NAME WITHHELD BY REQUEST
Few times in my life has an event disturbed me so deeply that, when I think about it even 10 years later, my heartrate still rises and a sickening lurch is conjured in the pit of my stomach. Given my current profession, this incident was embarrassing enough that I wish it could be forgotten, but it is still all too relevant and will forever be used as one of my most prominent teaching points. As one of the keystones of risk management — not accepting unnecessary risk — the following story is an example of a failure to properly answer the question, “Is the juice worth the squeeze?”
As a newly progressed Army UH-60 pilot in command (PC), a large portion of my job involves shaping and guiding newer aviators to ensure the strength of the branch. Although hard facts like limits and procedures are important to teach and enforce, nothing is more valuable than passing on lessons learned and experience gained. Just because I walked away from an incident doesn’t mean someone else will; and if it keeps even one crew from becoming a statistic, then I will continue to impress my near failure on all who will listen.
Several years before joining Army Aviation, I was a flight mechanic, which is equivalent to a crew chief, for the U.S. Coast Guard on the MH-65 Dolphin. Stationed in south Florida, our primary duties were law enforcement and search and rescue, with the latter taking the majority of our workload. With the nature of maritime accidents and the harshness of the environment, any announcement of an emergency was treated with the upmost urgency, no matter how brief the call. Such was the case on the night in focus.
Halfway through a 24-hour duty period and the end of a rigorous workday, I removed myself to duty quarters to catch some sleep. The call came at 2230, an uncorrelated mayday halfway between Key West and Cuba. Operations were normal at this point: we briefed, launched, conducted search patterns, refueled, repeated and returned home with nothing found. By 0330 I crawled back into bed and sleep was instantaneous. The knock came at 0345 — we were launching again. Yes, sir. No questions asked. It’s our job. I didn’t think twice. Fighting sleep inertia, I was reserved to the fact that this would definitely cap our duty day and flight limitations, and our relief would be waiting for us once we returned.
By 0400, we were airborne and headed south into the inky blackness over the Caribbean Sea. The moon had long set, and sunrise was just far enough away that the darkness reached its zenith. Now, I’m not proud of it, but flying over the ocean at night in a vibrating helicopter isn’t the most stimulating of environments. There’s no radio chatter, nothing to look at and, after nearly six hours of flight, the conversations had stalled. The flight director was performing its expanding square pattern diligently and I’d had about all I could take staring at the thermal imagery. I thought, “I’ll just put my head back for a second.”
I don’t know what shook me awake, and ultimately it doesn’t matter, but my immediate concern was embarrassment. I looked over my shoulder to see if the swimmer noticed, but he also was counting sheep. OK, whatever; nothing against the swimmer, but that wasn’t necessarily out of the norm. But then I looked forward. To my horror, both pilots had their chins to their chests, no hands on the controls — the flight director still making slow, right turns. To put it lightly, I “motivated” them awake and we all made the collective decision to return home immediately.
For the sake of this story, I’d like to say it was more dramatic than that — seconds from disaster, recovered feet from the water, only fumes left in the tank — but that wasn’t the case and isn’t the point. By our best guess, no one was in control of the aircraft for approximately 15 minutes. We had plenty of fuel until bingo, and the autopilot had several turns remaining until it kicked off and we would have flown off into the darkness.
Our flight concluded without incident or much of a word from anyone. In fact, it wasn’t until several days later that the lessons learned and point of this story became apparent, when the PC pulled us all together to discuss the flight. He apologetically revealed we never should have launched on that second flight. It is standard practice for a first-light search to be conducted with a fresh crew after every mayday case that turns up empty. Despite this and being given the option to go or not by operations, the PC had a “good feeling” about the case and really wanted his first rescue. We were not given the chance as a crew to make the decision or even discuss other options. That said, and not to put all the blame on the PC, nobody — not the other pilot, swimmer or I — spoke up.
Lessons learned
Given the constant emphasis that the mission comes first, the threat of tunnel vision is one with which we’re all familiar. As PCs, we’re the ones who are ultimately responsible and, when problems arise, we’re expected to make the decisions. That said, remembering that everyone has a voice and providing time for them to be heard cannot be emphasized enough, whether it be during crew resource management training or a post-flight after-action review. Had we taken just 15 minutes before launching that night to slow down and mull over the options, we more than likely would never have put ourselves in that situation.
Fast forward to today and it has become second nature for me to speak my thoughts out loud no matter how small the problem to stimulate the discussion (time permitting, obviously). That is what I emphasize to the junior pilots: speak up, let others speak and, most importantly, listen. Ensure every member of the team agrees the juice is worth the squeeze.