Summary: Chapters 6–8

In Chapter 6, Hanna-Attisha tells how her family moved from Michigan’s Upper Peninsula to Royal Oak when her father got hired by General Motors. Life was better there, and the children were able to get a good education, important to an Iraqi family. However, there were still occasional ethnic slurs. They were unaware that Royal Oak had a racist past, and the school didn’t teach them that.

Still, they had a good childhood, including both Iraqi and American traditions. Her father advanced at his job and was fortunate not to be fired when others were, and her mother returned to college to get a master’s degree and a teaching certificate. Hanna-Attisha says the family had “left a country that was . . . oppressing its own people for . . . [one] that allowed us to thrive.” The American dream, stemming from an elected government, worked for her family the way it didn’t for her kids in Flint.

Her mother, whom the kids call Bebe, has retired now and helps take care of Hanna-Attisha’s kids. Her father, whom the kids call Jidu, never stopped working, but eventually, after surviving many rounds of layoffs at GM, he retired a few months before the book takes place.

Hanna-Attisha’s mother asks about the barbecue she and her husband hosted in Chapter 2. Hanna-Attisha doesn’t tell her anything about the Flint water because she doesn’t want her to worry.

At the meeting with the Genesee County health officer, “the guy” (Hanna-Attisha’s term) complains about the lack of funding for issues like lead remediation. He says he is trying to build a better public health program. Hanna-Attisha knows this is difficult because of the inconsistent funding for public health in Michigan. Communities that need more money for other services, such as police, might get less for medical help. This made no sense, Hanna-Attisha argues, since obviously these communities had the greatest need. But that was how it worked since poorer communities have lower property tax revenue. Additionally, because poorer communities have lower tax revenue, they have to pay higher utility bills. Residential water bills in Flint were the highest in the nation.

The county health officer talks about lead abatement in the form of cleaning supplies to get rid of lead paint chips. However, when Hanna-Attisha brings up the high lead in the drinking water, he knows nothing about it. He tells her Public Works deals with water. Hanna-Attisha is confused, as his department collects blood-level data on Flint children. He says they haven’t noticed if the blood levels are high. Hanna-Attisha plans to send an email to his bosses, who will know something and help.

In Chapter 7, Hanna-Attisha says that people are drawn to the public health field for a variety of reasons, whether they are humanitarians, mathematicians, statisticians, or health professionals. Hanna-Attisha sees it as a combination of several factors. She loves to solve a mystery. History has had many great sleuths.

One such sleuth was John Snow (1813–1858), a British doctor who made great strides in preventing cholera when there were several outbreaks during the 19th century. People thought cholera was spread by breathing stagnant air, called the “miasma” theory. Snow suspected it was spread through unsanitary drinking water. The government tried to clean up the air by creating drainage systems for under-house cesspools. But the drainage led straight to the River Thames, London’s main drinking water source. Snow was able to narrow the problem down to a single pump. He told the Board of Guardians of St. James’s Parish, a local political body. They didn’t believe him but removed the pump handle anyway. The outbreak got better. Snow made a map and proved it was the pump.

Hanna-Attisha is impressed that Snow kept working at this, even though he wasn’t hired to do so. He “insinuated himself into the epidemic.” Since he had the tools, “He felt duty-bound to share his work and make a difference . . . and save lives.” This is the purpose of science, to make lives better.

Another person Hanna-Attisha admires is Paul Shekwana (1883–1906), a bacteriologist and a distant cousin who lived in what is now Iraq and was called to Iowa to work on a typhoid outbreak. He wrote an article urging doctors to wash their hands before and after seeing patients, and he wrote others about sanitation, food safety, and drinking water. He died under mysterious circumstances.

After her meeting, Hanna-Attisha understands that mistakes are being made in the name of saving money. She texts with Batanzo and then writes an email to several people in the county health department. Marc Edwards, the expert from DC, comes to Flint after being invited by LeeAnne Walters and Miguel Del Toral to do “citizen testing.” This testing finds alarmingly high lead levels, including one that is 1,000 ppb. Brad Wurfel, the spokesperson for MDEQ, says that Flint water meets the safe drinking water standards.

Hanna-Attisha notes that both DC and Flint are places where the people don’t have political representation. DC doesn’t have a senator or representative in Congress because it isn’t a state. Flint has an unelected emergency manager. Hanna-Attisha says, “Politics is about how we treat one another.” She goes on to say that excluding certain groups from politics isn’t benign. Rather, it’s malignant and intentional. Batanzo worries that, because Edwards is known as a maverick, he may make things difficult.

Hanna-Attisha sees several patients who are experiencing problems like ADHD and eczema. She tries to encourage all of them—and a mother who is switching to formula—to use bottled water. She orders blood-lead level tests. Hanna-Attisha worries that, since different doctors are seeing all the kids of Flint, they might not see the big picture.

Doing some online research, Hanna-Attisha finds an article about GM stopping using Flint water because it corrodes engine parts.

In Chapter 8, Hanna-Attisha doesn’t receive an answer to her email to the county health department. On Tuesday, she talks to Batanzo about the blood-lead screening. Hurley, the clinic where she works, tests all the kids on Medicaid for lead. She can get those results for the period before and after the water source was switched. There is no answer Tuesday.

On Thursday, Hanna-Attisha writes to Dean Sienko. He is a doctor and former military officer who worked for the CDC and is now an assistant dean at Michigan State’s School of Public Health. Hanna-Attisha forwards her unanswered emails to Sienko. She finally gets an answer from the county health department, but it is a non-answer.

Friday, she reaches out to Michael Roebuck, Hurley Clinic’s chief medical information officer, to see if he could get the blood-lead levels from their clinic. He also doesn’t answer.

Hanna-Attisha spends the weekend poring over reports. She sees her own kids and thinks of the children in Flint. Roebuck finally writes back Monday, promising the reports. She decides to contact Karen Lishinski, a nurse from the Michigan Department of Health and Human Services (MDHHS) who had visited the clinic to talk about blood-lead levels. She calls her. Lishinski answers the phone and says they’ve seen a spike. She’ll send the data.

But nothing arrives. Hanna-Attisha sends out another email, copying Dean. Unfortunately, he replies to all, saying that they’ve never heard of a child with high blood-lead levels where water was the cause. It’s always chipping lead paint. This assumption upsets Hanna-Attisha because it shows that he is biased to see only what he is used to seeing. What the eyes don’t see.

Analysis: Chapters 6–8

The paraphrase in the title comes into full focus in this section, as Hanna-Attisha deals with people who don’t, can’t, or won’t see the danger from lead in the water. Part of the reason, especially on the part of people like Dean, who has nothing to gain from covering up the danger, is that they have been trained to believe that lead poisoning only comes from ingesting paint chips. Maybe this is what “the guy” from the county health department thinks too. But it’s also possible that some people aren’t seeing because they don’t want to see the problem. Meanwhile, Batanzo and the others who are familiar with the DC water crisis are more prone to see the truth.

Duty is a powerful theme in this section as Hanna-Attisha tells about scientists who have felt duty-bound to use their knowledge to help people, even when they faced adversity and pushback for doing so. Hanna-Attisha feels a strong sense of duty to her young patients because she stands between them and potential harm. She feels guilty for telling people the water was safe. Similarly, while it might have been easier for John Snow to turn his back on the cholera epidemic when he was criticized for saying it was due to problems with the water, he felt duty-bound to try to make a difference. Marc Edwards, likewise, used his own money from his MacArthur Genius Grant (which is not required to be spent on any specific project) to help fix the bad water in Washington DC. These people all believed that, because they were fortunate to possess the knowledge that others didn’t, they should use that knowledge to help others who are out of the loop and vulnerable.

Other entities can also have a duty to people, even if they don’t recognize it. For example, the county and agencies like MDEQ have an obligation to people because people are relying on them. Hanna-Attisha mentions the high water bills paid by people in Flint. By accepting these people’s money and, also, by essentially isolating them from any other option for their water service, she says the government took on a duty to keep the water safe.