Inspectors behind the desks asked the immigrants for their name, hometown, occupation, destination and the amount of money they were carrying. Those who were allowed to pass went lower. Those detained for an additional judicial inquiry were waiting for the opportunity to testify in the Special Commission of Inquiry room, where their hearing would take place. About one percent would be denied approval for violating U.S. laws. Noise is absent at Ellis Island today. When tourists enter the Great Hall, they can still see the great American flag hanging on the north wall, and above the huge room the offices of the senior employees, on which thousands of passports were stamped daily, each with a resounding echo power. The most curious can visit the rooms on the side where immigrants suspected of having an illness underwent an intensive medical examination. Those who were considered sick were locked up in the infectious disease hospital next door, which was recently reopened to the public after decades of neglect. There was even a small courtroom where special hearings were held to decide the fate of a newcomer. But so much more is missing in this organized and archived scene: the tangle of cage-like fences, the rows and rows of benches filled to the last seat of immigrants from around the world and, of course, the loud noise they produced. PHS officials immediately transferred those with traces of chalk – typically 15 to 20 percent of arrivals – to physical or mental examination rooms. In the semi-private same-sex examination rooms, immigrants partially stripped naked and were examined using stethoscopes, thermometers and vision cards.

Sometimes height and weight were measured. People suspected of having mental health problems met with a PHS officer who asked them simple questions such as their name or age, and gave them tests that required manipulating dice or puzzles, or interpreting events depicted in photographs. Upon completion of the medical or psychological examination, the immigrant would receive an OK card or a medical certificate. But it was the last examination that was the most feared: medical examinations of the eyelids and eyes for signs of trachoma. A chronic eye infection, trachoma can now be easily treated with a single dose of antibiotic. Yet in the days leading up to such medical miracles, trachoma was a chronic, scarred, steaming ordeal. Three out of four victims remained blind. The day`s treatments were brutal, requiring many painful surgeries and months of caustic chemical treatments that offered little guarantee of healing. Medical policy often reflected a changing understanding of the disease as well as racist ideas about certain immigrant groups. In addition, medical policy has been used to justify the exclusion of some immigrants from the United States. Over time, emerging medical research, community protests, and shifts in public opinion have led to new guidelines for health screening. At the Angel Island immigration station, scientists and administrators called the germs “the most democratic creatures in the world.” They believed they could use science as a tool to objectively screen immigrants, regardless of skin color or social status.

However, not all immigrants were subjected to the same tests, and some groups were subjected to additional tests. In a 1922 appeal to President Warren G. Harding, the CCBA described immigrants being held in intolerable conditions for 40 days, at their own “great expense.” Officials dismissed the complaint, attributing the longer processing times to changes in medical standards. The Immigration Act of 1891 prohibited anyone with a dangerous contagious disease from entering the country. It was a way to prevent epidemics in the American population. If diseases were detected, the immigrant would be immediately quarantined or sent back to his country. The medical detainees were taken to Ellis Island Hospital. The average stay there was about two weeks. Many of the immigrants who arrived in the early 20th century were poor and hardworking. They set out to pave roads, lay gas pipelines, dig subway tunnels, and build bridges and skyscrapers.

They also got jobs in the new U.S. factories, where conditions could be dangerous, and made shoes, clothing, and glass products. Immigrants fueled the logging industry in the Pacific Northwest, mining in the West, and steel production in the Midwest. They went to Hawaii to work on sugar plantations. Finally, they negotiated better wages and better safety at work. They were on the verge of becoming the American middle class. Conducting an independent medical examination does not establish a typical physician-therapist-patient relationship as exists when a physician treats a patient in the hospital or outpatient clinic. However, the independent and objective (impartial) nature of the examination does not relieve the physician of any professional responsibility. For example, in most independent medical examinations, the doctor should pay attention to possible psychiatric disorders and ask the person if they have thought about hurting or killing themselves or someone else. If, during a re-examination following a positive answer, it appears that the person poses a significant risk of imminent harm to the person or others, the investigator must take steps to prevent such harm and facilitate referral to appropriate treatment and psychosocial support.

Thus, there is a “limited doctor-patient relationship” when conducting independent medical examinations. [1] [2] Each medically certified person was heard by a Special Commission of Inquiry (SIO) of the SI. Here, a panel of three ISIS officers questioned the immigrant about his profession, finances, and family living in the United States. In most cases, the BSI revoked the medical certificate and did not reject the immigrant. From about 1906 to 1930, only a handful (1.6%) of medically attested persons appealed an exclusion decision; The chances of success for those who appealed were at best uniform [10]. Deportation could separate families; Husbands and wives were often separated and children could be deported without their parents (although one of the parents could choose to return with a child). After 1924, the only passengers brought to Ellis Island were those who had problems with their papers, as well as war refugees and displaced persons who needed help. Ellis Island remained for three decades and served a variety of purposes, including an internment camp for enemy merchant seamen during World War II. If an immigrant`s papers were in good standing and he was in fairly good health, the Ellis Island inspection process took 3 to 5 hours. The inspections took place in the Standessaal (Great Hall), where doctors briefly searched each person for obvious physical complaints. Ellis Island doctors soon became very adept at performing these “six-second examinations.” Until 1916, it was said that a doctor could identify many conditions (from anemia to trachoma) simply by looking at a person.