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

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

Dr. Mona is horrified when she initially finds out that there is lead in Flint’s drinking water and government officials are doing nothing about this issue. Decades of research demonstrated that lead adversely affects behavior and cognition. There are truly no safe levels, especially for children. As soon as Del Toral’s report confirmed lead in Flint’s water, government officials should have been doing everything in their power to help Flint residents and switch their water source.

“Even today,’ I went on, ‘kids and grandkids of Hajis’ employees reach out to us, totally out of the blue, to tell their Haji stories, and they always mention his generosity. So their gratitude is passed down through stories and extends to us, even to you, Haji’s great granddaughters. Because Haji’s actions in life, and things he believed in, left a mark on us all—even though we can’t see it.” 

Dr. Mona attributes her passion for activism to her family’s rich history of standing up to injustices. One of the strongest familial influences on Dr. Mona is her grandfather Haji. Haji taught Mona to treat everybody well because all humans are equal. It is this principle that partially drives Mona to help her Flint kids.

“His conclusion: the pipes serving the Walters home were leaching lead. MDEQ was using faulty testing procedures. And Flint wasn’t using corrosion control. He included the blood-lead levels of the four Walters children as evidence of impact, and he predicted that Flint could be facing an epic water crisis. He recommended that the EPA offer the city and MDEQ technical assistance.” 

This passage is from Miguel Del Toral’s report, and it is one of the earliest pieces of evidence that Dr. Mona presents that illustrates government officials showed gross indifference to Flint residents. Rather than the EPA launching further investigations into the Flint water, they discredited Del Toral. The director of the office where Del Toral works ultimately resigned in January 2016 after a scathing report by the agency’s inspector general found that the EPA should have acted much sooner on the Flint water crisis. This prompted Representative Kildee to put together a bipartisan bill that requires the EPA to notify communities if they find lead in their water.

“Everyone in government knew about this inequity—in fact, it was the legislature’s choice to set up the system like that—but the unfair situation was passively accepted with a ‘well, life isn’t fair’ shrug. And the state government’s cuts to local revenue sharing made things much worse.” 

One of the most shocking parts of her story is the discussion around how funding for public health is allocated in Michigan. Wealthier communities amass more funding because they have a greater tax base in contrast to less-wealthy communities. As Dr. Mona points out, this should be the opposite. Communities with fewer resources should be given great help from the government. Rather than fixing this issue though, government officials passively accept it, which further perpetuates the inequities seen in wealthier and poorer communities, such as Flint. 

“Urban poverty is less lethal now, but in some respects, nothing has really changed.” 

During Charles Dickens’ time, an average member of the working poor died at the age of 16. Urban poverty is perhaps less lethal today, but low-income and minority communities living in cities still face far greater challenges than their wealthier and non-minority peers. For example, a child born in Flint will live 15 years less than a child born in the surrounding suburbs. 

“All I cared or thought about was getting somebody to pay attention. But so many days had come and gone, I suspected that it wasn’t just laziness or distraction. I was starting to wonder if they were purposefully not getting back to me.” 

This point is one that Dr. Mona returns to throughout the book: city and state officials were turning a blind eye to the Flint water crisis. In earlier chapters, Mona details her attempts to get in contact with the county and state health departments to access a larger dataset of children. Despite sending numerous emails and even talking to officials on the phone, she did not get the dataset she needed until much later in the book after she had exposed the crisis.

“It was in Flint that the middle class, and some would say the American Dream, was truly born.” 

In the early to mid-20th century, Flint was a booming city. Part of what drove the city’s prosperity was Flint automobile workers’ willingness to strike against GM. This strike went on to influence the wages, the benefits, and the working conditions of working people throughout the US for decades to come. 

“His battles with the EPA, the CDC, WASA, and the D.C. government were notorious in water circles and had sparked continuing investigations, hearings, and court cases. It had been a long and painful decade fighting governments and water utilities to root out lead from their water, an uphill battle that had left Edwards, according to things Elin had heard, emotionally and psychologically damaged.” 

One of the key figures in this story is Marc Edwards. His experiences fighting for the people of DC took a huge toll on him. Unlike the Flint water crisis, he and other researchers were never able to get the blood data to prove that lead in water had poisoned children. As such, the crisis never truly resolved itself, and some water officials were even promoted. Dr. Mona and Elin are initially worried about bringing Edwards into their coalition because they had heard he was combative with authorities. Ultimately, they go to lunch and become allies in the fight for Flint’s kids. 

“Before industrialization, children rarely had lead in their bodies. It was due only to industrial greed and convenience that it was mined and released into the environment. Even the ancient Romans suspected it was dangerous, even deadly, but we in the modern age allowed it—we looked the other way and let convenience drive policy.” 

Kettering and GM are largely responsible for releasing lead into the environment and American bodies. In their quest to make more money, they invented leaded gasoline. Despite knowing that TEL was extremely dangerous, they convinced the government that anti-lead activists should have to prove this harm before they discontinued its use. Unable to do this, leaded gasoline poisoned American soil and bodies for decades. 

“The health departments were blatantly covering up, stalling, or inefficient and slow to respond, or they truly didn’t care. It could be laziness or, worse, an indifference to poor black and brown people. They didn’t hear the sirens I was hearing, while I couldn’t get them out of my head.” 

Dr. Mona repeats this concern several times throughout the books: the fact that Flint kids were primarily African American and poor was the reason government officials were not being more proactive about the Flint water crisis. Unfortunately, there is evidence that supports this concern. Email exchanges between state officials showed clear indifference towards the residents of Flint. One official even went so far as to say that they shouldn’t pour resources into the community.

“So that was it: we were back in the Bizarro World of the Kehoe rule, where we had to prove there was danger and harm before anything could be done. The onus was on us.” 

Dr. Mona and her colleagues tried to get ready-to-feed formula from the USDA to give to Flint mothers. Despite stating that babies might be drinking contaminated water, the USDA could not provide waivers unless there was a health advisory or emergency. Kehoe’s rule strikes again. Mona and her colleagues will have to prove the children are being harmed first, rather than agencies taken precautions to mitigate any possible harm.

“The more I learned, the more I saw how wrongheaded the public health approach to lead was. It was ass backward. When we test a child for lead, we are testing the child’s environment. Children become the proverbial canaries in the coal mine, as we use their bodies, their lives, as instruments to test the world around them. If they test high, that means there’s lead in the environment. This is useful to know, but for the child, it’s already too late.” 

Coal miners used canaries as an early-warning signal for toxic gases, primarily carbon monoxide, in coal mines. If the canaries died, then the miners knew that dangerous gases had collected where they were working, and they needed to leave. Children and lead testing are like canaries in the coal mine because scientists must use their bodies to test the environment around them. Like the canary, if there is lead in the environment, it is too late for the child. The current public health approach should instead be focusing on preventing lead in the child’s environment than testing to see if it is there already.

“There was no way I could walk around Flint, watching kids grow into adolescents and then adults, and wonder if their problems were related to a poison that I hadn’t done enough about.”

Mona knows once she goes public with her study, she will face immediate backlash from the city, county, and state officials. However, she makes clear that the Flint water crisis was not about her career or reputation. From an early age, her family has emphasized that she and her brother must not turn a blind eye to injustices; they should take a stand. As a result, Mona knows that, no matter what, she will fight for Flint’s children.

“He fought for something bigger than a country or a religion, a tribe or an ethnic group. He fought for all people, for humanity, with a hope that there was another way to live.” 

This passage is about Dr. Mona’s great-uncle Nuri Rufail Koutani, who fought back against British colonialism and fascism. His story, along with those of other family members, illustrated to Dr. Mona that people cannot allow great injustices to dull them into passiveness. To make the world a better place, we all need to remain sharp and be willing to take a stand. 

“He was copping out already. Okay, maybe there is lead in the water, he was saying, but it isn’t the city’s, the state’s, or the feds’ responsibility—or mine. It’s the people’s fault.” 

This passage refers to Dr. Mona’s meeting with Mayor Walling. Dr. Mona had hoped that by showing Mayor Walling her study’s results that he would be willing to stand with them and issue a health advisory to alert Flint residents to stop drinking the water. Unfortunately, he does not react any differently than other officials she had approached. He doesn’t put the onus on the city and state for lead in the water, even though it is their fault with the water switch. Instead, he blames Flint residents and their old water pipes. 

“All of me was in the fight now.” 

Chapter 18 is one of the few instances where Dr. Mona admits that she is worried about shaming her family, profession, and community if her study is somehow wrong. Rather than letting this sense of shame consume her, it pushes her to make sure that her study is robust. Mona knows that her data will change the conversation around the Flint water crisis, so she must continue to fight. 

“I took Liam’s baby bottle out of my bag. I walked out into the hallway, to a small bathroom across from my office. I filled the bottle with Flint water. It looked okay, pretty clear. But that wasn’t the point. The point was what our eyes couldn’t see.” 

Mona borrowed a baby bottle to use as a prop during her press conference. She held it up to the attendees before diving into the stats to show that, while the water might look fine, it was truly unsafe. In so doing, she presents a powerful image for how what the eyes can’t see deceives us into thinking that a situation might be safe when it is not. 

“Local pediatrician. It was true. That’s what I was. But every time I read those words, I felt smaller and smaller, like a clueless quack, a know-nothing.” 

Initially, the backlash hurts Mona, especially because many of the attacks are personal. However, after a few hours of sleep, she remembers that this fight is not about her or her reputation, but it is about Flint kids.

“We were in a numbers war. But the numbers were kids—real kids.”

Since the water source switched, government officials have not been seeing the water crisis as one that affects people. Instead, they have been more concerned about its effect on the city’s budget. Mona reiterates to the reader and to herself in this passage that this battle is truly about Flint kids, which should take precedent over money.

“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 denial 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.”

Mona and her colleagues are surprised by how fast the state starts to come around on their findings. Eden Wells is partially responsible for this shorter fight. Despite Wells’s boss sending out an email that asked his subordinates to prove Mona wrong, Wells expressed much more caution. She was willing to rerun the numbers and admit that the state’s findings matched Mona’s.

“At the EPA, when asked about using federal money to buy water filters for city residents, the Region 5 Water Division chief, Debbie Baltazar, wrote to the regional administrators and others, ‘I’m not so sure Flint is the community we want to go out on a limb for.’” 

This passage is truly heartbreaking. Mona mentioned a few times in the book that she thought the government officials’ indifference to Flint residents might be tied to Flint being a poor, Black community. This email, along with others, provides some support for Mona’s concern. 

“Flint falls right into the American narrative of cheapening black life. White America may not have seen the common thread between Flint history and these tragedies, but black America saw it immediately. That the blood of African-American children was unnecessarily and callously laced with lead speaks in the same rhythm as the Black Lives Matter, a movement also born from the blood of innocent African Americans.”

Flint is one of the most egregious modern-day examples of environmental injustice. The water crisis happened in Flint partly because it was a primarily low-income, African American community. As several others note in the book, this water crisis would not have happened if it took place in a wealthier, white community. The structural racism that afflicts all aspects of American society also fueled the modern-day lead poisoning of children. 

“The state wouldn’t stop lying until somebody came along to prove that real harm was being done to kids. Then the house of cards fell.” 

Mona emphasizes that she was not the most important piece of the Flint puzzle. She just happened to be the last piece with the blood-lead data that authorities could not ignore. As such, they were finally able to prove to city and state officials that lead in water ended up in children’s blood. Thus, lead exposure from water was a serious public health crisis.