What the Eyes Don't See_A Story of Crisis, Resistance, and Hope in an American City

by Mona Hanna-Attisha

  Just a month before, he’d undergone shoulder surgery for various injuries that had compounded over the years from playing baseball and racquetball, then lifting weights. He was still in pain and probably shouldn’t have been grilling at all. But Elliott loved his Kamado grill so much, it was hard to keep him away—sometimes we joked that it was the son he never had. He insisted he didn’t need help, and truthfully I didn’t know anything about barbecuing, so I rushed upstairs with just enough time to change into jeans and ask the girls about their time at Skull Island day camp.

  Nina and Layla, nine and seven, my dark-haired, brown-skinned little girls, mostly get along, probably because they are so different. Nina is studious, quiet, and somewhat introverted and anxious. Layla, our baby, is direct and demanding—kind of like Mama Evelyn, a force of nature. You always know where things stand with her. They both loved their eight weeks of summer day camp but hated their first day of Skull Island. By the time I found them in the kitchen, they’d worked themselves into a frenzy of complaint. Most of their friends were away on family vacations, they said. Why couldn’t we go away?

  If inequality has a favorite season, it’s summer. My brother, Mark, and I didn’t grow up with luxuries like summer camp, and my patients in Flint rarely had chances to experience something that so many upper-middle-class families take for granted. Many of those kids are stuck at home, sometimes in neighborhoods where playing outside isn’t a safe option. Academically, they tend to lose some of what they learned the previous year in school—what’s called the “summer slide”—because they aren’t kept intellectually stimulated over the summer. Meanwhile rich kids go to camp—and receive lots of academic and extracurricular enrichment, along with bonding time with their peers and healthy outdoor activities. Knowing about this disparity—and that we were on the privileged side of this inequality—kept my sympathies for Nina and Layla in check. Plus, I had too much work this time of year for a family vacation. It wasn’t the end of the world for my girls, only the end of summer.

  Annie and Elin arrived with their own kids and husbands, and we all began catching up. Our shared history was deep. In the drama club at Kimball High, we had been hams. In the environmental club, Students for Environmental Awareness (SEA), we were passionate activists, spending weeknights knocking on doors, circulating petitions, and organizing events. What we learned in those years had shaped us. Annie, an Irish-Italian beauty with long, straight blond hair and a tall, athletic build, was the founder of Opera on Tap, a network of opera singers who perform in bars, stores, and parks. Elin was now working remotely from Detroit for a D.C.–based think tank. We all had our own kids now, five little ones between us.

  The last time the three of us had been together was my wedding—and we shared a few jokes about that. Wedding planning had been agonizing for a number of reasons but mostly due to my powerful aversion to the traditional wedding style of Detroit-area Chaldeans, the Iraqi Christian sect to which both Elliott and I belong. Chaldean weddings are Big Fat Greek Weddings on steroids—with debke dancing, Arabic pop music, professional belly dancers, and always a high-end open bar for up to a thousand guests. Hummus, baba ghanoush, and tabbouleh are followed by a full-course meal that doesn’t start until 10 P.M., usually consisting of many types of kebab and saffron-infused rice. Leaving a wedding, or any kind of Iraqi party, without being absolutely stuffed is unheard of. Refusing to eat any of the multiple courses is a grave insult. For dessert, the yummiest weddings will have baklava from Shatila Bakery in Dearborn along with a traditional wedding cake.

  But that kind of extravaganza didn’t really fit with my lifestyle or worldview—or Elliott’s. So we spent our minimal wedding-planning hours dreaming up ways to upend tradition. Which was how we came to throw our reception in the Detroit Science Center—we invited our guests to “Mona & Elliott’s Science Project.” And instead of “The Wedding March,” we asked Elin, a pianist, and her husband, Mauricio, a cellist, to play the theme to The Princess Bride when I walked down the aisle.

  And rather than the usual two dozen bridesmaids and groomsmen, our small “wedding party” consisted entirely of immediate family members. My brother, Mark, and his wife, Annette, were my “maids of honor.” Elliott asked his sister, Angie, and brother, John, to be “best men.” The whole thing turned out to be a wonderful and fun experiment. Except I will never live down setting the church on fire.

  Annie was singing Schubert’s “Ave Maria,” her hypnotic soprano voice flowing through the church. Elliott and I were standing together, looking at Father Frank on the altar. We were calm and taking everything in stride. I was a young pediatric resident beginning my life with another pediatrician, a creative and sensitive guy. Before we met, I had had three rules of dating: (1) no doctors, (2) no Chaldeans, and (3) no Republicans. Elliott was 2.5 of the 3. (Raised in a conservative family, he admits that he once voted for a Republican.) But the force of his charm and romantic persistence won me over.

  The ceremony itself was straightforward. And now before us, on an altar cloth, were two small candles, both lit, representing Elliott and me. In the middle was a large candle that wasn’t lit. As Father Frank had instructed during the rehearsal, we were each supposed to take a small candle and together light the big one. This act would symbolize our union.

  The week before, I had successfully performed my first spinal tap on a newborn. Light a candle? Piece of cake.

  We lit the big candle in the middle of the table without incident. Then, as I tried to make sure my little candle was safely returned to its holder, I must have pressed down on it too hard. (I’m not known for my light touch; my handshakes are notoriously firm.) The candle toppled over. Within seconds, the altar cloth was in flames. Elliott reflexively tried to put the fire out with his hand and burned his fingers, while Annie’s singing of “Ave Maria” seemed to grow louder, fueled by our little inferno.

  JUST BEFORE THE ALTAR CAUGHT ON FIRE, FATHER FRANK LOOKING ON

  Flames were leaping. Smoke was now rising around us. Then I heard Mark’s deep voice bellowing behind me—he couldn’t stop laughing. Others in the pews began to chuckle. I turned around to see the face of my mom: sheer horror.

  Amid the smoke and Mark’s infectious laughter, Father Frank frantically smothered the flames. Elliott and I just looked at each other, smiling; he grinned through the pain of singed fingers. Elin, Annie, and Mauricio played on, flawlessly, in perfect harmony, as if nothing were happening.

  We wanted an unconventional wedding, and we got one.

  * * *

  —

  SO HERE WE WERE—more than ten years later—standing around the flames of the smoky Kamado grill while Elliott cooked the chicken. To honor the reunion of the survivors of our wedding fire, we opened a bottle of wine that Elliott and I had brought back from our sort-of honeymoon ten years before. I say sort-of because even back then, I couldn’t fully unplug from work mode. I combined a honeymoon with a pediatric residency rotation at the American University of Beirut Medical Center.

  The wine was Ksara, from the famous vineyard in Lebanon. We had saved it for a special occasion. Not being wine connoisseurs, though, we didn’t know about its short shelf life. After a decade, it was undrinkable.

  We opened another bottle and watched our kids form an impromptu rock band and crank the Block Rocker, their karaoke machine, up to its loudest setting. The toy guitars and plastic drum set were all super cute, but the noise sent me to the corner of the kitchen, where Elin and Annie and I caught up, wineglasses in hand.

  “How’s work going?” Elin asked, zeroing in on me for some reason.

  “Things are awesome,” I said, which is what I always say, being an innate optimist, along with super! or amazing! even if things aren’t. I allowed that my job at Hurley was demanding but becoming a little routine, but it’s not like I had the time to do more. Already there weren’t enough hours in the day.

&nbs
p; Annie went next. Her life wasn’t any calmer. She had a young daughter at home and no family nearby to help, and her nonprofit was exploding worldwide, while she was also running her own Web services and business consulting company.

  Then it was Elin’s turn. She was proud of her Swedish name and background, but to me—a dark-skinned, dark-haired immigrant kid from the Middle East who had garlicky hummus in my school lunches—Elin always seemed like the quintessential all-American girl. I’d envied her fair complexion, gray-green eyes, and light brown curly hair when I was younger, along with her other gifts. In the Advanced Placement classes we took together at Kimball, Elin had sailed along, getting perfect scores and grades without breaking a sweat and excelling at the piano at the same time. It’s funny how strong these high school impressions can be, because even though I knew from our recent visits that Elin’s career had hit the doldrums, I continued to think of her as one step ahead.

  Always precise with her words, she confessed that she’d relocated from Washington to Michigan to be closer to her family, but working from home felt isolating. She didn’t sound that enthusiastic about her projects either. Life had forced too many compromises on her. Maybe being the valedictorian came with unsustainably high expectations.

  Then she turned to me with a total non sequitur. “What are you hearing about the Flint water?”

  The question surprised me, as did the abrupt shift in Elin’s demeanor. Her eyes were suddenly boring into mine.

  “I’ve heard the complaints,” I said. “But the state says it’s fine—in compliance.”

  “No,” she said, shaking her head. “It’s really not.”

  ELLIOTT AND I HAD BEEN INDOCTRINATED by our parents: being an Iraqi host means offering your guests more food than three times as many people could eat. That night was no different. Elliott finally pulled the slightly charred chicken off the grill, and our noisy rock band took a break and wandered toward the heaping platters of food.

  As soon as we got the kids settled, cutting up their food into kid-size pieces, Elin and I found each other again. She talked quickly, with intensity and passion.

  She had seen a memo written by a former colleague of hers, Miguel Del Toral, who worked in the Chicago office of the EPA. He had come to Flint a few months before, after being contacted directly by a resident who was concerned about her water. He personally arranged to have an independent test of the tap water in the resident’s home.

  “I worked with Miguel. I know Miguel,” Elin said. “I trust him. He wouldn’t write this memo if there wasn’t a serious problem.”

  “And?”

  “He says that Flint is not using corrosion control.”

  The urgency on Elin’s face was unmistakable, but I was still a little lost.

  “What is corrosion control?”

  A shriek rose up in the next room. The posse of kids was already restless and returning to the drum set, guitars, keyboards, and karaoke.

  “A system of Flint’s size is required to have corrosion control as part of the Safe Drinking Water Act. Water is naturally corrosive, but water systems are supposed to treat the water to reduce corrosivity. When you change the source of the water or how it’s treated, this changes the way the water reacts with the pipes—that’s what we learned from the D.C. water crisis.”

  The D.C. water crisis? I didn’t think I’d heard of that. The music began again, worse and even louder. Elin and I tucked into a deeper corner of my kitchen. “Whether corrosion is a problem or not depends on what the pipes and plumbing are made of,” Elin went on. “In Flint, the service lines, the pipes that run from the street into people’s homes, are made of lead. And the plumbing inside people’s homes has lead too.”

  “Wait a second,” I said. “Are you saying—”

  Elin nodded. “If Miguel’s right that Flint is not using corrosion control, that means there’s lead in Flint’s water.”

  “Lead in the water?”

  Elin waited a few moments while I processed the news, then began nodding slowly. “And based on Miguel’s memo,” she went on, “the lead levels in the Flint water are really, really high. He suspects that MDEQ isn’t testing correctly. That’s why he leaked the memo.”

  “Are you kidding me?” I shook my head. “Why would anybody at the EPA need to leak their own memo?”

  Elin cocked her head and just stared at me, deadpan. She was waiting for me to catch up.

  “Okay,” I said, moving on. “So how could the testing not be done right?”

  “MDEQ is probably testing for the results they want, which will underestimate the amount of lead in the drinking water. The loopholes in the Lead and Copper Rule allow for that. The utilities do it all the time—trying to game the regulations and manipulate the data to minimize the amount of lead collected in a sample. I don’t trust them.”

  I am not naïve. I was only twelve when I saw photographs of children who had been poisoned by Saddam Hussein, when he gassed the Kurdish town of Halabja and murdered thousands of his own people. I had nightmares for weeks. I learned then what governments were capable of.

  But here in Michigan?

  It was one of those moments when part of your brain whispers, Please, can we go back to five seconds ago, before we knew this?

  If what Elin was saying was true, it meant my kids, my Flint kids, who were already struggling with so much adversity, were in even greater danger than I’d imagined.

  I know lead. All pediatricians know lead. It’s a powerful, well-studied neurotoxin that disrupts brain development. There is truly no safe level.

  What about my imagined government scientists with their white lab coats and test tubes? What had happened to them? They were supposed to make sure our water was safe.

  So far only one lone bureaucrat seemed to be doing the right thing and he had to leak the information to get it out. But if Miguel Del Toral was right, an entire city was being lied to. And the liars were the very people we trusted to keep us safe.

  I thought about all the complaints about water in Flint over the past year—the state had answered them with a parade of assurances. Just five months before, because of general water-quality issues and an outcry from residents, the Flint City Council had voted to return to Detroit water, but Governor Snyder’s appointed emergency manager described that decision as “incomprehensible” and rejected it as too costly.

  How could money be more important than clean water? Or the safety of our kids?

  And just a month ago, the mayor himself had gone on live TV, filled another glass with Flint water for the cameras, smiled, and drunk it.

  * * *

  —

  I DON’T KNOW IF I’d ever felt so stunned and disillusioned and sad all at once. What had I done? Where had I been?

  Baby after baby had come into our clinic. We gave the same advice. It’s fine. Yes, it’s fine. Drink the water. Of course it’s okay. Flint has low breastfeeding rates for a number of reasons. Powdered formula is the norm. To make formula from the powder, you have to mix it with tap water. Meanwhile, for older kids, because of our emphasis on healthy living and lowering sugar in their diets, we are always recommending fewer juices and soda. And more water.

  It’s fine. Drink the water. Of course it’s okay.

  When my pediatric residents came to me with questions from patients, I said the same thing, just as I had been taught: Tap water is the best and safest.

  I drink it. The coffee I mainlined all day was made with it.

  Flint water.

  Lead.

  I thought of Reeva and her sweet baby sister, Nakala, who had started the shift to powdered formula the week before. How many days had passed? Four or five days of tap water with lead.

  Little Nakala wouldn’t feel any different. The poisoning would be quiet. Lead exposure is known as a silent epidemic because there are no immediate signs o
f it. But once it was in her bloodstream, the lead would enter her red blood cells and wreak havoc, interfering with the mitochondria, the part of the cell where energy is produced. It would go on to disrupt the formation of the dendrites, disturb the myelin sheath that surrounds nerve fibers, and interrupt the way hemoglobin carries oxygen through Nakala’s body.

  It would settle in her soft tissue and her bones, where it would crowd out calcium. Some heavy metals—iron, copper, zinc, selenium—have health benefits in small amounts. But not lead. It does only harm.

  Nakala’s central nervous system would receive the worst impact from the lead, primarily in her still-developing brain. A significant amount of lead exposure can cause swelling of the brain, headaches, lethargy, anemia, dizziness, muscular paralysis, sleeplessness, loss of appetite, and abdominal pain. It can affect vision and hearing, and in extreme cases, it can cause kidney failure, coma, and death.

  Even at lower, single-digit levels, the damage is irreversible. For an infant like Nakala or a two-year-old like Reeva, enough exposure can mean developmental delays, cognitive impairment—literally, a drop in IQ—as well as memory issues, attention and mood disorders, and aggressive behavior.

  Brain scans show that lead exposure in children causes an erosion of gray matter that makes it harder to pay attention, regulate emotions, and control impulses. It also affects the white matter of a child’s brain, which acts as a conduit for signals within the central nervous system. As lead-poisoned kids reach their teens, they have a much harder time in school and are more likely to drop out. As they reach their twenties, research suggests, they may be more likely to commit violent crime. Lead is even suspected to have an epigenetic or multigenerational impact by changing a child’s DNA. It’s really science-fiction comic-book stuff, like the X-Men, except the victims aren’t getting superpowers. Their powers are being taken away.