What the Eyes Don’t See: A Story of Crisis, Resistance, and Hope in an American City

Dr. Mona had high expectations for how the meeting with Mayor Walling would go. She truly believed that, based on the data and the fact that he was born and raised in Flint, he would issue a health advisory to Flint residents. Both the Flint city manager and the public works department head attended the meeting, along with several of Dr. Mona’s coalition members, including Jenny, Dr. Reynolds, Kirk, and Senator Ananich. Mona started her presentation “with someone human and real” (224): a photograph of a young girl named Makayla. Makayla was not a real patient, but she was based on a composite of Mona’s patients. She outlined the potential behavioral and health implications of lead exposure to the young girl, as well as the costs to the city, county, state, and federal governments. She then dove into their own research, which found elevated blood-lead levels in Flint children post-water switch; a finding which was contrary to every national and state trend which showed blood-lead levels decreasing for children.

After her presentation, the mayor asked a few questions, and defended the city, state, and federal government. He blamed the old pipes in Flint residents’ homes and said there was no corrosion issue with the Flint water. In fact, he believed the point was moot since Flint residents knew to flush their water. To Mona, this statement was absurd. As a pediatrician with an environmental health background, she did not even know to flush water after prolonged periods of no-use. Plus, with the highest water bills in the country, Flint residents were not going to waste water by flushing. Mona spoke of the need to declare a public health emergency, obtaining bottle water or premixed formula for Flint babies, and switching the water back to Detroit. According to the Flint city manager, the latter point was impossible.

Dr. Mona gave the mayor an ultimatum. If he did not make the public announcement about the lead in Flint’s water, Dr. Mona and her team would. The deadline passed without an announcement from the mayor.

The Hurley press team announced a press conference the day after the mayor’s office refused to cooperate regarding lead in Flint’s water. Behind the scenes, Mona and her team were ensuring that they had “built a coalition of support” (240). For example, Edwards gave his EPA friends, including Del Toral, and trusted media contacts a heads-up that Mona’s team had found support in the blood data for lead in Flint’s water. He also invited Walters and other citizen scientists in Flint to attend the press conference.

Despite having checked the data analysis multiple times, the situation reminded Dr. Mona of an Arabic word that she knows well but deplores: Aeb. It means “shame” but is much broader—akin to the dishonor you bring upon your family and community when you behave poorly or stray from the norm. The idea pushed her harder to make sure her results were not wrong because “the most colossal aeb of all” (242) would be to embarrass and shame her family, colleagues, Hurley, and the pediatric profession, and to let Flint residents down even more. To Mona, what gave her the strength to stand up to the city, county, and state governments was a combination of her family’s story of loss and displacement, knowing that she stood on the shoulders of giants who for centuries fought to make the world a better place, and the fact that she was a mom and cared deeply about all children. 

Governor Snyder’s office heard about Dr. Mona’s press conference. Dr. Mona notes that “they went nuts” (250), demanding to see the data. The new interim dean for Michigan State University’s medical school, Aron Sousa, also called Mona that morning to tell her that no one from the university would be attending the press conference. Sousa said that, while the university supports her as a faculty member, they cannot support her research on blood-lead levels in Flint kids. Mona was confused and disturbed by the proclamation. MSU was a land-grant institution, and the medical school is the nation’s pioneer in community-based medical education. To Mona, it was both her and the medical school’s job to advocate for the kids. Sousa’s initial response might be tied to Mona not simply sticking within the parameters of being a pediatric residency director. Instead, she was standing up for what she believed was right and entering the advocacy space. Mona also wonders if part of the pushback was due to money—the state government allocates nearly $300 million to MSU each year.

At the news conference, Dr. Mona, while sharing the research findings, kept to the story of Makayla. But she knew the human aspect, while critical, was not enough. To really open the audiences’ eyes, she held up a baby bottle filled with water from Flint, reiterating that, “This is what our babies are drinking, for their first year of life. Lead-tainted water during the period of most critical brain development” (256). She went on to list a number of recommendations for Flint, including telling residents to stop drinking tap water, providing lead-clearing filters, encouraging mothers to breastfeed, and switching the water source back. The truth was finally out for the Flint water crisis, but Mona’s battle with government officials was not over.

City and state officials immediately disputed and discredited Dr. Mona’s findings after the press conference. One of MDEQ’s spokesmen in a follow-up press conference insinuated that Mona “was an unfortunate researcher” (260). The state health agency said that Mona’s findings were due to seasonality, not realizing (or perhaps ignoring) that Jenny and Mona had controlled for seasonality in the research study. They also said her results were not consistent with the state’s data, accusing her of splicing and dicing the data to get the results she wanted. Splicing and dicing is the worst thing to say about a study, because it meant that the researcher “was knowingly lying” (261). Mona felt defeated and knew that the state would not revisit its own data. Rather, the onus would once again be on the public health official to prove lead was causing serious harm to children. The local media also referred to Mona as a “local pediatrician” (264), which added to Mona’s feelings of helplessness and quackery. 

Strength and certainty replaced Dr. Mona’s despair. To her, this “war of numbers and data” (265) was not about her own career, but it was about Flint’s children. Mona decided to fight back against the city and state’s counterattack. As part of this counterattack, the state released a PDF that contained total numbers of children in Flint zip codes with elevated lead levels by month for the past few years. This PDF was not comparable to Mona’s study, something which she emailed her team and The Flint Journal reporters about. The state PDF only showed monthly counts and not the raw numbers, used a much larger age range (up to 16), and looked at first-time lead levels only for patients with multiple lead levels.

Dr. Mona came up with a way to prove the state wrong and improve her own study at the same time. They could use geographic information systems (GIS) software to pinpoint more specifically the neighborhoods receiving only Flint water and compare these neighborhoods with the blood data. If the blood-lead levels of children in these neighborhoods were still testing high, then Mona’s findings were even more conclusive. The more precise mapping technique supported Mona’s findings. A statistician from the Detroit Free Press also did their own analysis of the state’s data release and found that it supported Dr. Mona’s findings, too. The newspaper then ran a hard-hitting editorial that went after Governor Snyder directly and his refusal to acknowledge that the water switch had poisoned Flint kids.

Mona began working with the hardest hit neighborhoods to help them deal with the lead crisis. The city-wide lead exposure was an additional toxic stress on a community already facing numerous toxic stresses. There were known interventions that pediatricians could recommend to mitigate the impacts of the toxic stress, but they required additional resources. To be sure that the Flint kids stood a chance of living healthier lives, Mona and her team compiled a list of demands (e.g., school health, nutrition, transportation services, and early literacy programs), something she learned from the Flint sit-down strikers and other advocacy organizers.