What the Eyes Don't See

by Mona Hanna-Attisha

  Most mornings, usually by 7 A.M., I had a conference call with Dr. Reynolds, Kirk, and Jamie from the United Way to go over the day’s developments and plans. Sometimes Andy and Senator Ananich joined in. We were incredulous at the state’s all-out resistance. We were horrified, on fire. Once I started swearing, I really took off. Andy threw wicked insults at our antagonists—dumb bastards—but Marc Edwards produced the most ingenious ones. To him, Wurfel wasn’t just dumb or a bastard. According to Marc, he was a “fucktard,” which, according to Urban Dictionary, means “an extraordinarily stupid person who causes harm.” I had never heard the word before and didn’t like it, to be honest, but it worked.

  Meanwhile, my wish list for Flint kids kept getting longer. School health. Early literacy programs. Nutrition. Transportation services.

  Nobody on the team grew disenchanted. We talked through our options, discussed next steps, and strategized about how to keep pushing the state to deal with the water, which it was still refusing to do. We wanted filters and bottled water brought to the neighborhoods with the worst water first. We wanted them home-delivered. Where is the National Guard? How do they get activated?

  We all had our areas of expertise, but it was almost comical what we didn’t know, which was almost everything. Some days we met in person—or patched in the others—and wondered aloud, How do emergencies usually get handled? It was the blind leading the blind. If we had been dealing with a chemical spill or a flood, the proper authorities would have been “activated” and ordered to help long ago. When Toledo had had a water issue less than a year before, water trucks arrived in less than twenty-four hours. Where was the sense of urgency here? We wondered why the state didn’t send support, but then we realized that sending in relief at such a large scale would be an admission of blame.

  So the stalling continued. And without a command center or authority of any kind, first-responder responsibilities fell to the local United Way. Our goal stayed the same. We needed to get people filters and bottled water. And after that, we had to explain how to install the faucet filters. Jamie was working with the food bank and the Red Cross, figuring out how to get donations and coordinate involvement from big community groups, and working with residents and volunteers to get it all done on the ground level. He was tireless in taking on new tasks.

  Ahead, we had a million steps to take before we got to the impossible goal—getting the water source switched back to Detroit. But we never lost sight of it. We stayed focused on deeds that led to action, on words—at least in public—that helped rather than hurt, on a perspective that handled triage and short-term obstacles but never lost sight of where we wanted to wind up. We were always in contact, connected, thinking together. At least once a day, Marc and I caught up—and quickly became a tag team. He was the master of water-safety issues. I took on all health matters and anything that involved Flint kids. The pushback from the state just gave us more fight.

  As soon as there was a new development, which was several times a day, I updated the rest of my team—Jenny and Elin—and heard their ideas. The rest of the minutes of the day were an obstacle course of calls, responses, interviews, and disappointments. It was an all-consuming campaign.

  I relished each small sign of progress. And as many times as the hurtful words “splice and dice” emerged unbidden into my mind, I also hung on to the moments that gave me hope. It wasn’t until a break came that I realized how much I needed one.

  A BREAK CAME THE WEEK FOLLOWING THE press conference. Out of the blue, I received a call from Eden Wells, the chief medical officer for the state of Michigan, whom I had met over the summer. She apologized for “not reaching out earlier.” She wanted to have a “physician to physician” conversation.

  I was surprised to hear from her. I was also excited, gratified, hopeful, and skeptical, the wild stew of conflicting feelings I was getting used to by then, something that came with almost every development. First there was paranoia: Why does Eden Wells want to get in touch with me? A few minutes later, a sense of optimism and relief. Wow, the chief medical officer for the state of Michigan! This is great news. Finally, an opportunity to cut through the crap. And then skepticism: Nothing will happen. Again.

  On the phone, Eden didn’t sound like a monster. Her voice was normal and friendly. She remembered our meeting at the vaccine press conference in July, which now seemed like years ago, and where we’d shared a laugh. My white coat said Michigan State; she was on the faculty at the University of Michigan. That was supposed to mean we represented two rival schools, except I don’t care about rivalries, or football, and besides, I had attended and love both universities.

  She explained why she was calling: she was now the state’s “point person” for the water “controversy.” I had several conflicting reactions to that news but kept them to myself. She wanted to ask a few questions about our research—and how I’d arrived at the findings.

  So I told her about our methodology, referenced past research done in this area, and explained how Jenny and I had reached our decisions about how to do the study—and why our numbers were different from the state’s.

  We were running our numbers again, I said. This time we were using GIS software to be more precise. Then I mentioned I was still waiting for the state’s blood-lead-level data, the entire spreadsheet of each test for every child, not the elementary one-page tally sheet they had released earlier. Our request was still pending. By then, we had even submitted an official IRB application to the state for their raw data.

  Eden said the state was going to relook at its data—so she could compare “apples to apples”—and that she would try to expedite my request for the state’s raw data. The way she sounded, it seemed like it wouldn’t be a problem. And I found myself feeling relieved—even good—for the first time in a while. I trusted Eden on some level. I even offered to do my own GIS-based analysis of the state’s data and to give Eden the results in a day, in a desire for complete transparency. The state office didn’t have GIS experts.

  Finally, I was having a peer-to-peer conversation with another scientist and doctor, discussing my findings and how I got there.

  Finally, somebody was thinking about the science and methods instead of ridiculing me and calling me “unfortunate” and “hysterical.”

  Following up on our call, I sent Eden published articles about how lead in water spikes in the summer and how I controlled for it. I shared recent research from Montreal scientists showing how every 1 ppb increase in lead in water increased blood-lead levels 35 percent. And I told her how GM had stopped using this water because it was corroding engine parts. Privately, I wondered how much the Detroit Free Press story, which called the state’s numbers into question, had provoked her call—and got the governor’s people to withdraw from the attacks and actually look at their data and my research.

  Later on, when the Freedom of Information Act requests went through and the agency emails became public, some of my questions were answered. It turned out that when Eden called me, she had already received an email from her boss at the MDHHS, Nick Lyon, directing subordinates to prove that I was wrong, even before they’d seen my study, even before they’d looked more closely at their own numbers. Lyon’s office had been commissioned to look into the water-quality complaints months before. And when they saw a spike in blood-lead levels—as Karen Lishinski had revealed—they had been blinded by preconceptions and reached the conclusion there was nothing to worry about. Now, in the face of my research, Lyon asked his department to “make a strong statement with a demonstration of proof that the blood-lead levels seen are not out of the ordinary.” In other words: he was telling the public servants to stand firm that their results were right, whether they were or not. Don’t bother rechecking them. Instead, go on the attack.

  The state determined that my Achilles heel had to be seasonality. It was the only remotely credible argument that could be used to discredit my
research.

  Didn’t Lyon care about protecting kids?

  Didn’t he care about science?

  No, I think all he cared about was winning. It was risky, a gamble. He had to count on the fact that nobody else in his agency, or the governor’s office, would come along and care about kids or science either. If folks could claim global warming is a hoax, tobacco is good for you, and asbestos is a safe building material, the Flint blood-lead levels should be easy enough to obscure.

  But I think Eden Wells cared about science, or appeared to. That’s what caused the tide to slowly turn, what eventually stopped the cover-up, the lies, and the stonewalling.

  When Lyon sent out his directive to make me look bad, Eden sent out an email to colleagues with a caution:

  Dr. Hanna-Attisha is doing a GIS Analysis now and that is why she really wanted the data. She has a group of Epis and statisticians behind her. She has a strong foundation in research. She would understand the limitations of the data.

  Was she sticking up for me? I’ll never know. Maybe she decided that it wasn’t so smart to attack and discredit somebody with real research chops (although there was no group of epidemiologists and statisticians behind me, just Jenny). Or maybe the media stories were beginning to get traction, and she feared that her own reputation as a public health professor was at risk. But I choose to believe that she really cared about good science and about kids.

  Either way, whatever the truth—or whatever combination of pressures and factors was at play—I think if it weren’t for Eden, the state’s denials could have continued months longer, maybe years. Flint might have been another D.C., with agency officials digging in their heels year after year, until nobody cared anymore and the pipeline to Lake Huron was finished anyway. But instead of pushing back at me, Eden made her scientists rerun their numbers, using correct methodology.

  On October 1 the Genesee County Health Department declared a public health emergency, and the governor’s office announced it was having a news conference with Nick Lyon the next day at 1:30 P.M.

  I heard from Andy immediately. The governor’s office and Lyon were going to confirm my findings tomorrow. The state had surrendered.

  Holy shit. You have got to be kidding me. It was hard to believe or process.

  But Eden called and confirmed it, on her way to the press conference. “We ran the numbers as you did, and the state’s blood-lead numbers are consistent with yours,” she said.

  I thanked her, kind of numbly, not sure how grateful I was supposed to be.

  “And at one-thirty,” she went on, “you will get access to your state data request.”

  All the blood-lead levels for all the kids in Genesee County. Finally. But it was weird that it was being released at the exact same time as the press conference. Did they think I would leak the info if I got it ten minutes earlier? The state was changing its tune, but its lack of finesse and strange ways continued to bewilder me.

  * * *

  —

  TECHNICALLY, I WASN’T INVITED to the official state news conference, but I wanted to go and hear what the state had to say, directly, for myself. That way I could gauge the reaction and get a feeling for what might come down next. If Kirk and I had a chance to corner somebody in power, even better. We still needed an emergency responder. And we wanted to continue our drumbeat about getting the water changed back to Detroit.

  Kirk figured out a way to get us both included. He picked me up at Hurley in his silver Jeep and drove to a small, out-of-the-way building, the Kettering Innovation Center on the Kettering University campus. Kettering, who had pulled so much lead out of the earth and poisoned so many kids.

  There were protesters outside. We were happy to see them, and I thanked them for being there, for their activism. I wanted to protest too.

  Inside, the small room was packed with media. Kirk and I separated and were squished into two different sides of the small room. At the front, Eden Wells, Nick Lyon, and Mayor Walling were hovering around a podium and preparing to talk. I looked around and noticed Dan Wyant, the head of MDEQ—the guy in charge of the Drinking Water and Municipal Assistance Division, in charge of all those people in white lab coats who’d been entrusted with making sure our water was safe.

  Brad Wurfel was in front, facilitating, or appearing to. He was tall and cartoon-handsome, with a pearly-white smile—a classic public relations guy. It was part of his job to look chill, but I sensed that under the surface he was sweating and scared. Or he should have been.

  Eden opened the conference by saying the state had looked at its data again, and although the numbers weren’t exactly the same, there was an increase in the percentage of kids with elevated blood-lead levels.

  “We understand many have lost confidence in the drinking water,” Dan Wyant said to the room. “We need to build that back. We need to do that more.”

  There was an unveiling of a ten-point “comprehensive action” plan. It was not comprehensive. It was not action. It was basically a logo. It did include testing the drinking water at Flint schools, but otherwise it was pulled together at the eleventh hour by people with no experience, depth, or foresight and definitely no public health experience. Thank God for the media, because reporters were asking great questions:

  “Is corrosion control being used?”

  “Yes,” Wyant said. Unwittingly or not, he was wrong.

  “Do you think the Genesee County Health Department should have declared a public health emergency yesterday?”

  “No,” Lyon responded.

  What the fuck? I whispered under my breath. But there was more dumb stuff to come. Finally the state had stopped fighting my research and conceded there was a problem, but it still seemed to be fighting the idea that it had anything to do with the creation or mitigation of the disaster.

  After the press conference, Kirk and I went into a different room and had a chance to talk to state officials, to dig into the details of what seemed a superficial ten-point plan and to insist that the water source be switched back to Detroit. I had a chance to meet feisty Sheldon Neeley, who represents Flint in the state legislature. He was mad at the state and took a break from a few heated exchanges to thank me for my work. I gave him a hug. Later, I heard a rumor that he showed up in Mark Valacak’s office with a baseball bat, demanding that a public health emergency be declared.

  Across the way, I saw Eden Wells and greeted her. I was excited and eager to check out the state’s raw data, a larger sample, and do my own analysis on it—our holy grail.

  Eden was cordial. So was I. But not far away, a shouting match exploded between Jamie and Harvey Hollins, the director of urban initiatives, who seemed to be Governor Snyder’s new point person for Flint. Although the United Way was part of the governor’s new plan (“call 211 for filters and water”), nobody had contacted Jamie yet, and he was furious. The fight was face-to-face and tense. Hollins seemed rattled and hadn’t expected a confrontation. Only the press were supposed to be there.

  As I took this all in, feeling both horrified and gratified, suddenly I realized that Brad Wurfel was right next to me. He was towering over me, like a human embodiment of the state’s ten-point plan: all suit and hair, no substance.

  I couldn’t help myself, because I believe in standing up to bullies.

  “You called me unfortunate,” I said, looking up at him. “You said I was irresponsible. You said—”

  He grimaced, then his face turned very solemn. “I’m sorry,” he said.

  Wow, that surprised me. The monster actually seemed to feel remorse. Fucktard said he was sorry. But my next reaction was unexpected. I thought, Why the hell is he grimacing and solemn and apologizing to me?

  I wasn’t the person he should be apologizing to. Every kid in Flint deserved one. Every resident of Flint. They all deserved an apology and much more. Wurfel’s was the first of many I’
d hear the next year, and every single one made me feel awful.

  I nodded. Okay. Fine. Get it off your chest. I had a hunch he wouldn’t have his job much longer, and I was right.

  Then Dan Wyant approached me—the head of MDEQ. He mumbled some kind of greeting and explained that he “meant” to make a public apology to me, but the opportunity hadn’t come yet. He sifted through some papers in his hands, his prepared remarks and talking points, desperately looking for the piece of paper where his apology was written out.

  “If someone asks, this is what I am going to say,” he said.

  I felt sorry for him, to be perfectly honest. He was probably a nice guy, seemed like he meant well. But he was in over his head.

  Forget the nonapology and the mumbling modesty. I had something I had to ask. “Why wasn’t corrosion control added?”

  He gave me the same blah-blah-say-nothing response that we’d all been hearing on the radio and TV for weeks. It had finally been discredited, but he was still saying it. He didn’t have his job much longer either.

  The next day, Saturday, October 3, water filters were distributed to the public for the first time, at the University of Michigan–Flint campus. Marc Edwards advised us on the brands that did a good job filtering out lead. NSF 53–certified lead-clearing filters were purchased and provided by the United Way, thanks to Jamie’s efforts and thanks to online fundraising by Marc’s engineering students. I stayed home to finally spend some time with Nina and Layla, but my residents and medical students volunteered at the filter distribution and kept me informed about how it was going.

  Filters were prioritized for pregnant moms, formula-fed babies, and zip codes where the water was known to be the most toxic.