.

Sometimes we wait two days to see a doctor.

People aren't getting the care that they need.

In 1890, La Flesche became the sole physician to both the Omaha and the nearby Winnebago Tribe, working for the Office of Indian Affairs.

She's 24 years old, and overnight she inherits 1,244 patients scattered across a 1,350 square mile reservation, often covered in two feet of snow.

And this was before Google Maps.

She would get up at five o'clock in the morning, and it was just absolutely numbing, blizzards day after day.

And she would fling a buffalo robe around her shoulders and she would go off caring for these patients, and then went to bed at 10:30, too tired to eat.

And she would get up the next morning and do exactly the same thing.

Working up to 75 hours a week, La Flesche also led public health campaigns to educate families about infectious diseases.

At that time, we were impacted by influenza and tuberculosis.

After the smallpox epidemics took out so many, we no longer had access to our traditional forms of healing.

So Susan La Flesche became a modern day medicine woman.

"I feel that I have an advantage knowing the language and customs of my people, and as a physician can do a great deal to help them."

Because some members of the Omaha Nation were skeptical about her Western medical practices, La Flesche occasionally supplemented her treatments with traditional healing methods.

In 1894, La Flesche married Henry Picotte, a Yankton Sioux, and the couple had two sons.

Henry had been in Wild West shows.

He was a showman.

They moved to the village of Bancroft, just off the edge of the reservation.

And Susan entered into private practice, treating both native people and white people.

She kept a lantern in her window at night to guide people if they were sick so they could find her no matter how stormy it was, how dark it was.

"My office hours are any and all hours of the day and night."

I can't imagine what it would be like to be the only doctor for the entire reservation.

The demands on her were significant.

On the San Carlos Apache Indian Reservation back in the 1990s, when I worked there.

We had a hospital with four to six physicians that served a population of about 10,000 people.

Another big part of my career has been directing programs and mentoring students to encourage them to enter health and public health careers.

But also to help them see that they didn't have to give up being an American Indian person to become a Western trained physician.

Despite chronic illness and going deaf in one year at age 40, La Flesche was tireless in her community work.

She starts a library for children.

She teaches Sunday school.

She starts a quilting circle for Omaha women.

She translates legal documents... it just goes on and on and on and on.

A longtime advocate for temperance, she also lobbied for a ban on alcohol.

Alcohol was introduced to the Omaha tribe through the fur traders.

We were already in this downward spiral.

But once it took a hold you saw a complete change in our tribal structure.

And she was witness to all that.

She would go to the state legislature and beg them to not allow the whiskey peddlers to set up camp on the reservation.

There was nothing she wouldn't do to try and prevent the scourge of alcoholism.

A cause which, in 1905, hit tragically close home.

Her husband died of tuberculosis, but heavily contributing to weakening his immune system and spreading the disease was his alcoholism.

In the 1910s, as the Omaha nation lost more of its land to white settlers, La Flesche became an outspoken critic of federal land allotment policies, despite having worked for the Bureau of Indian Affairs for many years.

She testified about the unconscionable theft of Omaha Indian lands.

She was astonished at how inept and corrupt the Office of Indian Affairs was.

"We have suffered enough from your experiments... We have been practically robbed of our rights by the government... We have lived on broken promises."

La Flesche's crowning achievement came in 1913 when she opened the first privately-funded hospital on an American Indian reservation.

This modern hospital, and operating room, and modern equipment it had been her dream for 25 years.

"One of the greatest present needs among Indians is hospital work."

La Flesche did not get to run her hospital for long.

Bone cancer claimed her life in 1915 at the age of 50.

The hospital served patients for 30 years, and is now a national historic landmark.

You cannot understand the magnitude of Susan's achievement unless you understand the tide that she was swimming against.

She was able to thread this very elusive bi-cultural needle, without losing her native soul.

I really admire her for recognizing that the impact that she could have as a physician wasn't only in the exam room.

Her legacy is showing that in addition to being a physician, you can be a public health advocate.

"I shall always fight good and hard, even if I have to fight alone."