Standing quietly on a hill in the northwest corner of Walthill, Nebraska, a small village on the Omaha Indian Reservation, is a 105-year-old hospital.

The hospital bears little resemblance to contemporary medical centers. Only one-and-a-half stories tall, the American Craftsman-style building holds two general wards, a maternity ward, an operating studio, and five private rooms, in addition to a kitchen, an office, and staff quarters.

When the hospital first opened in January 1913, however, it was a marvel: the first modern hospital on the Omaha Reservation, built without government support—financial or otherwise. Funding, supplies, and medical equipment came from public charities and private donors across the country. A benefit concert was held at Carnegie Hall to raise money for the new facility, and architect William Steele of Sioux City, Iowa, was brought in to draft its plans.

Remarkably, the entire campaign was the result of tireless crusading on the part of Dr. Susan LaFlesche Picotte—the first Native American woman to earn a medical degree, and the Walthill Hospital’s greatest champion.

Nevertheless, today the Walthill Hospital, also known as the Dr. Susan LaFlesche Picotte Memorial Hospital (added to the National Trust's 11 Most Endangered List in 2018), is a designated National Historic Landmark and is listed on the National Register of Historic Places. It is, undoubtedly, the most prominent memorial to the woman popularly known as “Dr. Sue.”

According to Jill Dolberg, the Deputy State Historic Preservation Officer at Nebraska State Historical Society, “there are few places in Nebraska dedicated to the memory of a woman like her who, so early in history, had such an impact. Any woman, regardless of ethnicity, who traveled across the country so she could return to help her community is a woman worth remembering.”

Ironically, Dr. Picotte herself never worked at the hospital she helped realize. She died only two years after it was completed at the age of 50, following decades of chronic illness and disability that rendered her too frail to practice medicine in the final years of her life.

Instead, the care the Omaha received from Dr. Picotte often occurred inside their own homes. Even when she was in poor health herself, Dr. Sue, sometimes accompanied by her two sons, would travel miles by horse and buggy to visit and care for the ailing, often cooking meals for her patients. Her busiest months were usually during the winter, frequently brutal in the Midwest, but even then Dr. Picotte made herself available.

The first true “hospital,” in fact, was inside her sister Marguerite’s garage, where the critically ill would receive more complex treatments, including surgery. Later, following her own home’s construction across the street, Dr. Picotte’s basement served as the second “hospital.” For those she was unable to return to health, it also served as a morgue.

Both of these structures—Dr. Picotte’s home and her sister’s garage—still stand. The home was only recently listed on the National Register of Historic Places, and the effort to include the garage in the 1988 nomination that resulted in the Walthill Hospital’s listing on the NRHP failed. Its history remains largely unknown to this day.

For those most familiar with Dr. Picotte’s life and legacy, the lack of recognition for these more humble structures is vexing, but not surprising. Ideally, OTHRP would like to see all three of these buildings be incorporated into a historic district, along with a hotel, jail, and several other properties in and around Walthill that date back to the turn of the 20th century. It is the hope of OTHRP that the development of a historic district would allow for a more comprehensive retelling of the period in Omaha and American history that shaped Dr. Picotte and her generation.

“Dr. Picotte was an educated and assimilated woman, who was able to do what she did at the height of the Victorian era in an intensely patriarchal society,” says Richard Chilton, OTHRP’s project facilitator. “We need to revisit the indigenous side of that history.”

“During her time there were more highly educated Indians than white people in Walthill,” says Dr. Dennis Hastings (Omaha), the founder and co-director of OTHRP, whose grandparents were well-acquainted with the LaFlesche family. “That generation produced a lot of educated and capable people, doing just as much good as Dr. Sue.”

Indeed, Dr. Picotte, renowned for her intelligence and work ethic, was no anomaly. Her father, Iron Eyes (Joseph LaFlesche), was a prominent leader during a tumultuous period in American Indian history when many tribal peoples, the Omaha included, found themselves swept up in the ferocious politics and unrelenting upheaval associated with American expansion. Although he never learned to speak English, Joseph LaFlesche came to believe that assimilation and integration were the only ways to ensure the survival of the Omaha people. All of his children, encouraged to pursue advanced educations, went on to carve out noteworthy places for themselves in their rapidly changing world.

Susette LaFlesche Tibbles, an author, artist, and activist who, alongside others, helped those injured at Wounded Knee shortly after the 1890 massacre, was interpreter for the Ponca Leader Standing Bear during the precedent-setting 1879 case Standing Bear v. Crook, which formally established that Native peoples are indeed “persons within the meaning of the law.”

Rosalie LaFlesche Farley, the namesake of nearby Rosalie, Nebraska, partially managed the Omaha tribe’s finances, sometimes for her family’s benefit. Marguerite LaFlesche Diddock often gave speeches on behalf of an ailing Dr. Sue and later donated the land upon which the Walthill Hospital was built. Francis LaFlesche became the first indigenous ethnologist, writing extensively on his own life and people.

Susan’s sons, Caryl and Pierre, both served in World War I. Caryl Picotte also served in the Philippines during World War II, where he was captured and spent 3 ½ years as a Japanese prisoner of war. Caryl’s son, unable to join the American military, enlisted in the Canadian military during WWII.

Dr. Picotte, however, made a name for herself by pursuing medicine in an era when few women were able to pursue work in any professional capacity. In addition to her labor as a physician, Dr. Picotte tackled some of the biggest public health issues of the day, including tuberculosis, and promoted cleanliness and hygiene. In a letter to her sisters in the years following her return to the reservation, Dr. Picotte wrote, “I’m not accomplishing miracles, but I’m beginning to see some of the results of better hygiene and health habits. And we’re losing fewer babies and fewer cases to infection.”

Later in her life, Dr. Picotte expanded the scope of her work. She began to advocate for the Omaha in increasingly tense land disputes, frequently writing to the Bureau of Indian Affairs to complain of underhanded dealings and petition for Omaha interests. She also took a more meditative perspective on the Omaha themselves, according to Dr. Coffey: “She wrote letters where she talked about Omaha gardens, Omaha beliefs, probably picking up on her sister Suzette’s work—trying to make the Omaha people appear human to those who thought they were monsters.”

Dr. Picotte is not without controversy. Her missionary zeal alienated her from her people, and her ardent campaign for temperance, along with her disdain of time-honored Omaha medicinal practices, has complicated her legacy.

“She probably thought she was bringing ‘truth’ and curative powers to her people,” says Dr. Coffey. “To a certain degree she was, but she was bringing the white experience of medicine, not the Indian experience of medicine. The Indians weren’t without medicine. They had medicine, their own medicine, and it was very good, but they weren’t prepared for the white man’s disease.”

For the most recent update on the Dr. Susan LaFleche Picotte Center in Walthill, Nebraska read this recent update on past 11 Most sites.

This story has been updated to reflect recent changes to the status of the Dr. Susan La Flesche Picotte Memorial Hospital.