Moss on Conway, 'Forgotten Ellis Island: The Extraordinary Story of America's Immigrant Hospital'

Lorie Conway
Sandra Moss

Lorie Conway. Forgotten Ellis Island: The Extraordinary Story of America's Immigrant Hospital. New York: Smithsonian Books, 2007. 185 pp. $26.95 (cloth), ISBN 978-0-06-124196-3.

Reviewed by Sandra Moss (Medical History Society of New Jersey) Published on H-New-Jersey (April, 2008)

Ellis Island Remembered

In 1998, the Supreme Court gave New Jersey sovereignty over most of Ellis Island, including the hospital complex, the subject of Forgotten Ellis Island. Lorie Conway is a Massachusetts filmmaker who has devoted much time to the research and production of a movie about Ellis Island hospitals. This book arose from that project. In the course of producing the film (which one hopes will appear shortly on public television), Conway interviewed and consulted an impressive array of historians and National Park Service experts. She also did the historian's hard, lonely work of sifting through photo archives and scrapbooks.

Conway tells her story in such a way that one is left with an indelible impression of voices, not only quoted in and alongside the text, but also easily discernable in the scores of stunning vintage photographs. Little details catch our eyes and draw us in--a group of children clustered about a nurse who is trying to write a report; a detainee in a striped bathrobe reading a newspaper on the locked porch of the Contagious Disease Hospital; a group of nurses, some in high-buttoned white boots and others in more fashionable modern footwear beneath their starched dresses and caps; the traumatized faces of rows of detainees with the dreaded "X" chalked on a coat lapel; bald children with headscarves undergoing therapy for the stubborn scalp infection known as favus; the irritated bleary eyes of children and adults suffering through lengthy painful treatments for trachoma, a dreaded communicable eye infection and leading cause of blindness, which, if uncured, was an automatic ticket back to Europe; and multiethnic clusters of girls and women in hospital-issue dresses with a touch of trim at the collar.

The relatively short text and accompanying pictures are arranged in five groups. "Building the Immigrant Hospital" explains the political and medical context in which the massive medical complex was conceived and planned. We all have a mental picture of Ellis Island buildings (at least the already restored main building), but the incorporation of architectural beauty and design into these most functional of government structures, built in a rush at the turn of the century, gives us pause and entices us to linger over the pictures of bricks and mortar.

"Walking the Line" describes, from varying points of view, the triaging encounters between boatloads of Europe's frightened and hopeful emigrants and the Public Health Service doctors, nurses, and attendants who guarded the United States against disease. The medical mandate also included the duty to determine fitness for work--after all, labor is what America needed in those last decades of expansion and the heyday of industrial development. The inspection system, despite a staggering daily census, was surprisingly efficient, rarely unnecessarily cruel, and, for most immigrants, quick.

The next section, "Treating Patients by the Thousands," brings us into the hospital, and it is here that Conway's research really pays off. The voices, in photographs, quotations, and text, are eloquent, moving, informative, and unfamiliar. Pictures of overcrowded immigrant vessels and Ellis Island inspection lines are familiar, but here Conway shows the tragedies, boredom, fear, and joys (yes, there were some) of hospitalization on Ellis Island. There is a pervasive sense of family, both absent and present--mothers detained with their young children, older children detained while parents and siblings who passed inspection waited for them in New York City, temporary "families" comprised of fellow detainees and nursing staff, and even an avuncular visit to a frightened child by a young Italian/Spanish/Yiddish Ellis Island translator (armed with a chocolate bar) named Fiorello La Guardia.

"Rejecting the 'Riff Raff'" focuses on darker issues. Seemingly limitless boatloads of southern and eastern European migrants were increasingly feared by the descendents of earlier generations of mostly northern Europeans. Political, religious, social, and economic concerns became conflated with the medical mandate of the Public Health Service on Ellis Island. The Psychopathic Pavilion was designed to fulfill three functions: observe questionable cases, treat acute stress resulting from the hardships of the voyage, and house those slated for passage back to Europe. Some immigrants were rejected because of clear mental illness or dementia. But what happened when nativism and changing immigration policies butted up against the murkier medical (or pseudo-medical) quandaries of personality, "feeblemindedness," intellectual capacity, cultural differences, and general foreignness? Could intelligence be determined across language and cultural barriers? Here, enters New Jersey psychologist Henry Goddard of the Vineland School for Feeble-Minded Boys and Girls, whose earlier flawed research into the south Jersey "Kallikak" family led to his eugenicist conclusion that both moral virtue and social degeneracy were genetically determined. Goddard introduced state-of-the-embryonic-art intelligence testing, based on recent work of French psychologist Alfred Binet, into the Ellis Island triage mix. How could even the best-intentioned medical officers reliably detect "feeble-mindedness" in the face of language and cultural barriers heightened by illiteracy, poverty, exhaustion, homesickness, and anxiety? Not surprisingly, intelligence testing at Ellis Island was a minefield, negotiated with varying sensitivity and success by often-ambivalent Public Health Service directors and examiners. Conway's necessarily brief overview is balanced, avoiding the pitfalls of what historians like to call "presentism."

Conway's final chapter, "Falling into Disuse and Decay," touches on the immigration restriction acts of the 1920s and changes in medical screening procedures. These acts and changes eventually led to the demise of Ellis Island as an immigration facility by the early 1930s.

The book has its problems, though none major. Unfortunately, for the historian, most pictures are captioned only with quotations relevant to the picture--for example, an operating room scene is accompanied by quoted memories of an immigrant's childhood encounter with the Ellis Island surgical staff. Some captions are found one or two pages after the picture, as is the case with a moving portrait of five detainees awaiting deportation in a mesh-enclosed porch of the Psychopathic Pavilion. The modern reader is unable to place many of the photographs in time (the Ellis Island Hospital was active for the first three decades of the twentieth century). The author does not indicate how the archival photographs were filed, but some of them probably had identifying information on the back or were included in labeled folders.

The modern color photography by Chris Barnes--an old shoe, peeling paint, invading ivy, and general rust and dust--seems sentimental and self-consciously "arty" beside the vintage black and white "record shots" that have acquired eloquence by the passage of time. As a stand-alone photo essay, Barnes's photographs would be truly moving, but the story they tell is not the story of this book. Similar but less self-conscious photographs by Larry Racioppo for the Save Ellis Island Web site would probably be of more interest to historians.

It is a matter of taste, but this reviewer was put off by the relentlessly overdone design by Judith Abbate--perhaps Conway should have exercised greater control and drawn a stronger line between book and her forthcoming film. The reader is distracted from the reading of history and study of photographs by intrusive callouts and captions in every shade from black through gray to white (on black) with a mind-boggling array of font sizes, plain and italic typefaces, upper and lower cases, black and gray backgrounds, and strange oversized brackets.

Conway's written history, a mere forty-five pages of wide-spaced text, is little more than one chapter or magazine article in length. Although she is not a historian, she worked carefully and listened well to her "cadre of professional advisors" (p. 161). The text reads a bit like the work of a committee, but it is well referenced and engaging in style. The author's claim (supported by a jacket blurb by Doris Kearns Goodwin) that she is "the first to research this forgotten chapter of Ellis Island's history" is somewhat overstated (Alan Kraut, interviewed at length by Conway, and other historians have covered much of this historical ground) (p. x). The author frequently consulted Kraut and Howard Markel, historians of American medicine who focus on immigration before and during the Ellis Island period. The historically minded reader who wants to understand the tensions between immigration and medicine should follow Conway's example by reading Kraut's Silent Travelers: Germs, Genes, and the "Immigrant Menace" (1994) and Markel's Quarantine: East European Jewish Immigrants and the New York City Epidemics of 1892 (1997).

Conway tells the right story. For most immigrants and for America the cup was more than half full. Although there was a full measure of human tragedies and professional failings, no major epidemic entered through the immigration station and most immigrant families passed safely into the country. Despite the hand wringing and general nastiness of various nativists and eugenicists, many thousands of immigrants who came through Ellis Island and their descendents did pretty well in America.

So, does this book belong in your library or even on your coffee table? You could wait for Conway's film when it appears on public television. If Conway lets the historians like Kraut have their say--that is, whole sentences and even full paragraphs instead of sentence fragments and sound bites--then it might be worth holding out for the DVD. But, with a few caveats, the book stands on its own. The historical text is capably written and carefully researched, and the archival photographs are hypnotic. The voices of Forgotten Ellis Island are compelling.

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