So Susan travelled East again. This time to Virginia, where she had enrolled at Hampton Institute, one of the most prestigious schools for non-white students in the US. There she met another woman to support her on her way, the resident physician Martha Waldron, who was a graduate of the Woman’s Medical College of Pennsylvania and urged her to apply to the school as well. With the help of Alice Fletcher, Susan was able to secure funds for a scholarship from the Office of Indian Affairs, likely making her the first person to receive aid for professional education in the US. The one catch was that she was forbidden from entering any kind of romantic relationship during her studies as well as a few years after to “allow her to fully focus on her practice.” It seems that she didn’t care that much though, or at least she never mentioned it, and so off she was, her dream within reach.

In 1889, after just two years instead of three, she graduated the WMCP with honors on top of her class and finally returned home to Nebraska to become the physician for the Omaha Agency, operated by the Office of Indian Affairs. Quickly people began flooding in. As you might have deducted from the incident with the old woman back when Susan was still a child, the medical care at the reservation was bad. Many tribespeople were sick with cholera and tuberculosis and many came to her for help in other matters as well. She became more than just their doctor, she was a lawyer as well as a priest and accountant to them. So many insisted to be treated by her, that her white partner quit, leaving her solely responsible for the medical care of over 1300 patients in a 450 square mile area. 

But first she fell in love. In 1894 she met Henry Picotte, a Sioux, and they married the same year. The couple settled in Bancroft on the Reservation and Susan opened her own little practice there, making no difference between the ethnicities of her patients. One or two years later their first son Caryl was born and two or three years later the second one, Pierre, arrived. After giving birth (and presumably resting for a little while) Susan continued to work, relying on her husband to take care of the family and household. We are in Victorian times, mind you, this was incredibly unusual! Shortly before her death she would even get to build the hospital she always dreamed of, but more on that later.

For more than 25 years Susan would work tirelessly for better medical care and illness prevention for her people, advocating for the use of screen doors to keep the flies out, for better sanitation and most of all against alcohol. She had recognized the growing numbers of people with tuberculosis which can be directly traced back to alcohol consumption. She also witnessed first- hand the white whiskey peddlers and how people pawned clothes and even land just to get more to drink. Even her husband slipped into alcoholism and would eventually die from tuberculosis in 1905. She saw her people suffering and she saw alcohol as the culprit – at least the culprit she could do something against. And she did. 

In the 1890s she ran a campaign to enforce prohibition on the reservation which failed, partly because many Omaha people were illiterate at the time and liquor dealers were handing them ballots against prohibition and/or bribed them with alcohol. Finally in 1897 a law was introduced that outlawed trading alcohol against land …however it proved impossible to enforce.

Anyways, she helped people with their inheritances and land sales and at some point she realized there was a circle of men, both white and Omaha, who cheated minors out of their inheritances and thus out of Omaha land. After campaigning for her tribes right to their land for years she now suddenly wrote to the Office of Indian Affairs that the Omaha people needed the continued guardianship of the state. Yes, I was just as confused as you probably are, but it’s actually quite a smart plan. Susan accused the OIA of the lack of business skills of her people and held them accountable for minors under their guardianship losing their land to fraudsters and reminded them of their duty to protect the Native Americans. Simultaneously she chastised them for having treated her people like children since the beginning which was the whole reason for this mess. The plan kinda backfired though and in the end the Omaha became even more dependent on the OIA and lost even more land, if not to fraudsters.