What the Eyes Don’t See

What the Eyes Don’t See

by

Mona Hanna-Attisha

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What the Eyes Don’t See: Chapter 1 Summary & Analysis

Summary
Analysis
On August 26th, 2015, Mona dropped her two daughters off at day camp and headed into work at Hurley Medical Center, a public hospital in Flint. As she arrived in her office on the pediatrics floor, she put on her white coat—her “armor.” Reading the news at her desk, she noticed a story about the tap water in Flint—one of many she’d seen lately, but the unsubstantiated stories felt like “white noise” to Mona. Instead, she turned her attention to the busy day ahead and the barbecue she was hosting for some friends that evening.
This passage shows what a typical day looked like for Mona before she found out about the Flint water crisis. Like many other people who lived and worked around Flint, Mona wasn’t fully attuned to the real problems the community was facing. A lot of the news coming out of Flint was “white noise” that she “armor[ed]” herself against. Flint was a community in need, a city that had been left behind—and though Mona was involved with helping its children, she would later realize that she wasn’t putting in the level of investment her patients deserved.
Themes
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Community Values and Collective Duty Theme Icon
As Mona reached for a pen in her coat pocket, she pulled out a colorful scrap of paper—a gift that a young patient, Reeva, had given her the week before while Mona examined Reeva’s infant sister, Nakala, during a checkup. Nakala’s mother, Grace, was a young Black woman who told Mona, during the visit, that she needed to stop breastfeeding so that she could go back to work. Grace was planning on switching to powdered formula mixed with water, and she asked Mona if the tap water in Flint was safe to give to Nakala. Mona assured her that the water was fine.
This passage foreshadows the devastating crisis that was, unknown to Mona, already unfolding throughout Flint. Mona was advising her patients to ignore the “white noise” they’d heard about the quality of their water without taking the time to look into what was really happening on the ground in her community. Later, Mona would throw herself into attaining justice for her patients and neighbors—but at this moment, she had no idea what was truly going on in Flint.
Themes
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Community Values and Collective Duty Theme Icon
Mona knew she wanted to be a doctor from a young age. After earning a degree in environmental health from the University of Michigan, Mona studied medicine at Michigan State University and, during her residency, gravitated toward a pediatrics specialty, charmed by her young patients’ unbelievable resilience. Mona always felt that pediatrics was a chance to set her young patients on a path toward the best possible future. By shaping lives early on, pediatricians play a huge role in defining their patients’ health for the rest of their lives.
Mona might have been ignorant about exactly what was happening with Flint’s water supply—but she was an impassioned, dedicated physician who’d built her practice around making careful, conscious investments in her patients’ futures. Mona believed in the power of preventative care and attention, and she was committed to giving her patients the best head-start in life that she could.
Themes
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Mona decided to become a medical educator rather than a private practitioner so that she could reach her community through Hurley, a public hospital in Flint that serves a largely poor, minority population. At first, Mona was daunted by the prospect of how to attract new medical residents to Flint, when many young residents want to live in big metropolitan areas—but as residency director, Mona quickly built a bustling, diverse program full of doctors committed to the city of Flint and its residents.
Mona worked hard to bring talented, dedicated professionals to Flint. She wanted to make sure that the Flint community was full of people who were really invested in its success and prosperity, and she committed herself to doing everything she could to bring resources and help to her community.
Themes
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As the director of the Community Pediatrics rotation at the hospital, Mona has long taught her students a quotation attributed to D.H. Lawrence: “The eyes don’t see what the mind doesn’t know.” Mona encourages her residents to look at the whole portrait of their patients’ lives. Especially in a place like Flint, where racism, disinvestment, and violence have greatly impacted the community, it’s important to take a holistic approach to treating patients. The life expectancy of children born in Flint is still a full 15 years less than the life expectancies of their peers in neighboring suburbs—and Flint physicians have a responsibility to watch for symptoms of the larger structural problems their patients must contend with. 
In this passage, Mona introduces a quotation that encapsulates the book’s central idea. One can’t see what one isn’t looking for, is essentially what the quotation cited here suggests. So Mona and her team of pediatricians at Hurley didn’t only need to know their stuff as medical professionals—they also needed to know what life in Flint was really like, and how the many social, economic, and environmental problems in Flint stood to affect their young and vulnerable patients. By opening up their minds first, their eyes would help them to see even the most obscure problems and roadblocks.
Themes
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Community Values and Collective Duty Theme Icon
Quotes
The negative environmental factors that affect children in Flint are today known as “adverse childhood experiences” (often abbreviated as ACEs) or “toxic stresses.” During the most formative years of one’s life—the childhood years—these toxic stresses or adverse events can actually alter a child’s brain function and physical development. Many studies have shown that ACEs directly increase children’s chances of developing asthma and directly decrease children’s life expectancies. So, Mona and her fellow physicians must look for the factors in their young patients’ environments that might diminish their health and put them at risk down the line. 
This passage gives some context about just how much is at stake in Mona’s particular line of work—especially for pediatricians in a community like Flint. Flint is a city that has been forgotten and disadvantaged for decades. High crime rates, poverty, and environmental triggers threaten to seriously diminish the futures of all of Flint’s children. By understanding how fragile children are at this stage of life, pediatricians are uniquely primed to help their patients and their parents avoid toxic stresses in a child’s essential formative years.
Themes
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Community Values and Collective Duty Theme Icon
In order to make sure that the residents she trains are sensitive to their patients’ struggles, Mona makes sure they take a crash course in the history of Flint and the history of racism in medicine. She also ensures that they meet with community leaders and activists who are working to make Flint a better, safer place. In spite of the hardships the city has faced, Mona’s residents quickly learn that the spirit of Flint’s community has never buckled.
Even though Flint is a complicated place, it’s a resilient one. Mona says here that she wants to make sure that even as her residents educate themselves about Flint’s complex history and the issues that it faces, they’re also putting their focus on faith, resilience, and long-term plans to help Flint’s children prosper. 
Themes
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Community Values and Collective Duty Theme Icon
In 2011, Michigan governor Rick Snyder declared Flint to be in a state of “local government financial emergency,” as it was near bankruptcy, and he appointed an unelected emergency manager to run the city. This took power away from Dayne Walling, the passionate mayor of Flint. The emergency manager, reporting to the governor, decided to cut Flint’s budget by changing the source of its tap water from safe, pretreated drinking water piped in from the Detroit Water and Sewerage Department—which got its water from clean Lake Huron. Instead, Flint would now source its tap water from the Flint River, formerly a toxic industrial dumping site.
Here, Mona provides some context as to what was happening in Flint at the start of the book’s narrative. Flint was a place no one wanted to invest in—not only that, but state-appointed officials were actually trying to cut Flint’s meager budget even further. By switching the water source to a local one, the government would be saving Flint money. Even though that budget cut stood to put Flint’s citizens in danger, state officials turned a blind eye to the consequences of what a new water source could mean. No one with significant power was looking out for Flint—not even those elected and appointed to do so.
Themes
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Truth vs. Corruption Theme Icon
The Michigan Department of Environmental Quality (MDEQ) and the federal Environmental Protection Agency (EPA) declared the water safe to drink—and people like Mona took them at their word. On April 25th, 2014, Mayor Walling shut off the valve to the Detroit water supply and opened the pipes to the Flint River. Complaints about the quality of the water began rolling in almost immediately. The heavily chlorinated water was irritating people’s mouths and skin. A boil-water order was issued, and the city of Flint soon released an all-clear announcement. But Mona’s high school friend, Elin Betanzo—an environmental scientist who’d previously worked in the EPA’s Office of Ground Water and Drinking Water—was less certain about the safety of Flint’s water.
Even though the officials in charge of determining the quality of Flint’s water insisted it was fine to drink, actual Flint residents knew that something was wrong. But their protests were largely ignored as the government turned to short-term solutions rather than examining the underlying issue with the water. This passage suggests that there has, for a long time, been a pattern of outcry and abandonment in Flint in which residents demand better resources and fairer treatment while those responsible for ensuring their well-being ignore them outright in an abandonment of their duty to the community.
Themes
Racism and Environmental Injustice Theme Icon
Truth vs. Corruption Theme Icon
Community Values and Collective Duty Theme Icon