After completing her studies and earning her degree, Susan returned to Nebraska as a government physician. She rode on horseback from reservation to reservation, from family to family, treating the sick. It is said that, by the time of her death, she had treated every member of the Omaha Nation.
After a time, she married and settled in Bancroft, Nebraska where she had a private practice treating both Native and white patients. She adopted Christianity, and became a missionary of the Omaha Blackbird Hills Presbyterian Church. She moved to the newly established town of Walthill and founded a hospital there.
Susan went on to be a leading citizen of Walthill, and headed a delegation to Washington, D.C. to fight against the sale of liquor in Nebraska. She was so successful in her endeavors that a covenant was placed in land sale documents of that time prohibiting the possession of liquor on any land purchased from the Omaha.
Susan died at 50, and is buried in Bancroft, Nebraska.