Summary: Chapters 21–23

In Chapter 21, Hanna-Attisha wakes up thinking about her kids, her patients. She knows she must plan her next move. She also speaks to her mother, who has seen the press conference. She worries her mother will be ashamed. Instead, Talia says, “You were so brave, mumtaz—excellent!” Hanna-Attisha knows that she and LaChance did their research correctly.

The state releases its own study, which shows all children up to age 16 who had elevated blood-lead levels in Flint over the years. However, it is unsophisticated and unscientific. Hanna-Attisha emails her team to let them know why her data is correct. She also decides to do her study again but only with children whose homes are receiving Flint water.

The media continues to repeat the phrase “splice and dice.” The mayor’s office issues a lead advisory. The Flint school district decides to stop allowing kids to drink the water at school.

Hanna-Attisha speaks to Kristi Tanner, a statistician with the Detroit Free Press. She shares her study with her, and she looks it over with another reporter. They analyze the state’s data release and run a story. The story, which refers to Hanna-Attisha as a “hospital researcher,” states that, prior to the water switch, lead poisoning was going down in Flint. They call it a “brewing health crisis.” The newspaper also runs an editorial, where they say, “It’s hard to understand the resounding yawn . . . from the governor’s office [about] . . . news [that Flint kids] have been . . . poisoned.”

Hanna-Attisha and her team try to come up with ways to get clean water to Flint kids. She worries about their future because they’ve dealt with a lot of toxic stress that will affect them for a long time. She realizes that they need to take other actions to help them too. She and Kirk formalize a list of demands. Thinking of public health advocate Alice Hamilton, Hanna-Attisha plans her next move.

Hanna-Attisha does a battery of interviews: TV, radio, and print. The hospital’s press office is overwhelmed with requests. She tries to impress upon reporters that there is no cure for lead poisoning and that the effects are terrible. Wurfel continues to try to discredit her, calling her hysterical, a word often used to discredit women.

Meanwhile, she continues to think about her demands. Some are for lead abatement, such as filters and bottled water. But she also wants early literacy programs, nutrition, and transportation, which will make the ill effects of lead less bad. They work with local organizations and the United Way to install filters. She hangs on to hope.

In Chapter 22, Eden Wells, the chief medical officer for the state, contacts Hanna-Attisha. Hanna-Attisha remembers meeting her at a vaccine conference, where they discussed the university logos on their white coats. She states that she’s the point person for what she terms the “water controversy” and wants to talk “physician to physician.” She asks questions about Hanna-Attisha’s research. Hanna-Attisha is happy to talk to her and sends her articles, including about how she controlled for summer water spikes.

Hanna-Attisha later finds out that Wells and other employees of the MDHHS have been directed to discredit her research. They are supposed to double down on their assertion that the blood-lead levels are normal. They attacked her research based on seasonality because it was the only argument they had. Hanna-Attisha wonders about Nick Lyon, Wells’s boss at MDHHS, “Didn’t he care about protecting kids? Didn’t he care about science? No . . . [he] only cared about . . . winning.”      

Wells makes the state’s scientists rerun their numbers. She confirms that their numbers now match Hanna-Attisha’s.

Hanna-Attisha attends a press conference the next day. She thanks the protestors for being there. The state announces its plan, and it doesn’t have much to it. The reporters question it. Hanna-Attisha and Kirk meet with state officials and insist that the water must be switched back and that other measures need to be taken in the meantime, such as filters. Hanna-Attisha sees Brad Wurfel, and he apologizes. She confronts him, because she believes in standing up to bullies, saying, “You called me unfortunate . . . You said I was irresponsible.” She thinks that she’s not the one owed the apology; Flint kids are.

The next day, they begin distributing water filters to the public.

In Chapter 23, through public records requests, Hanna-Attisha and her team learn many things. For example, state officials knew they were lying, in many cases, and they had been drinking bottled water since 2015. They had also manipulated the water samples that were tested. Miguel Del Toral had alerted MDEQ and the EPA to the lead levels in LeeAnne’s home in 2015, but they’d dismissed his findings. She found out that there was also an uptick in Legionnaires’ disease, which is caused by waterborne bacteria. She feels that the government’s disdain for Flint people is shocking. She sees a memo, written by a woman at the EPA, Debbie Baltazar, saying, “I’m not so sure Flint is a community we want to go out on a limb for.” Hanna-Attisha believes this is pointed cruelty and racism.

Hanna-Attisha fights to ensure that the water source will be switched back. Filters aren’t enough. More activists get involved, including Jesse Jackson (born 1941) and Michael Moore.

Finally, the governor announces that the water will be switched back to Detroit water. Hanna-Attisha tries to enjoy her victory, but even as it happens, the state employees are implying that the high lead may have something to do with paint and not cleaning enough, victim-blaming.

Hanna-Attisha sends a memo out to her residents, with a quotation from Margaret Mead: “Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has.” She also says, “This [is] an incredible example of our power and credibility as physicians.”

Many politicians visit Flint. The most important to Hanna-Attisha is their senator, Debbie Stabenow (born 1950). They show her around, and she is upset about the lead exposure but also about how disenfranchised Flint residents are. She wants the governor to declare a disaster to get more funding, and she promises to fight for more funding. Hanna-Attisha asks that Flint kids be able to get ready-to-feed formula. Stabenow vows to fight for it.

In October, the water gets switched back.

Analysis: Chapters 21–23

Although they are all minor characters, Hanna-Attisha’s parents and other family play an important role in the story. They have taught her to be an activist and to stand up against injustice. Both Hanna-Attisha and her brother have taken this advice to heart. Although Hanna-Attisha knows her mother is worried about her, wondering why she has to be the one to take a stand, she is gratified to realize that her mother thinks she is, as she says, excellent.

The theme of corruption and injustice pervades this section, as many Michigan public servants line up to discredit Hanna-Attisha’s research even though, as she later founds out, many of them know the water is dangerous. The fact that the government officials were drinking bottled water is similar to GM switching out the water source because it realized it was corroding their engine parts. However, GM wasn’t elected or hired to serve the people of Flint, but the government officials were. They also had to be aware of the cases of Legionnaires’ disease. The disdain of the EPA, an agency specifically meant to protect the environment and staffed by people concerned with such things, would have been even more shocking but for the experience the reader already knew Batanzo had had when she worked there. One wonders what Debbie Baltazar thought she meant when she said, “I’m not so sure Flint is a community we want to go out on a limb for,” other than that they were poor, Black people. This is environmental racism at its worst.

Many people involved with the Flint crisis did face later consequences, either legally or in their careers. Eden Wells was charged with involuntary manslaughter in connection with the Legionnaires’ disease deaths caused by Flint water. Other officials were also charged, including the governor, who was charged with willful neglect of duty. Howard Croft resigned from his position and was charged criminally. Others, including the state, were targeted in a civil class action suit by Flint residents. The governor was also charged criminally.