THIS WEEK: >> When your plan falls apart >> Command and control >> What might have happened
FLYING LESSONS uses recent mishap reports to consider what might have contributed to accidents, so you can make better decisions if you face similar circumstances. In most cases design characteristics of a specific airplane have little direct bearing on the possible causes of aircraft accidents—but knowing how your airplane’s systems respond can make the difference in your success as the scenario unfolds. So apply these FLYING LESSONS to the specific airplane you fly. Verify all technical information before applying it to your aircraft or operation, with manufacturers’ data and recommendations taking precedence. You are pilot in command and are ultimately responsible for the decisions you make.
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This week’s LESSONS
When it All Falls Apart
I didn’t fly into Oshkosh this year—or more correctly, I flew commercially to Chicago and drove the rest of the way up—but I’ve heard a lot about how it went for those who did. The weather was LIFR (“low IFR,” ceilings below 500 feet or visibility less than one mile) in forest fire smoke most of the time from Friday before the event into the first day of AirVenture on Monday. The visibility improved to marginal VFR (ceiling 1000 to 3000 feet and/or visibility 3 to 5 statute miles) midday Saturday and Sunday afternoon, and when that happened the floodgates opened…that is, the massive movement of aircraft down the AirVenture Notices to Airmen (NOTAM) corridor leading up to Fisk and the pattern into Wittman Regional Airport (KOSH).
Standard separation on the NOTAM arrival is one-half mile in trail. But in the reduced visibility of smoke the NOTAM broadcast directed pilots to remain two miles in trail while otherwise following the procedure. This cut arrival capacity by 75% and the “conga line” quickly stretched more than 50 miles back to the farthest published entry point. Still, the chaos was containable if everyone followed the procedure.
That was apparently a big “if.” Numerous reports both from those in the air and others listening on the ground state there appears to have been a huge uptick in noncompliance with the procedure this year as compared to years past. Some airplanes were flying too fast. Others were flying too slow. Instead of using the currently designated arrival point pilots were flying direct to intermediate waypoints in the procedure or even just parallelling the arrival corridor, looking for a gap and squeezing in (thus violating the as-amended two miles in trail directive). Ground-based controllers were commanding aircraft with inadequate spacing at the final fix to go all the way back to the beginning, a 100-mile round trip before making it back to Fisk. Pilots were reportedly yelling and even swearing at each other on the arrival frequency that was NOTAM’d to be “listen only” for pilots unless safety demanded.
From all accounts it was a mess. Still, as far as I know there were only three incidents on the procedure: one pilot declared an emergency after electrical failure in an all-electric (including electronic ignition) Experimental aircraft. The pilot of a Luscombe landed straight in on Runway 9 causing traffic correctly landing on Runway 27 to go around. I overheard one pilot describing how he entered a rain shaft that reduced inflight visibility to zero in the already smoky sky as he neared Oshkosh.
The vast majority of inbound pilots, of course, did their very best to follow the procedure correctly. That brings me to this week’s LESSON: what might you do if, despite your very best efforts, some outside influence makes your plans fall apart?
The first and most obvious thing is to fly the airplane. If you have an autopilot and have mastered its operation, use it—you may need the devote mental bandwidth and/or physical manipulation of aircraft systems to meet the demands of the situation. Start by using basic modes: heading and altitude hold, nothing fancy if it’s not already programmed in because the deeper you get into autopilot operation the more likely you’ll mis-program it under the stress of the event. If you don’t have an autopilot simply hold wings and pitch level and trim off the pressures. All this assumes you don’t have to take evasive action, but if you must then focus on the evasive maneuver, collision avoidance and obstacle/terrain clearance until that threat has passed.
Perhaps less obvious but just as critical: maintain command of your aircraft. Ask passengers for help as needed. If you’re participating in Air Traffic Control tell controllers what you are going to do and what you need from them to make that happen. But don’t delegate decision-making to anyone else…you are pilot-in-command, and you need to remain in command. As my friends in the Cirrus community say, “loss of control of an aircraft is always preceded by loss of command of that aircraft.” I believe them.
Anticipate the threats inherent in the operations—the possibility of rain obscured in smoke, for example—and have a pre-planned way out in case that happens. Further, anticipate that other pilots may not fly by the rules, watch closely for them, and exercise an escape option if the need applies. I’ve written before about how I clear airspace when flying a visual traffic pattern, including looking for aircraft on a “backward base” (left traffic when right is prescribed, for example) and aircraft and vehicles near runway hold short lines that may scoot out onto the runway as I’m coming in. Anticipation and vigilance are even more critical when a whole lot of airplanes are trying to get to the same destination at the same time.
Don’t fixate on the primary goal. In this case that was arriving at Oshkosh on your first attempt down the NOTAM procedure. Inbound toward Fisk, for example, almost all traffic would be along the corridor or coming at it from the south. The population is much smaller north of the route, and far fewer airplanes would be there. As a rule of thumb, then, most exit strategies while inbound on the procedure might best begin with “turn left,” to the north, into typically less occupied air unless some known condition (weather, the odd other aircraft) prevented it. “Divert early, divert often” should be top of mind as you fly into a mass gathering like AirVenture…or any time your plans fall apart.
Way back in college I wrote, I recall, an essay the gist of which was “we know we can still trust in the goodness of humanity when we follow the rules at a four-way stop.” Much more recently I took a coworker on her first flight in a light airplane. When she asked about a control tower at the nontowered airport I likened flying into an airport without a control tower to a four-way stop: we know the rules and expect everyone to follow them, but we have to watch others closely too. The AirVenture arrival is a four-way stop that’s been exposed to growth hormones and radioactivity. There are rules, but everyone bears watching.
As far as I’ve seen and heard no one was hurt during the NOTAM approach this year. That’s something of a miracle. A reportedly record number of airplanes did safely arrive, with almost no incidents…better than most years. I commend the pilots who followed the NOTAM and arrived safely. I implore those who deviated from the plan to do better next time, or to stop flying in if they can’t (or won’t).
The LESSON of Oshkosh applies everywhere, anytime. Fly predictably, maintain command and control, and watch out for noncompliance.
Questions? Comments? Supportable opinions? Let us know at [email protected].
Debrief
Readers write about recent LESSONS:
Reader “Captain Bob,” who does not use his name but is, I believe an aviation trial attorney, takes me to task (again)…this time for our most recent LESSONS stemming, in part, from the double-fatality midnight crash of a Beech Baron. Bob writes:
Come on Tom. Your other carefully considered comments would pack a much greater punch if you would do some research and connect the dots first: This is one of many sources of the same information. I presume you know how to use this website: https://amsrvs.registry.faa.gov/airmeninquiry/. Daddy was NOT instrument qualified and the kiddo was neither instrument nor multi qualified.
Out of curiosity I had looked up the pilots after the preliminary information came out. But FLYING LESSONS is not here to litigate accidents (of course, by law NTSB investigative results are usually not admissible in court). Instead, I use the accidents people are talking about as the beginning of discussing what might have happened, and what might happen to them under similar circumstances. The objective is to consider possible scenarios the reader may encounter regardless of personal experience and qualifications.
One should never read Mastery of Flight and go away with a simple “I would never do that.” I want people to think of situations where they might make bad choices, so they can pre-make good choices to avoid similar situations.
One LESSON was that even the final results of an NTSB investigation may explain what happened in the moments immediately preceding an accident, but they rarely go into depth on potentially why it may have occurred. Bob quoted what I wrote in that report:
The obvious LESSONS from the preliminary data revolve around night flight, attempted visual flight into areas of instrument meteorological conditions (IMC), and pilot fatigue. The second-level concerns might focus on why the pilot may have decided to attempt the flight, and why he chose to fly VFR instead of on an instrument flight plan under positive Air Traffic control. A tertiary level of LESSONS might explore whether flying IFR would have made much difference.
The “whys” of this particular crash include:
• Why would the pilot have taken off so late at night?
• Why would the pilot have attempted this flight in an area of hazardous weather?
• Why did the pilot not hold an instrument rating?
• Assuming the airplane was insured, why would a company insure a VFR-only pilot in a multiengine airplane (which is far from the norm)?
• As I wrote and was quoted, would filing and flying IFR (if qualified to do so) made any difference in this case?
There are several good online descriptions that go into greater depth to try to explain the cause of this specific accident. I prefer to let the NTSB do that job because there’s frequently information not reported or not available in the months following a crash that are revealed in the final NTSB report. By then discussion of that specific event has largely disappeared from public discussion, in most cases. But if I’m successful the broader LESSONS inspired by initial reports and internet chatter will have already become entrenched in readers’ decision-making.
Am I wrong?
More to say? Let us learn from you, at [email protected].
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