The hospital built in 1854 by James Renwick Jr. is the only New York City landmark in ruin, according to the Roosevelt Island Historical Society. The society would like to see the building restored, but whether it will be remains a question. "We’re still waiting," says Judy Berdy, the society’s vice president.

The hospital rests on the southern tip of the island once called Welfare Island in honor of its collection of unwanted city institutions. The island housed an insane asylum, a prison and a tuberculosis ward. The programs are long forgotten, but the buildings remain. The island boasts six New York City landmarks, including a lighthouse and ancient church.

Thousands of people died at this hospital before 1900. One in every 100 people who died in NYC in 1854, died at Renwick, according to the Roosevelt Island Operating Corporation of New York state.

In 1997, the state awarded over $50,000 to the New York Roosevelt Island Operating Corporation. The money was used to stabilize the Smallpox Hospital until further work could be done. Prior to that, the RIOC spent $1.6 million on designs for a 25-story office building, landmark preservation and seawall construction, but no action was taken. The most recent proposal calls for a 350-room hotel, a conference center, and 50 residential condominiums.

"The possibility of a restored Renwick Memorial will take on greater possibility if the Roosevelt Island Operating Corporation Board approves the [hotel] plan," says the corporation's spokesman, John Durso.

The board has plans to develop the southern tip of the island with a Marriott hotel. The hotel proposal follows a long list of attempts to develop the site.

Berdy calls the plan unrealistic. "I don’t know how you can develop a 350-room hotel without disrupting the community and our lifestyle. Residents just won’t go for it," she says.