The 8-year-old girl sat and watched the old woman dying.

She watched as the sun went down and the old woman grew weaker and the doctor did not come. She watched in the darkness as the old Omaha Indian woman struggled and the white doctor was summoned a second time, a third time, a fourth, and still he did not come.

Eight-year-old Susan La Flesche sat there into the early morning in the year 1873. She watched the old woman take her final breath. And she made a decision, a vow that changed the course of her own life and the course of countless other lives, too.

“Her conclusion was that the (old woman) died because she was just an Indian,” says University of Nebraska-Lincoln professor Joe Starita, author of the new and stunning biography of this little-known American hero, Susan La Flesche. “Those were her own words: ‘It was only an Indian and it (did) not matter.’

“That incident stayed with Susan, to the point that she decided to spend the rest of her life doing whatever she could so that no Omaha Indian would die an agonizing death without somebody there to tend to her.”

So here is what Susan La Flesche did. Born in a buffalo-hide tepee and raised in a remote village 70 miles north of Omaha, she left her family and her tribe, traveled to faraway New Jersey, then Virginia and then the dizzying metropolis of Philadelphia. She finished second in her class at what’s now Hampton University. She fought her way into one of the few medical schools in the world that would take women. She finished first in her medical school class.

She became the first Native American to graduate from medical school. She did this in 1889, 31 years before women could vote and 35 years before Indians were recognized as American citizens.

Then she turned down prestigious job offers, a potential life of fame in New York or maybe Paris. She took a train back to Nebraska, and she took a job as the only doctor tending to Omaha Indian patients spread across 1,350 square miles.

And that, believe it or not, is just the beginning of a remarkable story that most of us have never heard. It’s a hero’s journey, an American odyssey, largely hidden in plain sight for a century. And it happened right here in Nebraska.

“If she would have done this anywhere between Chicago and New York, she would be on the $20 bill!” Starita says. “That’s not even really hyperbole. That is probably true!”

Starita, a UNL journalism professor and one of Nebraska’s most popular nonfiction authors, has set about making Susan La Flesche into a household name with his new book, “A Warrior of the People.”

A former Miami Herald investigative reporter, Starita weaves skillfully through the singular life of Susan La Flesche Picotte. He takes us along as Dr. Sue rides a buggy over the frozen Great Plains, fighting through subzero temperatures and white-out blizzards to care for desperately ill elders and sick kids. She mounts public health campaigns to eliminate communal drinking cups, promote screen doors that keep out disease-ridden flies and warn against the evils of alcohol abuse. As years become decades — as the doctor has her own children, her own health problems and suffers the untimely death of her husband — she succeeds in making the Omaha Indians healthier and extending their lives.

That isn’t all. She also creates a library and promotes education, and organizes quilting circles while urging the preservation of the Omaha culture, and teaches Sunday school and presides over church services while extolling the virtues of faith. She advocates for her people, fights for them in countless letters and meetings with politicians in Lincoln and Washington, D.C.

That isn’t all. In 1913, La Flesche realized a lifelong dream. She raised money and opened a modern hospital on a hill overlooking her hometown of Walthill. There, she tended to pregnant women and sick patients of every race and creed until her own death two years later.

“A single widowed woman built a modern hospital without a single tax dollar on an Indian reservation in 1913,” Starita says. “That was unheard of then. That’s unheard of now. That’s insane.”

And that still isn’t all, argues Starita, who believes that Susan La Flesche’s importance to the Omaha Tribe went far beyond checkups or hospitals.

“If you pull back, and look at the helicopter view of her life, what you see in its totality, on the medical front, the political front, the social front, the spiritual front, you see a woman whose foremost contribution to her people was giving them hope, in places where hope was often so hard to find,” Starita says. “That’s the helicopter view. She gave them hope.”

Even as she did all this, La Flesche struggled with things that seem oh-so-familiar in 2016.

She was paid far less than her male counterparts. She struggled to balance career and family, working punishing hours while also tending to her elderly mother and caring for her young children.

“She was flying solo in a world where she had a lot of anxieties, a lot of fears, while trying to achieve this very delicate balance between caregiver and caretaker,” Starita says. “And I think there are a whole lot of women, in the opening years of this century, who have found themselves in exactly that spot.”

And La Flesche’s letters and her pleas to politicians are infused with the belief she began to form at age 8, as she witnessed the death of an elderly member of her tribe. A belief that her people would be forever treated worse than other people unless she did something to change it.

“In 1873 Susan saw firsthand evidence that from a certain vantage point, her vantage point, it appeared that Indian lives didn’t matter,” Starita says. “If you look through the lens of Standing Rock, through the lens of Whiteclay right now, you can still say that the question is very much up for grabs.”

Starita’s last book, “I Am a Man,” told the story of Standing Bear, the Ponca chief who fought for equality inside an Omaha courthouse and eventually won the right to be considered a man in the eyes of the law. That book prominently featured Susan’s older and arguably better-known sister Susette La Flesche, more commonly known at Bright Eyes, who served as Standing Bear’s interpreter and confidante during and after the trial.

“I Am a Man” has sold 20,000 copies to date and was named the state’s One Book One Nebraska selection in 2012. But “A Warrior of the People” may be more important, because it tells us a story hardly anyone knows. Yes, Susan La Flesche Picotte is in the Nebraska Hall of Fame, and, yes, Omaha’s Picotte Elementary is named after her. But Starita makes a compelling case that Susan La Flesche deserves far more than that. That she deserves a place alongside this country’s Native American heroes, and its women’s rights activists, too, after living a life every bit as earth-shattering as Standing Bear or Rosa Parks.

“Susan La Flesche understood that the purpose of life was not to try and avoid pain and suffering. That was hopeless,” Starita says. “Susan believed that the purpose of life was to find a purpose, and then to find the courage to live out that purpose. That is what she did every day of her adult life. That’s her truth.”

matthew.hansen@owh.com, 402-444-1064, twitter.com/redcloud_scribe

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Correction: Susan La Flesche's name was misspelled in an earlier version of this column. 

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