child’s mother, Grace, who had expressed concern about the tap water when switching from breastfeeding to formula. Dr. Hanna-Attisha had assured her that the tap water was safe.

The author explains that she had always wanted to be a doctor growing up: her parents were both scientists, and she was always skilled in her math classes. In high school, she saw herself as an environmentalist, and this eventually led her to create an environmental health major at the University of Michigan’s School of Natural Resources and Environment. She describes how at home she felt when she was finishing her coursework and discovered pediatrics. While she acknowledges that her husband, Elliot, who is also a pediatrician, seems to be better with children, she still believes that she relates to her younger patients well, and she feels it is her mission to serve and protect them. She also feels that good health starts in childhood, and she tries to instill this attitude into her patients. She also attempts to instill this attitude in her medical students, and she believes that by teaching doctors, she can have a larger impact on medical practice.

In 2011, Dr. Hanna-Attisha became the director of the pediatric residency program at Hurley Medical, a public hospital that largely serves groups from lower socioeconomic brackets. When she took the position, the center was in danger of losing accreditation, but after her guidance, it soon achieved a ten-year accreditation status. She is also in charge of attracting new doctors and residents to the hospital. When residents come, she teaches community pediatrics, a rotation designed to show residents how health can be impacted by environment and community. This is also where she derives the title of her book: by focusing on a bigger picture, the mind can train the eyes to see all of the factors that might lead to health problems. The environment of Flint, Michigan, has many disparities that might not be immediately observable by health professionals, especially related to socioeconomic status, and Dr. Hanna-Attisha believes that her students “need to be trained to see the symptoms of the larger structural problems” that can lead to poor health in patients. Systemic inequities, she claims, are hardest on children, who are still growing and learning, and these can lead to both physical and mental developmental problems. However, with the right environment, brains can heal. Dr. Hanna-Attisha makes sure that her students know all they can about Flint and the effects of poverty and racism on health; they even tour Flint and meet with stakeholders throughout the city. Dr. Hanna-Attisha sees hope in Flint, despite the systemic inequities that plague it, and she loves working there. She hopes, ultimately, to instill these feelings in her students.

Dr. Hanna-Attisha then returns to the subject of tap water in Flint. The city had previously received its water through Detroit, which received its water from Lake Huron. To cut costs, Flint politicians decided to build their own pipe to Lake Huron, but in the meantime, they took water from the Flint River, known to be polluted with toxic runoff. Despite complaints and the fact that a test showed high levels of carcinogens in the water, the city continued to claim that it was cleaning the water and that the water was safe to drink.

Chapter 2

That evening, Dr. Hanna-Attisha returned home to her husband, Elliot, who was grilling chicken for their barbecue party, although his arm was in a sling from a surgery weeks before. Her daughters were also there, and while they had enjoyed their summer camp, they were miffed that they had not gone on vacation for the summer. Her friends Annie and Elin arrived, and they joked about how they had not been together since planning Dr. Hanna-Attisha’s wedding. The wedding had been small compared to those thrown by other Chaldeans (an Iraqi Christian group), and it had gone smoothly until Dr. Hanna-Attisha had knocked over a candle and set the altar cloth on fire. Ultimately, this had not ruined the day, and she looks back fondly on her wedding.

Returning from her wedding-day reverie, she and her friends opened a bottle of wine to celebrate their reunion after nearly ten years. They had saved the wine for a special occasion such as this, but given the wine’s short shelf life, it was undrinkable. As the friends caught up, Elin asked Dr. Hanna-Attisha what she knew about the drinking water. Although Dr. Hanna-Attisha had heard complaints, she believed that it was safe to drink. Elin emphatically told her that it was not.

Chapter 3

As the barbecue progressed, Elin spoke more about the water in Flint. Elin knew a man named Miguel del Toral who worked for the Environmental Protection Agency (EPA) and had recently tested Flint’s water. She explained that Flint used no corrosion control, meaning that the water could corrode the plumbing in people’s homes. In Flint, most of the pipes that took the water to people’s taps were made of lead, and according to her contact, the lead levels in Flint’s water were dangerously high. The reason no one had caught this yet, she suggested, was that local testers were manipulating the data.

Lead is a dangerous neurotoxin that affects brain development. Dr. Hanna-Attisha thought about all of the advice she had given her patients to drink the water in Flint. She thought about Grace, whom she had advised to switch to formula, and the havoc that lead-tainted water might have on the baby’s body: children are especially susceptible to drops in mental function, mood disorders, and problems with memory if they are exposed to lead.

Dr. Hanna-Attisha could no longer focus on the party as she talked to Elin. Elin said that even if they were to try to press this issue, it would likely be years before the government would respond and fix anything. The author and Elin had been members of a high school environmental activist group, and they had always been interested in issues of environmental and social welfare. The author remembered how they had once protested the operation of an incinerator that was close to an elementary school and their efforts to shut the incinerator down. Dr. Hanna-Attisha was inspired to fix the lead issue in Flint, but Elin reminded her of the Washington, DC, water crisis, which took years to resolve and which no one was ultimately held accountable for. There was no proof that the water in DC was affecting those who were drinking it. However, Dr. Hanna-Attisha had access to many Flint children’s blood samples. She thought about how she might leverage her position at Hurley Medical as the party continued around her, and after the guests left, she prepared her children for bed.

Analysis

This set of chapters gives us a sense of Dr. Hanna-Attisha’s character and motivations. Even when we hear about other characters, it is often in contrast to herself. For instance, we learn early on that Dr. Hanna-Attisha’s given name, Mona, means “wish” or “desire,” and she contrasts this to her brother’s name, Muaked, which means “confident.” She also explains that despite the meaning behind her brother’s name, the name was eventually lost as they traveled across the world, becoming the Anglicized name Mark. By retaining her name, the author thus retains a part of her cultural heritage. When she describes her husband, who is also a pediatrician, she compares her ability to work with children to his superior ability. The other character who receives lengthy attention is Elin, who tells Dr. Hanna-Attisha about the water crisis; the author compares her extroverted personality to Elin’s more introverted one. It is also in this chapter that we learn about Dr. Hanna-Attisha’s commitments to social justice, education, and health. She sees these topics as interconnected. Finally, we learn that she is generally optimistic: she sees hope and promise in her patients, and she cannot believe that the American government would knowingly poison its people. These characteristics underscore her commitments and motivations throughout the rest of the story.

Additionally, we see some of the major themes that will arise in the book appearing in the prologue and first three chapters. For instance, we learn that family is important to Dr. Hanna-Attisha, and she introduces the idea of hope when she explains her name. Throughout the book, her family members are always close to her, and she is willing to interrupt the central narrative to tell her readers more about them, as well as to highlight community members (for instance, her patients) whom she regularly works with. We also see that awareness and education are major ideas that appear in the text. These ideas are tied to Dr. Hanna-Attisha’s family, who value education and political activism. They are also values that the author promotes in the book; we see this in her own community-engaged practices when she is teaching her residency students.