The Nurses of Ellis Island: Life and Work Inside the Golden Door , by Michelle C. Hehman and Arlene W. Keeling

Millions of immigrants to the United States arrived through Ellis Island from the time of its opening in 1892 to its closure in 1954. During its peak operations leading up to World War I, Ellis Island processed hundreds of migrants each day, subjecting them to a medical examination to determine whether they were healthy enough to enter the country. Many of them, especially the lower-class passengers stuck in unsanitary and crowded steamship-steerage compartments during their voyages, contracted contagious diseases and other conditions. To prevent the spread of their diseases, these immigrants were admitted to hospitals on Ellis Island. There, nurses cared for them.Michelle C. Hehman and Arlene W. Keeling’s The Nurses of Ellis Island is a vivid, cinematic picture of what nurses did for these patients. As they credit in their book, the idea for a history of the nurses on Ellis Island came from the late Barbara Brodie, professor of nursing emerita at the University of Virginia and a mentor and colleague of Hehman and Keeling. The idea caught wind, and Hehman and Keeling visited Ellis Island in 2017 and 2019. Their sense of place is palpable throughout the book, buoyed by a robust range of primary sources—newspaper articles, nursing journal articles, memoirs of Ellis Island nurses, and government documents. In addition to their illustrative and accessible prose, each chapter presents multiple archival photos and images that show the hospitals, nursing care, medical technologies, and immigrant patients’ experiences of treatments while on the island. Moored around ideas of place—in a physical sense and also in terms of nurses’ place in the medical hierarchy and in immigration regulation—the book presents the experiences, reflections, and values of the nurses who worked on Ellis Island.The book is organized chronologically, anchored in federal immigration reforms and restrictions that were legislated during the operation of Ellis Island and in between World Wars I and II. Chapter 1 sets the scene with the establishment of Ellis Island and the Ellis Island Hospital. The nurses served as part of the Marine Hospital Service to care for immigrants who arrived too sick to continue on to the mainland, sometimes suffering outbreaks of contagious diseases such as measles, typhoid, and scarlet fever. Hospital operations on the island paused when a fire burned through the hospital in 1887, but after the opening of the new Ellis Island General Hospital in 1902, United States Public Health Service physicians and nurses would return to care for immigrants.Now at the new Ellis Island General Hospital, Chapter 2 introduces us to Margaret V. Daly, a nurse who worked at Ellis Island for over three decades and whose records and recollections appear throughout the rest of the book. She and the other nurses encountered patients ranging in age and coming from various cultures, presenting communication barriers that nurses had to navigate. As more of these patients arrived ashore suffering contagious diseases, a Contagious Disease Hospital was constructed to contain their spread. In 1911, the Contagious Disease Hospital opened on Ellis Island. Attentive to place, Hehman and Keeling describe the design of the hospital, which was engineered to contain diseases such as trachoma, measles, and favus, an inflammatory disease of the scalp. Nurses treated favus with epilation, a process by which they would pluck hair from the follicle and then apply powders and oils to the patient’s scalp—a painful procedure. Hehman and Keeling also describe the nurses’ methods for infection control, including protective clothing with specific donning and doffing procedures. Furthermore, Hehman and Keeling describe the nurses as confronting the “duality of their roles—agents of the state on the one hand and professional healers on the other” (68). The United States Public Health Service physicians and nurses working on Ellis Island often held misgivings about providing the medical justifications for deporting some migrants who had weathered the long journey to Ellis Island.World War I changed much of the operations on Ellis Island. As Chapter 4 describes, the army and Red Cross nurses took over the Contagious Disease Hospital and used the island for military drills before departing for service in Europe. Again, Hehman and Keeling’s frame of place highlights the island’s position near the ports of New York, ready to deploy service members across the Atlantic Ocean. Besides the nurses, the patients changed too. Instead of immigrants, more soldiers were admitted into the hospital, sick with tuberculosis and diphtheria or injured by trauma or “shell shock.” After World War I, immigration policy was further restricted, and fewer patients were admitted into the hospitals on Ellis Island. For the patients who were admitted, nurses cared for a range of conditions. Detailed in Chapter 5 are care for patients pre- and post-surgery, patients with scarlet fever and tuberculosis, and patients with psychiatric disorders such as “insanity” or “idiocy,” which, by that time, were grounds of inadmissibility. In 1907, the Psychopathic Pavilion was opened on Ellis Island for these patients. Hehman and Keeling contextualize these immigration restrictions against the eugenicist beliefs that circulated not only among the medical professions, but also among the anti-immigrant movement.Finally, Chapter 6 covers Ellis Island nursing during World War II. Some trainees in the United States Cadet Nurse Corps were assigned to Ellis Island for the last portions of their training. Around the same time, as air travel became more common than travel by sea, Ellis Island received fewer immigrants. In 1951, the Ellis Island hospitals closed, and in 1954, the government left Ellis Island.As full, detailed, and rich as the episodes of nursing care are in this book, one underdeveloped idea is the book’s relevance to ongoing immigration issues in the United States. Hehman and Keeling claim that the book “reveals the enduring nature of many issues surrounding immigration, public health, and the role of nurses in society” (7). However, since the book ends around the time when Ellis Island closed in 1954, the book is limited in its ability to draw parallels between then and now, especially when so much has changed in between. The English writer L. P. Hartley once wrote, “The past is a foreign country.” Along those lines, the US immigration system during Ellis Island’s time is quite different and foreign compared to the system now, or even compared to the decades following Ellis Island’s closure. The Immigration and Nationality Act of 1965 unintentionally and dramatically altered the demographics of the US population to include more Latin American and Asian immigrants. A wall has been erected at the country’s southern border. Detention centers for undocumented migrants have been opened and privatized. It’s hard to see nurses negotiating their place in today’s system in the same ways they did on Ellis Island. Nevertheless, this book’s merit and value lie in its vibrant depiction of nurses’ experiences bound within that time.Hehman and Keeling’s book contributes a vivid account of the skills, professionalism, and values of care and human welfare of the nurses on Ellis Island, adding texture and detail to the broader history of nursing and immigration and tracing shifts in sentiment toward immigrants. As if left on the island, these nurses’ labor and service had been unknown. Now, Hehman and Keeling’s immersive account transports us there.