The Challenger Launch Decision: Risky Technology, Culture, and Deviance at NASA
By Diane Vaughan
University of Chicago Press, 575 pages, $24.95
No Downlink: A Dramatic Narrative About the Challenger Accident and Our Time
By Claus Jensen
Translated by Barbara Haveland
Farrar Straus Giroux, 397 pages, $25
Though it hardly seems possible that 10 years have passed, it was on Jan. 28, 1986, that the nation was shocked by the image of the space shuttle Challenger, with its diverse crew of seven astronauts, disintegrating before our collective eyes. There was an immediate demand to know “why?”–why did this horrible accident happen?
Until now the accepted wisdom has been that the accident was a result of decisions by “amorally calculating managers intentionally violating rules to achieve organization goals”–as Diane Vaughan puts it in “The Challenger Launch Decision.” But neither Vaughan nor the author of “No Downlink,” Claus Jensen, accepts that conclusion. Instead, these two very different books, appearing so long after the event, reach fundamentally the same conclusion: that the decision to launch Challenger was an almost inevitable organizational mistake, the kind of mistake that happens when large, complex organizations deal with tricky technologies.
To Vaughan, the accident was no individual’s fault but rather the culmination of “a series of seemingly harmless decisions . . . that incrementally moved the space agency toward a catastrophic outcome.” To Jensen, the accident was a particular manifestation of “forces within large systems, political organizations, and corporations which would, by all accounts, become more and more difficult to monitor and control.”
And that is perhaps the most important general finding of the two books–the suggestion that organizational mistakes are inevitable and that the social control of risky technology is thus an extremely challenging task. As Jensen puts it, large systems “are not going to guard themselves.”
Vaughan is a professor of sociology at Boston College, and her book is the result not only of in-depth, painstaking research in the vast collection of original documents related to the Challenger accident, including the more than 9,000 pages of interview transcripts that resulted from the post-accident investigation of the Rogers Commission, but also of interviews conducted with many of those involved in the long chain of events that led up to the launch decision.
Her purposely narrow focus is on the Solid Rocket Booster (SRB) part of the shuttle system; it was an O-ring on a SRB joint that failed during the Challenger launch and was the proximate cause of the accident.
Firmly situated within the academic study of organizational behavior, Vaughan’s book is full of what she characterizes as “thick description.” It is not easy reading, but those who follow her sophisticated line of reasoning will be rewarded with multiple insights into “the hazards of living in this technological age.”
Key to Vaughan’s analysis is what she calls the “normalization of deviance.” Step by step during the design of the SRB joint and its performance in the 24 shuttle flights preceding Challenger, NASA engineers accepted the risks of a design that did not perform quite as expected but also did not fail. Each small deviation from expectations became accepted after the fact and then was treated as the norm against which future deviations were evaluated.
By the end of 1985, the many signals that the shuttle was operating with a major design problem had become almost lost in the repetitive process of clearing the shuttle for each launch. The evidence presented the night before the Challenger launch by engineers from the SRB’s manufacturer, Morton Thiokol, was not sufficiently convincing to reverse the collective judgment of those responsible that the risk of O-ring failure continued to be acceptable.
No rules were broken. No manager deliberately ignored predictions of possible failure. Rather, they made a judgment to accept the risk of going ahead with the launch within what Vaughan calls a “bureaupathological” context created by the decisions and behavior of the preceding decade. Very unfortunately, that judgment was horribly mistaken.
Vaughan’s account of how all this happened is very wordy. She tells us what she is going to do; does it; then tells us what she has done. The study is full of references to a wide range of organizational and sociological studies that are not likely to be of general interest. Professor Vaughan is writing as much for her academic colleagues as for a more general audience. In the end, however, the cumulative force of her argument and evidence is compelling. Challenger was close to a “normal accident,” a term first coined by Vaughan’s colleague Charles Perrow. What was different was that high visibility individuals, including teacher Christa McAuliffe, were its victims.
We learn a great deal in this book about how a large organization manages complex technical systems; Vaughan gives us a rare view into the working level realities of NASA. What she finds are highly skilled people doing the best job they can in the face of uncertainties about the performance of the technological systems they are trying to operate and limits set on their work by the various pressures coming from above. Her portrayal is at one level reassuring; these are not lazy bureaucrats unconcerned about the quality of their performance. But it is also chilling, for it was these people who made, with the best of intentions, a tragic mistake. Do other mistakes, with even more disturbing consequences, lurk in our future, mistakes related not just to space but also other areas of high technology?
Jensen’s book is in every respect less substantial than Vaughan’s. A Danish professor of literature, Jensen wrote “No Downlink” without leaving Denmark, and he depends for his information totally on others’ accounts of the U.S. space program in general and the Challenger accident in particular. His book covers the whole history of spaceflight; the account of the accident itself does not begin until more than two-thirds of the way through the text.
He writes in an overly dramatic, rather superficial style. At least in translation, the book is annoyingly full of incomplete sentences and unjustified characterizations. (For example, he describes NASA’s plans to launch a planetary spacecraft including a device powered by highly toxic plutonium as “nonchalant.”)
There is little new or particularly penetrating here, and “No Downlink” can be recommended only to those either unfamiliar with earlier accusatory books written in a journalistic style, like Malcolm McConnell’s “A Major Malfunction” or Joseph Trento’s “Prescription for Disaster,” or to those who want to read every study of the Challenger accident.
That accident continues to haunt the U.S. civilian space program. Even after 50 post-accident launches, it is not clear what the public and political reaction would be if there were another shuttle failure involving loss of life. And if these two books have any message, it is that large organizations employing risky technology will make mistakes.
We all hope that the next shuttle-related mistake will not have the catastrophic consequences of the Challenger accident. But we also need to ask ourselves whether the benefits of space development are worth taking, even if more pioneers lose their lives along the way. I, for one, believe the answer should be “yes.”
