Family history is a standard component of most doctor’s appointments. Healthcare providers have good reasons for collecting this information – by learning more about the genetic, behavioral, and environmental factors that can affect our health, they’re developing a fuller picture of the patients in front of them. As a literary scholar, though, I have my own reasons for analyzing my family’s medical history.
In 1922, my great-great-aunt Pearl Libow arrived at Ellis Island from Russia sick with typhoid fever. Though she, her mother, and her siblings had eagerly anticipated a reunion with her father and brother, who had immigrated earlier, sixteen-year-old Pearl spent her first sixteen days in the United States at Manhattan’s Broad Street Hospital. From there, she was transferred back to Ellis Island, where she was held for two additional weeks. While I had learned the basics of “Aunt Pearl’s” story from relatives, research led me to Pearl’s own telling, which was recorded by Elizabeth Yew, M.D. for the Ellis Island Oral History Project in 1978. Listening to the interview, it struck me that Pearl’s oral history might be more than just a glimpse into the life of a relative who died a few weeks before my ninth birthday. Indeed, her narrative has much to offer the still nascent field of public health humanities.
Focusing primarily on the stories public health professionals tell about their work, Lise Saffran explains that a unique tenant of public health narratives, as opposed to other stories of illness, is that they necessarily “move back and forth between the micro and macro” (“Public Health Storytelling Practice” 1537). Pearl’s oral history provides a lay perspective that takes a similar approach. Throughout her narrative, Pearl emphasizes the impacts she feared her illness might have on others – and she especially worries about her family’s distress. While she testifies to her personal suffering while undergoing hospitalization and detainment in a foreign country, she also highlights her awareness of the communicability of both her actual infectious disease and the emotional effects of her prolonged and uncertain immigration process. If, as Stephanie A. Larson argues, the widespread view of storytelling as a mode of individual expression presents a challenge for the public health humanities, Pearl’s community-centered narrative presents one approach to resolving this tension (27). While Larson makes a strong case for “the importance of multiple stories” to narrative public health ethics, we might also attend to the seemingly secondary figures and communities who hover in the margins of illness accounts (27). Indeed, for a story about quarantine, Pearl’s narrative persistently reminds us that illness is rarely an isolated event.
When she arrived in 1922, Pearl joined a wave of more than 25 million immigrants who came to the United States during the Progressive Era, but she was also part of a remarkably small minority of those whose immigration processes were hindered due to infectious disease (Markel and Stern 1315). Much medical immigration restriction during this period was shaped by eugenic thinking and thus focused largely on chronic rather than acute conditions (Baynton, Domage). “Quarantinable diseases” such as typhoid were seen as easier to manage, as Pearl’s relocation to a New York hospital for treatment demonstrates (Markel and Stern 1318). And yet, for teenaged Pearl, who spoke no English, her inevitable release was far from obvious. “I couldn’t discuss with them how long will I have to stay or long they’ll keep me there,” she recollects, “…I didn’t know where I stand.”
When she was admitted to the hospital on Ellis Island, Pearl had, by her own account, been “cure[d]” by the physicians at Broad Street Hospital and needed only to be “checked over by [Ellis Island’s] own doctors” before she was permitted to leave. This process lasted two weeks. In her oral history, she describes how misinformation (rather than the disease) spread among patients during this period of uncertainty. At one point, she was told by another young patient, “‘they will send you back because if you still have your sickness in you, they wouldn’t let you go out in this country.’” Unable to communicate with officials or healthcare providers (some of whom she remembers quite fondly) without the presence of an interpreter, Pearl struggled to corroborate this information – “I figure maybe the girl knows more than I do and really they’ll send me back.” Both the culture of anxiety among patients and the language barriers they faced seem to have directly impacted Pearl’s health as she recovered from her fever. After two weeks without solid food at Broad Street hospital, she weighed only 90 pounds. When she was finally offered food at Ellis Island, she recalls that although “the food was good,” “to me everything didn’t taste so good because I was so emotional upset….whenever I used to start to talk or eat, I used to get choked up because I was so disturbed that who knows if they’ll ever [let my family] take me home.”
Given that she’s recalling the scene five decades after the fact, it’s no surprise that “home” for Pearl refers not to Russia, but to the Jewish neighborhood in Brighton Beach, Brooklyn where she and her family lived for many years. And yet, it’s not difficult to imagine that for teenaged Pearl, the apartment newly inhabited by her parents and siblings in 1922 already seemed like home. Pearl’s narrative presents her family as her chief priority throughout her detainment. In the recording, she becomes emotional when admitting how much she missed her father: “It is very sad thing when you look forward to come here and I didn’t see my father for a long time.” While she explains that “when you are very young it’s a terrible thing” to be separated from one’s parents, she also focuses on the effect her illness and detainment may have had on them.
During that period, she saw only her mother and brother, who visited for an hour each week “dressed in white clothes and a mask on their faces because they thought it’s very contagious, this sickness.” While these protocols protected them from typhoid, Pearl explains that she did spread her anxieties about immigration restriction to her family. During one visit, she tells them, “I heard that maybe they will send me back.” This spread of (mis)information from Pearl impacts her illness experience. “To me,” she recalls, “it was very upsetting because I knew how much my parents suffered by it.” Pearl worries, too, about its effects on her older brother who had earned the money for her voyage by working in a Manhattan grocery store. “He meant so well,” she laments, “and here everything went wrong.” She elaborates: “I felt very upset because we looked so much forward that we’ll have such a nice time that my brother pay for us and everything came very easy for us…He took care of whatever was necessary. And here I got sick and I spoiled the whole pleasure.” Pearl’s language here suggests a view of her illness as literally contaminating the smooth immigration experience her brother had worked to provide. As such, she presents her illness experience as communicable, even when her disease itself remains contained.
Even the form of Pearl’s oral history refuses the individualistic format of most illness narratives, as Yew’s interview is repeatedly interrupted by an additional voice. While the Ellis Island Oral History Project’s transcript leaves this third party unidentified, this thickly accented female voice almost certainly belongs to Pearl’s older sister, Bessie. The sisters not only traveled together from Russia to New York but also worked together as seamstresses in a Manhattan garment shop and lived together in Brooklyn until Bessie’s death in 1989. At times, Bessie seems to annoy Pearl in that way that only siblings can. After one interjection, Pearl briefly bickers with her sister about whether the interview is meant to capture “your voice or my voice.” But Bessie also plays a crucial supporting role, clarifying occasional points of confusion and offering her sister the ironically elusive English word for “interpreter.” Later, too, she seems to provide emotional aid. While sharing one particularly emotional anecdote, Pearl chokes up before giggling and telling Yew, “I’m crazy,” a comment she makes whenever she becomes emotional during the interview. We hear Bessie’s muffled voice in the distance, and, after a moment, Pearl resumes the interview: “Anything else? I’m sorry. I’m crazy.” Though her voice hovers in the background for much of the interview, Bessie’s marginal, familial presence ultimately anchors Pearl’s narration. As an oral history, Pearl’s illness narrative is both explicitly communicable in that she is telling it directly to an interviewer and communal in so far as the at-home recording structure allows the voices of others impacted by her illness to permeate her record of it.
Beyond documenting her concern for her family, Pearl’s oral history also registers her awareness of how her illness could have impacted the broader U.S. population. Pearl presents herself as a transnational carrier of disease when she tells Yew, “I got the germ someplace see because we stopped in a few places before we came to Paris [where she boarded the ship].” At Ellis Island, she recalls, “they figured that if I had something like typhoid fever, I could bring it in, and many more people will get sick of it.” Although she describes her extended detainment as a period of emotional anguish, it’s striking how willingly she accepts the officials’ decisions in retrospect. This tension is captured in her reflections on the other patients she met: “There are so many young little children that are kept in a room by themselves. It is very heart breaking when you come there…But they had reasons for keeping them. They wanted to save the rest of the people that are here. You can’t blame them.” As one of those young immigrants “kept in a room” by herself, Pearl is moved by the sight of her fellow patients, but she extends this concern to “the rest of the people” living in the U.S. as well. When she tells Yew firmly, “I don’t blame them for doing it. For me it was no picnic,” she expresses a sense of her containment as a necessary self-sacrifice for the sake of public health.
Listening to her tell her story today, when so much of familial, national, and global life has been disrupted by the ongoing COVID-19 pandemic, Pearl’s story registers the experience of illness at each of these scales. When she embarked on her transatlantic voyage, she may have anticipated finding community by reuniting with family members and making a new home in an unfamiliar country.
Despite her disappointments, Pearl’s narrative suggests that the deferral of her immigration did not foreclose these bonds. As she revisits her illness experience more than fifty-years later, she brings her close family ties and her sense of national belonging with her. By her account, she was connected to both her family and the broader United States’ population even as she was kept apart from them.
For contemporary health humanities scholars interested in public health, Pearl’s oral history illuminates how experiences of infectious disease and quarantine might give rise to unique illness narratives that foreground community bonds and social responsibility. Just as physicians use family history to contextualize their patients’ health, so too can health humanities scholars turn our attention to the minor characters – both named and unnamed – whose presences shape stories of health.
Acknowledgements
I am grateful to physician and family history enthusiast Leslie Libow for first introducing me to “Aunt Pearl’s” story.
Bibliography
Baynton, Douglas C. Defectives in the Land: Disability and Immigration in the Age of Eugenics. The University of Chicago Press, 2016.
Dolmage, Jay. Disabled upon Arrival: Eugenics, Immigration, and the Construction of Race and Disability. The Ohio State University Press, 2018.
Larson, Stephanie A. “Why Stories Matter: An Introduction to Narrative Approaches to Public Health Ethics.” Narrative Ethics in Public Health: The Value of Stories, edited by Drue H. Barrett et al., Springer International Publishing, 2022, pp. 23–31.
Markel, Howard, and Alexandra Minna Stern. “Which Face? Whose Nation?: Immigration, Public Health, and the Construction of Disease at America’s Ports and Borders, 1891-1928.” American Behavioral Scientist, vol. 42, no. 9, June 1999, pp. 1314–31.
Saffran, Lise. “Public Health Storytelling Practice.” The Lancet, vol. 397, no. 10284, Apr. 2021, pp. 1536–37.
Image source: Rhododendrites, “Ellis Island hospital window mural,” Wikimedia Commons.
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