What the Eyes Don't See

by Mona Hanna-Attisha

  The Director of the DEQ has issued two official statements in the last two days contending that the City currently meets all federal and state standards and we have noted that we are well ahead of our 2016 target for corrosion control….

  Blah, blah, blah. No urgency. No heightened concern. The rest of it was a bunch of long-winded, do-nothing bureaucrat talk. It felt like a preemptive excuse. If the bubonic plague infected the state of Michigan, should we form a committee?

  The water had poison in it! The impact of lead is irreversible. They weren’t using any corrosion control at the time, so Croft was lying about that—or he had bought the lies being dished out by MDEQ.

  But I could ignore Croft for the moment because at nine-thirty on Friday morning, the mayor, Dayne Walling, emailed Kirk directly, wanting to talk. Croft had fortunately looped in the mayor. And now his office wanted all the information so it could “respond/act accordingly.” Kirk forwarded the emails.

  We were actually getting traction. Somebody was listening, even if it was a mayor who had been politically neutered by the governor. He wasn’t in charge anymore, but then neither was the governor’s fourth EM. That position had been recently vacated, and decision-making power had shifted to Natasha Henderson, the Flint city manager. Even so, Walling had the title of mayor, which still must mean something. He was also a famous native son of Flint who could certainly attract a lot of attention to the water issue. If we got Walling on board, things could happen quickly.

  Kirk scheduled a meeting with Walling for Monday afternoon. The goal was to get a health advisory issued, which would kick into gear a number of governmental responses to the water problem—except we had absolutely no idea what authority was supposed to issue it.

  That gave me the weekend to finish my analysis and create a presentation for the mayor’s office. Just two days to make 100 percent sure our numbers were right. Two days. I was under the gun again.

  As soon as I filled in Jenny, we hunkered down and got in touch with Marc Edwards. We were taken by his obvious care for the kids of Flint and his eagerness to help, but I knew he had another side. His reputation for brusqueness and moral certitude was legendary. He had made enemies out in the world. So far we’d seen only glimmers of this. For instance, Marc finally remembered that he had met Dean Dean before, during the water wars in Lansing, and emailed to inform us that Dean Dean had been an “unhelpful dupe” back then. But at the same time, here Marc was, being so generous and helpful to us.

  Jenny and I had worked on dozens of academic studies over the years, but putting together an utterly perfect and unassailable one—in a matter of days, no less—was a bit of a leap. The pressure was intense. One minor error, even one that didn’t affect the findings, would give critics the ammunition to undermine me. One minor error and all our efforts would be for nothing, and Flint kids would go on being poisoned. I was already out on a limb—and already being ignored. We had to produce a study that couldn’t be.

  This is where Marc was crucial. He had done a similar study in D.C. of children’s blood-lead levels—and he knew what would make our study ironclad, flawless, and impervious to insult. We shared more results, how the increase was even greater in the zip codes where he had found the higher water-lead levels.

  FROM: Mona Hanna-Attisha

  TO: Marc Edwards

  SENT: Saturday, September 19, 2015, 10:23 P.M.

  SUBJECT: RE: Prelim results—confidential

  FYI all is still confidential, but we also ran EBL % for kids<5yrs in the higher risk zip codes (48503-48505) pre 1.7% to post 5.3% p<0.001.

  bad.

  We are really pushing for a health advisory so that we can get released necessary resources for high risk kids.

  thanks, mona

  He wrote back instantly. “That pretty much nails it down…stunning how fast you did it.”

  * * *

  —

  THE LAST EVENT OF the Michigan AAP meeting for me was Saturday’s “advocacy lunch.” This luncheon group was larger than the board meeting, about one hundred people, all pediatricians, and I knew many of them. The room was larger, another windowless conference room with round tables and so-so food.

  The best thing about being a pediatrician is that caring about kids, speaking for kids, and advocating for kids is an essential part of the job description. At a conference of surgeons or dermatologists, they might have a lunch theme like “malpractice risks” or “how to maximize billing.” But not pediatrics. That’s why I’ve always felt at home in the specialty and with my colleagues. We don’t just treat children’s bodies—we fiercely protect their potential.

  Looking over my in-box of emails with Marc, I was starting to think we were not alone. Five hundred miles away from my clinic in Flint, in Blacksburg, Virginia, there was a guy in a very different profession who seemed to care as much as we did.

  As the lunch got under way, Dr. Reynolds told the crowd he’d been at home sick the week before, when I’d called to discuss the Flint water. He invited me to explain my findings to the group. With more confidence than I’d had at Thursday night’s board meeting, and armed with more details, I stood and shared my concerns with the pediatricians. We were looking at the data, I said, but preliminary findings were very troubling. We were building a coalition—I’d just gotten off the phone with our state senator’s office, I was working with Representative Kildee’s office, and I’d involved a nonprofit health coalition and the Genesee County Medical Society. The greatest obstacles so far were the county and state health departments. We needed their data and they weren’t sharing it.

  As soon as the lunch was over, a crowd of concerned pediatricians descended on me with expressions of disbelief and encouragement. My chair of pediatrics at MSU, Dr. Keith English, who was sitting next to me, leaned over and pledged to help.

  * * *

  —

  THE OTHER MARK IN my life, my older brother, had been unusually absent lately. Normally we talked every week, sometimes every day—about our kids, our parents, what’s happening in the news, and occasionally what’s going on at work. Mark has always been wise for his age—his hair even started going gray in high school. I counted on him for advice, certainly anything halfway legal. Whatever was going on in our lives, we knew, without talking about it, that we had each other’s backs.

  A partner at the successful public interest law firm in D.C. he helped start a few years ago, Mark is always fighting quixotic battles. Some I never heard about, some I heard about later, after he’d won or lost. He fights on a different front, in a different place than I do, but wherever he is, Mark is fighting the same battles that I am—for the same people, the same ideals, the same reasons. He battles employers to recognize low-wage workers’ unions. Or he files suits on behalf of immigrant workers for wage and hour violations. He fights discrimination. He fights racism. He takes cases other lawyers won’t, aggressively litigating in court for years and finding ways to win. It is part of the commitment to justice our parents hammered into us as children.

  But in late August, when I first heard the news about Flint water from Elin, Mark had been traveling, and after that he was tied up settling a big case, representing sanitation workers who were being cheated out of overtime pay. I wasn’t sure he’d been following the news in Flint, but knowing Mark, I suspected he was.

  We had our first chance to catch up on the weekend of September 19, when he came with his family for his University of Michigan Law School reunion. I had the medical conference to attend and Mark had reunion events, but I knew that sometime over the course of the weekend, amid the hubbub of a family gathering that included movies, a football game, and the usual platters of delicious food, thanks to Bebe, we’d find time to talk. Mark’s wife, Annette, and I had been friends at the University of Michigan and classmates at the School of Natural Resources and Environment. She’d met Mark at a part
y I threw. Over the years, Elliott and Mark had become close, almost like brothers. To make things even better, Mark and Annette’s two boys are about the same age as Nina and Layla. Our two families even spent winter breaks together, usually with Bebe and Jidu.

  A FAMILY PHOTO, AT A WEDDING, 2014

  As usual, the first forty-eight hours together were almost completely about eating. Bebe had been cooking nonstop for days, making every dish Mark loved, especially spicy Iraqi curries. Elliott planned an outdoor movie night on Friday with a projector borrowed from our neighbors, using the garage wall as a movie screen. He ordered Buddy’s Pizza from the Detroit chain, my brother’s favorite—half-meat, half vegetarian, jalapeños and chopped basil on top, and cooked well done. Not that we needed to order out.

  On our last day of the gathering, when Bebe was exhausted from overcooking, and all four kids were busy playing, Mark and Elliott and I sat around the dining table and began working on a thousand-piece jigsaw puzzle that our friend Walter had given Elliott to pass the time during his shoulder recovery.

  Mark and Elliott and I are all jigsaw puzzle fanatics, but Elliott was clearly uncomfortable. He kept moving his shoulder, trying to find a better position, readjusting the splint, then seemed to resign himself to pain.

  He was the first to say something about the water. “Mark, I’m really worried about Mona. We both know she’s tough, but she’s been under a lot of stress lately.”

  “Oh?”

  Mark kept his head down and was still moving the pieces scattered across the table surface and connecting some edges.

  “Even the girls have noticed how distracted she’s been.”

  “It’s about the Flint water,” I said.

  Mark began drilling, lawyer style, for details. He’d heard about the water. He’d been focused on the high cost, and the resulting water shutoffs when residents couldn’t pay their bills. Citizens went to the UN, charging that this was a human rights violation.

  I sketched out the lead issues, or tried to, quickly—starting with Elin and Marc Edwards. “He’s the guy who uncovered the D.C. water crisis,” I said. And in another indication of how that event had been covered up—or not covered enough—Mark had only a dim memory of it, even though he had been living in the District at the time and is one of the most politically aware and astute people I’ve ever known. Before becoming a labor lawyer, he had been a campaign organizer and a good one.

  I told him about the blood-lead-level data that Jenny and I had been studying—and ran some ideas by him, about how to make the most of it and make sure the state listened and took action.

  It didn’t take him long to analyze the politics. Mark’s assessment: Walling was up for reelection and, as the incumbent mayor, was closely associated with the water switch. This would hinder his appetite for finding a solution. Also, Walling’s limited power flowed through Lansing, so he would be hard-pressed to take a risk by going against Snyder. So it was good for Flint that Senator Ananich, who was a friend of Mark’s from college, was pushing the state for answers. Mark was thrilled to hear that Ananich and his wife had taken in a foster baby—“He’s going to be a fantastic dad”—and relieved to hear that Ananich had joined the group that was coming together and backing me. You’ll need a good team, he said.

  Then he asked about Hurley and whether the hospital was behind me. I nodded.

  “It is a public hospital, right?”

  “Yes. Owned by the city,” I said. “Not many public hospitals are left—it’s the only one of its kind left in the state.”

  “So if the state has gone after every single person who has tried to expose the water problem, what makes you any different?”

  I had a group of puzzle pieces in front of me, all the same color. He had a point. And I just kept listening until he was finished making it.

  Mark’s practice in recent years had shifted. Taking a page out of Haji’s entrepreneurial playbook, he had taken a risk and started his own public interest firm with four friends on Labor Day 2008, in the middle of the Great Recession. A substantial part of his work now included representing whistle-blowers in complex corporate fraud cases—something I’d never really thought about until that moment. I didn’t even think of myself as a whistle-blower. So when he started talking about whistle-blowing, pushback, retaliation, and other repercussions, he was speaking from experience.

  “I know you have your ducks in a row, but even if you are right, they still may try to take you down. They may go after you somehow,” he said. “That often happens. Or you might lose your job and your reputation.”

  “I’m more concerned about the kids,” I responded, “and letting everyone down.”

  We continued working on the puzzle. The edges were almost finished.

  “She’s not eating or sleeping,” Elliott said, sounding emotional. I could tell he was expressing concern that had been building up inside him. Unable to talk to me about it directly for some reason, he was doing it obliquely now, through Mark. “I only wish I could do more to help.”

  I hadn’t considered the toll it was taking on him—not being able to say anything or to help with something that was consuming me, taking up all my time. As for stress, I had to confess that it was worse than anything I’d ever experienced, far more than my wedding, childbirth, losing my grandparents, buying a house and moving, or even my dad’s heart attack. It was certainly worse than medical school examinations.

  “Just so you know what’s ahead,” Mark went on, “it could get rough. Many whistle-blowers, even if they’re successful in exposing fraud, have their lives destroyed. They become obsessed, sometimes paranoid, sometimes with good reason. And it’s often a years-long fight. Many are retaliated against. I have clients who have lost their homes and friends, their marriages destroyed. One even killed himself. That’s why I always counsel new clients—even though they’re doing the right thing—that they need to seriously consider the costs. You have to be prepared for the worst.”

  This made me think of the other Marc. His scars from the D.C. fight were obvious—and I wondered if he’d always have them.

  And it made me think of Elin, who predicted a years-long battle.

  Just then Bebe appeared in the kitchen. No doubt she noticed that we were suddenly silent. I assumed she had heard some of Mark’s cautionary words, which didn’t help.

  “What’s Mona up to now?” she asked in Arabic.

  “Nothing, Mama,” I said.

  “Mona likes to get mixed up in things she shouldn’t,” she said.

  “It’s nothing like that, Mama,” Mark said. “Don’t worry. Mona’s strong. Hadeeda.” The word means “iron” or “steel.” It’s Arabic shorthand for “tough as nails.”

  As soon as she wandered off, Mark turned to me again, knowing he didn’t have much time to finish before Bebe reappeared. He spoke more softly this time.

  “There are lots of risks. But it sounds like you’re doing what you can to minimize them.”

  “Trying to.”

  My worst fear was that I would be humiliated in front of my parents, Elliott and the girls, my extended family, my medical residents, my professional colleagues, and my friends. That I might make a monstrous mistake and blow it somehow—and look as if I were in over my head. I worried about being the idiot who yells “Fire!” in a crowded movie theater when there is no fire. There is an Arab concept called aeb, or “shame.” I always did my best to banish it from my brain, because it’s wrong and stupid and shouldn’t be in my mind, but at the same time, it had been planted there so long ago, it was like a tumor that couldn’t be completely excised. It had cells that kept mutating and replicating.

  Mark took a random puzzle piece from my hand and fit it into an empty spot, almost as if he were psychic and knew exactly where it belonged.

  “You know what you have to do.”

  “Yep.
”

  “Because this isn’t about what happens to you if you do something. This is about what happens—or doesn’t happen—if you don’t do something.”

  This is what it means to be a member of a family, to have people in your life who trust you and support you and who know you sometimes better than you know yourself. Mark was there, my mom and dad were always there, and Elliott was always there, to stand with me no matter what was going down. What we had was more than love. We understood each other. We were grounded in the same core ideals and morals—and were always moving toward the same goal: to make the world more just, more equitable, and a more human place. To do the right thing, even if it was hard.

  This wasn’t about my career over the next few years, or even a tarred reputation. This was about how my entire life would look to me years from now, when I was Bebe’s age or older. Mark knew that and was just reminding me that I knew it too. There was no way I could walk around Flint, watching kids grow into adolescents and then adults, and wonder if their problems were related to a poison that I hadn’t done enough about.

  It wasn’t a choice, really. I was ready to do whatever was needed. And now all I had to do was try to spend the rest of the weekend being real and present and not freaked out. That didn’t happen. I had to finish my analysis—and start my presentation for the mayor. But somehow we managed to finish the jigsaw puzzle on Sunday by the time Mark and his family left.

  IF MY DAD HAD BEEN AROUND that weekend, we would have played Konkan. We’d have been sitting around the same table, but instead of spending hours on the puzzle, we’d have been dealing out cards and eating fistuq, or pistachios. My dad loves an evening of Konkan. We all do. Elliott, who grew up watching his own dad play the game, can sit for long stretches at the table, hand after hand. Mama Evelyn still comes and plays—and has taught all her great-grandkids the rules of the game, the way she taught Mark and me.