This week, the New York Times published a remarkable story by aviation writer William Langewiesche that details the horrific crash of Lion Air 610, a crash that killed all 189 aboard the Boeing 737 Max. After the similar crash of Ethiopian Airlines 302 that killed 157, regulators worldwide grounded the 737 Max amid concerns that a new system called MCAS had failed, resulting in uncontrollable runaway trim that doomed the two airliners and all 346 souls aboard the two.
From the start, the discussion of what caused the crashes has been a polarized one. On one hand, the design of MCAS was poorly thought out and rushed through both design and certification. Boeing and the FAA are being grilled by a Congressional committee about this process, though at this point what will come of the probe remains to be seen.
On the other hand, many pilots disagree that MCAS is ultimately to blame, regardless of what the investigations determine. That system, which automatically trims the airplane nose-down to overcome what the angle-of-attack sensors are saying is an aerodynamic stall, will trim at regular intervals and high-speed until the trim is fully nose down and impossible for pilots to outmuscle.
The problem that these pilots have with the “blame MCAS” mentality is that the automated stability system is easy to overcome, if you know what you’re doing, that is, and if you’re a competent pilot, the claim goes.
This lack of competence is, in fact, exactly what Langewiesche focuses on in his cutting analysis of the Lion Air crash, blaming that lack of airmanship (a term he describes as “anachronistic”) on a culture of poor training that has arisen in countries like Indonesia and has been tolerated by aircraft manufacturers who were eager “to sell their airplanes to any airline without restraint.” Indonesia deregulated its airline industry in the late 1990s, the author writes, “..in the hope of providing for the sort of fast, low-cost travel that might help bind its islands together.” The problem, Langewiesche continues, is that, “The free-for-all soon raised questions about how to manage safety. That is a polite way of putting it. A race to the bottom comes to mind.”
This approach, the Times article says, “reduces pilots to journeymen and ignores the role of airmanship in safety.”
Langewiesche contends that that lack of airmanship was exposed because Lion Air flies Boeing aircraft, and Boeing planes, he writes, rely on pilot skill as a last line of defense against mechanical and electronic failures.
And Lion Air’s safety record is abysmal. “From 2003 to 2007,” according to the article, “the Indonesian accident rate as measured by fatal flights per million departures had grown to be 15 times as high as the global average.”
I’ll let you read Langewiesche’s brilliantly crafted narrative of the Lion Air accident, one that he details step by step, describing the malfunctions the crew encountered and the steps they took in attempting to overcome them, measures that were ultimately, as the world now knows, were insufficient to save the lives of those onboard.
Again and again Langewiesche returns to the question of airmanship, or, rather, the lack thereof. It is, indeed, hard if not impossible to explain the failure of the pilots in the Lion Air crash to reduce power—extremely high airspeeds greatly exacerbated the aerodynamic forces they were battling against to regain control of the 737 Max. Langewiesche says of the Lion Air captain, that even though “he did not know about the MCAS … he had just experienced a violent runaway trim after flap retraction, and you might think he would have had the wherewithal to leave the flaps alone and throttle back to slow or, alternatively, pull into a climb to achieve the same result while also buying time. But no, he stuck obediently to 5,000 feet, left the throttles forward and retracted the flaps.”
Langewiesche doesn’t defend the design of MCAS—why, for instance, does it trim to a fully nose-down configuration?—or the approval process that ended with the stability augmentation system being fielded on production 737 Max planes, but he ultimately lays the blame on the pilots who, he concedes, are the product of a flawed safety system driven by economic forces, corrupt political and corporate oversight, and maintenance organizations, and questionable recurrent training practices.
Still, the author suggests that were he in a position of authority to do so, he would return the airliner to service as it's currently configured. He writes in conclusion, “What we had in the two downed airplanes was a textbook failure of airmanship. In broad daylight, these pilots couldn’t decipher a variant of a simple runaway trim, and they ended up flying too fast at low altitude, neglecting to throttle back and leading their passengers over an aerodynamic edge into oblivion. They were the deciding factor here—not the MCAS, not the Max.”
It’s a tough conclusion for me to wrap my head around. The author admits that the economic model of low-cost airlines like Lion Air is antagonistic toward safety culture, that Boeing failed to reveal, or one might even say “hid” the existence of MCAS from its customers, that parts suppliers ship substandard replacement components to airlines, and that pilots in many parts of the world are overworked and under supported. Yet he still concludes that the fault of the two 737 Max catastrophes was on the pilots.
The pilots probably should have been able to overcome the baffling mechanical malfunction they faced, true. But Langewiesche fails to address the fact that in simulator reenactments many pilots here in the United States have been hard pressed or unable to overcome a sensor malfunction that drove the repeated automatic deployment of rapid and repeated nose down trim of MCAS, even though those same pilots entered the sim knowing in essence what they would be encountering. That foreknowledge was a hedge against disaster that the pilots of Lion Air 610, whatever other mistakes they made, did not have in their favor.
Ultimately, the author’s attitude about airmanship and the pilot’s role in safety is sadly outmoded. The view of the pilot as the hero, the one who stands as the last line of defense against disaster is the stuff of John Wayne movies. The truth, which Langewiesche admits, is that a very small percentage of pilots who think they would be up to the task when faced with a difficult challenge in a flight simulator actually succeed at the task.
The dream of every pilot being a hero, like Tammie Jo Shults or Sully Sullenberger, is wishful thinking. Even worse, it gives rise to accepting inadequate aviation infrastructure, systems and training.
As poorly as the pilots of Lion Air 610 performed, they had the deck stacked against them, and if studying accidents shows us anything, it is that when things start going south in a complicated cockpit, even good pilots can have a very bad day. We need to expend our energy on keeping those bad days from happening instead of hoping in vain to have a pair of heroes in every cockpit.