Health Care, Rights, and Dignity

Healthcare has been a volatile political topic since at least the early 20^th century, and in the face of vituperative cuts to the already flimsy social safety net, alongside the assault on and denial of science and medical technology, these are grim times. The rollbacks on rural healthcare funding, cuts to community-based clinics, as well as the undermining of public health protections, (which hit hardest in the very places where access was already fragile) has created a deplorable reality. Simply put: when hospitals close and public programs are gutted, it is the poor, the elderly, and communities of color who pay the steepest price. That’s the very bad news.

The potentially ever-so-slightly less bad news is that in the US at least, we have a long legacy of community-based health care giving, often administered by women, that has sought to fill some of the gaps in public care-access. Many of these unsung she-roes of health care have been Women of Color, called to this form of public service as a result of personal or community tragedies they witnessed, and their desire to do better by their people.

It is my hope that this third edition of #SistoryLessons will give you a sense of inspiration and resilience, as families and communities strive to survive, and unleash innovative and canny methods ways to ensure that their loved ones have health options that serve them well.

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What Susan La Flesche Picotte, Rebecca Lee Crumpler, and Modjeska Monteith Simkins Can Teach Us About Health Care, Rights, and Dignity

This week, we honor three foremothers who demonstrated how deeply intertwined health and justice are—and that it has been so throughout the history of this society. Dr. Susan La Flesche Picotte, Dr. Rebecca Lee Crumpler (featured in my book), and a new face to many, Modjeska Monteith Simkins, all integrated the practice of medicine with an activist’s resolve. Theirs was an unwavering commitment to mend not just bodies, but the soul of their communities.

Their stories underscore that healthcare is never just about medicine, hospitals, or drugs—it is about power, equity, and the right to live with dignity. Let’s continue to imagine strategies and actions to uphold their legacies.

Susan La Flesche Picotte: A Mission for Health

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When we were driving through Nebraska this summer on an extended road trip, my husband shook me out of the stupor of long, flat trails by announcing, “I just saw a sign for the Susan La Flesche Picotte Memorial.” As the countryside in Walthill, Nebraska, is quiet and remote-feeling, we pulled over to a nearby convenience store to ensure we were on the right road. Excitedly, I showed the cashier my book Our Brave Foremothers: “I wrote this book about Black, Brown, Asian, and Indigenous women who made history, and Susan La Flesche Picotte is in it, right here!” I exclaimed, showing him the page.

He didn’t seem terribly impressed, but he directed us to turn left out of the store, take the first right, and go up the hill and we’d see it.

We arrived at the Susan La Flesche Picotte Memorial Hospital, a modest wooden building erected over a hundred years ago, after it had closed for the day, so I was not able to enter. All the same, we took photos of me holding open her pages of the book, me standing next to the memorial plaque, and me standing in by the locked front door in front of the covered wooden portico where I could imagine many patients rehabilitated over the decades. I placed my right hand on the cool wood and thanked her for having chosen to serve her people.

When we returned back down the hill, I saw a young Omaha woman in hospital scrubs entering the convenience store. “Susan,” I whispered to myself, “your legacy lives on!”

Susan La Flesche Picotte was the first Native American woman to earn a medical degree in the United States. She was inspired, no, compelled, to study medicine after witnessing an unbearable tragedy: an elder woman was seriously ill and the tribe sent a foot messenger to the hospital to plea for the doctor. Even though he begged for help on four separate trips, the white practicing physician ignored the request, and the woman died.

Now this kind of injustice may sound shocking, but the willful denial of treatment has a longstanding, evil, and racist tradition in American health care. You may be familiar with the medical neglect celebrities like Serena Williams and Beyoncé experienced during their pregnancies (imagine what it is like for the non-rich and famous!)

You may also be familiar with the story of Henrietta Lacks and her “immortal” HeLa cells, exploited for medical “good” (important research breakthroughs) but without her consent (the family was paid retribution in 2023, after a protracted legal battle.)

I need to add my personal history to this sad legacy, with the story I have been told about my maternal grandmother, whose first name I share. I was told that in the early 1950s, she was suffering from a bad case of pneumonia, and they called for an ambulance and none ever came. Rozella Buggs Floranz’s death left behind five daughters and a son, the oldest, my father. (Part of why I started Brave Sis Project was to shine a light on how close these tales of wrathful injustice actually can be to the circles we navigate in.)

So yes, the grief and trauma young Susan experienced was hardly unique. It marked a turning point in her life, however. Her desire to do systemically shift the destiny for her people burned hot, and despite the grander opportunities available to her outside of Indian County, Susan La Flesche returned home to her own people after completing medical school. Her first post ended up being the only one she’d ever hold: reservation doctor, first in Bancroft, Nebraska, and later in Walthill.

“Dr. Sue,” as she was known, treated the sick, promoted public hygiene to prevent outbreaks of tuberculosis and cholera, and campaigned against alcoholism, which was devastating her community. (Susan’s own fate would be caught up in the tragedy of addiction, as her own husband, a French-Sioux man named Henry, would eventually die from alcohol-related tuberculosis.)

The physical manifestation of Susan La Flesche Picotte’s legacy is the hospital she founded in 1913, in a wooden building both humble and stately, where she devotedly treated local patients—many of whom had been denied care by US government doctors. The cycle of neglect would have remained a despicable norm, if not for her.

Reflection: What does healing mean in your community?

Rebecca Lee Crumpler: The First Black Woman Doctor in the US

Born in 1831, likely in Delaware, Rebecca Davis was raised in Pennsylvania by an aunt who was an unofficial medical caregiver for the neighborhood. Folk medicine was respected and relied upon, especially within communities that had little access or ability to obtain “western” health care. With that dichotomy in mind, Rebecca was motivated to find ways to integrate home-grown medicine with scientific methodologies.

There are several well-known accounts of how “western” medicine usurped traditional folk medicine, and this is a worldwide issue linked to colonialism and conquest alike. Add patriarchy to that mix: folk medicine was generally associated with women’s wisdom (and in some traditions, even witchery). And you know what happened to witches...

One deplorable outcome of western dominance over women's health care was the demise of traditional midwifery, so integral to Black and Native communities, over the course of the 20^th century. With the advent of “modern” (medical) childbirth, herbs and knowledge was replaced by morphine and scopolamine, inducing “twilight sleep” childbirth (later deemed controversial for many reasons, including potential harm to the fetus).

To return to Rebecca: she was a young woman possessed of self-confidence and resolve. She boldly stepped into arenas that had never admitted someone like her before. First, she received training as a nurse’s apprentice, but she so surpassed expectations that her instructors encouraged her to apply to medical college. When she earned her medical degree in 1864, she became the first Black woman physician in the U.S.

The odds would have been steep for any female doctor to overcome at this stage of history. But Rebecca faced even bigger hurdles as a Black physician. Nevertheless, she contributed a great deal to the community and the field of medicine itself, as a physician, researcher, groundbreaking author, and symbol of resilience and determination. From the dawn of the Civil War through to the Reconstruction era, Rebecca dedicated her career to serving those society had abandoned.

Many Black and Brown “lady docs” today owe her an enormous debt of gratitude!

Reflection: What other positive things happen when women speak up?

Modjeska Monteith Simkins: A Lowcountry Icon

Known as the “Matriarch of South Carolina’s civil rights movement,” Modjeska Monteith Simkins worked at the intersections of public health, housing, and law—helping lay the groundwork for one of the most significant legal cases in U.S. history.

Pivoting from public education to public health led her into a statewide leadership role, helming South Carolina’s only statewide public health institution. In the wretched Jim Crow South, Modjeska would continually criss-cross the Palmetto State, providing care, education, and empowerment alike. As a leader in her local NAACP chapter, she stood firm in the face of discrimination and even threat of physical harm.

Modjeska continued to be active in Civil Rights issues such as voting rights, school desegregation, and economic justice well into her eighties. She is too little-known outside of her home state, and yet, hers is the kind of relentless, community-aware leadership that can serve as a model for those seeking change and health equity today.

Reflection: What is a system, issue, or injustice you are attracted to fixing or improving, even when most people steer clear?

Reflection and Action: Journal Prompts for Everyone

Thinking about Susan La Flesche Picotte: Write about a person who helped you heal, and how that influenced made you a better giver of care for others.

Thinking about Rebecca Lee Crumpler: What barriers have you faced in your career? Write about a challenge you overcame at work or school.

Thinking about Modjeska Monteith Simkins: What is most concerning today for rural communities when it comes to health care, and how can these challenges be confronted?

HerStory / OurStory: Journal Prompts for Women of Color

Celebrating our legacy as women of color and thinking about Susan La Flesche Picotte: How do you honor your ancestors through service? Explore traditional healing practices, if possible, from your own cultural heritage.

Celebrating our legacy as women of color and thinking about Rebecca Lee Crumpler: How does your community’s relationship to healthcare shape your choices? How could you mentor someone entering your field, formally or informally?

Celebrating our legacy as women of color and thinking about Modjeska Monteith Simkins: Where have you created change by confronting the minutiae? (As they say, the devil is in the details!)

Activated Allies: Prompts and Actions for White Friends

Taking action in honor of Susan La Flesche Picotte: Support Indigenous-led medical and STEM organizations, such as AISES (where I once served as Development Director) or SACNAS, the Society for the Advancement of Chicanos/Hispanics and Native Americans in Science.

Taking action in honor of Rebecca Lee Crumpler: Research local Black women in medicine. How can you amplify or invest in their work?

Taking action in honor of Modjeska Monteith Simkins: Learn and share about Black women’s role in desegregation cases, and connect this history to some of the health disparities of today and spur conversation in your circles about this.

More on Their Lives

When Susan LaFlesche was just eight years old, she witnessed a traumatizing, tragic, and entirely unnecessary death: a woman of her Omaha tribe was gravely ill, and a messenger was sent to a doctor for help—four times. The doctor ignored the pleas for assistance, refusing to budge: he had a turkey hunt the next morning and didn't want to lose any sleep. She was, he shrugged, “just” an Indian.

For Susan’s community, such horror was almost a banality. Native Americans like her tribe had endured more than three centuries of devastation, from European diseases that decimated entire tribes, to forced migrations, lost territorial wars, the broken promises of insincere treaties, and a life confined to reservations with inferior resources and diminished opportunity.

Determined to make a difference, Susan pursued an education far beyond the bounds of what was expected for Native women of her time. She would go on to obtain a western medical degree and integrate it into her care of indigenous people.

Such an integrated approach was bold: during this era of forced cultural acculturation, many elders held on to traditional practices like buffalo hunts and powwows, while children like Susan were encouraged (some would say forced) to learn European history and values, and leave their "Native ways' behind.

You may be aware that, particularly during the lat 19th century, Native children were, systematically and forcibly separated from their families and communities, in the name of “Western education.” Susan herself had been carried off to a reservation school and later to an East Coast boarding school, where she was impelled to reject and forget her traditional way of life.

But she didn’t.

After boarding school, she sought to continue her education, enrolling at the Hampton Normal and Agricultural Institute in Virginia. Hampton was and is a HBCU (historically Black college or university). Many HBCUs also admitted Native Americans, and so Susan was welcomed into the institution, where she excelled, graduating at the top of her class in 1886. And she had a plan.

During this era, there existed a handful of progressive patrons who sought to rectify some of the systemic harms perpetrated upon Native people. Thanks to such support, Susan was able to continue her studies, earning her medical degree in 1889 from the Woman’s Medical College of Pennsylvania. This was, at the time, the only medical school in the country exclusively for women.

Degree in hand, Susan returned home to the Omaha Reservation. There, she served as the sole doctor for an area that spanned more than 1,350 square miles (!) It is sincerely difficult to imagine the level of dedication and stamina needed to treat ailing communities over such a vast geography.

Understanding the long-embedded distrust of Western medicine among her people, Dr Sue blended traditional healing practices with her treatments. And, responsive to the many intersecting challenges her community neighbors faced, Susan found herself taking on many roles beyond “just” doctor—she was a de facto legal advocate, counselor, and bureaucratic guide for those navigating the convoluted Office of Indian Affairs.

Her dedication was boundless; after working 20-hour days, she kept a lantern burning in her window so patients could find her home in the middle of the night, even during blizzards. She also had two children, combining motherhood with selfless sacrifice to her community, even after the death of her husband.

Two years after achieving her greatest ambition in opening the first privately funded hospital on a reservation, Susan LaFlesche passed away. Though gone too soon, at the young age of 50, she left behind a legacy of compassion, determination, and trailblazing achievement.

Inspired by her aunt, who raised her and practiced traditional healing, young Rebecca Davis left her Pennsylvania home to become a nurse’s apprentice in Boston. She excelled in her training, and her teachers were determined that the young woman apply to the New England Female Medical College (at this time, nursing schools did not yet exist).

It was an audacious undertaking for 1860, which was after all the antebellum era and the Victorian age to boot. Morés of the time considered women to be “too delicate” for the medical profession. And those who proved they possessed the mettle to deal with blood and body parts, might find themselves criticized for “taking the place” of men, (where else have we heard such flimsy and fact-free complaints lately?). It is no wonder women were and grossly underrepresented in medicine at this time: of the 54,543 physicians in the United States, 300 were women. African American women? Zero.

Rebecca was excelling at her medical school studies, but a year into the program, she lost her scholarship. This financial setback would have sidelined another woman, but Rebecca was dogged. She found a means to secure new funding and carried on in pursuit of her degree. But tragedy struck again in 1863 when her husband, a formerly enslaved man named Wyatt Lee, died of tuberculosis.

Despite these extreme personal and financial hardships, Rebecca managed to graduate with her medical degree in 1864, sealing her place in history as the first African American woman physician in the U.S.

Rebecca Lee’s career began with promise. She was hired to work in in Virginia with the newly formed Freedmen’s Bureau, a federal agency established to help formerly enslaved people transition to independent livelihoods. Through her practice treating families in need, she discovered her life’s passion: caring for women and children.

She married a second time, in 1865, to a Mr. Arthur Crumpler, himself an escaped slave. The couple moved to Boston, where she embraced the opportunity to serve the communities she’d known as a student. She opened a private practice and had a daughter.

Sadly, as we know, discrimination is not confined to the American South, and Rebecca Lee Crumpler faced enormous challenge in Boston. For example, pharmacists often refused to fill her prescriptions, hoping to drive patients away. But this was a determined woman, as we’ve already seen: instead of closing her practice, she redoubled her commitment to medicine.

In 1883, Mrs. Crumpler published A Book of Medical Discourses, generally considered to be the first medical text written by a Black woman physician. She dedicated the tome to “mothers, nurses, and all who may desire to mitigate the afflictions of the human race,” and included practical family health topics ranging from newborn care and breastfeeding, to preventing cholera and measles, to warning against common but harmful treatments like giving brandy and gin as pain relief.

Rebecca Lee Crumpler’s grit, resolve, and compassion helped open the doors for more women and more Black Americans to succeed in medicine. While hers is still far from a household name, her legacy is celebrated by many in the field who honor her as a trailblazer who refused to let prejudice define her destiny.

Born on December 5, 1899, in Columbia, South Carolina, Modjeska Monteith grew up on a family farm just outside the capital city. Country life was simple and girls were not expected to do much beyond getting married and raising children of their own, but Modjeska had a few higher ambitions than that.

Upon graduating from Benedict College in 1921, she began teaching at Columbia’s Booker T. Washington High School—the first and for many years, largest public high school for African American students in South Carolina. All was going well until 1929, when her career was abruptly interrupted. The cause? Her marriage, to a man named Andrew Whitfield Simkins. South Carolina state law prohibited married women (of any race) from teaching.

But rather than retreat from public life, Mrs. Simkins turned her energy toward public health. In 1931, she became Director of Negro Work for the South Carolina Tuberculosis Association, the only full-time, statewide African American public health position in the state. Traveling across hundreds of miles, she organized clinics, educated families, and fought to reduce rates of tuberculosis, syphilis, and other preventable diseases that ravaged rural Black communities.

Modjeska’s work soon expanded into the broader domain of racial equality. In the 1940s, she helped found the South Carolina State Conference of the NAACP and served as its secretary from 1941 to 1957—the only woman officer in the organization. She played a key role in legal battles that chipped away at Jim Crow laws, including Briggs v. Elliott, one of the five cases that culminated in the landmark Brown v. Board of Education decision ending school segregation.

Like many leaders of the Civil Rights era, Simkins was courageous in the face of danger. Her home was fired upon, her reputation smeared with false accusations of communist ties, and her activism cost her jobs, friends, and public standing. But she would not be intimidated and she would not be deterred. Her modest house on Marion Street in Columbia, the state’s capital, became a meeting ground for civil rights leaders, a safe haven for activists, and a strategy hub for lawsuits and protests.

Even after stepping down from the NAACP in 1957, she remained active through interracial alliances like the Southern Conference Educational Fund, continuing to push for voting rights, school desegregation, and economic justice well into her eighties.

Modjeska Monteith Simkins died on April 5, 1992, leaving behind a legacy as one of South Carolina’s most influential and uncompromising voices for equality. Today, her home is preserved as a historic site, a testament to a life spent in tireless service to justice.

What These Women Knew, and What We Must Remember

Susan, Rebecca, and Modjeska remind us that community care can be an act of not just medicine, but of liberation—especially when it concerns people who have been systemically denied. Black people. Native people, rural people, and poor white people all owe a great debt of gratitude to community caregivers like these three women and countless others.

Perhaps this is one of the topics around which your personal activation can make a difference.

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