She became valedictorian.

On March 14, 1889, she received her medical degree.

She was twenty-three years old.

The milestone is often phrased as “the first Native American woman doctor.”

Some sources go further and describe her as the first Native American to earn a medical degree in the United States.

Historical terminology varies, and care is needed when defining “firsts.”

But the central achievement is secure: Susan La Flesche became the first Native American woman in the United States known to earn a medical degree.

She now possessed the credential that could have opened a very different life.

She could have stayed east.

She did not.