The title of Dr. Mona Hanna-Attisha’s book, What the Eyes Don’t See, is a significant one: the phrase appears several times in the text, and it may refer to a number of events that occur in the story. On a basic level, the people of Flint were being poisoned by lead in their water. Lead particles are not visible to the eye, a point which Dr. Hanna-Attisha raised during a press conference in which she explained why lead in drinking water is so dangerous. In fact, she illustrated this by putting lead-filled water inside a baby bottle. However, a larger point is that often people do not see toxicity as it is happening. Although people were being poisoned, the poisoning was slow, almost imperceptible. In this case, the eyes could not see the poison, the act of poisoning, or the effects of the poison until it was far too late.

However, toxicity in this book does not refer only to poison in water. The term “toxic stress” appears several times within the text, referring to social inequity and constant adversity. Lead in the water is a literal toxic manifestation of a more metaphorical toxic environment for the people of Flint. Dr. Hanna-Attisha teaches medical students how to be effective doctors; much of this entails training them to see what the eyes often do not, such the effects that an adverse environment can have on one’s mental, emotional, and physical well-being. Thus part of her curriculum entails having her medical students go out and discover the community in which they practice. Toxic stress, just like toxic water, is easy to discount because it is so difficult to pinpoint. The direct causes can be imperceptible, and it is not until long-term exposure that any evidence of toxicity can be seen. She encourages her medical students to see beyond their eyes, just as she encourages her readers to do the same.

As a result of this philosophy, there are points in the book that may initially seem like they do not belong. Although the primary narrative, that of the Flint water crisis, is linear, it is often broken by asides and historical information that does not necessarily progress the story. Chapter 9, for instance, gives a detailed history of General Motors, labor unions, and Flint’s economy. Chapter 16, is a genealogical account of the author’s family dating back to the 1500s, as well as an introduction to a distant relative who was an Iraqi activist in the early 1900s. On the surface, these chapters have little to do with the Flint water crisis; however, they offer readers insight into the workings of the author’s mind and the ways in which Dr. Hanna-Attisha strives to see that which the eyes do not. The history of Flint, for instance, provides insight into why so many Flint residents are from diverse populations and why they live below the poverty line. It demonstrates that the water crisis and the government’s initial dismissal of any kind of problem are historically situated, not just one-off happenings. On the other hand, Dr. Hanna-Attisha’s family history provides insight into her own motivations and why she would be willing to become so deeply and emotionally involved in the water crisis to begin with. At one point in the story, she suggests, activism might not be a conscious choice, but something written into her DNA.

Tied to this idea of activism is the idea of hope, which is a major theme in the book. The prologue explicitly acknowledges that while there are many dark aspects to this story, especially governmental ignorance and...