In an era when women couldn’t vote and Native Americans were denied citizenship, Susan La Flesche shattered not just one barrier, but two, to become the first Native American woman doctor in the United States.

Born in a buckskin teepee on the Omaha Indian Reservation in northeast Nebraska on June 17, 1865, Susan was never given a traditional Omaha name by her mixed-race parents. Her father, Chief Joseph La Flesche (also known as “Iron Eye”), believed his children as well as his tribe were now living in a white man’s world in which change would be the only constant. “As the chief guardian of welfare, he realized they would have to adapt to white ways or simply cease to survive,” says Joe Starita, author of “A Warrior of the People: How Susan La Flesche Overcame Racial and Gender Inequality to Become America’s First Indian Doctor.” “He began an almost intense indoctrination of his four daughters. They would have to speak English and go to white schools.”

While Iron Eye insisted that Susan learn the tribe’s traditional songs, beliefs, customs and language in order to retain her Omaha identity, he also sent her to a Presbyterian mission school on the reservation where she learned English and became a devout Christian. At the age of 14, she was sent east to attend a girls’ school in Elizabeth, New Jersey, followed by time at Virginia’s Hampton Institute, where she took classes with the children of former slaves and other Native Americans.

La Flesche persevered and graduated in 1889 at the top of her 36-woman class to make history by becoming the first Native American woman doctor. Although prodded to remain on the East Coast where she could have lived a very comfortable existence, the 24-year-old La Flesche returned to the reservation to fulfill her destiny.

She became the sole doctor for 1,244 patients spread over a massive territory of 1,350 square miles. House calls were arduous. Long portions of her 20-hour workdays were spent wrapped in a buffalo robe driving her buggy through blankets of snow and biting subzero winds with her mares, Pat and Pudge, her only companions. When she returned home, the woman known as “Dr. Sue” often found a line of wheezing and coughing patients awaiting her. La Flesche’s office hours never ended. While she slept, the lantern lit in her window remained a beacon for anyone in need of help.

La Flesche preached hygiene and prevention along with the healing power of fresh air and sunshine. She also spoke out against the white whiskey peddlers who preyed on the tribe members, continuing her father’s work as a passionate prohibitionis.

As difficult as it may have been to straddle two civilizations, La Flesche “managed to thread the delicate bicultural needle,” according to Starita. “Those with no trust of white doctors flocked to Susan,” he says. “The people trusted her because she spoke their language and knew their customs.”

La Flesche again shattered stereotypes by continuing to work after her 1894 marriage to Henry Picotte, a Sioux from South Dakota, and the birth of their two boys at a time when women were expected to be full-time mothers and home makers. “If you are looking for someone who was ‘leaning in’ a century before that term was coined, you need look no further than Susan La Flesche,” Starita says. “She faced a constant struggle to serve her people and serve her husband and children. She was haunted that she was spreading herself so thin that she wasn’t the doctor, mother and wife she should be. The very fears haunting her as a woman in the closing years of the 19th century are those still haunting women in the opening years of the 21st century.”

Starita believes that La Flesche, who passed away at the age of 50 on September 18, 1915, faced greater discrimination as a woman than as a Native American. “When I got into the research, I was stunned by how deeply entrenched gender bias was in the Victorian era. White women were largely expected to just raise children and maintain a safe Christian home. One can only imagine where that bar was set for a Native American woman.”

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