A lot of us have visited the beautiful museum at Ellis Island and pondered our collective and family history. Fewer, however, know that there is an abandoned hospital complex on the island, empty since 1954—and crumbling. If you’re relatively fit, possess a pair of closed-toe shoes, and are willing to sign a waiver saying you won’t sue anyone if some debris falls on your head, you can see it.A nonprofit called Save Ellis Island, working with the National Park Service to preserve the old buildings, raises funds in part through eerie hard-hat tours of the hospital. I went on a tour in the company of the New York Adventure Club, which gives its participants access to additional areas of the complex.Twenty-five intrepid explorers gathered at the entrance of the museum and were met by Barbara, a docent for Save Ellis Island. She took us west, past the areas open to the public, and opened a metal gate that we all passed through. “You are now in New Jersey!” she announced. (The island was the subject of a legal battle between the two states. In 1998, a court ruled that only about 17 percent of the island is actually New York … but, alas for New Jersey, it’s the part where the museum is. New Jersey still gets a small portion of the museum’s concessions fees.)Barbara explained that back in the day, the Ellis Island Immigrant Hospital consisted of 22 buildings spread over the southern part of the island. The area on which the hospital was built is manmade, constructed from landfill and concrete excavated during the building of the New York City subway system. During the hospital’s heyday, from 1902 until 1930, over 3,500 immigrants died there—half of them children—and 350 babies were born. Barbara noted that being born on Ellis Island was no guarantee of citizenship. Babies were in limbo, at the mercy of individual decision-makers.The United States’ first public-health hospital was advanced for its time: Doctors used fluoroscopy and an autoclave to sterilize mattresses, stressed the importance of healthful food and sunlight, and knew to isolate patients with highly communicable diseases from other patients. Ellis Island was one of the first places in the country to employ a full-time female physician, Dr. Rose Bebb, who could make anxious non-English-speaking women feel more at ease. Sadly, though, Ellis Island also used IQ tests designed (poorly) by eugenicist Henry Goddard, finding an extraordinary number of immigrants to be “feeble-minded.”As you no doubt know, 75 percent of the immigrants who came to America at the turn of the century came through Ellis Island. Very few, however, wound up in the hospital. Steamship companies would have to pay for the return of sick passengers, so screening was careful before emigrants left the shores of their home countries. Still, one person in 10 was marked for additional medical screening. Doctors watched to see if the new arrivals could walk up the ramp from the ship and up the steps to the screening area without becoming winded. They looked for a limp. They looked for evidence of psychiatric disorders. They looked for asymmetrical faces and/or an inability to pass an incomprehensible IQ test as evidence of intellectual deficits. They looked for fungal infections of the skin like ringworm and favus. In the test that was scariest to the new arrivals, they used a buttonhook to turn eyelids inside out and look for trachoma, which in those days led almost invariably to blindness. (Sometimes, though, the busy doctors used their unwashed fingers to conduct eye exams. President Theodore Roosevelt visited in 1906 and recorded his dismay that “the doctors made the examination with dirty hands and no pretense to clean their instruments.” Soon, however, handwashing and the sterilization of instruments were the order of the day.) The tests were extremely cursory—usually taking no more than 30 seconds, since each doctor saw hundreds of patients a day. The purpose, though, was to determine who was healthy enough to work. America did not want gadabouts.Only about 1 percent of the 12 million entrants were deported for medical reasons. (Of course, every immigrant claimed to know someone who was sent back; the threat was a huge source of foreboding and terror.) Somewhere between 2 and 10 percent of new arrivals spent time in the 750-bed hospital, but of those, 90 percent were ultimately allowed to enter the country.The hospital’s own lifespan was short. In 1914, the year the complex was completed, over 10,000 patients from 75 countries were treated; as the United States started to crack down on immigration after WWI, though, demand for its services decreased. The hospital closed in 1930. For several years afterward, the FBI used the buildings as a field office; in the 1940s, military personnel were treated there for shell-shock with electroconvulsive therapy. In 1954, the Coast Guard, which had jurisdiction over the hospital complex, abandoned it entirely and left it to the elements.***Our group walked past the boarded-up obstetrical building and “psychopathic” ward through grounds littered with chunks of building materials, an old rusting bell, a huge corner of ornate decorative metalwork from a no-longer-extant building, perhaps on Liberty Island. The grass was lush and green, and there were water views all around, but the areas with cement walkways were cracked, with aggressive weeds pushing their way through all the surfaces. Windows were covered in plywood or buckling, their glass panes shattered.Our first stop inside the hospital proper was the laundry. A huge rusting machine looked like a beached whale in the middle the room, with a slab of sinuously curving, broken ironwork plating haphazardly leaning against it. The walls were an archeological layer cake, with bits of green and black and tan paint peeking through the peeling white. The floor was so covered in dirt it was impossible to see what material it once was. We saw a giant, scary square maw with an iron wheel on the outside—it looked like a place you would burn bodies. It was the autoclave, where beds were disinfected.We meandered through the main hospital, seeing the spookily quiet wards for infectious-disease patients. Rooms for tuberculosis patients had two sinks: one for washing and one for spitting. Barbara pointed out that you could tell how communicable the most dangerous diseases were by the thickness of the door to each ward and the size of the window embedded in it. When we looked into one mirror in one bathroom in the tuberculosis ward, we saw a perfectly framed view of the Statue of Liberty. Did the person in that room love to see it, or did they grieve?Dead leaves skittered along floors; pipes dangled from ceilings. Doors, loosed from hinges, leaned against piebald walls. In places, we could see watermarks a third of the way up from the floor. These were left by Superstorm Sandy, which submerged the entire island in 2012 and closed the museum for a year. Save Ellis Island, which was founded in 1999, began leading small groups through the hospital complex in October 2014.The staff housing on the upper floors was better preserved and perfectly clean. Rooms were harmoniously simple, featuring brick fireplaces with sweetly carved surrounds and detailed mantelpieces, tidy built-in wardrobes, huge windows with harbor views. Even with the peeling paint and chipped windowsills, they looked like the perfect setting for an Instagram hipster-minimalist wedding.The contagious-disease hospital consisted of 17 pavilions arrayed around a long, sinister-looking central corridor. Some of the windows are so overgrown with ivy, we couldn’t see out. Tree limbs poked inside other windows, their panes cracked and pieced. Everything made of metal—beams, frames, gears—was rusted to a dark red or brown. Wooden floors were disintegrating to reveal subflooring beneath and packed earth beneath that. We saw an operating room with a lonely metal table at its center. And we saw the autopsy area, with stadium seating for visiting doctors and medical students and a floor-to-ceiling, eight-drawer, built-in cadaver-storage area. The most oddly intimate detail was the line of rusted coat hooks all along the back wall. We could imagine young men carefully hanging up their overcoats to sit down and watch a master pathologist at work.Here and there throughout the hospital complex were giant black-and-white photo illustrations by the French street artist JR. He’d blown up old, faded pictures of immigrants and staff, silhouetted them, and wheat-pasted them onto various walls. We’d turn a corner and be confronted by a young man seeming to peek from a half-hidden spot behind a wall, his broad-brimmed hat echoing the shape of the lampshade hanging from the ceiling in the otherwise empty room. Or we’d see a group of huge-eyed children, their heads wrapped in cloth as part of their favus treatment (their scalps would be covered in tar, which would be allowed to harden and would then be ripped off along with the hair, or later the application of salicylic and other acids would destroy the fungus) peering from broken windows; some faces were missing as green branches poked inside. There was a little boy in a newsboy cap and knee pants carrying a trunk on his shoulder as big as he was; there was a group of hollow-eyed doctors in white staring out at the camera. I found JR’s work otherworldly and powerful, a perfect match for the setting. The plan is to let the silhouettes, exposed to wind and cold and damp like the rest of the building, stay up until they start to peel and decompose.JR said in an interview when the hospital complex opened: “I want to find the story behind each person who left his or her country. I want to know what made them leave everything and everyone behind, even when they knew they’d never be able to come back. It takes so much courage. There were immigrants in Ellis a hundred years ago, there are migrants now, and there will be some in a hundred years, so we have to do what we can to try to relate to each individual story.”Save Ellis Island estimates that it will take $300 million to restore the entire complex. As of this writing, the Save Ellis Island tour is about $60, including a ferry ticket; the same tour with additional rooms, led by a Save Ellis Island guide under the auspices of the NYAC, is around $70 including ferry ticket.***Like this article? Sign up for our Daily Digest to get Tablet Magazine’s new content in your inbox each morning.