What the Eyes Don't See

by Mona Hanna-Attisha

  Both WASA and the EPA knew, and did nothing.

  In January 2004 The Washington Post published its first story, reporting on the elevated water-lead levels uncovered by Edwards. At this point, not even the D.C. mayor and council members had been told. In response, WASA issued a health advisory to pregnant women and young children in homes with lead service lines—but high water-lead levels were later found in homes with copper service lines too.

  As Edwards testified to Congress in March 2004, the corrosive water was leaching lead not just from the old lead service lines outside homes but from brass fixtures inside homes as well. It turned out that brass fixtures, even when marketed as “lead-free” by the manufacturer, could still contain an average of 8 percent lead. That wouldn’t change until a new regulation took effect in 2014.

  As the evidence became public and overwhelming, EPA and WASA administrators hunkered down, more interested in self-preservation than in public health. These agencies were joined by the CDC, which cooked up its own corrupt study and issued a statement in March 2004 that there was no evidence any child had been harmed by the elevated lead amounts.

  To make matters worse, D.C. didn’t want to pay to replace entire lead pipes, so it recommended the “partial” replacement of lead service lines. But in a partial replacement, the disruption of lead scale in pipes caused even more elevated lead levels in the water.

  Marc Edwards, now stripped of funding and discredited by the utility and two government agencies, continued his research independently by working with homeowners directly and mortgaging his house to pay for it. Ultimately, his work and science were irrefutable. In 2008 he was awarded a MacArthur “Genius Grant” for his research. The following year he published a report on the D.C. crisis in Environmental Science and Technology, which tied the elevated water-lead levels to raised blood-lead levels in children. It garnered every piece of scientific acclaim under the sun.

  What he discovered confirmed his worst fears. As many as 42,000 children in D.C. had been in the womb or under two years of age when they were exposed to harmful amounts of lead in drinking water from 2000 to 2004. The effects were irreversible—and almost impossible to prove.

  No proof, no blame. As Elin had told me, the wrongdoers in the D.C. crisis escaped conviction or consequences. Many were even promoted. There were investigations and lawsuits but none were conclusive. Proving that lead had had harmful and lasting effects on specific children in D.C. was harder than proving that tobacco causes cancer. Without such a smoking gun, the wrongdoing could go unchecked. And it did. Nobody went to jail. Nobody even lost their job.

  Meanwhile, the public health community continued to believe the CDC mantra: that lead in the water could not harm kids. The CDC carried a lot of credibility. Everybody knew what eating lead paint chips did to kids, but without ironclad studies to disprove the CDC’s assurances about lead in water, the misperception continued. And the CDC, now invested in a cover-up, did nothing to reverse its claims until it had to. In 2010 a congressional investigation found that the federal agency had made “scientifically indefensible” claims that the lead levels in D.C. were not harmful—and had knowingly used flawed data. The CDC issued a statement the next day acknowledging errors, and made a correction.

  And what about the children? What about the ones who received the full impact of the lead crisis—younger children, whose brains were the most vulnerable? How are they doing? Based on what we know about how lead affects developing brains, we can make some assumptions. Some may have experienced inexplicable developmental delays, behavioral problems, low test scores, and blunted potential. Some today may have neurological effects, cognitive impairments, and maybe even higher aggression and tendencies toward violence. Adults across the District may be experiencing an elevated risk for memory loss, early dementia, hypertension, gout, and retinal hemorrhages.

  But these things were never investigated.

  * * *

  —

  AROUND TWO IN THE MORNING, I put down my iPad, trying to process it all. I couldn’t remember when I’d stayed up so late. But I was confused and reeling from what I’d read. Why wasn’t the D.C. crisis better known? It was a public health tragedy—the kind that government regulations are meant to protect us from—that occurred right under the noses of our most powerful institutions. Why hadn’t it changed everything?

  The next day, in a serendipitous twist of fate, I had a meeting scheduled with the Genesee County Health Department, initiated by none other than the health department employee who was in charge of lead in the county. He had been awarded a grant—or the county had—to provide cleaning supplies to any family with a young child who was tested and shown to have elevated lead levels in their blood. They had designed prescription pads with information about lead abatement and cleaning supplies that we were supposed to distribute to affected families. We were meeting to figure out how to implement the program and coordinate work between the health department and the clinic.

  Wild luck, right? The county expert on lead, even if he did restaurant inspections half the time, had to know something about children’s lead levels. Whether the source was paint or drinking water, it shouldn’t make a difference, right? And he’d have advice for me. For all I knew, the entire problem could be solved in a day. One meeting, one word with the right official—sometimes that’s all it takes. Maybe this guy could push the right button and make all the lead disappear.

  I picked up my tablet again and sent an email out to the three residents from my Community Pediatrics rotation who would join me at the county health department meeting later that morning. It is my habit to take residents with me to county or city meetings, since advocacy is best seen up close and in action. I sent them the articles and links Elin had shared with me and asked them to please read them before the meeting.

  Then I started to write an email to my resident Allison. Just a week before, we’d seen little Nakala together. I kept thinking about how I’d told Nakala’s mom that the tap water was okay.

  Water. It is the most essential substance on earth. Seventy-five percent of our bodies is made up of water, and an even bigger percentage of a baby’s body. It helps maintain body temperature and blood volume. It removes waste from the body, lubricates joints, and protects tissues. For babies on powdered formula, water is pretty much everything they consume, at a time when their brains are developing the most.

  I wanted to get a case of bottled water to Nakala’s mom. Even better, we needed to issue a statement to all our patients, to all the kids. Was it too early in the morning for that? As I drifted off to sleep, I composed memos and texts and emails in my mind, a relentless parade of words and warnings.

  But I needed to stay calm. I needed to be strategic and careful. I needed to know more. The way to win this fight would be to keep a cool head.

  I KNEW AS SOON AS I WOKE up that my mom was downstairs. The sweet smell of breakfast had reached the second floor. She had arrived before dawn, while we were sleeping, and was already in the kitchen, making crepes, beating up eggs, flour, butter, and milk, then pouring the batter onto the electric crepe maker. One by one, she produced the thinnest, most delicate pancakes, Nina’s and Layla’s favorite breakfast. My mom expressed her love in many ways, but as with most Arabic moms, love began with food.

  Across the room, Elliott was asleep in the reclining chair, the ice machine still humming away. On the bed next to me was my iPad, where I’d tossed it, in a fit of disgust and fatigue, around two in the morning. I felt a twist in my stomach when I looked at it. I showered, dressed quickly, pulled my hair back into a bun, and went downstairs, eager to get to work. My meeting with the guy from the health department was first thing, at 8:30 A.M. That was all I could think about.

  My mom greeted me in Arabic, “Sabah al-kheir, habebtee.”

  Her voice was, as always, delicate and bright. We hugged, as always, even if we have just seen each ot
her an hour before, even if I am just coming back from the grocery store. When we talk on the phone, which is often two to three times a day, it feels like we hug first. She is shorter than I am, tiny, barely five feet tall, topped by awesome choppy white hair that beautifully contrasts with her tan brown skin.

  “Sabah al-noor, Mama.”

  She was drinking Iraqi chai, a superstrong and supersweet concoction that’s brewed with loose black tea leaves and sometimes cardamom pods, then doused with an insane amount of sugar, enough to form a crystalline layer at the bottom of the clear glass cup. Over the years, my parents cut the sugar, but they never cut back on drinking chai. They brewed it every morning in a ceramic pot insulated with a handmade tea cozy and put on an electric warmer, where it sat for the day. As with most Iraqis, chai was an obsession with them, consumed at all hours, even on the most blistering summer days. As kids, Mark and I drank chai wa haleeb, a warm and creamy brew with lots of milk, the taste of which takes me immediately back to childhood. It wasn’t until Mark got to law school, and I got to medical school, that we moved on to the higher amounts of caffeine that modern life seems to require. As comforting as the smell was, today was not a chai day.

  As I sleepily made myself a strong dark coffee, my mom lifted a steaming crepe from her crepe maker and began making another. Even in retirement, she was unstoppable in many ways—still knitting a new sweater every month, reading a couple of novels a week in Arabic or English, celebrating each holiday and birthday with special cakes and delicious dishes that she made better and faster every year. In our first years in America, when Mark and I were little and she was so lonely and homesick, she would make sudden appearances in my school classroom, her English still rough and uncertain, carrying large platters of sweets and baklava that dwarfed her body.

  Once we left the Upper Peninsula, after my dad finished his postdoc and was hired by GM, she changed. She was quicker to laugh. Her warmth and positive energy made it easy for her to make friends. My parents rented a tiny apartment in Royal Oak, a suburb of Detroit, and began building a new life, joining the vast Arab community all over Metro Detroit. In a year they had enough money, some loaned by a cousin—because they couldn’t get a real mortgage—to buy a small one-story brick house from a Palestinian friend on Mark Orr Road, where the cookie-cutter houses were set close to one another. That’s where we lived for the next fifteen years, where Mark and I spent our childhoods. On summer days we rode our bikes to Memorial Park and to Ray’s Ice Cream, a shop right out of the 1950s, where the line snaked out the door and down the sidewalk.

  Education was the religion of our family, embraced as a way to a better life but also to a richer, more intellectually alive existence. Doing schoolwork and getting good grades were expected by my Arab tiger mom. But in addition to what we learned in school, my parents urged us to read and learn independently about geography, history, literature, international affairs, and current events.

  * * *

  —

  WE PAID A PRICE for our new American lives, in ways that were often unexpected and painful. In Royal Oak, there were only a handful of other minority kids in our schools. Mark and I, while growing up there, rarely talked or obsessed about being called “camel jockeys” and other ethnic slurs. Though these incidents were infrequent, they did seem to coincide with U.S. military actions against Arab countries, usually Iraq, that kids were hearing about in the news.

  I’m sure my parents had no idea, before they settled in Royal Oak, about the working-class suburb’s dark history as a base of operations for Monsignor Charles Coughlin, usually shortened to Father Coughlin, and his angry, hate-spewing, anti-Semitic radio program, broadcast on Sunday afternoons throughout the 1930s—first on WJR, then nationally on CBS. At the time, with tens of millions of weekly listeners, he was one of the most influential voices in America.

  Coughlin promoted the racism and nationalism of Hitler and Mussolini, offering weekly installments of The Protocols of the Elders of Zion, the forged document that became the ur-text of anti-Semites. His newspaper, ironically named Social Justice, evangelized for America First–ism, a rudderless economic populism mixed with isolationism. After the outbreak of World War II, FDR’s administration declared his hate-filled broadcast “enemy propaganda” and created new broadcasting restrictions specifically to force him off the air.

  You would think my history classes in Royal Oak might have bothered to teach this. They didn’t. Instead, the working-class vanilla suburb of Royal Oak that Mark and I knew was universally called “Royal Joke.” It was a mecca for angsty punk teenagers with red Mohawks who hung out downtown near the Noir Leather fetish store, where I bought my first pair of Doc Martens. It was where indie coffee shops and grunge first arrived in Metro Detroit.

  Years later I learned that the pretty Catholic church on Woodward Avenue, National Shrine of the Little Flower Basilica, had served as Father Coughlin’s headquarters. And I was stunned to discover that the large post office in downtown Royal Oak—where our family mail was sorted, and where I dealt with bulk mailings for the political campaigns of John Freeman and my high school friend Dave Woodward—had been built to process the crazy amounts of fan letters Coughlin received. According to historian Alan Brinkley, in 1934 Coughlin received more than ten thousand pieces of mail a day.

  We don’t think enough about what lies beneath the veneer of the places where we grew up, as if childhood innocence lingers inside us, filtering out anything too complicated or too dark to consider. We step over complex systems every day, walking through history and pretending the darkness isn’t there. But the older I get, the more I want to really understand the world I’m in and how it came to be. I learned that from my parents—to dig deeper and not be afraid of what I might find.

  * * *

  —

  AIRMAIL LETTERS ARRIVED FROM overseas for my mom, their thin, see-through envelopes striped with blue and red slashes, the words par avion on the front. Inside, the blue-lined, extremely narrow paper was crammed with lots of writing in a little space. Sometimes Mark and I came home from school and noticed one of these letters open on the counter and were immediately filled with dread.

  As excited as my mom was to receive them, the letters often contained bad news, things happening six thousand miles away that she couldn’t do anything about. A letter might tell her that her brother or brother-in-law was being deployed to the front during the Iran-Iraq war, a senseless and drawn-out conflict that killed more than one million people between 1980 and 1988. Or she’d learn that a favorite uncle was dying. I would arrive home thinking about homework or a weekend party with friends from SEA, and the next thing I knew, I was hearing about cousins dealing with air raids and food shortages, or about an old family friend who had disappeared. My mom would read and reread these letters, sometimes for hours, crying. There was still homemade food in the kitchen, ready for us. But her mind had traveled elsewhere.

  Things were easier in the spring, when she was consumed by our garden, planting roses in the front and growing a large vegetable garden in the back—eggplant, peppers, tarouza, or Iraqi cucumbers, and so many tomatoes that by the end of August, she harvested enough to can for the winter, so our maraka always had the best flavor. Along the side of our house, near our bedroom windows, she planted honeysuckle, white and yellow buds that blossomed in the spring and filled our rooms with the smells she remembered from home. The number of plants and containers and smells in our garden seemed to multiply each year, forming a lush jungle that grew all summer until my mom moved the plants back inside for the long Michigan winter, when our dining room became a greenhouse. The plants grew as high as the ceiling and drove my father crazy. My mother slowly re-created elements of her distant home in ours. But the legacy she aimed to create wasn’t just in the physical space we lived in.

  MY MOM AND ME IN FRONT OF OUR CHILDHOOD HOME IN ROYAL OAK

  After five or six years
at his job, my dad was promoted to the highest research position, “technical fellow,” at the GM Tech Center in Warren, a space-age building designed by architect Eero Saarinen. GM’s informal 1960s slogan—“what’s good for General Motors is good for America”—was becoming a little outdated, but not in our house. What was good for GM was certainly good for our family. The company was still a vibrant innovation machine, much like Bell Labs, IBM, and Kodak used to be, and gave my dad the freedom that a creative scientist and inventor can usually only dream about, along with financial stability, a pension, and health benefits. In return, he designed and developed new metal tools and parts, alloys and applications—acquiring forty-three patents in his name. In time, though, he would watch the greatest international manufacturing company in the world slowly fall apart.

  Eventually my mom returned to college to validate her chemistry degree from Baghdad University, getting a master’s in chemistry and a teaching certificate at the same time. She discovered that ESL (English as a Second Language) teachers were in demand all over the state, and before long she had a job as a “parapro,” or paraprofessional, similar to a teacher’s aide, at our high school. (Mark and I joked that she worked there to spy on us.)

  Once certified, she thrived as an ESL teacher, tapping into her own experiences as a reluctant immigrant. She worked for years helping young students, mostly from Japan and the Middle East, including refugees from war-torn Iraq. Along with teaching them English and getting them through their textbooks and coursework, she helped them acclimate to their new lives, explaining American customs like school musicals, homecoming dances, and the prom.