There’s a classic scene at the beginning of The Godfather II in which young Vito Andolini passes through Ellis Island’s immigration line. It is there that, due to an immigration officer’s carelessness, he is given the mistaken surname of Corleone, which is actually the village of his birth. Moments later, frightened young Vito is informed that he must spend a long stretch in confinement, due to the fact that he is suffering from tuberculosis. The whole process takes mere seconds, as the officers have no time to waste—there are thousands of others waiting their turn. (The haunting scene that follows can be viewed here.)
That sliver of near-perfect cinema long led me to believe that Ellis Island officials were fairly assiduous about picking out diseased turn-of-the-century immigrants. But the truth was apparently quite the opposite:
The procedure was intimidating, and, indeed, between 1891 and 1930 nearly 80,000 immigrants were barred at the nation’s doors for diseases or defects. Yet the vast majority were allowed to enter the country—on average, fewer than 1 percent were ever turned back for medical reasons. Of those who were denied entry, most were certified, not with “loathsome and dangerous contagious diseases,” but with conditions that limited their capacity to perform unskilled labor. Senility (old age), varicose veins, hernias, poor vision, and deformities of the limbs or spine were among the primary causes for exclusion. That so few of the more than 25 million arriving immigrants inspected by the PHS were excluded sets into bold relief the country’s almost insatiable industrial demand for cheap labor.
There was actually nothing really “medical” about the medical examinations endured by Ellis Island immigrants. The conventional wisdom at the time was that every disease had obvious physical symptoms, which trained doctors could spot in a flash. But while new arrivals at Ellis Island were only given a quick once-over, immigrants coming to the U.S. from the south and west were subjected to much more invasive inspections—solely because of racial prejudice:
Non-Europeans faced more considerable medical obstacles to entry at the nation’s Pacific Coast and Mexican border immigration stations. At Texas border stations, PHS medical inspectors stripped, showered, disinfected, searched for lice, and physically examined large groups of immigrants. All second- and third-class Asians immigrants arriving in San Francisco endured a physical exam similar to that conducted along the Mexican border in addition to routine laboratory testing for parasitic infection, which required detention at Angel Island for one or more days. Disease, health officials argued, was not so easily “read” in the “inscrutable” Asians, particularly the Chinese.