52 pages • 1 hour read
Mona Hanna-AttishaWhat the Eyes Don’t See: A Story of Crisis, Resistance, and Hope in an American City
Nonfiction | Book | Adult | Published in 2018A modern alternative to SparkNotes and CliffsNotes, SuperSummary offers high-quality Study Guides with detailed chapter summaries and analysis of major themes, characters, and more.
Prologue-Chapter 4Chapter Summaries & Analyses
Prologue Summary: “How I Got My Name”
In the opening chapter of What the Eyes Don’t See, Mona Hanna-Attisha (Dr. Mona) bluntly describes what the book is about: “It is the story of a government poisoning its own citizens, and then lying about it” (13). As director of the pediatric residency program at Hurley Medical Center, the public hospital in Flint, Michigan that primarily serves low-income and minority patients and most of the children in the city, Dr. Mona helped uncover gross negligence by city, county, and state officials. Despite knowing that Flint water contained lead, these officials tried to convince parents in Flint that the water was safe to drink. The crisis not only manifested itself in water, but in the bodies of society’s most vulnerable population: children, and especially those from low-income and minority backgrounds. As Dr. Mona notes, no lead exposure is safe, especially for young children.
Dr. Mona also introduces several aspects of her family history that have shaped her passion for activism. Haji, her grandfather, gave Mona her name, which means “hope, wish, or desire” (4). While her parents emigrated to the US, many of their family members, including Haji, stayed in Iraq. As an Iraqi-American, she grew up hearing stories from her parents about the atrocities committed by the Ba’athist regime of Saddam Hussein against the Iraqi people. Under his reign, “Iraq was called a ‘Republic of Fear’” (7). A seemingly innocent comment made to a neighbor or teacher could result in families thrown in jail and tortured. Saddam also used chemical weapons against Iraqi citizens. From a young age, Dr. Mona knew that people in power were capable of great evil.
Chapter 1 Summary: “What the Eyes Don’t See”
Chapter 1 opens with Dr. Mona telling a young mother, Grace, that Flint water is safe for mixing baby formula. Despite Dr. Mona reading local online news stories about Flint residents complaining about their water, she believes the government authorities who continued to say the water was safe.
Flint was once an upscale city with low unemployment rates. However, the closure of the General Motors plant and subsequent white flight to the suburbs eroded the city’s tax base, turning it into an impoverished area. Compared to the rest of Michigan, the median household income is 50% lower, and the poverty rate is double in Flint. A child born in a neighboring suburb will also live 15 years longer than Flint children.
To make matters worse, in 2011, Michigan’s governor, Rick Snyder, suspended the democratically elected mayor, Dayne Walling, and replaced him with a governor-appointed, unelected emergency manager (EM). Governor Snyder was able to do this because of the city’s unbalanced budget. Representative democracy no longer existed in Flint. One of the EMs, as a budget-cutting measure, decided to change the source of Flint’s tap water. The city’s original water source was from the Detroit Water and Sewerage Department (which sourced its water from Lake Huron and the Detroit River), which was safe drinking water, but expensive.
Instead, the EM and members of the governor’s office decided to switch the water source to the polluted Flint River while they built their own pipeline to Lake Huron. Despite the river being an industrial waste dumping ground for decades, the Michigan Department of Environmental Quality (MDEQ) and the federal Environmental Protection Agency (EPA) maintained the Flint River water was safe for drinking. Yet, as soon as the switch happened, residents complained about the smell, color, and taste of the water. Children and adults developed skin conditions due to high levels of chlorine, which was used to treat the water. Government authorities continued to deny there was a problem with the Flint river as the city’s primary water source.
To Mona, immunizations and well-baby care are not enough for the children living in Flint. Treating Flint kids means understanding not just physical ailments, but also the city’s history and the various environmental and community factors they interact with. Both the visible and invisible factors have profound impacts on a child’s health and wellbeing. To help first-year residents better understand the lived experiences of these children, including the adverse childhood experiences (ACEs) or toxic stresses, she directs the rotation called Community Pediatrics at Hurley. The curriculum focuses on the history of racial injustice in the US, particularly in medicine, and the history of Flint. It also includes meetings with community leaders and activists, and first-year residents must attend nonprofit, school, daycare center, and home visits, community events, and court trials and hearings. Dr. Mona’s goals are for the residents to see the spirit of the community (which has never collapsed despite decades of structural racism), feel empathy and solidarity with Flint residents, and to see the city’s deeper potential.
Chapter 2 Summary: “The Barbecue”
Dr. Mona recounts a barbeque that she and her family had with two of her childhood friends and their families: Elin Betanzo, an environmental scientist who spent several unhappy years working for the EPA’s Office of Ground Water and Drinking Water, and Annie Rici, an opera singer in New York. Mona, Annie, and Elin were members of their high school environmental club and were passionate environmental activists. They organized events to raise awareness for local environmental issues, knocked on doors to talk to locals about these issues, and circulated petitions. Their biggest environmental advocacy achievement in high school was helping to prevent the Madison Heights incinerator, which was next to an elementary school, from reopening. The three of them were last together at Mona’s wedding, where Mona accidentally set the altar cloth on fire. At the barbeque, Elin tells Mona that the Flint water is not safe.
Chapter 3 Summary: “The Valedictorian”
Elin, who was valedictorian of her high school graduating class, explains to Dr. Mona the gravity of the Flint water situation. Elin had seen a memo written by Miguel Del Toral, who worked at the EPA’s Chicago office and was a former colleague. Del Toral believed that the city did not use corrosion control when it switched the drinking water sources from the Detroit Water and Sewerage Department to the Flint River. Corrosion control is standard use in US water systems to keep lead and other metals in the water pipes from leaching into the water. Water from the Flint River was more acidic than water from Lake Huron and Detroit River. Without the corrosion control, the water from the Flint River stripped the rust from the pipes, which had served as a protective layer against the lead water pipes, resulting in large amounts of lead from the rust leaching into the water. This means that there are high levels of lead in Flint’s water. A similar scenario had happened in Washington, DC in the early 2000s, something which Dr. Mona did not know about.
Del Toral leaked the memo because he suspected that the MDEQ was incorrectly testing the water to get the results they wanted (i.e., Flint’s water was safe for drinking). Dr. Mona expresses her horror at the situation. Growing up, she saw photos of children from the Kurdish town of Halabja who Saddam Hussein poisoned with a deadly gas. She knew governments were capable of great evil, but she never believed the US government would commit similar acts. Dr. Mona also became concerned for her Flint kids. Because of advice from Flint city officials, she had told mothers that the water was safe.
Lead poisoning is “known as a silent epidemic because there are no immediate signs of it” (41). Lead is more dangerous to children than adults because their growing bodies absorb more lead. This is especially the case for babies on powdered formula, which is many of the Flint babies. Water is all that they consume. Children’s brains and nervous systems are also more sensitive to lead’s damaging effects. Damage from lead exposure, even at low levels, is irreversible. Scientific studies demonstrate that lead exposure can lead to cognitive impairment (drops in IQ), attention and mood disorders, aggressive behavior, and developmental delays.
Researchers and scientists in DC were never able to access children’s health data. Thus, they could not show the direct link between lead exposure from water and increased lead levels in children’s bodies. But Mona might be able to. As head of the pediatric residency program, she has access to children’s blood tests. Elin tells Mona to examine the blood data.
Chapter 4 Summary: “Haji”
In this chapter, Dr. Mona tells her children, Layla and Nina, a bedtime story about their grandfather Haji and why he rarely attended church. Haji and his brothers owned a perfume factory in Iraq, which burnt down. Factory workers encouraged Haji to rebuild the factory. Many even offered him money, despite being poor. The goodness of his friends and employees deeply moved Haji. In contrast, the local Chaldean priests did not offer help, but instead told Haji that the accident was God’s punishment for Haji’s arrogance. From that point forward, Haji rarely attended church.
To Dr. Mona, Haji was a humanist. He believed that people could make the world a better place. He taught Mona two important lessons, both of which she was teaching her children. The first is to treat everyone the same, no matter their background. The second is to always do the right thing, even when it seems impossibly hard.
Prologue-Chapter 4 Analysis
For the first half of the 20th century, Flint—the birthplace of General Motors (GM)—was a flourishing city buoyed by the automobile industry. GM alone drove 90% of the city’s local economy by the middle of the century. Economic prosperity for Flint’s residents came to a screeching halt, as GM moved plants to the suburbs and primarily white families left en masse following these new jobs. Decades of racist housing practices, some by GM, ensured that Flint’s African American families remained in the city. The faltering of the automobile industry starting in the 1970s led the city to have one of the highest unemployment rates in the country. Flint’s population—around 200,000 at the height of its property—has plummeted to 100,000, a majority of whom are African American and over 40% are living below the poverty line.
In 2011, Flint, which had a $25 million deficit, fell under the control of the state of Michigan. Governor Rick Snyder suspended the power of the mayor, replacing this official with an unelected, governor-appointed emergency manager (EM). The purpose of the EM was to try and cut city costs. This led to the tragic decision to switch Flint’s water source from Detroit to the extremely populated Flint River. There were immediate water problems from the start of this switch, and Flint residents tried to raise the alarm that something was wrong. City, county, and state officials ignored their concern and covered up the true magnitude of the problem. It is against this backdrop that Dr. Mona’s story takes place.
Dr. Mona uses a combination of personal stories (including text messages and emails) and cited research to draw the reader into her story. As an Iraqi-American, Dr. Mona grew up knowing that people in power are capable of doing horrendous things to their own citizens. Many American readers might assume that our government, because it is a democracy, was not capable of such acts. Yet, Dr. Mona’s story is about one of the worst acts of environmental injustices in the modern age, where local, county, and state government officials poisoned Flint residents and then covered it up for nearly two years. By weaving family history, her story as a pediatrician in Flint, and statistics, Dr. Mona demands an emotional response from her readers to not only acknowledge the structural racism in the US that contributed to the Flint water crisis, but to also want to be part of changing the country for the better so that everyone has access, including all Flint children, to the American Dream.
These opening chapters hint at one of Dr. Mona’s central arguments in What the Eyes Don’t See is that environmental injustices disproportionately affect minority and low-income communities. Mona spends much of Chapter 1 explaining the challenges that Flint residents, and particularly children, face. These challenges include racism, high unemployment rates, violence, crumbling infrastructure including schools, illiteracy, high infant mortality rates, and lower life spans. She notes that, “Navy SEALs and other special ops medics train in Flint because the city is the country’s best analogue to a remote, war-torn corner of the world” (23). Because of these toxic stressors, Flint children need so much more than routine primary care. Instead they are poisoned by lead. Like Mona, Elin’s revelation that the Flint water is truly unsafe jolts readers.
There is another key theme presented in these early chapters that Dr. Mona will frequently return to later in the book: community coalitions can fight social injustice. Mona begins to lay the groundwork for key members of this coalition. First and foremost are the Flint residents. Despite local and state officials continuing to tell them their water is safe, they continue to fight back because they know this is a lie. One of the residents even invites Miguel Del Toral, an EPA employee, to test their water, which confirms it contains lead. Based on these findings, Elin tells Mona about the water situation, which immediately prompts Mona to get involved. Mona is driven by her deep love for the Flint children, but also by her own family lessons which have instilled in her to always do the right thing even in the face of great adversity.
