The Weekly Reflektion 48/2023

During our working day, we often tend to focus on prioritisingthe less important things, rather than the important issues.Sometimes we are distracted, sometimes the more important tasks are more complex and difficult, and sometimes the more important things are just routine and relatively boring.  

Wreckage from the Eastern Air Lines Flight 401.

Do you focus on the important issues?

Eastern Air Lines Flight 401 was a scheduled flight from New York JFK to Miami. Shortly before midnight on December 29, 1972, the Lockheed L-1011-1 TriStar crashed into the Florida Everglades, with 101 fatalities. Three of the four cockpit crew members, two of the 10 flight attendants, and 96 of the 163 passengers were killed, 75 people survived.

The flight was uneventful until 23:32, when the aircraft began its approach into Miami International Airport. After lowering the landing gear, the First Officer noticed that the landing gear indicator, a green light identifying that the nose gear is properly locked in the “down” position, had not illuminated.The pilots cycled the landing gear, but still failed to get the confirmation light. The captain told the tower that they would discontinue their approach and requested to enter a holding pattern. They were assigned an altitude of 2000 ft (610m), and the flight control was put in autopilot mode while they worked on the problem. The aircraft crashed into the Everglades a matter of minutes later.

The investigation discovered that the autopilot mode had been inadvertently adjusted when the captain accidentally leaned against the control column while turning to speak to the flight engineer. In this mode, once the pilot releases pressure on the control column, the autopilot maintains the pitch attitude of the aircraft until it is again moved. The slight forward pressure on the stick would have caused the aircraft to enter a slow descent which was unnoticed by the crew. 

After the aircraft had descended 250 feet (76 m) from the selected altitude of 2,000 feet (610 m), an altitude alertsounded to warn the pilots of an inadvertent deviation from the selected altitude. This also went unnoticed. Investigators believe this was due to the crew being distracted by the problem with the nose gear light. The flight engineer was not in his seat but visually checking the landing gear so would not have been able to hear the alarm. Since it was at night and the aircraft was flying over the darkened terrain of the Evergladesthere were no ground lights or other visual signs indicated the TriStar was slowly descending.

The focus on one issue, and distracting from other issues is termed ‘attentional tunnelling’. The entire crew became occupied on the landing gear issue, to the detriment of their main job, flying the plane. The cause of the landing gear confusion was later discovered to be due to a burned-out light bulb.

Do you have trouble maintaining focus on the important issues in favour of other less important issues? A regular pause for reflection during your working day to check that you are focussing on the important issues can be of help. This could also be relevant on the home front, assuming of course that the participants agree what is important!