Chapters 7–9 Summary and Analysis
Chapter 7
Dr. Hanna-Attisha explains that she entered the field of health because of her humanitarian interest as well as her passion for science. Providing history on public health, she explains that the government has only been involved in people’s health for the past few centuries, as nations industrialized. One of her favorite historical figures is John Snow, the founding father of public health. He was one of the first doctors to suggest that communicable diseases, especially cholera, might be spread through drinking water, not miasma (bad air), although he was doubted at the time. He created a map of cholera victims that predicted where they had received their water and was thus able to prove his theory. In this way, Dr. Hanna-Attisha asserts, Snow was “speaking science to power.” In her own family history, she has a similar figure, a distant cousin named Paul Shekwana, who was a bacteriologist in the early 1900s. He was instrumental in reducing the spread of typhoid fever and convincing medical professionals to wash their hands. He was later found dead below a railway trestle, and it was never fully understood how he died.
After her meeting with the health official, Dr. Hanna-Attisha sent an email to him and his supervisors in the county health department, raising the issue of Flint’s water. While texting Elin, she also learned that Marc Edwards, the biophysicist and whistleblower during the DC water crisis, had come to Flint to investigate and was reporting high levels of lead in residents’ drinking water. However, the Mississippi Department of Environmental Quality (MDEQ) had dismissed his claims. Elin feared that the issue would worsen before it improved, just as it did in DC; she was also concerned that even though Edwards was an expert in water corrosion, his involvement as an inflammatory figure might make it more difficult for some to believe the findings.
For the rest of the day, Dr. Hanna-Attisha had pediatric appointments. She saw a child that appeared to be developing symptoms of ADHD (a disorder that can be associated with lead poisoning), a child that had switched from soda to water, and a child that experienced bad eczema after bathing. She ordered blood-lead tests for these children and later advised a new mother to use bottled water to make baby formula. As her day progressed, she felt that every case she saw was water-related. She began to ask other doctors and residents if they were seeing elevated lead levels in blood tests, which they affirmed. She began to think about how she needed a way to test a larger population to begin making generalizable claims about the water and these elevated blood-lead levels. Before her day ended, she learned that when Flint had switched their water source, the GM plant had received a waiver to switch back to Lake Huron because the Flint water was corroding their automotive parts. She ends the chapter by cursing the MDEQ spokesperson, Brad Wurfel, for telling residents of Flint to “relax” about their water.
Chapter 8
During the last week of August, Dr. Hanna-Attisha learned that her husband’s arm was not healing properly and that he might need another surgery. Her mother and father were both traveling, meaning she must spend more time with her daughters. By the last day of August, she was still waiting on a response from the health officials that she had seen several days earlier. As this was the beginning of a work week, she was convinced that she would hear back, but the day went without a response. That night, she told her husband about the...
(This entire section contains 1666 words.)
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water in Flint. As a pediatrician, he understood the gravity of the situation and encouraged her to keep fighting.
The next day, she emailed Elin, asking if Elin knew the date that the Flint water switch happened. Dr. Hanna-Attisha believed that she could compare blood-lead levels from before and after the switch; however, she would need access to this data. She decided to email the county health department again, but two days went by without a response. She asked for advice from Dean Sienko, or “Dean Dean,” one of her mentors, a public health advocate, major general, and associate dean of public health at Michigan State University. Later that day, she received an email from the county health department which suggested they might be able to start a research study six months in the future. Frustrated, Dr. Hanna-Attisha reached out to Michael Roebuck, an ER doctor at Hurley, to see if he could help her access blood-lead data from their clinic. However, even he did not respond to her. Labor Day weekend came, but Dr. Hanna-Attisha was distracted for the entire holiday.
When she checked her email after the weekend, Dr. Roebuck had responded to her; he was able to find her the blood-lead data she needed. She then asked the director of research, Kay Taylor, to help her sort the data. Additionally, she called another expert in lead poisoning, Karen Lishinski, about data from all of Michigan. Dr. Lishinksi confirmed that there had been a blood-lead spike over the summer. Dr. Lishinksi also promised to send her the data. Dr. Hanna-Attisha tried to distract herself by answering emails and waited in vain for the data to come in. When Dr. Lishinski did not send it, Dr. Hanna-Attisha sent a third email to the county health department and copied Dean Dean on it. He was the only one to respond and said that the only lead poisoning he was aware of had come from paints. She realized that she was going to have difficulty convincing anyone to care about this issue and sent an email to Dr. Lishinski asking again for the Michigan blood-lead data.
Chapter 9
Dr. Hanna-Attisha reflects on the first time she visited Flint, on a trip to AutoWorld, a car-themed amusement park. The park, which was built in 1984, was an attempt to draw more visitors and help provide employment in Flint. However, the rickety park failed to attract customers, and it eventually closed. She also remembers the Michael Moore film Roger and Me, which details the closing of the GM plants in Detroit and Flint and briefly addresses AutoWorld. Since the film, Flint had been an example of how deindustrialization can gut a city. But Dr. Hanna-Attisha returned to do her medical work there, believing that the people of Flint represented hope.
She then explains that GM began in Flint in the early 1880s as a carriage business. Over the course of fifty years, GM grew to a series of massive manufacturing plants, and it began manufacturing tanks and bombers during World War II. Many Black people left the South to find jobs in the Michigan plants, and by the 1950s, GM was a thriving, diverse business. However, housing and neighborhoods were segregated, and racist practices prevented Black residents from attaining high-paying jobs or living in anything but rental properties. In the 1960s, Flint became a site of civil rights protests. Dr. Hanna-Attisha makes sure that her residency students know this history, especially the bargaining agreements and strikes that occurred in the 1930s. Employees for GM would go to work and sit, halting production. Eventually, the strikers won and were paid a fairer wage, allowing a middle class to emerge in Flint. Such strikes would not have been possible without the Michigan governor at the time, Frank Murphy. Murphy was a progressive thinker who supported strikers and would eventually go on to be the first Supreme Court justice to use the word “racism.”
Dr. Hanna-Attisha also describes how housing developed in Flint. With the formation of a new middle class in the 1950s, suburbia was able to flourish, and shortly thereafter, equal housing laws were put into place. Still, as a result of this, real estate agents were able to convince white homeowners that property values were dropping. These agents would buy white properties under their value and then sell them to poor Black buyers for much more than they had paid. Slowly, property values did, in fact, decrease, and those who were more affluent began moving farther and farther outside of Flint. While all of this was occurring, the US was attempting to desegregate schools; however, Flint was unable to reach full desegregation as a result of intense violence. By the 1980s, many of the companies that supported the economy of Flint, such as GM, had closed and moved. By the time of the water crisis in Flint, the city was run by a Republican mayor, Rick Snyder, who had decimated the police force and was selling Flint’s resources.
Analysis
The importance of history occupies a large portion of chapters 7–9. For instance, in chapter 7, Dr. Hanna-Attisha uses history to show that doing what is right is not without consequences. Her story of her own cousin, Paul Shekwana, shows how dangerous being a public health advocate can be. Shekwana died under mysterious circumstances—possibly suicide, but as the author implies, he may have also been killed because he had “caused too much trouble with all his bad news about germs.”
Chapter 9 encompasses an entire history of progressivist movements in Flint, including the formation of labor unions, successful strikes, and fair and equal housing. However, despite this progress, many racist strategies were still in place afterward in order to exploit Black residents and prevent them from attaining equality. These strategies, the author suggests, had a longstanding effect on Flint, leading to the racial and economic disparities that persist today. History, she seems to suggest, has a profound effect on everything that we do, whether it is a personal history, as in the case of Dr. Hanna-Attisha, or a more social history, such as that of Flint. She states that “places are more complicated and nuanced than a sentence or one explanation can offer . . . no single bad decision or unfortunate event created modern Flint.” It is, instead, the city’s entire complex history that has created its modern-day manifestation.
