This Halloween, if you’re willing to wear a hard hat and brave a late October sea breeze, you can visit one of the great haunted sites in America for the first time in decades. Abandoned to the elements since the 1950s, the Ellis Island Immigrant Hospital has been reopened to specially guided tours in all of its dilapidated glory. Sitting across the ferry quay from the excellent, successful Immigrant Museum (the old immigrant arrival hall), the Immigrant Hospital was used to care for, and in some cases isolate, immigrants who were too ill to let in to the country. Sometimes the cause of delay was temporary or even pleasant–350 babies were born in the hospital, for instance–but often not. 3,500 immigrants died there, Moses-like, within sight of what they had sought.
Now, Save Ellis Island, the charity behind the museum, has partnered with French artist “JR” to project images of the hospital in its working days onto rooms and corridors that have fallen into ruin. (While the plan is eventually to restore the Immigrant Hospital, as fans of Philadelphia’s Eastern State Penitentiary know, sites in decay have an appeal of their own.) And though JR claims not to believe in ghosts, he thinks if they exist anywhere, they’re here: “there are some rooms, you don’t want to walk alone.”
When immigrants came to Ellis Island, which they did by close to one million per year during peak immigration in the early 1900s, they were given a cursory inspection by a Public Health Service Officer (perhaps 30 seconds, though the lines were long—each doctor was seeing about 400-500 immigrants per day). Most immigrants passed and were admitted to the country, but about 20% of the inflow was pulled aside for further observation, and ten percent held at the hospital for further medical care. This was the age of early modern medicine and the beginning of public health, lying in between the discovery and popularization of germ theory on the one hand, and the discovery of penicillin and the widespread use of vaccinations on the other. How terrifying it must have been to know exactly what was killing the patient and yet have few options to confront it.
But as Lorie Conway, the producer of a documentary on the hospital, Forgotten Ellis Island, notes, the Ellis Island Immigrant Hospital was one of the most advanced in the world. Given the challenges of the time it did surprisingly well. Nine out of ten patients who were admitted walked out as newly minted, healthy Americans. Given that the hospital often had 10,000 patients per year, it’s amazing only 3,500 died in three decades. That doesn’t mean all outcomes were optimal, of course. As fans of the hit show The Knick will know, surgery in this era was gruesome and primitive, with the ecstatic sense each new procedure was beating what used to be death sentences coexisting alongside the fact that a lot of times, the surgery was just killing or maiming the patient anyway.
Perhaps the most tragic cases were those in the chronic disease ward. As there was no cure for bacteriological diseases, it would have been to no avail and to a great deal of harm to let someone with cholera or scarlet fever—both of which killed millions in the 19th century—loose in NYC. Some, who had persistent, long-lasting, contagious diseases, such as trachoma or tuberculosis, had to be sent home. Mostly, though, quarantine was used: those afflicted with virulent contagious diseases were separated off to either beat the illness (and so, in this case, enter the country) or die of it. What palliative care could be given was, but there were not many options beyond that.
Though various forms of isolating the sick had been around since time immemorial, it was the practical, mercantile Venetians who first invented systematic, institutionalized quarantine in the 14th century to deal with the Plague. Where properly applied, it was one of the few measures before the 20th century that could stop the spread of pandemics.
Pandemics and plagues, while often associated with Middle Ages, enjoyed a strong comeback during the 19th century. The Industrial Revolution crowded the poor into unsanitary city slums and accelerated the spread of disease with the advent of steamship and rail travel. While the inhabitants of Seven Dials slum in London or the Lower East Side in New York were more at risk sanitation-wise than the rich, pathogens, as readers of Thomas Mann’s Death in Venice know, recognized no class distinctions once they found you. Eventually, the societal wealth generated by the Industrial Revolution would fund a lot of what cured these diseases, from new sanitation infrastructure to medical research financed by industrialist-philanthropists. But in the interim, quarantine became a necessary measure.
Ellis Island Immigrant Hospital declined following the passage of the Johnson-Reed Act in 1924, was closed in 1930, and finally was abandoned completely in 1954. The invention of penicillin in 1928 made many death sentences into easily treated ailments, and the widespread proliferation of vaccinations through public health campaigns eliminated most remaining major viral epidemic diseases as public health concerns in the First World. The concerns for which Ellis Island Immigrant Hospital were built are supposed to be a thing of the past.
But apparently not. As Ebola threatens to make the leap from being a rare tropical disease to a menace to the First World, America is debating measures that have not been widely needed for a century—particularly quarantine. Since Ebola has no known cure and no vaccine, that means we’re roughly back to the tools that we had when the Immigrant Hospital was open. As the public debate grows, it seems like much of the cultural knowledge designed to deal with such issues has fallen out of date, and our postmodern paradigms are not up to dealing with the issue. On the one hand, reflexive bans for a travel call seem both impractical and likely to impede our ability to stop the disease in Africa. (Do conservatives suddenly think that the government has suddenly gotten more competent at logistics than airlines, and better at aid than charities?) On the other hand, the reflexive desire among lefties and the media to label natural caution regarding a plague area racist is both nasty and stupid. Does MSNBC’s Touré, for instance, really think that people would be less frightened of an incurable epidemic disease that makes you bleed out of every orifice in your body for a week and then die if it were coming from, say, Poland?
Against this backdrop, a focused quarantine combined with generous aid to affected nations seems to be gaining acceptance as the way to go. This mimics a pattern from history: at the same time the Ellis Island Immigrant Hospital was operating its quarantine wing, Americans were sending significant aid to the oppressed and diseased lands of Southern and Eastern Europe and welcoming those who had been proven to be healthy into the country. The public is wary, as it has a right to be: our public leaders have screwed up crisis after crisis after crisis lately. Nor does it add to the Administration’s credibility when it denies the need for quarantine to the public out of one side of its mouth and orders it for soldiers who’ve been to infected areas with the other. When world experts are calling Ebola unpredictable, dangerous, and poorly handled, and the White House appoints a political hack to handle it and says everything’s fine, people are going to worry.
The care of aliens is one of the oldest commandments: “Do not mistreat or oppress a foreigner, for you were foreigners in Egypt.” (Exodus 22:21). Furthermore, the feeling that the elite should not be shutting out the poor from due care during epidemics is etched into America’s cultural memory, from the old tradition of Main Line WASPs working in the Settlement Houses to the cautionary horror of Poe’s “Masque of the Red Death”. But none of this means that there is a moral obligation to allow the infectious among you when you have no recourse for the infection. The Bible also contains some of the world’s earliest recorded isolation measures (Lev. 15:4-5), and Ellis Island was staffed in part by compassionate volunteers who nonetheless remembered that precept.
One of my friends said to me the other day that you’ll know Ebola is a problem when you no longer hear the name of everyone who has it. A similar level of thinking underlies the movement toward quarantine. Opponents of the measure insist that quarantine won’t stop Ebola from getting into the U.S. That’s not the point. There were cholera epidemics in the U.S. in the time of Ellis Island; does that mean it would have been responsible to let cholera-stricken passengers unload directly to the Lower East Side? As Forgotten Ellis Island points out, “No major epidemic can be traced to an immigrant who entered America after treatment at the hospital.” Simply, a properly tailored quarantine could help contain the disease to manageable levels.
Despite Ellis Island’s reputation as the Island of Tears, gained in part due to the dead and deported ghosts of the Immigrant Hospital, it’s worth remembering that while it operated, Ellis Island only turned away 3% of all prospective immigrants (and only 1% due to medical reasons). Usually, despite the long lines and nerve-wracking inspections, immigrants were passed through as new citizens within a day. At worse, state-of-the-art healthcare, such as it was, awaited them. This is a process—and a time frame—that those dealing with modern immigration “system” would probably gladly take, be they a highly-qualified Deutsche Bank employee in London waiting on our endless, Kafkaeque visa process, a shopkeeper from Manila awaiting the Green Card lottery, or a farm worker from Mexico facing the endless limbo of illegally crossing the border.
But that 3% amounted to some hundreds of thousands of people. While better-educated, more understanding officials would have cut down on some of those deportations, the quarantine wing of the Immigrant Hospital bears witness to the fact that a good many were necessary. There is still a need even in the most liberal immigration regime for basic control over the border and over public health, and even sound policy carries a human price.