“We Have Lived on Broken Promises”: Charles A. Eastman, Susan La Flesche Picotte, and the Politics of American Indian Assimilation during the Progressive Era

The physician, perhaps more than any other figure, has personified the formation of the new, professionalized middle class that emerged during the late nineteenth century.¹ Concurrent to this development in the “search for order”—and not unrelated to it, as Tom Holm points out—was the height of the movement to fully assimilate American Indians.² Two Great Plains Indian physicians, Charles Eastman (Santee Dakota) and Susan La Flesche Picotte (Omaha) stood at the crossroads of these developments. Graduating medical school within a year of each other, their lives largely paralleled each other. Eastman and La Flesche were both Christians with extensive contacts among white Protestant reformers. Both began their medical careers employed by the Office of Indian Affairs (oia), supported policies that promoted American Indian assimilation, and served as cultural mediators between Indians and whites.³ Yet both became disillusioned with the oia and the assimilationist mission more generally. Their disillusionment was rooted in a shared belief that “civilization” had caused widespread health catastrophes among their peoples, particularly tuberculosis and alcohol-related health problems. While white reformers celebrated Eastman and La Flesche’s rise to educated, middle-class status, their work as physicians and knowledge of medicine ultimately led them to question the tactics—and indeed the desirability—of assimilationist policies.

Like other reform-minded Americans of their day, Eastman and La Flesche grappled with pressing questions regarding state and society. In a world that had been rapidly altered due to the second wave of industrialization, how best to solve social problems such as poverty and environmental degradation? Was the state obliged to assume new responsibilities? And most importantly for Eastman and La Flesche, did the United States have any particular obligations to American Indians, whose conquest and dispossession had made possible the modern nation?⁴ Both physician-reformers struggled with these questions throughout their lives, and again there were strong parallels between them. Although they began their careers as agents of the state seeking to impart white values and customs to Indians, Eastman and La Flesche transformed into critics of the state. In the latter part of their careers, both preferred to work with private organizations and initiatives in order to address the problems facing their communities. They adopted a revised mission: imparting Indian values and mentalities to whites. But while the two had more commonalities than differences, in their final assessments La Flesche was more favorable to the state, and potential state interference into the lives of its citizens, than was Eastman. This distinction is attributable to the physicians’ gender difference as well as the divergent historical experiences of the Omaha as compared to Dakota and Lakota peoples. Even as they responded to similar conditions, the physicians’ politics were indelibly shaped by their gender and tribal identities.

Among the handful of scholars who have examined Eastman and La Flesche, several have criticized their alleged complicity in colonial and non-Indian ideologies. For instance, literary scholar David J. Carlson accused Eastman of promoting an image of childlike Indians in need of white guidance, and hence legitimating allotment policies.⁵ Alternatively, some scholars have more accurately characterized Eastman and La Flesche as cultural negotiators who attempted the Herculean task of balancing Indian autonomy and cultural preservation against the harsh conditions of their time. This group includes historians Tom Holm, Frederick Hoxie, Raymond Wilson, Benson Tong, Peggy Pascoe, Philip Deloria, and literary scholars Drew Lopenzina and Lucy Maddox, among others.⁶ Taking this later perspective, this comparison highlights Eastman and La Flesche as physicians, a role which they interpreted quite broadly. For them, becoming Indian physicians meant healing bodies and the social ills that had befallen Plains Indians.

A close examination of Eastman and La Flesche’s trajectories demonstrates the complexities of what Hazel Hertzberg and others have called “Indian progressivism.”⁷ Eastman and La Flesche were part of a cohort of highly educated Indians who emerged as public representatives of...