What the Eyes Don't See: A Story of Crisis, Resistance, and Hope in an American City (One World Essentials)

by Mona Hanna-Attisha

we were warmed by the kindness of Upper Peninsula Michiganders—who cheerfully called themselves “Yoopers”—and the tight-knit international graduate student community.

A country can endure trauma and neglect and become a place where people are cared for, where democracy and equality and opportunity are once again encouraged and advanced. Where poverty is silenced instead of people. Where we nurture one another and create stable and safe environments for all children to grow up. This is where healing begins.

A baby who is properly fed and loved and kept healthy, and surrounded by people and communities that value and protect her, has the best chance of becoming a healthy adult. This is what drew me to pediatrics—we pediatricians are at the pivotal intersection of clinical care and prevention. Every aspect of my job—from immunizations to emphasizing the importance of bike helmets—is not just about ensuring kids are healthy today. It’s about tomorrow, next year, and twenty years from now. We see life at its beginning, when it can be shaped for good.

As Frederick Douglass said, “It’s easier to build strong children than to repair broken men.”

There’s an expression I have always liked, a D. H. Lawrence distillation: The eyes don’t see what the mind doesn’t know.

A kid born in Flint will live fifteen years less than a kid born in a neighboring suburb. Fifteen years less. Imagine what fifteen years of life means. In a country riven by inequalities, Flint might be the place where the divide is most striking.

I give my Community Pediatrics residents this Bertolt Brecht poem from 1938, “A Worker’s Speech to a Doctor,” which lays out the stakes better than I ever could: When we’re sick, we hear You are the one who will heal us. When we come to you Our rags are torn off And you tap around our naked bodies. As to the cause of our sickness A glance at our rags would Tell you more. It is the same cause that wears out Our bodies and our clothes.

Resilience isn’t something you have or don’t have. It’s learned. While the stress hormone response in a child overloads the child’s system, it can reset to normal if she is soothed by caring adults in a nurturing, stable environment and community. The brain can heal.

I can’t assume all our residents know the history of racial injustice in this country, let alone the historic racism in medicine. So the curriculum includes webinars on race and health and a discussion of the story of Henrietta Lacks. (Everyone in medicine knows HeLa cells, but many of them don’t know about their namesake, a woman whose life vividly illustrates medical racism and its consequences.)

We discuss the Tuskegee syphilis experiment, the infamous clinical trial that the U.S. Public Health Service conducted on six hundred African-American men between 1932 and 1972. Tuskegee participants were told that they were getting free healthcare for life, but in reality they were enrolling in a study of the natural progression of untreated syphilis. Even after the discovery and widespread use of penicillin, which cures syphilis, this inhumane experiment continued. The men—who were selected because they were poor sharecroppers with little education or recourse to the law—were still not treated.

Untreated syphilis is gruesome, causing lasting damage to the body, with symptoms including nasty lesions and eye damage, as well as nervous system and cardiovascular breakdown.

Flint has been through so much—after decades of downward spiraling, it has become beleaguered and almost bankrupt. But the spirit of the community never collapsed.

He taught me to treat everybody well, because we are all equal, no matter what we look like, what we believe in, or how much money we have. To always do the right thing, even if it’s hard. Even if people tell you it’s impossible. And maybe that’s even better than going to church.”

“In the little world in which children have their existence,” he wrote in Great Expectations (1861), “there is nothing so finely perceived and so finely felt, as injustice. It may be only small injustice that the child can be exposed to; but the child is small, and its world is small.” The feelings of children are as vulnerable as their health.

“The law knows no finer hour than when it cuts through formal concepts and transitory emotions to protect unpopular citizens against discrimination and persecution.” On behalf of another group of “unpopular citizens,” he referred to the internment of Japanese Americans during World War II as the “legalization of racism” in his dissenting opinion in Korematsu v. United States. The first justice to ever use the word racism in a Supreme Court opinion, he went on to employ it seven more times before it disappeared from court opinions for two decades.

The eyes don’t see what the mind doesn’t know.

“Because this isn’t about what happens to you if you do something. This is about what happens—or doesn’t happen—if you don’t do something.”

The power of money can’t be underestimated, ever. As Karl Marx said, “It transforms fidelity into infidelity, love into hate, hate into love, virtue into vice, vice into virtue, servant into master, master into servant, idiocy into intelligence, and intelligence into idiocy.” Or as the Bible says more succinctly, the love of money is the root of all evil.

I took Liam’s baby bottle out of my bag. I walked out into the hallway, to a small bathroom across from my office. I filled the bottle with Flint water. It looked okay, pretty clear. But that wasn’t the point. The point was what our eyes couldn’t see.