November 16, 2014 1 Comment
January 21, 2014 Leave a comment
Below are links to a number of stories I have written on the topic of risk management. They contain the names and stories of men I knew, errors people made, and an indication of the costs. Note that this isn’t second hand tales, or mystery email names, There were real people I knew, and in some cases loved.
Aviation magazines are full of stories about accidents, but two things are different here. Almost never, does a magazine writer have the task of speaking of a person he knew. This distance doesn’t assure objectivity, it just allows condemnation without consideration. Second, I am one of very few business owners that ever makes comments about accidents. If you want people to blindly buy things, everyone knows you don’t talk about dead people. I know this too, but my goal isn’t just to sell things, it is to share the things that others before me took the time to teach me.
Above, a 2006 photo of our friends Bob and Sarah Bean. I can say without the slightest hesitation they are the finest human beings I ever met in aviation. Most people cherish others attached to them by blood, experience or common thought. I shared none of these with Bob; I loved him solely because he was the human embodiment of “Love thy neighbor.” It has been a number of years, but the loss of Bob and Sarah is still a spear in the heart that makes all other cuts seem small.
If you are new to flying please read this first:
Also, please read and understand this: Comments on aircraft accidents
Below are the titles in color, and a brief segment of each story to indicate the contents. You can click on any color title and read the full original story:
Risk Management, Factor #1, Judgement. “Judgement is the vital element, and without it, the other factors, experience, education and all the rest, don’t add up to any protection.”
Risk Management, Experience vs Judgement. “I want to show people that when I am writing a simple sentence like “two personal friends of mine with more than 25,000 hours each” I am not kidding, and the point I am making isn’t some abstract Flying magazine platitude”
Risk Management – Human factors ” The evidence that fools present for the existence of luck is vague and anticdototal at best. Hard, proven and factual evidence for the existence
of Physics, Gravity and Chemistry can be found at any crash site.”
Risk Management, Wrong airframe, Wrong experience level. “when a guy is new, he makes a critical decision, before he has much experience or good advice to base it on. This choice is which airframe to build.”
Risk Management, Judgement Error, money in the wrong place. “There are many people who are great people who don’t make good decisions around planes. There are also people who are first class A-holes who exercise good judgment. Like it or not, the later live a lot longer.”
Effective Risk Management – 2,903 words “This was the first time I can clearly say I understood the cost of keeping your mouth shut. This was the first step to me becoming the kind of “Bastard” who publicly points out people doing dangerous things.”
“If only someone had told him……” “they chose to ignore the warnings or discount them for reasons that frequently seem hard to remember after the damage is done. It is not the lack of information, but the willful choice to ignore it that is at the root of trouble.”
Expert Witnesses in civil Aviation trials. “The important point that I would like traditional homebuilders to understand and take away is simple. All three of these men wrote books that purport to be grave warnings about terrible flaws in aircraft designs in aviation. I cannot comment on how strongly any of these men felt about these topics, but I will tell you that each of these men aggressively pursued legal positions on these subjects so they could hire
themselves out as industry experts in some very expensive and damaging lawsuits, including the highest one ever paid out in aviation.”
Steel tube fuselages, “Safe” planes and 250mph accidents “Keep factor #1 in mind: Who is flying? I would rather land a fast wooden plane at night with a zip lock bag of 100LL in my lap, a lit Cuban cigar in my teeth and my feet chained to the rudder pedals than take a trip around the pattern on a sunny day in a Stearman with some of the pilots I have met. I am serious. Avoid these people like your life depends on it, because it does. Make it your goal in aviation not to be one of these pilots.”
Greatest Book on Flying Ever Written, (Is your life worth $16?) “GPS, radios, arbitrary boundaries and written tests have nothing to do with
flying. Don’t worry about the test from the FAA: be much more concerned about the one run by Physics, Chemistry and Gravity when you leave the ground as there are much greater consequences to failing theirs. Langewiesche is going to teach you to pass this far less forgiving exam.”
Above, My friend Bruce Smith, a 25,000 hour aviator for whom I had the greatest respect. He was the personification of why we used to hold airline pilots in great esteem. He was a classic Pan Am overseas captain in the Golden Age of jet travel. He was a man who lived life in a way that Teddy Roosevelt would have called strenuous. Bruce raised his children abroad and captained his own sailboat across the Atlantic many times. Eating dinner with him involved immodest drinking and commensurate storytelling. He’d always flown light aircraft. His Navion was the very first airplane I ever worked on as a newly minted A&P.His fun-loving side coexisted with his far more serious morality. His wife was on the Pan Am 103 flight that was blown up by Libyan terrorists over Lockerbie, Scotland. I met Bruce after this when he was living in modest circumstances. He was one of a very small minority of the victims’ families who refused to accept any compensation offered which did not include a Libyan acknowledgement of their involvement. He traveled to Africa and offered his services to anyone willing to do damage to the Libyan regime. He was principle above all else. In recent years, the Libyans admitted their role and denounced terrorism in order to get their assets unfrozen in the U.S. This never would have happened if Bruce and the handful of others had capitulated on their principles.Over the years that I knew him, Bruce spoke little on these subjects. He was far more concerned with getting the most out of the day at hand. But this was all done while living his life according to his code of what was right. The years I knew him were a sterling example of how a principled and resilient man lives. He was truly a pilot in command of his own life.He died in the crash of a certified Swift airplane. He was ferrying a plane only 10 miles. The plane had been sitting outside more than a year. It was not in good condition. The engine failed shortly after take off.
The New York Times obituary for Bruce Smith is worthwhile reading at http://www.nytimes.com/2007/10/01/us/01smith.html
Above our friend Ken Terry, A man of huge influence on Grace’s flying. A pilot of tremendous skill, he had flown more than 40,000 hours. As much as his ability it the cockpit was impressive, it was his human character I respected. He was a hard and principled man who had a difficult time sharing space and conversation with people who chose not to care about, nor get involved in the troubles of their fellow man. He could be gregarious and his friendship came both with great trust and the expectation that you would live up to your side. For people who need others to be “nice”, he was intimidating. If you needed a man with principles who was always willing to fight for them, literally if required, Ken was a person you would have treasured.
January 21, 2014 1 Comment
At the bottom of this story is a commentary I wrote on human factors several years ago. It was prompted by an internet discussion where several builders were proposing complex arrangements for engine controls and questioning the value of the Nason switch we recommend for engines with electric fuel pumps.
The recommendations we make are in accordance with the things I know about human factors in general aviation. My degree from Embry-Riddle is in Professional Aeronautics, which is basically accident investigation. The classes were a broad variety of subjects in aerodynamics, performance, meteorology, statistics, etc., but we spent a lot of time studying human factors. Most people have heard the saying “Guns don’t kill people, people kill people.” If you had seen all the accident reports and investigations we studied, you would understand my variation “Planes don’t crash, people crash planes.”
Any discussion of risk in GA aircraft that excludes human factors, or even how humans react to an equipment failure is not worth having. Yet, most of the conversations about risk management in experimental aircraft all get focused on reliability of the mechanical systems, as if the people in the plane were never a factor in any homebuilt accident. Know this: Most accidents in homebuilt aircraft are caused by people willfully doing things that any objective observer, even a novice one, could pre-identify as poor decision making.
Lets say you are new to home building, or maybe even aviation in general. You are concerned about safety. One of the most unsettling things to you is reading about accidents, or equipment failures that happened to pilots with 20,000 hours or builders with PhD’s in engineering. If experienced people like that have had problems, what possible hope does a green new guy without experience or specific education have?
Actually, the new guy can be at far lower risk. I have said plenty of times that managing risk is about exercising judgment, period. Experience and training are only a defense if they are combined with exercising good judgment. without the latter, Experience and training only allows the person without judgment to push the envelope further or flirt with how much they can get away with.
The is an age old saying that a new pilot starts off with a full bag of luck and an empty bag of experience, and his has to fill the experience bag before he drains the luck bag. Take this story as 100% bullshit entertainment for non-aviators. In reality, every pilot must be trained in judgment (“Decision making”), and then exercise it while flying as PIC within the limits of his skills, as the day, plane and situation present themselves.
Stay away from any person in aviation who actually believes in ‘luck.’ They have abdicated from the responsibility for taking care of their lives. Understand, even though they ‘sent in their resignation letter’, Physics, Gravity and Chemistry don’t accept these resignations, and they still hold him fully responsible. The evidence that fools present for the existence of luck is vague and anticdototal at best. Hard, proven and factual evidence for the existence of Physics, Gravity and Chemistry can be found at any crash site. The new statistics that used to be people didn’t run out of luck. Most of them didn’t run out of experience or training either. Most of them just decided that it ‘would be alright’ if they tried something that was poor judgment.
The most important thing for a new guy to understand is that it is called “Human Factors”, and not called “random chance.” If accidents happened to people at random like the way people win lottery tickets, the only thing for accident investigators to do would be to divide the total hours flown by the number of accidents, and then brief every single pilot that they would face the same rate. The very premise of accident investigation is that they are inherently preventable. They each have their own probable cause, and humans, not luck, almost always played a role. Understand that role, don’t repeat it yourself, fly within your personal envelope, and you are practicing effective risk management. -ww.
Our 601XL on final to arrive at Oshkosh 2004. The airport, city and Lake Winnebago can be seen in the distance in the photo above. The layout of the controls, including the starter button right above the throttle and the A/B ignition switch above the VSI reflect things I know about Human Factors. We set up the 601XL with 2 fuel pumps and 2 ignitions. If the engine had any kind of a hiccup, the procedure is to throw the A/B switch, go full rich and apply carb heat, period. If it is going to get better, that will take care of it. Pilots who thought that lots more switches would allow them to analyze the instruments in a hiccup, decide if it was fuel pressure or ignition related, then select a different switch combination are kidding themselves. The first thing that disappears in an emergency for a 200 hour pilot is his analytical skills. He is far better off with simple procedure and practice.
Above are 13 Nason switches. These are Part No. SM-2C-5F. In our arrangement, this is the switch that automatically turns off the electric fuel pump when the plane is on the primary ignition but it has no oil pressure. In an accident, the pilot does not have to turn the master off, or even be conscious, this part does the job. Yet, I have read many internet Chuck Yeagers say that if they were about to have a forced landing they would always remember to turn the pump/master off. In 25 years of flying I have been the first person at the scene of four crashes, and the master was on in all four. Human factors training tells you this is an important system.
Think human factors applies to just new green pilots? It doesn’t. I have worked on both Mig-15’s and 17’s. Above is the cockpit of a 15. It is not an easy nor forgiving plane to fly, and their pilots had to have significant training just to survive the plane, far less combat. Look at the panel and see the vertical white stripe; When this plane enters a spin, the procedure is to have the pilot jam the stick forward and align it with the offset white stripe. Even professional pilots benefit from the simplification of procedures. People who like to complicate things rarely are willing to acknowledge any possibility that such a design and their own lack of training under pressure is the actual weak link in the system.
(* note that soviet attitude gyro colors are reversed from western ones, a very serious potential human factor issue.)
Below, the 2008 comments:
Touching on human factors in aircraft; It is a big topic in aviation, a sub discipline in which you can get a Ph.D.. In our application it boils down to this: The least reliable part in most well built planes is the pilot. The funny thing about saying this is people who don’t fly are offended or disillusioned to hear this, people who do fly for fun all have a personal memory or two that keeps them from arguing the point, and people who work in aviation know that this is absolutely true.
Before anyone is too offended, let me say that I include myself in the category of least reliable parts. I have been around enough great pilots to know I am not one. Yes, I can fly stick and rudder planes just fine, and can do so without working instruments etc. But three times in the last 12 years I have been in a plane that was not functioning correctly. At this point, most people, myself included, will fall back on their most basic training and procedures. The saying is that “Your skills will not rise to meet the challenge, they will sink to the level of your training and practice.”
If the training was good and the procedures are simple, good. If you have zero experience with being PIC, it is easy to daydream that under pressure you will have all the analysis skills of a B-36 flight engineer, but you won’t, and if you set your plane up in a way that requires multistep procedures and cross checking instruments and decision paths, you will probably even forget to fly the plane.
I know pilots, like Dan Weseman, Gus Warren, Anthony Hanson and our friend ‘Frosty’ who are immune to stress in the air. Most of us are in a different category. Safety lies in honesty, and honesty requires each of us be truthful when evaluating our skills and laying out or planes for the pilots we can train to be rather than the ones people daydream they are.
Having been in a stressful situation, it is very hard, once safely back on terra firma, to continue to believe that you are in the ‘ice water circulatory system club’, if you have just seen your skills shrink under real pressure. I am OK with this revelation, and I use it to my advantage.*(see below)
Because the Corvair started out life as a car engine, a lot of people with a good background in cars feel like they know a lot about how a plane with a Corvair engine should be arranged. Some things do translate, but if I had to name the single facet of aviation that car people fail to understand, it is how little of their troubleshooting and analysis skills will function when the fan stops. For this reason, the layout should be simple, and the emergency procedures well practiced.
*Risk Hierarchy of piloting:
Most Safe: Daydreamer, never finishes, never flies, dies at keyboard choking on potato chip. Not an aviation statistic.
Moderate Risk: OK training, self illusions never challenged
High Risk: OK training, finds way out of a few jams, thinks he is in ice water club, keeps taking more risks. Often incorrectly eulogized as a member of ice water club.
Acceptable Risk: Good training, realistic self evaluation, practices emergency procedures, OK with getting autograph of guy in ice water club.
Very Low Risk: Card carrying member of ice water club.
Before I leave this topic and go back to speaking of Corvair hardware and airframe components, I would like to put down one more story on the subject. As the title indicates, part of this story looks at how Judgement is more important that experience. At the center of this story is Ken Terry, a friend of mine. I wrote the last part of this story 18 months ago. The risk management part of this is tangential. On the surface I bring up Ken’s story because I want to show people that when I am writing a simple sentence like “two personal friends of mine with more than 25,000 hours each” I am not kidding, and the point I am making isn’t some abstract Flying magazine platitude, it is something directly taught to me by a man I knew well. You read about people with 40,000 hours, but do you know one? Was he your instructor? Did he lead a life that Hayden or Hemingway would have understood? Ken Terry was this and more. He was tremendously influential in Grace’s flying, an incredible instructor on many fronts. Although I was angry with him at times, I want to publicly say I was very lucky to have known him.
Most people go through their life with the detachment of a grazing cow. They are insulated in the little cocoon, mesmerized by their smart phone, unaware of humanity around them. If asked to engage, they most often camouflage their insecurity in some feigned cool cynicism, always safely indifferent on every topic. Ken was the anthesis of this, he was 100% alive, and he felt that Everything Mattered, and he was willing to fight for these things at the drop of a hat. If you wanted to live in a cocoon, he was threatening. If you needed to act to save someones life, you would treasure him.
Below the surface, There is a different story that matters to me. Ken is the last member of a trilogy of friends I once had. They did not all know each other, but they are directly connected in my life. It’s about brotherhood, how far you would go for another human in trouble, and what it might cost you, but it isn’t a happy story. They are all dead now.
Ken was the only person with my compulsive need to save Mike; I thought Mike was fate serving me a second chance, possible redemption for failing to save Ben. Deep inside I want to tell you why they were great people, how much richer my life would have been had they lived. But I can’t find the words to make anyone understand that, so all I am left with is a tangential story about risk management and some note typed last year at 3 am, thinking of people who still seem alive.
Looking at the risk management part of the story, you can read the link below to Ken’s accident. Get a good look at the destroyed T-34. Grace flew that plane many times, she did most of her aerobatic training in it. It would be very hard to express to you how skilled a pilot Ken was. He was not a former airline guy with a T-34 for putting around in retirement. He was a master of competitive aerobatics, and I saw him fly a number of planes, T-34, Eagle, Skybolt, J-3, C-152, and many others with a degree of control on the limit of the envelope you didn’t believe existed. He didn’t run out of skill the day he died. What he ran out of was options, and getting to that point is about making decisions headed into an ever narrower position. I find it very hard to say this, but it was probably an error on his part to get to an optionless position. That isn’t condemning the man, it’s me really asking you to learn something from him.
The 3 am story from 2011:
I just spent the last hour and a half out in the shop doing small stuff like deburing fly wheels and bending mounting tabs for oil pickups. I have done these tasks so many times that it is the kind of task that I can do without thinking about it. I just spent a lot of this time thinking
about a guy named Ken Terry.
Ken has lived at Spruce Creek, our old airport as long as I have known him. A cantankerous guy, I met him back in 1991 or so, the way that most people met him, by having an argument with him. Ken was a difficult guy to like right off the bat. He had an anger management issue that makes me look like I’m ready to guest host “Mr Rodgers Neighborhood.” He was always an in your face, tell it like it is, kind of guy. He didn’t need you to like him.
Twelve years ago Ken, who was a regional aerobatic champion and a life long pilot taught Grace how to fly fundamental aerobatic maneuvers in his T-34 and Christan Eagle. She used the second plane to get her IAC patch. It was a milestone in her flying, and Ken treated her like a daughter he never had. To Grace, he was a very nice guy, but to others he was gruff.
I was thinking about Ken tonight because he was killed in the crash of his T-34 on Saturday. Arnold called me up to say that he was dead. We live 100 miles north, and news travels the gap slowly. Here is the most important thing Ken taught me; People who are hard to like at first are often easy to respect later, and vice versa. It makes a lot of sense it you think about the qualities that make many people popular, and then think about how these are not an asset it a moral dilemma.
When I was president of EAA-288 I had a big argument with Ken that almost came to blows because he pulled a snap roll on take off in a 290HP Skybolt at an EAA picnic we were having, where I was trying to show people in the community how civilized aviators are. I was fed up with him, and I couldn’t think of anything good about him that was worth the other costs. About a month later he pulled up in front of my old hangar at midnight. He got out and said that a very good mutual friend named Mike Holey had fallen off the wagon for the thousandth time, and was out driving around drunk, and we should go find him. Ken explained that he was still not speaking to me, he just wanted a one night truce. I explained that I had done this for Mike many times before, and it never did any good. Ken asked if I was OK hearing tomorrow that Mike was dead, and I told him I didn’t think I could stop that it if was going to happen. Getting angry, Ken said what if he runs over someone’s little kid, was I OK with doing nothing and finding that out in the morning?
I got in Kens truck, and it only took an hour to find Mike, drive him back to his place at the Ra-Mar trailer park, put him to bed and remove two tires from his truck. Ken drove me back to my hangar. When we got there I tried to say something about how he was right about doing it for some strangers kid. Ken got mad and asked me how dumb I was. He got in my face and said we didn’t do it for Mike, or some stranger or his stupid kid, we did it for ourselves, so we could wake up in the morning without having to add anything new to our lists of reasons for hating ourselves. He said that every honest intelligent man who has done something with his life already has a full list of things he has done that he now finds contemptible. No further explanation, he drove off. I watched his Suburban drive down Cessna Blvd. I realized that Ken was very hard to like, but he was easy to respect.
I was sitting at the work bench two hours ago thinking about that night and trying to remember what year it was. I was tired and couldn’t come up with the answer right away, but it was at least 10 or 11 years ago. For about 10 solid seconds I thought about calling up Mike Holey in the morning and asking him. I have known Mike since 1989 and I didn’t think he would be offended if I brought up a bad night in his life from long ago. Then I remembered that Mike shot himself and has been dead since 2003. Ten seconds is a long time to forget that, even when your real tired.
I like working alone in the shop late at night. Our airport is out in the woods and it is very quiet here late at night. Long after anyone would call, long after Grace went in, it is a good time to think about stuff you never do during the day. In another month I will be 49. Ken was right, if you live long enough, and your honest with yourself, you will have plenty to regret in the quiet hours. Mostly things you should have said or done, and a handful of things you wish you had not.
Tonight, I add Ken Terry to my group of friends that never get older. During the day I almost never think of them, but late at night, when I am alone in the hangar, they don’t seem nearly as dead. When I think about them I subconsciously let them get older, it’s a way of pretending they have been with me all along. It not all regrets, there are plenty of good memories.
At Oshkosh this year I had a guy told me that he liked home builts, but he really didn’t get into having to spend all the hours in the workshop, largely alone. I listened, and shrugged, didn’t say anything, couldn’t really. It was broad daylight, and far from my shop, and besides, if you tell people you don’t mind working in your shop alone because it gives you time to think about people you have lost, they will just think your mentally ill. -ww, 11/2011.
Here is a sample of the mail on this topic:
Zenith 601 Builder Ken Pavlou writes:
“William, I’m glad you write stories like these. It’s easy and nice to read about success stories, operational techniques, and product announcements, but I would argue that stories about judgment and consequences are far more important and valuable.
You would think that preservation of one’s life is more than enough motivation to do things right and practice good judgment. In the bigger picture though its more than just our own life that we are preserving. When we decide to learn to fly or build an airplane we become stewards of our hobby and aviation as a whole. We assume the responsibility of preserving our life, that of our passengers, and those on the ground.
We are also preserving our privilege to build and fly. Safety is absolute, it’s not an option. One can not and should not try to rationally talk themselves out of doing what is best for safety. If we stray too far from this we will see our privilege of flight regulated to the point of extinction. Thank you, Ken Pavlou”
On the topic of VE airframes, CC#17 &25 Host Arnold Holmes writes:
“Having read all of WW’s post on risk management, I can tell you that he is EXACTLY correct about the Varieze. I love flying my VE but I can honestly tell you that of all the airplanes I have flown I give the VE the widest margins. I find myself more alert and more attentive while flying it than any other airframe. It is not an unsafe design and it handles nicely but it is much less forgiving when you loose your engine on take off or need to land off field. In fact it is at least as bad at those things as it is good at others. That little canard up front has to work really hard and MUST have adequate airspeed to work. 50 feet in air in a climb configuration is no place to loose your engine or have a major power reduction in these airplanes.WW is giving everyone who takes time to read his post good, valid, experienced recommendations and you are foolish not to listen to what he has to say. He and I have known far too many that have died tragic horrible deaths simply because they refused to exercise good judgement, don’t be one of them!”
Builder Matthew Lockwood writes:
“There are old pilots and there are bold pilots, but there are no old, bold pilots” In this case, ‘bold’ means ‘lacking judgement’
Builder/DAR Jon Ross writes:
“William, Your interest in philosophy is appealing. That said, your comments about risk management and judgment are opinionated, yet correct.
Like you, I express many of the same sentiments to those that will listen. The problem is, most people will not listen. I am often disappointed by people who seemingly seek sound advice when I later learn that they are simply trolling for someone to tell them what they want to hear. With the Internet being what it is, there are many so-called experts who will provide just about any opinion needed to satisfy almost anyone. It would seem that decisions based upon little or no sound reasoning or factual engineering basis would not be commonplace; yet they are.
In my travels as a an amateur built DAR, I am often queried by many builders about their projects. Many of the questions I am asked are related to advice that these builders have been given. You see some very interesting things in the field; and I often fly home with the thought of impending disaster after what I have seen.
With the cost of aircraft engines being what it is, I often am told that the power plant of choice will be the Corvair. I politely ask if they have seen your engine builders manual and recommend that they buy a copy and consider attending one of your workshops. Being around like-minded people (I am talking about a culture of safety) can have a very positive effect; it can be contagious. Unfortunately, the reverse is true as well.
My own current project is a Breezy, and the engine I am using is the Continental O-200B. I am often told (it is always an unsolicited comment) that I should use a Corvair power plant. While I believe that this could be safely done, the O-200 is in my opinion, a better choice for my intended application. While I am interested in the Corvair, I will likely never build one up for flight. But I find this suggestion to use a Corvair to be common; and the person making the suggestion is almost always someone with no credentials to be making such a recommendation. (With one exception; and that person is a mutual friend of us both). The point I am making is that builders are often bombarded by what may sound like seemingly good advice. When that advice is coupled with saving money, the advice given moves closer to being regarded as sound in the mind of the listener, that’s just human nature.
I admire your efforts to counsel builders on evaluating their decision-making process; but I have learned in my life that sound judgement comes from the heart. Like you I will keep trying, but I often take heat for doing so.”
Builder Rhett Ashton writes:
“I don’t usually comment on internet articles or blogs, but I feel compelled to make a comment here. Well said William. Rhett, Royal Oak, MI”
Builder Bruce Culver writes:
“This is all really quite sad, people paying you for your experience with the Corvair and the custom quality parts, and then not following your advice, but then I am reminded of what an old flight instructor told me years ago, “Remember, the pilot is always the first one to arrive at the scene of the accident.” Would that more people remembered that”
Bruce, 100% of people are never going to listen, but the goal is to make it 1% more than it was yesterday. In homebuilding, we have time to get people to listen and think. A flight instructor has but a few hours over a few weeks. I have many hours, often over several years. It is very hard to get people to change their ways on most subjects, but people do listen when things are said directly. I think too many aviation messages are blurred in with the rest of the ignored warnings in life because for the sake of family presentation and marketing, the warnings are ‘cleaned up’, Without frank discussion between thinking adults, the warning gets ignored just like the ones that came with every consumer appliance.ww
Cleanex Builder and flyer Dale Williams writes:
Hi William, This story reminds me of a choice I had to make on my Cleanex when building it. I had bought a brand new Aerocarb from another builder at a fair price. It was the size recommended for the Corvair. I had read your manual and seen stories where others were getting good results although some were having difficulty getting them to set correctly. I had even flown one before on an Aerovee powered Sonex that I used to own. But then something happened.
Dan Weseman had agreed, early on, to do the first flight of my Cleanex when it was finished as I didn’t have a tail wheel endorsement and Dan had built the engine and was confident in the building abilities of Dick Fisher who was my building mentor and is currently a beta builder for the tri-gear Panther.
But when Dan learned that I was considering using an Aerocarb he flatly stated, “I will not fly it with an Aerocarb on it.” I asked why and he plainly told me that he did not believe them to be airworthy. I mentioned that you had seen them used and they were a choice given in your manual. He told me that he believed that your view of the carb may have changed but nevertheless, he would not fly behind an Aerocarb. I respect Dan Weseman and yourself greatly and took those words to heart.
I earned my tail wheel endorsement and performed the first flight last year. BTW … she performs very well with a Marvel Schebler MA3-SPA Carburetor. Thank you for your brutal honesty. Dale N319WF”
PS: If you want to share this story and decide to “change the names to protect the innocent” I understand. If you decide not to protect the innocent, I understand that too.
Dale, Between thinking people having an important discussion, there is no need to shield anyones identity. I only do that when a builder makes a mistake and I want people to learn from it without having them focus on the ‘who’, as much as the ‘why.’ In this case, we are only covering builders perspectives on decision making. Not everyone comes to the same conclusion, but how they get there, the evaluation process is what we want to develop.
Notice, I don’t tell people ‘never do this’ without a reason. I am far more likely to say ‘I choose not to, and here is why.’ The first is only about controlling others actions. May work for a moment, but does not help the guy at the next decision. The second approach is a building process where the guy starts evaluating things for himself. Neither me, his airframe designer nor his flight instructor will be with the guy when he goes to fly. At that point, he is far better prepared if he has developed judgement than a list of do’s and don’ts.
The Aerocarb is a mixed bag. On a Corvair, it should never be used in an application with a fuel pump. Gravity feed, it has flown a long time. I would not use one personally. If I tell people simply not to use them, or if I ignored their existence, builders would rapidly find out that Joe Horton has flown on for 800 hours on a Corvair, and then many people would just skip to ‘it must be fine’ without a thoughtful evaluation of its qualities, limitations and their specific needs.
Reducing Dan’s perspective on Aerocarbs to ‘not airworthy’ is an over simplification of his evaluation of wether he would choose to use the carb on a Corvair powered plane he was going to fly. Neither Dan nor myself would pick an Aerocarb for our own planes. That doesn’t mean they have not worked for others, but it is an important judgement call. No one should take this as a knock at the Monnetts; Look at it in reverse, they would not choose to put a Corvair on their Sonex, even though it has long been shown to function. I am not offended by this, it is a judgment choice of theirs, just like the carb evaluation is mine.
The underlying theme in your story from successful builder to successful flyer is about developing your own judgement, but being willing to alter it when you are presented with more information. The number one reason why people resist altering perspective is they find out that they have to spend more money. Even 25 years after starting this, I still have never grown thick skin about people being cheap around planes. There is a very different perspective to working on a budget or looking for value. Cheap is a guy who lives in a $400K house, just drove to the airport in a $40K car, telling me that aviation is the most important thing in his life, and then complaining that an MA3 costs $400 more than an Aerocarb. Cheap will hem and haw and ask things like “well what if I” and point to examples, often on other airframes and engines, ones he has never seen in person. I have no tolerance for that. He isn’t looking for ‘why’ or even ‘how’, he is just being cheap, and people like that have harmed a lot of people in aviation, not just themselves.
Mentoring is important in this field. If you experience doesn’t cover the topic you need to exercise judgement on, then find someone who’s perspective you respect, a person with a proven track record that you wish to emulate. This is just what you did with Dan. You have plenty of opportunity when following his path to ask ‘why’ and understand the logic of his judgement, and in the process expand your own. -ww.
Continuing on the theme, let’s look at a different risk management topic. It is often the first decision a builder makes. Stop and think about that: when a guy is new, he makes a critical decision, before he has much experience or good advice to base it on. This choice is which airframe to build.
What brings this topic up is related to a previous story. A few days ago I mentioned that a builder was pursuing having a very long prop hub made for a plane that I thought was a poor choice for new idea testing, especially if the guy had little experience in building, flying and testing. The airframe in question is a Rutan Vari-eze.
Before anyone gets up in arms, I am not attacking the design, Burt Rutan or anything else. The point here is that it is not a good airframe to test new ideas on, and many of the people who like this airframe have little direct personal experience with them, and often the same people have not previously re-worked or modified other engines installations, they just like the idea of the plane, and often view the Corvair as a cheap alternative to the approved O-200. This isn’t a radical nor blasphemous thing to say. Would you like to guess who would agree with me the most on this statement? I will bet Burt Rutan himself. I have met the man in person more than once, read a lot of what he has written, and I really doubt that anyone who has done the same is going to disagree with my assessment of Rutan’s position.
On our main website for the last 10 years, unchanged, is the following quote:
“A VariEze is not one of my favorite aircraft, due to its fairly high landing speed and comparatively poor pilot protection in an accident. If you gave me my choice of aircraft to have an off-field landing in, a VariEze would be near the bottom of the list. Most VEs are overweight, and the Corvair motor is slightly heavier than the recommended hand prop Continental. This is a weight sensitive airframe, where a few pounds are not to be taken lightly.”
Vari-eze fans often tout this as a very ‘safe’ aircraft. The statistics do not bear this out. Taken directly from the 1981 Canard Pusher, Rutan’s in-house newsletter, the following note, written by Burt:
“Homebuilt accident record statistics were reported for a three year period by The Aviation Consumer last year. They show an overall accident rate for VariEze of 2.59 (1.55 fatal) per 100 aircraft during the 3 years. Average for all homebuilt aircraft was 3.93 (1.07 fatal). We are not happy with this result, as we had expected the VariEze to be significantly better than the average homebuilt due to it’s strong structure and good stall characteristics.”
I am not saying it is a ‘bad’ plane, I am just pointing out that it had a higher than average fatality rate, and that is flying with the recommended engine, in an era where pilots flew more, when the design had active support and virtually all the pilots were original builders of the airframes. Change this to a non recommended engine, with a 8″ prop extension that I am sure will overload the crank, add in a second owner who had little or no Varieze experience and you are now speaking of a very high risk aircraft. I know pilots of great skill with ice water in their veins under pressure who would not fly that combination, even if I built the engine, far less a guy on a really tight budget building his first Corvair.
I have looked at this combination before. CC#17 and #25 host Arnold Holmes, a 20 year close friend of mine, owns and flies a 1,000 hour VE. He had it at Oshkosh two years ago. He and I have very carefully looked at putting a very powerful Corvair on his airframe. One of the motivators for the joint project was we were pretty sure that we could edge the Corvair speed record to 230-235 mph. Arnold has a lot of flight time in the airframe, knows more about composites than anyone most people have ever met, is an A&P/IA of outstanding record, and above all else, he has incredibly good judgement around aircraft. Guess what conclusion we came to: It wasn’t worth doing. A speed record is a dumb goal to risk much on. I am sure we could have done it at moderate risk, but to what end? After a lot of conversation, Arnold decided that he can’t bring the VE to our little grass strip, His son can’t begin to learn to fly the VE from the back, and his girlfriend likes Side by side seating much better. His solution? Simple, he bought my Tailwind project and is putting a Corvair on it and probably selling his VE. Steel tubing, 170mph and grass strip friendly, and a straight forward tractor installation appeals a lot more.
We have four builders who are planning on putting their Corvair on a VE. Let me directly say that I think people have a right to do high risk things in life. My goal isn’t to talk them out of it, but I will openly discuss what I think the risk is. If they are going to do it, logic says they are better off with my input. But I am also free to say that I am not going to assist them if I think that they are making poor decisions or are ignoring risks rather than minimizing them. That isn’t a policy that just applies to VE’s. I have refused to help some people who were building Pietenpols and 601’s with poor attitudes. A guy with no credible experience in test flying and engine development trying to have an 8″ prop extension made because he thinks he needs it for stream lining is not exercising valid judgement. I spent some time with him at a recent College, and he is a nice guy, but as I have pointed out, Gravity Physics and Chemistry don’t care about that. Today, I am sure he thinks I am an A-hole who is pissing on his rights and dreams. I am ok with him thinking that for a long time. It is a far better alternative to him thinking of me supporter right up through a first flight that ends poorly.
Think that was a little too dramatic? Fear mongering on my part? Just old WW pontificating and verbally being mean to a guy that has different ideas? Don’t answer until you read about my friend Steve Parkman. Great human being, very clever, family guy, friend to many people; Gravity Physics and Chemistry didn’t give a damn about any of that. You can read the link directly below on how he was killed on the very first flight of his VE with a 4 cylinder Geo engine. You put him in a steel tube aircraft that was a tractor with a 50 mph stall speed, a much better test platform, and he would have lived through that landing. Anyone who wants to have some sort of ‘composites are safe’ comment, spare it, it doesn’t apply to the VE configuration on an off airport landing.
Just in case that was a little too dry and technical for you to think about it being about a human being that many people loved, look at the link to the newspaper below. If is an interview with Steve’s widow just after the accident where she is now unsure how she is going to house and feed her kids. Note that it was two days before Christmas 1998:
A few years ago when I was on a three-day insomnia run, I wrote a story in the middle of the night for the Corvaircraft discussion group about being friends with Steve. I often called him during the day, but in the afternoon he would always break off the conversation to get his kid in person at school. When I heard he was killed, the first thing I wanted to know was what time it happened. For a while I had nightmares about a kid waiting alone in a school yard for a parent that was not going to arrive.
Lest anyone get off track and think that I am saying homebuilding in general is too high risk, lets bring this back in focus for a moment: This is about risk management through good decision-making. Right now, Dan Weseman has three kids who are roughly the same age span as Steve Parkman’s kids were then. Why am I not down at Dan’s telling him to re think about flying? For one simple reason; Dan has excellent judgement, is running a low risk test series, and he has made good choices all the way. If he saw any issue, he would stop and fix it correctly before the next flight. He leaves nothing to chance. In contrast, Steve didn’t always do these things. He might have gotten away with it, except for his choice of airframes as a test mule. That single choice, and it was a bad one, made all the difference. Simply put, it was the wrong airframe, and he was the wrong guy for a completely unforgiving test plane. He was a great guy, but that never counts. All that mattered was having the judgement to pick a better test plane, and on that point he came up short.-ww
If anyone wants to write me debating that pusher aircraft with composite or wood fuselages are not good test planes, please read the Vari-Viggen/O-320 accident report below first. I was on hand for the crash 10 years ago. I had spent the previous day admiring the man’s craftsmanship and personal style. He was a stand out in a group of 1,000 people at Frasca. The soy bean field he had a forced landing in was big and flat enough that I am pretty sure I could have landed at DC-3 in it. His fuselage did not protect him. It had poured rain the day before and it was later thought he had water in the fuel. With many planes this would have been an non-accident, but the man’s airframe choice did not work for him on that day. His wife had driven there and previously left for a 6 hour trip home. Some one was going to call her, but a pilot with 50+ years of experience stopped them so the woman could get all the way home and back to family before finding out she was a widow.
April 20, 2013 Leave a comment
Below is a five-year old photo of a 601XL built by a great guy named Ken Lien in WA. Paint job on the plane is super detailed, and it easily could have been a champion at Oshkosh. The major impediment to that happening is that Ken is dead and the plane was destroyed on the very first flight.
Although I spoke with him many times, I met Ken in person just once, at the Arlington airshow. By coincidence, one of his life long best friends has a hangar 700′ from mine and is in my EAA chapter. He told me many times what a great human being Ken was. I don’t doubt him at all; after 25 years in aviation I fully know that when builders make a serious error, physics, gravity and chemistry kill them without taking any consideration of what kind of life they led on the ground. It isn’t fair, but they are ‘inhuman’ like that.
I will share the highlights: Ken spent 18 months and thousands of dollars painting the plane. When I saw him at the Arlington show, he told me that the plane did not run well. We went over a lot of points, but I was pretty sure is was his MA3-SPA carb. To eliminate any possibility it was ignition, I handed him a brand new distributor. When he got home he confirmed that it ran exactly the same with new ignition. From this point he had the carb on and off the plane many times. What he did not do was send it into D&G fuel systems like I suggested for a $500 overhaul. He ran the plane up and down the runway several times, but did not run a ‘two minute’ full power test.
On the day of the first flight, he may not have intended to go, He had not flown in years, had no biannual and had no transition training. He took off and flew away from the airport. The engine quit a short time later. He crashed in a school yard, running into a brick wall inverted. Fortunately it was a Sunday and the place was empty. There was no fire. The airframe was destroyed, but in the news photos you could clearly see the flowing checkerboard paint job, with all it’s detail.
It is later found that he reassembled the carb incorrectly. It had floated over to idle cut off on its own. If he had run a two-minute test it would have done this on the ground; if he had spent the $500 for the overhaul it would have been correct; if he had stayed over the airport, he very likely could have glided back. But those are all things someone exercising good judgement would have done, along with getting back into flying in a controlled way. Again, I am sure he was a great guy. There are many people who are great people who don’t make good decisions around planes. There are also people who are first class A-holes who exercise good judgement. Like it or not, the later live a lot longer.
You can read more about the accident on-line, but I want everyone to know I am not slandering the dead here. I have a hand written 4 page letter from a friend in Ken’s EAA chapter describing how people there tried to get Ken to have a professional look at the carb. Long after the accident report, I heard from the guy who covered it, and he confirmed the probable cause.
It is well worth pointing out that this accident has absolutely nothing to do with Corvairs;The carb was the exact same model that a Continental O-200 uses. Had Ken selected an O-200 instead, he would have had the same carb, and there is no reason to believe he would have done anything different, and he would have ended up dead in the same spot, just the same. And before anyone goes there, it isn’t the carbs fault either, because any other person with good judgement would have just put it together correctly or had a pro do it. This accident had absolutely nothing to do with machinery at all. It was a 100% judgement error.
Ken’s story is not unique, I can think of dozens of builders who I have counseled that a 5th bearing and a good carb are a lot more important than a fancy paint job, a great interior, or any avionics. Think people listen to me? Less than 50% do. In many cases I resort to sharing the Ken Lien story, but it doesn’t change many minds. When a guy who I have worked with is about ready to go flying and he has a Dynon panel, a $2,000 interior and a paint job, but a poor carb, and no 5th bearing, and didn’t set the timing with a light, he may tell people he learned a lot from me, but in my book he didn’t learn a damn thing. If after several years of working together he still makes decisions like that, he missed everything important.
Go to any other website you like and I really doubt that you will find stories like the ones I write. Search for words like ‘Dead’ and ‘Killed’ words that I have used in dozens of stories; smart people never write about this stuff because they know it is bad for buisness…..besides, most people are not listening anyway. But I never learn, I still talk about these themes with the hope of getting people to think. If you are one of the people I am giving a hard time over poor decisions, it is your right to think of me as an A-hole. I’ll live with it. I don’t need to be liked, I am not in this to hold the hand of people without judgement and listen to their rationalizations while they walk straight to the graveyard. -ww
“We’ve recently received a number of photos from 601 builders nearing the finish line. Check out the progress of Ken Lien of Washington, Ken sent us a half dozen photos of his very sharply painted XL. “
April 20, 2013 Leave a comment
I was at the airport yesterday and spoke with Dan Weseman just after he completed test flight #4 on the Panther prototype. You can read the story of these flights on the Panther blog at:
Just like the first three flights, the fourth was mechanically flawless. Dan has inspected the aircraft carefully after every flight, but he has not had to make a single change nor adjustment. This is how every test flight program should go. Theoretically, Dan is flying a new design on a just built conversion engine, and this is thought to be dangerous. But I contend that he is actually at very low risk, because of one single outstanding factor: He has, and exercises, good judgement.
For comparison, let me point out that a number of people are killed in proven homebuilts with certified engines on their very first flight every year. In my 25 years of experience working with homebuilts and homebuilders every day, it is very clear that the number one cause of such accidents is poor judgement.
Ask a 5,000 hour pilot what is the most important risk management factor, and he is sure to tell you it is experience, yet I will tell you that I have had 2 personal friends with more than 25,000 hours each die in a plane because they chose to do something unnecessary and foolish. Ask a PhD engineer what is important, and he is sure to tell you that education is the number one factor. I have had several friends with engineering degrees that had been educated to know better, but still willfully did their last act in aviation against better judgement. Ask a guy who has been getting away with doing stupid things for years and he will tell you it is just luck or fate. Only idiots speak that way. Ask the man of great faith, and he will tell you that God protects. I will tell you that I have never met a man of greater faith than my friend Bob Bean, but when a poor decision and serious weather came together, Bob’s God protected his soul, but not his mortal life.
Judgement is the vital element, and without it, the other factors, experience, education and all the rest, don’t add up to any protection. Are you new to aviation and concerned because your flight instruction didn’t cover judgement? If the instruction was good it did. Quality instruction spends a lot of time on the subject of “Decision Making,” and this is the topic of Judgement. If your instructor spent more time teaching you radio procedures, then go find a real instructor and correct this error, now, before you fly again.
Here is very simple advice for the new: Don’t spend any time hanging around people with bad judgement. Here is some easy ways to ID them. If they ever use the phrase “It should be alright”; If the person speaks of luck; If they preflight planes while speaking on cell phones; If they are in a rush; If they planned on being home by dark, but then decide night flight is ok because they ran late; If they are poor listeners and finish your sentence for you with the phrase “yeah, yeah, I got it.”; If they brag about things they got away with, pencil whipped annuals or biannual flight reviews where they didn’t actually fly; If they are inherently cheap or complain about the cost of maintenance that is half what their car dealer charges; Any pilot who can’t tell you the Va speed of a plane he is about to fly; If they have the slightest tendency to show off in front of people; If you see any of these things, have nothing to do with such people. All of these are signs of poor judgement, and ignoring them and flying with these people is the equivalent of continuing to play Russian roulette.
The past 36 hours brought several examples of poor judgement. An email from a builder who is now taking the advice of his local Corvair car expert over how I teach people to torque flight heads, complete with a follow on email from the expert on how I do things absolutely backwards; A phone call from a builder who admitted to me that he ordered weak stainless head nuts by mistake, but was in a rush so he bolted the heads on with them anyway. In this process several of the nuts galled, but his solution was to just put more lube on them and put them back on (same man also used uncalibrated Chinese torque wrench to kill most of the studs in his engine on assembly); Third guy is trying to have an 8″ prop extension made for his Corvair, to be used on an airframe with a very high stall speed and little chance of survival in an off airport landing.
Now, back to my point about experience and education being no defense. One of the above people has a PhD in engineering and thousands of flight hours; another comes from a flying family and has attended two Corvair Colleges; another actually considers himself an aircraft mechanic. One of these people has been a paid expert witness at a civil trial over the mechanical judgement of others. I would not fly in any of the planes that these people are working on, and unless these people change what they are doing, neither should anyone else. I have seen about 50 Corvair projects seriously compromised by people who followed car mechanics over me, including 3 destroyed planes; I have seen countless people use substandard or incorrect parts because they were cheap or in a hurry, this was the direct cause of a fatality on a first flight, and about a dozen destroyed engines; a 7″ prop extension broke a non-5th bearing crank a few hours after I said it would, aircraft destroyed, pilot seriously injured.
Do you want your first flight to go like Dan’s Panther flights, or do you want me to be typing a story about your judgement in a few years? Is saving $10 that important? Want to “show” people something? Are you going to follow the advice of a car guy because he stops by your shop and pressures you? Think no one would do these things? They already have many times, and there is a long history of these things not working, at times with tragic results. I write about it all the time, but in one way or the other, 1/3 of builders make the same judgement errors. One out of five people flying today have never timed their engine with a light. Right now I could type in 100 stories of poor judgement off the top of my head; Flying 65 hours on break in oil, taking off for the first flight without a working charging system. Flying 4 flights without 1 spark plug connected, a take off and 90 mile cross-country with a completely blown head gasket. First flight with a car distributor with 45 degrees on mechanical advance. Static timing set to 32 degrees. etc, etc, etc.
Who can you trust? Yourself, that’s who. Every single one of the above things was unnecessary. In 75% of the above cases, people knew what they were doing was wrong, but they did it anyway, willfully. That is the definition of poor judgement. Let’s make up a number and say 1 out of 1,000 people who builds a plane gets killed flying it. The first thing to understand is that it isn’t a random drawing. This is not a lottery, it is almost completely under the control of the people in it. By my estimation, people who are chronically cheap, always in a rush, don’t do their homework, are show offs, or demonstrate any form of “get-ther-itis” are 50 times more likely to buy the farm. Having 5,000 flight hours is no defense compared to exercising good judgement.
I am not clairvoyant, but after 25 years of studying builders and having the time pass to see how their story works out, I have come to posses a disturbing ability to accurately predict people coming to harm. Every airport has a guy who predicts every single person will come to trouble, and when 1 out of his 10,000 predictions comes true, he wants to gloat over it. He would likely have a much more somber perspective, like I do if he had my track record of 1 out of 3. If I ever have a detailed conversation with you about rethinking your judgement, take it seriously. I don’t do it often, but I now need two hands to count the names of the people who thought I was kidding or not worth listening to.
If I ever seem short-tempered and cranky at times, much of it can be traced to a very ironic reality that I must live with. For 25 years I have worked to teach people they can participate in the best part of aviation, a path where they can learn to count on themselves, to really know what taking control of their life means. The Corvair itself is just good hardware, the real project is yourself. I have seen this work out for many, many people, and I find this very rewarding. But it remains very ironic that when I am done, the experimental aircraft community will judge the value of our efforts not on the track record of the builders with good judgement who achieved the most, but on the trouble caused by the ones who had poor judgement, people who would have had issues no matter what type of engine they chose. I have almost no control over this. This irony is true for most people who work in this field, they also know they have little control, so they wisely don’t ever bring up the subject. I’m not that smart, and every now and then, when I have a day with several examples of poor judgement, I try one more time to convince a few more people to exercise better judgement, just as if their life depended on it. -ww
February 21, 2012 Leave a comment
Here are a couple of letters we received on the subject of risk management:
Builder David Mehaffey wrote:
“Never thought I would see the truth in print. as one who is looking back , 80 and counting, the truth has usually been the first casualty at the airport. Hope to see more articles. God watches out for fools, he made a lot of them. I can testify to that. Take care.”
KR builder Donald January shared:
“William. I’ve always liked the saying ‘We do it right because we do it twice’. This shows me that at least the person found a mistake the first time and repaired it. Up here in the Dakotas you see a lot of scabbed together homebuilts and a lot of fools think the whole state is one huge runway. I’ve seen 150 Cessnas blasting down a gravel road for flight. I remember loading my father’s plane with chemical and having a farmer nearly walk into a turning prop. So we learned to ask the farmer to wait in his truck and the pilot will come to him for the daily spray area. You keep up the good work and hope to see you one day. Donald”
Zenith 750 Builder Dan Glaze wrote:
“Keep writing William, if your insight saves one life it will all be worth it. The following is the NTSB report from last August from my home FBO. This guy refused instruction just a week prior to killing himself, thank God nobody on the ground got hurt, Dan-o.”
NTSB Identification: CEN11FA597
14 CFR Part 91: General Aviation
Accident occurred Thursday, August 25, 2011 in Heath, OH
Aircraft: Nichols Lancair 235, registration: N777BN
Injuries: 1 Fatal.
This is preliminary information, subject to change, and may contain errors. Any errors in this report will be corrected when the final report has been completed. Excerpt Follows……”The experimental amateur-built airplane had accumulated 1,131 hours since being issued an airworthiness certificate on August 10, 1990. The pilot reportedly had not flown the airplane since he purchased it from the original builder on September 14, 2010. He had reportedly expressed concerns with the airplane’s ground-handling characteristics, and in the weeks preceding the accident, was seen performing several high-speed ground tests.”
February 20, 2012 3 Comments