What Went Wrong

Logic Fail of the Day

2011-05-06T12:04:00.001-04:00

is brought to you by the Main Street Christian Church in Russiaville, Indiana.

Pastor Stephen Bishop posted on his church's facebook (now either down or private):

“Well, yesterday's sermon was a big hit! We had a mass execution of feeder fish that I pulled out of a fish tank and then threw all over the floor. The kids were in shock and then started to pic[sic] them up and put them back into the fish tank. Obviously, most of them died in the effort...the point however was made that they cared more about .15 cent feeder fish then[sic] they do about their friends dying w/o Christ.”

This gets posted on Reddit, and sparks an interesting line of insane justifications from the holy man himself, including:

"The lesson was not in making things suffer or allowing things to suffer. The point of the lesson was that we shouldn't want individuals to suffer in hell for all of eternity. That we need to act quickly because none of us are promised tomorrow and that we only have this moment to make an eternal impact on the lives of those we love."

Yes, because killing things totally illustrates that.

"I got [these methods] from someone else and used them because it was a GREAT illustration that I believed would and infact[sic] did have a deep and powerfully positive impact for our youth and their relationship with Jesus. Again positive. Again, are you saying fish have souls, because that obviously is not what I believe."

Not having a soul = totally disposable and just fine to callously discard.

"First of all, I did not equate the spiritual value of the fish to their monetary value. Fish have no spiritual value, but they do have nutritional value in that fish are food. They were given to us to be eaten and to be eaten by other animals. We are to be concerned yes for all living things but more so for the souls of mankind. I read that Jesus taught this same lesson to the disciples when they just left their boats, nets, and FISH to go and follow him and become fishers of men. It was not a message of fear for Jesus nor was it a message of fear for me. It was a message of love...love for all of mankind and the desperate need to reach everyone with his love before it is too late."

Love!

"I removed the post and opened a thread of response here because there ARE CHILDREN who view our church's FB and they don't need to see all of the hate postings and cussing that is being sent to me. I[sic] not unsure of my methods and I am not the first individual to have used this illustration. I received it from Michael Rowan, who is a world renown[sic] sought after speaker and he received it from one of his personal friends. I am sure that there are other pastors out there who have also done very similar illustrations. If it makes everyone feel better, next time I'll go and buy a bunch of already processed fish (which were also raised to be killed and eaten) fry them up and throw them on the floor. Great impact there as well since it will also show the fact that we waited too long to save the fish and they got killed and fried. Same difference as far as I can tell. Of course there are those of you who don't eat anything that was living...right??? opps[sic]...wait, the carrots might still be thinking ,"please put me back in the ground, you're hurting me." Sorry for my satire but this is getting old. Fish do not have a soul and we are "worth more than many sparrows," for those of you who have decided to just rip scripture out of context go down just one more verse and finish the thought of Jesus in Luke 12. Of course in Genesis 1:28 God gives us "rule over the fish of the sea," but sadly nobody seems to want to recognize these facts. Again, sorry for my satire."

The point is fucking red-shifting as it goes over this dude's head.

RT the Pharyngula article on this, or use #mainstreetchristianchurch. I'd love to see this spread across the internet as a big old WTF moment.

On book publicity

2011-04-19T14:06:00.006-04:00

I was originally going to be good and pick a book that didn't already have loads of Internet argument, commentary, publicity, and frothing reviews; this one caught my eye initially because the cover is basically a stock photo with outer-glow Zapfino slapped on top of it as if it's 2006 all over again. But I am weak, and I am also not particularly nice, so I give you

[fanfare]

My Father's Daughter

by all-around superb human being Gwyneth Paltrow. Those of you who have better things to do than read gossip websites may not realize that Ms. Paltrow is not only an actress and a singer but also (in the words of eater.com) a lifestyle guru and cleanse practitioner. She's been foodie-ing for years; back in 2005 she claimed she would rather her children die than consume Lipton Cup-A-Soup. In 2008 she and chef Mario Batali, who wrote the foreword for My Father's Daughter, came out with a companion book to Batali's series Spain...A Culinary Road Trip. Her next foray into telling people what they should be doing was the online lifestyle newsletter GOOP. Now, with her own cookbook, Paltrow continues her rise to culinary superstardom.

Naturally, with an author of this prominence, the book publicized itself pretty efficiently. I doubt Paltrow had to do much calling of bookstores and offering to do signings if they had some spare room for a book table, or hiring publicists specifically for this purpose. On the face of it, the phenomenon of celebrity-with-book-deal isn't anything new; what sets My Father's Daughter apart from any of the other celeb books out right now (see Tina Fey's Bossypants, for example) is the amount of energetic, polarized, in some cases viral commentary on the Internet.

Back in December, Eater.com got hold of a preview copy of the book, and gave a precis of what we could expect. Tellingly, they offered only a little comment on the excerpts themselves, letting Paltrow's prose stand on its own:

"In the last ten years or so, cooking has become my main ancillary passion in life."

"I can still hear [my father] over my shoulder, heckling me, telling me to be careful with my knife, moaning with pleasure over a bite of something in the way only a Jew from Long Island can, his shoulders doing most of the talking."

"The stove is really the epicenter of my house — I am never far away from it and most of the time there is something atop it, simmering away for my family."

"I am constantly thinking about ways to give my children something filled with as much nutritional value as possible."

Now that the book is out, they've revisited it and are giving more of a review--while still allowing Gwyneth Paltrow to say everything about herself that they would be tempted to say about her. Here are Eater's sixteen best lines from the book. My personal favorite is

"I first had a version of this at a Japanese monastery during a silent retreat—don't ask, it's a long story."

But it's not all snark. The Atlantic offers a balanced view of the book, including commentary from an actual nutrition expert on the claims Paltrow makes. The overall impression is that My Father's Daughter has some decent recipes in it and does in fact offer useful advice in some cases, and once you strip away the hilarious permission given the reader to substitute actual pig bacon for duck bacon lest you find yourself unable to locate this latter substance, is written in good faith.

Finally, and perhaps most amusingly, Epicurious.com features a column by Julia Turshen, who assisted Paltrow with the book. Without meaning to (I have to assume), Turshen's chat with "the wonderful, supremely talented food stylist Susie Theodorou and her assistant Rebecca Jurkevich," who worked on the book with Turshen and Paltrow, illustrates everything about the world of the foodie that drives the rest of us nuts and makes us not want to buy My Father's Daughter (note that they can't spell cappuccino):

1. How do you take your coffee?

Susie: If I'm in Italy, a cappucino. Everywhere else, black.

Rebecca: It depends on the day. Either a good cappucino or an Americano. But my favorite is a cortado at Abraço. (Ed.: I couldn't agree more.)

Horrors of Soup

2010-11-24T17:42:00.001-05:00

So I found the Campbell's Book of How to Commit Atrocities in the Kitchen with Soup and scanned the most egregious of offenders.

Here is a teaser for what lies ahead:

CHEDDAR CHEESE SOUP BROWNIES.

mmmmmmmmmeat

2010-05-24T11:21:00.009-04:00

One of my favorite sources for Disturbing Vintage Advertising, TJS Labs Gallery of Graphic Design, offers corroborative evidence for the apparently crucial importance of meat in The Past. Meat wasn't just a source of protein for these people, it was practically a religion, complete with its own weird dialect (Meat of Good Eating! Meat--You're Right in Liking It! We waste not the Meat!*) and solemn injunctions to consume it not only for the sake of one's health and strength but for one's character as well. Meat: it helps fight Communism.

It had its own Cook Book.

But meat wasn't just limited to vast glistening centerpiece roasts. Meat could appear in many creative guises, such as Dilly Beef Cartwheel, Stuffed Pork Chops, Orange-Glazed Escarpments, Steak with Maggot Garnish (always serve with white zinfandel in an Erlenmeyer flask), Masked Identity Meat in Popovers, and Meatballs Attempting to Escape.

Meat dishes from this period can be roughly grouped into several categories: Meat that has been Ground and Shaped Into Masses, Meat that Maintains its Original Muscle Integrity, and Meat that Somebody Else has Already Processed. The variety of meatloaves and meatballs (meat loaves and meat balls, which sounds thirty times less appetizing) available in your standard Avocado Green and Harvest Gold kitchen would be categorized as Ground and Shaped Into Masses, as would leftover meat that has been chopped up and added to a jellied salad or vinyl sauce. Roasts and most hams, chops, and steaks would fall under the Original Muscle Integrity category, at least until the housewife cut holes in them and started stuffing cubes of Velveeta and canned pineapple inside. Meat that Somebody Else has Already Processed covers sausage of all descriptions, Spam and its forlorn competitors (Mor, Treet, Prem, Temt, Bif, etc), and canned ham.

Luckily for everyone, I've got examples of all three!

We'll begin with Mock Pot Roast, which is frankly sad. "Everyone squint, and I'll turn down the lights, and maybe if you wish real hard it'll taste like pot roast instead of a giant lump of ground beef, oats, and bottled gravy coloring!" The caption states that this is a "stunning" meat loaf in a dish. I suppose you could place the whole thing inside a sack and swing it at people's heads to stun them. I suppose.

Then we have Duchess Meat Loaf Pie, which is creative because it's a meat loaf in a skillet with instant mash on top and because it comes pre-infested with maggots.

The cook who is using ground meat may find herself faced with the difficult decision of whether to shape the flesh into a loaf or a ring. (Or a cube, or a cone, or a cowpat?) If she chooses the ring, she must fill the hole in the middle with enough green-flecked rice to support a selection of gleaming black shuttlecocks. If the loaf is selected, it must be topped with a miniature limp green octopus. Note the recipe for the "Piquant Ring" contains half a cup firmly packed brown sugar and a quarter-cup each of orange juice and molasses. Dentists must have loved the 70s.

Here we have semiconscious cow heads adorning round hamburgers and vinyl sauce (vinyl cheese, in this case) covering Wendy's-style square burgers. Note the use of what appear to be surgical pins to anchor the olives and tomatoes to the vinyl cheese.

Sometimes the housewife wanted to hide her shame and wrap up the ground meat inside a cabbage leaf. This never ended well.

Maggots are a recurring theme in the Great Book of Hamburger, as evidenced by Spanish Mince and Maggot Roll. Can you spot the worm head in this picture?

But nothing compares to this presentation: none of these ground-up gustatory delights can hold a candle to the following image:

Rapier-Pierced Bowel Movements in Ill-Fitting Buns.

That's quite enough of that. Let's move on to Meat that Retains its Original Muscle Integrity, with Sugared Pork Snout Roast. Doesn't that look amazing? Spiced pears, even!

Braising in bleach was one of the ways cooks in the 70s made sure their meals were free of illness-causing bacteria.

Here we have the fabled Death Valley Dead Thing Rôti. This must be cooked over a pale flame on rippled sand just as the sun peeps above a distant mountain range. Otherwise the skinwalkers will find you.

You think I'm kidding about the vinyl sauce thing? They came right out and said it: this unappealing pot roast is draped in a rich brown gravy. You don't drape gravy. You drape vinyl.

We've seen this before, but here's the pink petal posy ham à la sandworm head. Glazing of pig products with various viscous sugary syrups seems to have been not so much a fashion as an enforceable law: some creative individuals took advantage of the opportunity to glue things onto the side of their glazed pig chunks in the process of covering them in sugar. Somewhere out there on the internet there is a picture of a leg of something with a paddleboat design stuck onto it, made out of wheels of lemon. More about sugar and pig in future posts.

What of the third group, the Pre-Processed Meats? Well, the Meat Cook Book is diligent in explaining the various sorts of sausage known to man.

As many of you already know, the frankfurter was given a more classy and haute-cuisine sort of role in the sixties and seventies. Phrases like "frankfurter spectacular" and "Franks take on a new glamor in this gleaming aspic" now strike dread into the heart of the reader, but at the time we must imagine they were really considered to be more than just mechanically separated meat slurry spiked with nitrates. Take for example Frank Corn Crown, described as "fancy," or Glazed Apples 'n Franks. Gleaming, is what those are. Gleaming with sugar and preservatives.

Sausage could be possessive. You didn't want to get between a loop of kielbasa and its mustard pot.

Sometimes sausages were relegated to the role of garnish, but even so they were carefully prepared for their close-ups, some being given a golden spray tan and some remaining pallid and delicate grey-pink.

Sausage could also be brown.

And finally, pathetically, we come to Tangy Potato Salad, which consists of chunks of hot dog and potato mixed up with cream of celery soup. This, like several of the other dishes in today's post, is from the Better Homes and Gardens "Good Food on a Budget" cookbook, which offers the struggling housewife a variety of tips for "stretching" the food budget, including the use of variety meats and sating the heartier appetites with bread. "Good Food on a Budget" is less lurid and hallucinogenic than some of the earlier BHaG tomes, but it's a lot more depressing.

So have a Bacon Big Boy to cheer you up, and remember: MEAT MAKES THE MEAL.

I'm not making this up.

You'll Love to Serve Viscera the Modern Way

2010-05-20T15:33:00.006-04:00

I know I told you Ways With Ham was coming up next, but first I really do have to share with you the proper way to serve internal organs from various animals. I feel it's an important and oft-overlooked culinary achievement.

For instance, if you've ever wondered how to stuff a heart, you need wonder no longer. Stuffing hearts isn't, of course, the only way to serve exciting variety meats:

...for a down-home twang, or

for that Middle Eastern flair. But remember,

Those are of course beef kidneys in the above picture, which are supposed to look like giant glistening bowel movements. As of course you're well aware.

Now that we've got that out of the way, let's get on to HAM.

Everybody's favorite Spam precursor comes in many shapes. Here it is in sculptural waveforms; in petrified slab form; in glistening glucose-glazed slab form; in wet and green-tufted form, or in pink-petal-posied sandworm head form.

HAM.

You may possibly be wondering what the green substance is that's protruding from one of the above examples of HAM. It is in fact combined spinach, green onions, and parsley "tucked into deep cuts in meat." If that doesn't get your motor running, I can reassure you that like every other ham recipe in the universe of these books, it also contains enough sugar to give a whole cheerleading squad diabetes. I don't know why ham must be sweet: it should not be sweet, just as all other forms of meat should not be sweet. Would you put chocolate pudding on your steak? Then don't put honey on your ham, you wretched philistines.

To return to HAM, it is found in the wild in many shapes, before Better Homes & Gardens have got their psychedelic hands on it and drenched it in corn syrup: there is cylindrical, oviform, and pig-leg-shaped ham to be found, as well as rectangular, laminar, or long-barrow-shaped ham.

These hams have been sat on. Notice that the one in the middle apparently features a navel.

I trust this provides a thorough and well-balanced view of the world of ham, and close this episode of Non-Euclidean Food with the following image. I'm not telling you what this is: you will probably be able to locate it elsewhere on the web, but for now let it remain mercifully unidentified. This is from a cookbook published by a well-known and respectable family-oriented magazine.

Why Art Directors and LSD Do Not Mix

2010-05-19T08:47:00.003-04:00

A lot of these horrible retro cookbooks (or cook books, as they're often listed) appear to have been designed and laid out with considerable help from the Inexplicable Props Department. This isn't just the Seventies' fault, either: with the widespread introduction of microwave ovens in the 1980s, a new strain of awful food photography came to light in the genre of How To Use Your New Microwave guidebooks, with emphasis on the bizarre.

I present to you Microwave Miracles from Sears, circa 1981. There aren't any pictures of the actual miraculous microwave, but it's a pretty safe bet to imagine something the size of an industrial transformer in tasteful shades of black and brown wood-grain. (I have to admit, here, that I own a 1986 JC Penney microwave/convection oven which is still going strong, despite being old enough to buy its own booze. Microwave magnetrons don't really wear out.)

Apparently one of the things 1981 Sears microwave ovens did was to make everything very brightly colored, and to accent this brilliance the book's designer called in the full force of the Inexplicable Props. For example, Eye of Sauron Pea Soup is accompanied by giant salt-and-pepper shakers designed to resemble faceless banisters carved of jade, and posed against a backdrop of floating lime-green mushrooms. Monolith of Meat is posed with a disturbingly tiny stemmed dish of what is presumably either horseradish or whipped lard, and watched over by a distant, silent, silver cow-god idol.

Kebabs on Bleached Rice, accompanied by Banana Slugs in Spinach, are watched over by a pair of onion-shaped albino alien beings. Also note the cutlery handles, which appear to be ceramic puffins that have been stretched longitudinally. Stir-fried Worms are also guarded by two white aliens, cleverly disguised as little pottery pagodas, and served in an orange-red limbo in front of openwork screens designed to throw the shadow of the Cross on all they survey.

More unpleasantly, Jellied Emesis--also on bleached rice--is served with your choice of shredded coconut, yellow lima beans, or something brown and sticky which could be a chutney of some kind, and posed with a couple of artifacts stolen from the Vaguely Moroccan Or Something wing of the local museum. But none of these are quite as inexplicable as Turkey with Vinyl Sauce served as an offering to a miniature cast-iron coal-fired range. It's an adorable if somewhat disturbing miniature cast-iron coal-fired range and I want it (it comes with pans! And a coal-scuttle!), but what it has to do with bland slices of turkey breast served with broccoli I cannot fathom. I think at this point the art director was giggling madly and grabbing for any object he or she could find to pose with dishes. Dollhouse appliances? Great! Laboratory glassware? Bring it on! Dollar-store kitch? Beautiful!

Moving on, we come to Dismembered Fish stuffed with stuff and topped with bacon, accompanied with whipped lard and rabbit droppings, and posed with dead grass and a wood-and-metal fish sculpture gazing in frozen horror at something offcamera to the left. Note that the fish sculpture, unlike the fish entrée, still has its head attached.

Next up is Glistening Almond-Strewn Tripe, apparently served on the Mary Celeste. Technically this dish is "Filet of Sole Almondine," but I've also been advised that it could be a casserole full of Vinyl Sauce Puddles as seen on the turkey served with dollhouse kitchen appliances. Just arrange your foodstuffs on a plate and drape one of these over it and bang, you have a real classy presentation. See, for example, Mount St. Cholesterol, balanced atop eggs in a carton and regarded with disdain by a blue cock. The substance drizzled over this dish could easily be taken from the casserole-of-vinyl-glop.

In the 1980s, any decent housewife would take pride in her culinary skill and in the style with which she served guests and family. Crocheted Spaghetti is one of those dishes by which you can measure a chef's capability; the strands of albino pasta had to be woven just so on the serving fork, echoed in place settings by the melted Chianti bottles stuffed with broomstraw. If you got the pattern of pasta on your fork wrong, the whole neighborhood would know you weren't a good wife and mother.

Desserts were important too. Brownie with Melted Crayon, Yellow-Flavored Yellow Cake with Yellow Filling, and Baked Insulation topped with Whipped Cream had to be watched over by a belligerent pewter swan; really classy cooks would garnish the swan with plastic roses in a hue exactly matching the desserts.

Sometimes you had to serve meals outdoors against a weathered shingle wall, and when this was the case your standard beige vinyl sauce wasn't up to the task of presentation: you had to slather stage blood atop the vinyl sauce if you wanted your Pan-Fried Insoles to look their best. Serve with iced tea in a volumetric flask and breaded rebar pieces in a decorative bucket.

Finally, we come to Glistening Stew. The secret ingredient in this recipe is multiple coatings of polyurethane varnish. A properly prepared Glistening Stew will not move even if the pot is turned upside down and shaken. This example is served with salt and pepper shakers in an elegant blue-pattern porcelain, but the really interesting aspect of the presentation is the porcelain plate behind the stew pot, which appears to be staring in abject horror at the dish. Get me out of here, it's begging. For the love of God.

This concludes today's edition of Inexplicable Props and Yellow Glop. Stay tuned for Ways with Ham.

What went horrifically wrong

2010-05-18T15:30:00.005-04:00

...with cookery in the decades leading up to, say, 1990? How did anybody survive on meat jello and radish roses? It's been discussed by a lot of other people round the web, starting with James Lileks' Gallery of Regrettable Food and the godawful Weight Watchers recipe cards including Fluffy Mackerel Pudding. But there's no such thing as too many blog posts featuring culinary atrocities of yesteryear, so I'll jump right in with a few of my own.

My local Goodwill, quite apart from supplying me with designer clothes at ludicrously low prices, is a ready source of Awful Retro Cookbooks. Some of these are pretty staid and uninteresting (put glop in pan, add cream-of soup, bake) and some of them are the product of a diseased mind.

Let's play "Identify the Foodstuff."

Gulf oil spill, lava, liposuction products? Assuming this is meant to be edible, is the substrate a bread, or cake, or vegetable, or meat?

It's fruity.

How about this:

Really bad frog sculpture or microscopic shot of Staph aureus? I'd go for the latter.

It's ever-fancy.

Or this:

A friend of mine had hoped that this was bread. It's not. It's flavorful.

Some of these are from the Better Homes & Gardens Creative Cooking Library Best Buffets book. I don't know how much of this can be chalked up to the fact that people in the 70s apparently had limited perception of colors--perhaps some of these dishes might look less terrifying if they weren't so luridly oversaturated--but I think this is evidence that Batman villains were running the BH&G show. This gem also offers us Meat Balls with French Cream, an obvious attempt to encourage consumption of horse dung, Split Wieners and Impaled Cartoon Eyeballs under the stern glare of a pair of sentinel salt-and-pepper shakers, and whatever the hell this is. I'm particularly taken with the continued horse-dung theme in the pan of conjoined bread rolls at the top, which also suggests frog eggs. You see what I mean about color.

Also, it's nice that the Best Buffets authors took men's unique needs into consideration with a Bachelors' Feast featuring Deviled Bones and Neiman-Marcus Apple Pie, but I have to wonder about this guy, who is clearly dismembering a corpse. He's just jacked Mr. Rogers' cardigan, too. Not the type of Bachelor a woman really wants.

I leave you with the image of strife-torn Bolivia, this week on Storage Jars.

Setting the architectural world alight: plastic pleasure-domes and pointing fingers

2009-07-30T22:47:00.003-04:00

The word Summerland today conveys long pleasant golden days--the Lotus-Eaters' land in which it seemed always afternoon, a realm where the sun never set and the tiresome seasons never changed. This is because hardly anyone remembers what it meant to British holidaymakers in the dawn of the 1970s, or what it meant the morning of Friday, August the 3rd, 1973, when daylight revealed what was left of it.

It is interesting to compare the Summerland disaster to the King's Cross tube station fire. Fifty people died in Summerland, compared to thirty-one at King's Cross--but the King's Cross fire is mentioned far more often and gained far more media attention than did Summerland. Dr. Ian Phillips of the University of Birmingham has made what may be the most comprehensive and in-depth study of the Summerland disaster, which is well worth reading on its own; he muses that had a fire killed fifty holidaymakers in, say, Bournemouth, rather than on an obscure little island in the Irish Sea, it would have been a massive news story hailed as a national tragedy. He's right.

The Isle of Man is shaped roughly like a kipper. It is home to just over eighty thousand people, governed by the oldest parliament in the world, Tynwald; its flag shows a triskelion made of armored legs joined at the thigh. It has its own officially-recognised-as-a-legitimate-autochthonous-regional language, Manx Gaelic, and its indigenous Loaghtan sheep produce a particularly fine and much sought-after meat. And in 1971, it became home to a new concept in leisure: the first modern, completely climate-controlled, indoor holiday sports and entertainment center ever built in Britain.

Summerland in context

As the Sixties waned, the popularity of the British seaside holiday was fading in favour of cheap group tours to the Mediterranean. Spain in particular was attracting more and more lower-to-middle-class Britons who might otherwise have gone to Bournemouth or Minehead or even the Isle of Man for their summer hols. And honestly, anyone who's been to the British coastline in summer prior to, say, 2004 and the advent of summer temperatures regularly above eighty F would have to agree with them. British beaches are a) cold, b) windy, c) rainy, d) spiky or stony and e) all of the above at times, plus packed with hundreds of thousands of other determined holidaymakers and their porky children buying ice-creams and sticks of rock and cheap plastic pails and shovels to make sandcastles with. There's a certain dogged one-upsmanship associated with British holidaymaking: no matter how foully cold and rainy and disgusting it is, you are at the damn seaside and you are damn well going to paddle in the sea even if the sea is forty degrees fahrenheit and the colour of wet slate and everybody else is wrapped up in towels and anoraks and going "ooh isn't it cold." It is this mentality the planners of Summerland wished to exploit: instead of going off to Ibiza or Torremolinos or some other mucky foreign place where you were bound to get the runs, you could just nip off to the Isle of Man (a proper British holiday destination with regular ferries from places like Blackpool) and spend a fortnight in the endless tropical climate-controlled sunlight of Summerland.

The plot on which the Summerland/Aquadrome complex was constructed had long been used as a holiday/amusement park site. Located at one end of the promenade of Douglas, which became the Isle's capital in 1869, the site had first been developed in the 1790s for a structure called Derby Castle--at the time not even incorporated into Douglas, joined by a causeway. In the later 1800s the Castle property was bought by a gent who noticed the major uptick in tourist visits to the Isle and decided to capitalize on same by building what was in effect a prototype for Summerland: an entertainment center including a theater, ballroom, and restaurant/bar. There was even a roller-coaster and firework displays.

By the end of the 1800s the Derby Castle Company had merged with the other entertainment-venue companies vying with it for patrons. Through the World Wars, the entertainment center was used for various purposes such as factory work and storage for valuables from hotels used as internment-camps. It was said to be cursed; that anything built upon it would meet a sticky end.

After 1945 the Derby Castle property was bought by the "Douglas Corporation" in order to be redeveloped into a brand-new entertainment center designed to draw holidaymakers from the delights of the Mediterranean package holiday by replicating the attractions it theoretically offered. With the diminishing tourist trade and the lack of interesting and non-weather-dependent attractions in Douglas, the Isle wanted to create a center to entertain visitors even during truly awful weather. "The design presented," says a booklet produced by the Island's Development Company in 1972 (The Summerland Story, 1972, p.25), "is based on the idea of creating an environment where the sun always shines – an area in which the weather can be guaranteed and where every activity connected with a seaside holiday can be enjoyed by all ages. The scheme envisages, therefore, the maximum possible area enclosed by a structure designed to admit the maximum sunlight, implemented by artificial means, to create a permanent atmosphere of sub-tropical climate. Within this area it is aimed to produce a sense of being in the open air without the climatic hazards."

The arguments and agreements and parliamentary squabbling surrounding the development of what was to become Summerland are neither interesting nor uplifting. Suffice it to say that initially the swimming-baths (pool complex/Aquadrome) were definitely Wanted by the Isle government and money toward their construction was earmarked. At this point architects got involved--and at this point we start to see the inevitable confusion building. Perhaps Frank Gehry's architectural abortions aren't so bad after all: so far none of them has actively killed anybody.

The architects

James Philipps Lomas, a Douglas architect with two lowercase Ps, won the contract for Summerland because his ideas were "rather more imaginative" than his competitors' (in the words of Douglas' Borough Engineer, Byrom, 1971, quoted in Phillips, s2 p58). Here is Lomas and his colleague Mr. Brian Gelling looking at a model of their creation. Notice that the Aquadrome, in the foreground, backs up directly against the cliff on one side. (Also notice that it's a horrible Brutalist disaster.) Lomas had never worked on anything outside the Isle of Man, whereas Gelling had been employed at a larger firm with experience designing leisure centers on mainland Britain; this firm, Gillinson, Barnett & Partners, was eventually to be appointed "associate architects" for the Summerland/Aquadrome project and do all the working drawings and all the research into materials needed for the work.

This last is significant. Summerland was to shake up the world of architecture with its unprecedented use of particular materials, the properties of which could have used a little more research.

The construction of the Derby Castle Scheme had three components: the Aquadrome, Summerland itself, and a multistory car park which was never built. The Aquadrome featured two heated seawater pools with stadium seating, as well as a host of rather ominous-sounding other attractions including "aerotone, sauna, steam, hot, cold plunge, slipper, Vichy douche, massage, Russian vapour and Turkish baths." It opened in 1969 and was run by the Douglas Corporation (separate from Summerland). They had considerable difficulty sticking it to the cliff face that formed its fourth wall, and in fact had to bolt the cliff together to stabilize it, ending up with a messy and unbeautiful surface.

Summerland's plans had been drawn up in 1965. Construction didn't begin until 1968, and was disrupted in 1969 and 1970 by disagreements over the internal layout and what the probable tenant would end up doing with the building. An early model of the interior of the building shows a very different concept than what ended up being constructed. The Douglas Corporation waffled on a tenancy agreement for so long that in order to avoid expensive overruns the contract with the construction company was renegotiated to include just the building shell, rather than the internal structure. The shell was completed in December of 1970, just under the deadline. A new contract would have to be drawn up with the eventual tenant regarding the furnishings and fitting-out of the building. This is also significant, because the separation of internal and external structures involved a lot of fire code waivers and wriggling out of having to actually take structural precautions against disaster.

Douglas Corporation finally signed the UK hotel group Trust House Forte (THF) to a 21-year lease in December of 1970, which separated the managements of the Aquadrome and Summerland. Patrons would have to pay separate admission fees to the two attractions, and could not walk from one to the other without going outside, contrary to the original Scheme. The tenancy agreement did allow for work on the interior design and construction of Summerland to begin, and here is where the tragic flaws of the building begin to become manifest. The interior structure of Summerland was entirely done by the associate architects, Gillinson Bartnett & Partners, and not by Lomas and Gelling. Lomas's plans could not have taken into account design decisions made by Gillinson Barnett, and therefore could not have included an appropriate system of staircases and exits in the shell design to match the interior usage of the building.

After the fire, the investigation into Summerland's design unearthed this factor, which was used as an excuse by the architects: "The Commission was told that, during the long process of designing Summerland, the details of escape in case of fire could not be considered because the kind of occupancy, usage and activities were not decided, as no tenant had been nominated." (Summerland Fire Commission report, para 216, pg 21, quoted in Phillips, chapter 2.6, pg. 71.) The Commission wasn't having any of it, however, and concluded that Gillinson Barnett damn well could have made some educated guesses.

Materials

The revolutionary nature of Summerland as a concept was not so much based on its functioning as a leisure center but as a "weatherproof enveloping structure" within which visitors could enjoy the pleasures of a summer seaside holiday all year round. In order to create such a vast enclosed space, the associate architects turned to what was then a highly innovative building material, the polymethylmethacrylate sheeting sold as Oroglas. No one had ever used Oroglas on such a scale before: they created a whole roof and much of two walls of Summerland out of the stuff. This was not explicitly stated in minutes from the Tynwald discussions during the planning stages of the project: all the references to the construction used the words "glass" or "glass-like material," implying that the building would be constructed using largely traditional materials. Remember that it wasn't Lomas who was responsible for choosing materials, but the associate architects, Gillinson Barnett.

"The decision was taken to use Oroglas for Summerland by Mr Clifford Barnett at an early stage, and was confirmed amongst the architects before the Derby Castle Development Scheme brochure was presented to the Finance Committee of Douglas Corporation in August 1965 (chapter 2). Mr Barnett was not only insistent on an acrylic solution for Summerland; but a solution that involved the use of a particular type of acrylic sheeting manufactured by an American company that at the time had not been used on an extensive scale in Europe. His commitment to using Oroglas is picked up by the Summerland Fire Commission report (SFC Report, Paragraph 207, Page 69): “He [Mr Barnett] was clearly committed to it [Oroglas]”, the
report states....The architects wanted to create a building that was “unique and compelling” (The Summerland Story, 1972, Page 25). In the same brochure, the claim is made that Summerland would “set the architectural world alight for nothing had ever been designed to include so much of the transparent sheeting”." (Phillips, chapter 3, pg 98).

We don't need to point out the irony of the phrase "setting alight."

What did this marvelous material end up looking like in place? It looked like this. "Each panel catches the light to
provide an interesting and varying pattern on the façade," says the brochure. To modern eyes, it looks perhaps less interesting and innovative than "spiky," but at the time I.M. Pei had not constructed the Louvre pyramids and the Early Seventies Awful school of architecture was firmly in power.

Rohm and Haas, the manufacturers of Oroglas, themselves state that “There is no building code in America which would allow it [Oroglas] to be used overall as it was at the Summerland
centre. A structure like that would just not have been allowed in America.” U.S. fire codes require a comprehensive sprinkler system to be installed wherever Oroglas was used on a large scale, and in fact the UK subsidiaries of Rohm and Haas were aware of these codes and requirements...but did not pass them on to the Isle of Man chief fire officer.

The manufacturers knew Oroglas was combustible. Phillips refers to an ad hoc experiment conducted in Warwickshire by a council considering the use of the material in a project, in which a sample of Oroglas was set alight with a cigarette lighter and burned like merry hell: “The sample did not have chance to smoulder, as it burst into flames with a ferocity that I had not seen since like all young boys do, [I] set light to a ping-pong ball. It spat and flared, and we got a bit panicked that it would cause problems with the stuffy staff either side of our office.” An internal Rohm and Haas UK memo admitted that Oroglas could burn “in quite a frightening manner”. The letter warned that the material might not even fall free from its frame in the event of a fire. “The ways in which Oroglas may behave if involved in fire are not easy to predict and you should be cautious in discussions on this problem. The method of installation, size of panel and, in some circumstances, even the colour of material can have some effect.” (Phillips, chapter 3, pg 104.) One of the properties touted by the proponents of Oroglas was that it would soften and fall out of its frame at temperatures far below its ignition point, which was apparently known not to be the case. Rohm and Haas admitted after the fire that this information should have been provided to Mr. Pearson, the island's chief fire officer, but was not.

After the fire there was much throwing about of brains regarding whose fault it was that Oroglas was used in such amounts without a sprinkler system and whether the use of Oroglas had in fact been the cause of the fifty deaths. As it turned out it wasn't "Horrorglass" at fault for the disaster after all: it was another building material entirely, a substance called "Colour Galbestos," rolled steel sheeting coated in bitumen and asbestos.

Waive this for me

Isle of Man by-law 39 "requires a building’s external walls to be non-combustible and have a fire resistance of two hours." Both of these requirements were waived during the construction of Summerland, which is precisely why the disaster happened. Use of Oroglas was permitted due to a waiver requested by Lomas and granted on the understanding that, while Oroglas did not have a fire resistance of two hours, in case of fire it would theoretically soften and fall out of its frames, allowing people to escape through the gridwork of the walls. The Borough Engineer who recommended the by-law be waived to allow the use of Oroglas did so believing it to be non-combustible, which is rubbish. It's repeatedly stated that Lomas and the other architects assured the Douglas Corporation of Oroglas's non-combustibility, and this inaccurate statement of the material's properties shows up in promotional literature for the building. Post-fire investigations of Lomas and Gillinson Barnett show rather predictable mutual attribution of blame: Mr. Barnett calls Mr. Lomas cavalier in his approach to regulations, and Mr. Lomas claims that Mr. Barnett and his partners should have done their research and he trusted them when they said that Oroglas was totally safe. Either the architects didn't know they were telling porky pies or they didn't care. I don't know which is more disturbing.

The use of Colour Galbestos on the building's east wall was even more of a violation of Law 39, as it is neither non-combustible or fire resistant. It was used in place of concrete or regular steel sheeting because it was cheaper, and permitted due to a truly astounding sequence of failures to communicate: the Borough Engineer suggested Law 39 be waived for it because "he considered it an adequate material in all the circumstances;" the Douglas Corporation meant to ask the Local Government Board for the waiver but never got around to it; the Local Government Board received plans including the use of Colour Galbestos without being notified that its use required further Law 39 waivers; the Chief Fire Officer was never consulted about the use of Galbestos because nobody twigged that it was, in fact, lethally inappropriate. Similarly, the decision to use combustible plastic-coated fiberboard Decalin for the interior wall of the amusement arcade was made off the cuff and never discussed amongst the architects and designers with regards to the fact that it caught fire like anything.

Opening

Reaction to Summerland when it finally opened in 1971 was mixed. The building's promoters, unsurprisingly, thought it was just wonderful: “[Summerland] stands as a pulsating memorial to the foresight of its planners and supporters. It can only confound the critics of the controversial scheme when they see for themselves what has been achieved…The result can only be a source of pride to the whole Island...It will undoubtedly attract the widest publicity – not only because it is unique in the western world, but because it caters so ideally for leisure and relaxation in the unreliable climate of the United Kingdom," according to a full-page advertisement appearing in the Isle of Man Examiner on 16th July, 1971. Others were not convinced. John Carter, the travel journalist and TV presenter (Holiday and Wish you were here?) commented in The Times (19th May, 1973):“The centre’s glossy brochure claims it has ‘Attractions for every taste’, but I must beg to be excused from that generalization. I do not like motorway restaurants, either, but that is another variation on the theme.” (Phillips, chapter 3, pp. 116-118.)

Inside, Summerland offered a wide range of attractions including children's entertainment and play facilities, cafes, restaurants, and bars, amusement arcades, bingo, shuffleboard and artificial waterfalls, a tanning room, shops, and of course the Solarium--which was used for mass performances.

Despite the fact that its logo looks a bit like a gigantic pimple (or possibly the Eye of Sauron) the pictures convey a certain enthusiastic sort of gaiety. To modern eyes, Summerland drips with 1970s kitsch; James Lileks would have gone mad over the Marquee Showbar's purple and red awnings and plastic chestnut trees, or the bingo arcade's dental-appliance-pink and dog-diarrhea-yellow colour scheme. It's the apotheosis of Organized 1970s Fun, and not unlike one specific concept of Hell.

Now imagine all of this on a drizzly August evening in 1973, packed with around two thousand people listening to accordion music, dancing, drinking, roller-skating, tanning, eating, and generally spending money. It's still light outside as eight o'clock draws near. Outside on the terrace, where the mini-golf course is set up, three boys are hiding in a disassembled kiosk set up against the Galbestos part of the promenade wall, sharing an illicit cigarette.

The fire

The Summerland fire was started by a discarded match. While they were smoking, shortly before 7:40 pm, one of the boys lit a match which caught something inside the kiosk on fire. Apparently not realizing this or not thinking it would burn out of control, he joined his friends and some other boys on the terrace to talk about football. Soon afterward, they smelled something burning, and found that the floor of the kiosk was on fire. They tried to put it out, but the fire was beyond their control, and they ran away in fear.

By itself the kiosk fire would not have caused the disaster had Summerland been constructed of materials adherent to by-law 39. The fact that the fire was located right up against a wall made of Colour Galbestos doomed the center and fifty people inside it. An extremely fuzzy photograph taken between the fire's ignition and the full involvement of Summerland itself shows smoke and flames rising from the kiosk on the outside of the promenade wall: nobody knew that in fact it had also started a concealed fire inside the wall of the building. Holidaymakers alerted the staff to the fire around 7:55 pm, and staff members joined at least one patron in trying to fight the fire with chemical extinguishers and the building's fire hoses.

Even the staff thought the external wall was regular steel sheeting and would prevent the fire entering the building. In fact, it was already inside:

"The Colour Galbestos used at Summerland consisted of a zinc coated steel core, which was “covered with asbestos felt saturated with bitumen and then faced with a polyester resin coating” (SFC Report, Paragraph 152, Page 53). When the burning kiosk collapsed against Summerland, the Galbestos wall rapidly became red hot and ignited the material’s combustible coating (polyester resin and bitumen) probably after around 80 seconds (Sam Webb, RIBA, Personal Communication). Since the core (steel and zinc) of the Colour Galbestos has a high thermal conductivity, fumes were soon given off on the inner side of the wall after two-and-a-quarter minutes. “Strong flames” were coming from the Galbestos one minute later." (Phillips, chapter 6, pp.268-269.) The damaged Galbestos wall shows how the stuff buckled and twisted in the heat.

The inner wall, made of a plastic-coated fiberboard called Decalin, was also combustible. When the fire breached the Galbestos wall and entered the void, it ignited the inner side of the Decalin wall and spread across the eastern end of the building between the two walls. Phillips offers some chilling data: "It is estimated that the fire in the void started around 4-6 minutes after the external fire had become established in the remains of the mini-golf course kiosk. This internal fire then gained intensity – but at all times being confined to the void – over the next ten minutes between about 7.45pm and 7.55pm (Time estimate by Professor Rasbash; see SFC Report Paragraph 106, Page 38). It is not known what temperatures were reached in the void, but they may have reached 1000 degrees C close to and after the Decalin wall gave way..." (Phillips, chapter 6, p.273.)

When the fire broke through into the interior of the building, it did so at the ceiling of the amusement arcade (directly beneath the Marquee Showbar level), probably because the only firestopping within the void was located at that level (asbestos sprayed on metal girder). The flames roared across the ceiling of the arcade like a blowlamp, spreading rapidly across flammable furnishings and decorations. By the time the first flames were seen within the building, a considerable portion of the wall had already been burning for some time: with the breach of the inner wall, air rushed in and rapidly fed the fire. From the amusement arcade the fire spread, igniting the Oroglas promenade wall alongside the flying staircase, which caught fire after being exposed to flame for less than two minutes. Burning plastic dribbled to the Solarium below.

Eyewitness accounts agree that the fire spread incredibly rapidly--"as if the place had been doused with petrol," "like a bomb," "worse than the Blitz," "within ten seconds the whole place was on fire," "like wildfire," "the building went up like paper and was wrecked in no time at all." There was no warning, no fire alarm bell was sounded, and no official call was made to evacuate the building other than a terrified compere's shout over a microphone. People on the Marquee Showbar level and above had few escape routes from the building, all of which rapidly became jammed with struggling people. And the Oroglas--far from softening and dropping harmlessly out of its frames--was burning. Molten blobs of burning plastic rained on the screaming people struggling to get out, spreading fire across the Solarium floor. The gap between the terraces and the Oroglas wall acted as a chimney, sucking fire upward to the roof, which burnt out in perhaps ten minutes after ignition. The plastic panels had no time to soften and drop harmlessly from their frames: the temperature of the hot gases and of the flames themselves brought it up to ignition point in seconds. Recall the ad hoc experiment done in Warwickshire on a sample of Oroglas: once alight, it burned fiercely.

Of the vastly insufficient number of exits from the building, several were locked, including two of the main entrance doors and one fire exit immediately adjacent: some of these could be battered open, as the doors into the Aquadrome were, and some could not. People lost their way in the toxic black smoke and were overcome. Parents relaxing on the upper terraces were separated from their children playing in the lower-level skating rinks and the amusement arcade, some of them permanently. At 8:11 the lights went out as the manager shut off the power in the mistaken belief that it would improve safety by preventing electrical fires: the only light left was that thrown by the fire itself, obscured by billows of smoke. The emergency lighting, designed to come on in the event of a power failure, failed--either because the generators wouldn't start or because the switch to them was set in the "off" position. A supposedly safe enclosed exit stairway (the northeast service staircase) was not only not designed for use as an emergency exit but was also now pitch black and full of smoke.

The first alarm was called in to the Douglas fire station at 8:01 by a passing taxi driver; the second was from a boat offshore. Only after those did anyone in Summerland call for the fire brigade. No automatic fire alarm had been rung from the burning building whatsoever: this was investigated as having been either due to the setup of the alarm system or to fire destroying alarm wires. Once the fire engines arrived, however, there was little they could do: the fire had taken too great a hold and had too much fuel for them to hope to extinguish it. The main focus was then shifted to trying to prevent the Aquadrome from a similar fate.

By ten past nine--only an hour and a half after it began--the fire was under control, and by eleven the firemen were beginning to bring out the bodies.

The inquiry into the disaster published its report in May of 1974. Prior to the report's publication, most of the theories about the factors responsible for the deaths focused on the rapid fire spread due to the extensive use of Oroglas, the locked exit doors, and the delayed and disorganized evacuation of the building. In fact the Oroglas theory was still being cited as late as 2006 (Phillips mentions an article in the Isle of Man Examiner in March of 06 containing the line “Summerland was rebuilt without the lethal plastic dome, which had been responsible for so many deaths”). The Summerland Fire Commission report, however, scotches this theory, revealing the catastrophic combination of Galbestos and Decalin that had played a major role in the early development and spread of the fire. The combination of inappropriate material use, open plan design, insufficient staircases and exits, and delayed evacuation is what really caused the deaths of fifty people in Summerland.

The first three of these causes can be attributed to poor or nonexistent communication and research on the part of the architects and planners; the fourth could not be avoided, as there was no sign of the fire inside the building until twenty minutes after it had begun. People were still paying to enter Summerland for that twenty minutes after the boys' accidental ignition of the disassembled kiosk on the terrace. Nobody had any idea that the fire had penetrated the Galbestos and was burning fiercely inside the wall; the staff had had no reason to suspect that evacuation was necessary until after it was already far too late to save everyone inside.

Summerland's fire alarm system, like the Noronic's, had two stages. Public break-glass alarm points around the building would show up on an indicator panel in the "Control Room" when smashed, but would not sound the public alarm. A staff member monitoring the indicator panel would then be responsible for verifying the fire and sounding the alarms if necessary (by either smashing a staff fire alarm glass outside the control room or pushing a "test" button, not the Sound Alarm switch, on the console). The built-in delay was meant to allow for investigation of false alarms, but the fire station should automatically have been alerted when the public trigger was smashed. The fact that it wasn't indicates that the alarm panel itself had been taken apart and physically modified to extend the built-in delay to the automatic fire brigade alert, which Summerland had had done after prior false alarms without notifying the Chief Fire Officer. Which is a lethal version of "it's easier to ask forgiveness than permission."

As if the handy pre-sabotaged alarm system wasn't bad enough, the power supply to run it wasn't up to code, it turned out during the investigation. If the mains wiring was destroyed by fire, the backup generators were supposed to be able to provide power to run the alarm, but when these were examined after the fire they appeared to have been inoperable. Furthermore, the operator in the Control Room had had no training on the fire alarm system, did not know how to use the system, and was not aware that running the system was part of her duties.

The Control Room was set on the first terrace level facing the Solarium and the three terraces against the east wall, allowing the operator a continuous view of most of the interior. It was used in actual practice as the sound and light/announcer's booth for the Solarium, and in fact the operator on duty at the time of the fire reported not to the Fire Officer but to the Entertainments Manager, which gives you an idea of the room's role in the running of the building. There was in effect no fire and safety oversight from the Control Room, nor had there been under the management in place at the time of the fire. (It is worth pointing out that the first manager to run Summerland did take the Control Room seriously and its operators under his oversight were trained in emergency responses.)

When the fire started, the 19-year-old operator in the control room was not bothered because it appeared to be outside the building and no fire alarm station had buzzed on her panel as having been smashed. Even after the first public alarm glass had been smashed, no indicators were received in the Control Room, suggesting that the alarm system was already dead due to fire in the wall burning through the wiring. The operator could have sounded the actual alarm and sent a signal to the fire station, but did not do so. According to the report, "she felt that it was pointless to make an announcement because the fire was so evident in the building by this stage" (SFC report, paragraph 167, p 58, quoted in Phillips chapter 6 p. 278.)

The locked exit doors turned out, on analysis, not to have been as desperately fatal a factor as might be thought. Most of the deaths occurred on the terraces or the (few) staircases leading down from them to the Solarium floor or directly out of the building. From the third ("Cruise Deck", the highest point in the building) to the second terrace (Leisure Level) there was only one exit (the flying staircase); on the Leisure Level there was access to the flying staircase as well as the northeast service staircase which descended to the ground level and opened directly to the outside. From the first terrace one had a choice of the service staircase, the flying staircase, or the "rustic walkway" (an afterthought, not in the original plans). People struggling to escape from the terraces joined the throng on the Solarium floor running for the exits if they were lucky: if they weren't, they were stuck either on the terraces as the fire spread or on the staircases jammed with panicked people screaming in terror. The flying staircase--for many people the only exit of which they were aware--became enveloped in flames, killing at least 13 as they were overcome by fire and fumes or leapt to their deaths in the blaze below.

No villains

The official report's conclusion that the disaster was an accident attributable to human error and not to any specific "villain" surprised many. Here's what they said:

“In all the above inadequacies and failings, it seems to the Commission that there were no villains. Within a certain climate of euphoria at the development of this interesting concept, there were many human errors and failures and it was the accumulation of these, too much reliance upon an‘old boy’ network and some very ill-defined and poor communications which led to the disaster. It would be unjust not to acknowledge that not every failure which is obvious now would be obvious before the disaster put structure and people to the test."

Death by misadventure was the coroner's verdict--times fifty--and this, too, infuriated those who had lost loved ones in the disaster. If the architects and planners, the companies who sold them the materials, and the management in place at the time of the fire could not be held responsible, who could? God? Bad luck? The "curse" of the Derby Castle site?

There are no answers, but the Corporate Manslaughter Act of 2007--a result of unsuccessful prosecutions in cases of disaster--means that if anything like Summerland ever happens again, it would be possible to find the management of the building liable. As with almost every disaster, Summerland spurred the creation of new and more stringent safety codes and regulations, meant to address the various elements of the situation that had led to the appalling death toll. This comes as cold comfort to the families of the victims.

We should remember Summerland not for its kitsch and its desperately misguided concept. We should remember it because it is still the deadliest building fire to have occurred in Britain since the end of World War Two. We should remember it because the decisions that led to disaster are individually small and perhaps understandable: decisions that are likely to have occurred over and over since 1973. We should remember it because new is not always better, and because regulations are not always there to be waived.

Summerland was rebuilt in a vastly subdued version after the fire, but struggled to break even: in 2006 it and the Aquadrome, which had survived the fire, were demolished. After forty years the Derby Castle site has rid itself of a lingering scar, and Douglas--and the Isle of Man--can move on.

Information in this post is from Dr. Ian Phillips's book detailing the results of his research into the Summerland disaster. The book is available on the Web at Dr. Phillips's Birmingham University page. All images in this post are from Dr. Phillips's book (complete with original caption and citations where possible) and moved to my own hosting for purposes of illustration. No copyright infringement is intended and no money is being made: the research was done by Dr. Phillips, not myself, and this post is intended merely to present in summary the conclusions detailed in his work.

Wiki's article on the disaster states variously that 50 and 51 people were killed: there is controversy over the above-50 death toll figure, but Dr. Phillips states that he was unable to find any evidence to support the notion that more than fifty died.

What didn't happen at all: Ancient Egyptian Maser Technology

2009-07-10T12:08:00.003-04:00

I trust most people out there are at least somewhat familiar with the Great Pyramid of Giza (also known as the Pyramid of Khufu, or Cheops if you want to be all Greek about it). It's a big sort of triangular hunk of stone, not far from this river that runs backward. Been around a while. Appears with an eye stuck on it on the reverse of the dollar bill.

Now I am not a trained Egyptologist, but I am at least aware that the reason these things were built has been the topic of considerable discussion and frothing academic vitriol for at least a thousand years. Tomb or cenotaph? Tomb, cenotaph, or monument? Most people who have not had their brains surgically removed and replaced with live novelty goldfish will probably agree that the pyramids had at least something to do with the memorialization of dead god-kings, whether the dead god-kings were actually laid to rest for all time inside them or not. Most people do not spend good money, time and effort trying to reverse-engineer the pyramids into giant hydrogen masers.

I will digress here into a brief explanation of the maser qua the maser, for the benefit of those of you who never took Pyramidiocy 101.

It may surprise you to know that the thing you call a laser was originally known as an optical maser. The term stands for “microwave amplification by stimulated emission of radiation.” Masers work on the principle that excited atoms (Eee! Eeee!) can amplify radiation at a certain frequency; that is, you get a bunch of atoms of something, say hydrogen, and you excite them, and then you pass a microwave beam through them, and the bouncy atoms amplify those microwaves. This does you no actual good unless you’ve confined the bouncy hydrogen inside a resonant cavity, that is to say an enclosed space in which waves bounce around with low loss; if you do this, and beam the microwaves into this cavity, you will get repeated and functional amplification. So what? So you can then use this microwave energy to do stuff like, I don’t know, cook Stouffer’s frozen French bread pizzas.

Now, the ancient Egyptians did not record their use of microwave energy to cook Stouffer’s frozen French bread pizzas, but a gentleman by the name of Christopher Dunn is of the opinion that they did use this energy to run ancient Egyptian power tools. Oddly enough none of the temple carvings or tomb paintings thus far discovered by archaeology have shown the black-and-yellow god Deh’Wawat drilling holes in people’s heads to let out demons, nor yet his consort Bak-An-Dekar using the Circular Saw of Ma’at to frighten away Apophis from trying to swallow the Sun, but Christopher Dunn proceeds dauntless.

His argument is based on the fact that a great many of the relics of antiquity found in Egypt show a precision which he considers impossible without the use of modern power tools. The black sarcophagi at the Serapeum, for example, he contends could not have been made without the use of precision tools. Therefore, the ancient Egyptians must have had some kind of power plant to provide the motive force to turn their drills and cut their stone into perfect right angles: and, since the Great Pyramid was just sitting there, without even a dead king in it to justify its existence, Dunn focused on that as his power plant candidate.

How did it work, you ask? In order to understand Dunn’s theory you will need to become familiar with the internal architecture of the Great Pyramid.

See figure 1.

I confess I do not own The Giza Power Plant, Dunn's seminal work, but I've read the bits of it and his other theories that appear on various woo-related sites around the internet, and I believe I have grasped the main thrust of his point.

Apparently the Pyramid was designed to focus "energy" on a resonant chamber at its heart (the King's Chamber). The Pyramid is supposed to resonate at exactly the same frequency as the Earth, and the internal architecture is designed, according to Dunn, to maximize that resonation and produce piezoelectric energy out of quartz crystals in the granite slabs that line the King’s Chamber. It is not clear whether somebody had to stand outside hitting the Pyramid with a tuning fork while they were building it so that they could be sure to match resonant frequencies, but we can assume this was done with the appropriate ritual and ceremony. He's terribly excited about the levels of granite beams above the King's Chamber and how they were "tuned" whilst being cut:

Each granite beam was shaped and gouged on the topside as it was tuned! Thousands of tons of granite were actually tuned to resonate in harmony with the fundamental frequency of the earth and the pyramid!

And I am the Seriph of Klatch. Dunn does admit that he hasn't actually got any proof of any of this, but forges merrily ahead anyway:

Without confirmation that the granite beams were carefully tuned to respond to a precise frequency, I will infer that such a condition exists in light of what is found in the area. While I have not found any specific record of anyone striking the beams above the King's Chamber and measuring their resonant frequencies, there has been quite a lot written about the resonating qualities of the coffer inside the chamber itself. The coffer is said to resonate at 438 hertz and is at resonance with the resonant frequency of the chamber. This is easily tested and has been noted by numerous visitors to the Great Pyramid, including myself.

"I can't prove this but I think other people said things that mean it might possibly be true, so I'm going to use it to base my theory on."

Dunn's idea centers on the Grand Gallery, in which he posits that twenty-seven racks of Helmholtz resonators were installed. As the earth's vibration flowed through the Great Pyramid, the resonators converted the energy to airborne sound, which then was reflected into the King's Chamber, where it bounced around sufficiently to cause the granite beams to vibrate like a bunch of enormous silicaceous bass strings. "Thus," he concludes, "[with] the input of sound and the maximization of resonance, the entire granite complex, in effect, became a vibrating mass of energy."

So we have a vibrating mass of energy. What do we do with it in order to get our mystic ancient drill-presses to work?

Let’s take this step by step.

Dunn believes that the Queen’s Chamber was used to produce hydrogen via a chemical reaction between hydrated zinc chloride and dilute hydrochloric acid. Where did these chemicals come from, you ask? Why, they were pumped up vertical shafts inside the Pyramid to the tops of the two shafts opening into the Queen’s Chamber, whereupon they filled up the shafts and seeped at a controlled rate through the blocks in the walls of the Chamber itself. When Rudolf Gantenbrink’s robotic exploration of these shafts ended at a limestone "door" with two copper spikes driven through it, Dunn was ecstatic—never mind the lack of vertical shafts for his chemicals, these bits of copper were clearly electrodes which would signal that more chemicals were needed when a circuit between them was cut by the electrolyte level falling.

I'll let you think about that one for a minute.

When the National Geographic robot drilled a hole through Gantenbrink’s Door and the expected vertical shaft/copper cables were not, in fact, there, did this deter Dunn? Not a bit of it. He promptly fired up Photoshop and decided he’d do a bit of off-the-cuff theorization and massive overuse of filters that would allow the vertical shaft to exist after all, even though it appears to be nothing more than a shadow. One must have faith in the Giza Power Plant theory, because faith is a vital part of any scientific investigation.

Dunn also (and more egregiously, in my view) ignores the fact that the shafts through which these chemicals are supposed to have run are made of limestone. Anyone who’s ever done any work on karst topography--or lived in south Florida or the Ozarks or the Dales or the Peak District--knows just how easy it is to wear away limestone with plain old water, never mind hydrochloric acid. Why didn’t the builders line the shafts with granite, if they were going to be running corrosive liquid down them? How come the Queen’s Chamber isn’t a big amorphous cave in the rock dissolved away by the chemical reactions supposedly going on inside? Where did the ancients get the ingredients to mix these chemicals in the first place/isolate them from naturally occurring substances? How were these technologies made possible before the construction of the Pyramid? Dunn does not relate.

Having made his hydrogen through this wildly improbable reaction, Dunn then takes us along the horizontal passage that links the Queen’s Chamber with the Descending Passage. The spent chemicals would trickle away down the shaft known as the “well,” which is something like 28” by 28” at the top. Why it needed to be that big, Dunn does not explain. The hydrogen, then, was wafted up through the Grand Gallery to the King’s Chamber.

As mentioned, the Grand Gallery supposedly contained stacks of Helmholtz resonators. During its journey up to the King's Chamber, the hydrogen would have been excited by all the good vibrations, and when it got to the resonant King's Chamber, it would have been seriously excited to the point where it could do some stimulating of radiation emission.

At this point Dunn leaves interesting fancy behind and goes right the hell over the edge into foaming-at-the-mouth insanity: he posits that at this point, a microwave signal from space came down the northern ventilator shaft ("wave guide") into the sarcophagus in the King’s Chamber so that the energized hydrogen atoms could amplify its signal exponentially. This amplified microwave signal then was collected by something in the other airshaft of the King’s Chamber, and beamed up out through the shaft into space where it hit a satellite and was beamed back down to earth to be used in power tools.

Mmhmm.

Alan Alford, one of the pyramid theorists whom I will not tar with the brush of pyramidiocy, due to his ability to see the massive howling gaps in the logic of most theories, has the following to say on Dunn’s King’s-Chamber flight of fancy:

Firstly, the mouth of the northern airshaft is cut too high in the wall to align with the sarcophagus, so any incoming microwave signal would have passed right over the top of it. It is not clear how it could have interacted with any equipment inside the box.
Secondly, Dunn assumes that the sarcophagus had no lid (pp. 189, 222) and that the signal interacted with hydrogen atoms inside the box. But there is clear evidence that the sarcophagus did originally have a lid and that it was hermetically sealed (see my book Pyramid of Secrets, pp. 73-74). I am not entirely certain how this affects Dunn’s theory, but there could not have been any hydrogen in the box.

Thirdly, the mouth of the southern airshaft is cut too high in the wall to align with the sarcophagus, so it is difficult to see how the output from the box could have been channeled into the shaft.

Fourthly - and worst of all - Dunn insists that the entire lengths of the northern and southern airshafts would have to have been lined with gold- plated iron in order to have an efficient conduit for the electromagnetic radiation (pp. 186, 221-22). This is quite simply at odds with the facts, as Dunn well knows. For both the shafts have been surveyed by robot and not a trace of a metal lining has been found (the iron plate found by Vyse in 1837 was embedded in masonry close to the southern shaft but it is not clear whether it actually formed part of the shaft). So, what happened to the iron? How was it removed from tiny shafts measuring approximately 8 by 8 inches to their entire lengths of 235 feet and 174 feet respectively?

The sum of all this ranting is but this:

If you are crazy enough and have enough disposable income to wander around Egypt and have your picture taken holding sciency-looking objects, you can get a lucrative book deal out of it and people will want to be your friend and write even more ludicrous ~~fanfic~~books based on your theory.

Or possibly “the world is full of gullible morons.” I’m no longer sure.

Epilogue: Dunn is almost charming in his excited attempts to reverse-engineer explanations for artifacts other than "we don't know." Here's his thoughts on the putative Helmholtz resonators:

One of the most remarkable feats of machining can be found inside the Cairo Museum. I have stood in awe before the stone jars and bowls that are finely machined and perfectly balanced. The schist bowl with three lobes folded toward the center hub is an incredible piece of work. With the application of ultrasonics and sophisticated machinery, I can understand how they could be made, but the purpose for doing so has long escaped me. It seems like a tremendous amount of work to go to just to create a domestic vessel! Perhaps these stone artifacts, of which there were over a thousand found at Saqqarra, were used in some way to convert vibration into airborne sound. Are these vessels the Helmholtz resonators we are looking for?

Information in this article is from the following:

Dunn's website
The Giza Death Star by Joseph Farrell, available on Google Books
The Giza Death Star Deployed by Joseph Farrell, available on Google Books
Alford's refutation of Dunn

It does matter what you do with your old equipment: Goiânia’s dance with cesium-flavoured death

2009-06-26T14:11:00.004-04:00

This is a story with two subjects. On the one hand, we have another blatantly irresponsible organization failing to take the most basic safety precautions; on the other, we have the deadly results of ignorance. It’s far from the only tale of its kind; the list of radiological accidents in developing or less-developed countries is depressingly long.

In order to explain how Goiânia happened, we need to touch briefly on the nature of the machine that started the disaster. Radiotherapy for cancer can take many forms: teletherapy (now known as external beam radiotherapy), where the source of radiation is outside but focused on the body; brachytherapy, where sealed radioactive sources are placed inside or next to the part of the body needing treatment; and systemic or unsealed source radiotherapy, where a soluble radionuclide is injected or ingested into the body. Mostly when people think of radiotherapy they think of external-beam/teletherapy machines with the rotating gantry and patient couch.

These days EBRT is mostly performed using linear accelerators, which produce a powerful beam of beta radiation (electrons) or X-rays with the push of a button and do not require dangerous radioactive source capsules, but in the early days of teletherapy they didn’t have that option. The two most common radioactive substances used as teletherapy sources are cobalt-60 and cesium-137. Both of these will kill you quite quickly if you pick them up in your hands: the machines using them rely on massive lead shields to limit the radiation to a controlled, collimated beam. The cesium-137 source in the Goiânia accident was filled with highly soluble, highly dispersible powder, rather than pellets of metallic solid material. This would prove to be important.

The unit involved in the accident was a Cesapan F-3000, a 1950s Italian design containing what was probably a source capsule manufactured in America in the seventies. It would have looked a little something like this (images from IAEA report). The rather ominous-looking head was capable of moving up and down on its support pillar and rotating through a couple of horizontal axes, and contained the source capsule in a rotating assembly that could move to line up the window in the capsule with the radiation aperture in the head, as illustrated here. The window in the shielding of the capsule, through which radiation could escape, was made of iridium. According to the International Atomic Energy Agency (IAEA) report, the source itself was of standard international dimensions and potency.

This machine was left in the derelict premises of a private radiotherapy clinic in Goiânia, capital of Goiâs State, Brazil, after the partnership that owned it dissolved toward the end of 1985; a cobalt teletherapy unit from the same clinic premises was removed and transferred to a new facility, but the cesium unit stayed where it was. We aren't sure why.

Vagrants used the gutted building to shelter in; wildlife came and went, and the Cesapan F-3000 stood there growing quietly more obsolete. It is perhaps surprising that it remained unmolested for two years before enterprising locals considered its potential scrap value.

On September 10, 1987, two men, A and B, began to try to dismantle the machine. It took a while and several attempts, but by September 13 they'd managed to extract the rotating assembly from the massive shielding of the radiation head. Outside this shielding, the unprotected source was giving off 465 rads an hour, or 4.65 Gray if you want to be modern about it. For comparison, the accepted annual radiation dose for non-nuclear-workers in the USA is between 1 and 5 millisieverts, or ~ 0.001 to 0.005 Gray.

They put the assembly in a wheelbarrow and took it to A's house; A had suggested salvaging the machine for scrap in the first place. That day, both of them began to vomit; over the next few days, B developed diarrhea and edema of his hand, which subsequently would develop into a burn corresponding to the size and shape of the window in the source capsule. They attributed their symptoms to something they'd eaten, and in fact when B saw a doctor he was told his symptoms were due to a food allergy and he was to take it easy for a week.

The real horror begins

In the days between September 13 and September 18, A had been tinkering with the rotating source assembly, which he'd dumped under a mango tree in his yard. He was trying to get the source capsule free of the assembly. At some point he managed to break the iridium window of the source with a screwdriver.

He thought that perhaps the intensely radioactive cesium thus exposed might be gunpowder, and tried to light it.

On the 18th he managed to get the breached source free of the rotating assembly, and sold the whole mess to a third man, C, who owned a junkyard nearby. That night, C went into the garage where the bits were stored and noticed that the stuff in the broken capsule was emitting a blue glow, and brought the capsule into his house to show it to his wife. Because it was so pretty and so strange, they thought it might be valuable, or have supernatural powers, and invited their friends over to have a look. On the 21st one of these friends dug out some of the powder with a screwdriver and took it away with him to give to his family and friends. Quite a few of them rubbed it on their skin like body glitter. C received a total dose of 7Gy and survived. His wife (5.7 Gy) would not.

I know this reads like a horror novel. It gets worse.

More people were (unsurprisingly) suffering the symptoms of acute radiation sickness: C's vomiting wife was examined at a local hospital, diagnosed with food poisoning, and sent home to rest. Her mother came over to take care of her, and took home a dose of 4.3 Gy.

Two of C's employees were tasked with removing lead from the remnants of the assembly, and worked on it from September 22 to 24. Directly exposed to the breached source capsule, they would be among the four victims who did not survive.

The last of the four fatalities was C's six-year-old niece, whose father had visited C and taken away some of the glowing powder. This was left on the table and handled by the family during meals. The little girl had played with the powder and put her fingers into her mouth. According to one source, when international medical teams arrived to treat the victims, they found her in an isolated room in the hospital because the staff were afraid to go near her.

On the 23rd, B was admitted to hospital: his skin lesions were diagnosed as related to some exotic disease, and on the 27th he was transferred to the Tropical Diseases Hospital.

The authorities finally become aware of the accident

After doing its damage to C's friends and family, the source and rotating assembly were sold to a second junkyard. The sudden epidemic of vomiting and diarrhea among their acquaintances was not lost on C's wife, who became convinced that the glowing powder from the capsule was responsible for all the sickness. On the 28th, ten days after the source was transferred to C's ownership, she and one of C's employees went to collect the remains of the source and rotating assembly from the second junkyard, put it in a plastic bag, and took it by bus to a hospital, spreading contamination as they went. The employee and C's wife presented a doctor, P, with the source in its bag, and she told him that it was "killing her family."

By now the employee who had carried the bag was developing a serious radiation burn on his shoulder, where it had rested, and he and C's wife were sent to the Tropical Diseases Hospital, where B and several other contamination victims had been sent for treatment. One of the doctors at the TDH was beginning to suspect that in fact the nearly identical symptoms of this whole cohort of patients could have been caused by radiation, and he contacted a colleague who had independently been contacted by Dr. P. Dr. P had initially thought that the bag contained bits from X-ray apparatus, and became wary of it, moving it outside the facility (and thus probably saving his own life).

The doctors at the TDH had another look at the patients, with the mysterious bag's contents in mind, and agreed that it would be a good idea to contact the state department of the environment; when they did, it was recommended that a medical physicist examine the package.

On the 29th they found a medical physicist, W. He found a radiation monitor used for uranium prospecting, which had a range of 0.03–30 microgray/hour, and set off for the hospital where the source was currently located: quite some distance away he noticed that the monitor was pegged no matter where he pointed it. He assumed it was malfunctioning and went back to fetch a different one, which showed exactly the same thing as soon as he turned it on.

At this point W realized that something was desperately wrong. At the hospital, Dr. P had become sufficiently concerned about the source in its bag that he had called the fire department, which had arrived and was preparing to chuck the whole thing into a handy river; W arrived on the scene just in time to prevent this. He convinced them to evacuate the hospital and make sure no one else got near it, and after talking with Dr. P they set off together to C's junkyard–where the monitor again read off the scale.

The official response begins

W, among others, managed after some effort to notify the secretary of health. Once the authorities had been convinced that yes, in fact, this was a huge deal and would require evacuation of a large number of people, steps began to be taken with considerably greater speed. The physicist and physician at the radiotherapy clinic's new location were notified, and the source was tentatively traced to the abandoned clinic and the cesium unit.

Civil defense forces were notified; the TDH was informed that a number of patients were contaminated; the known sites of contamination were resurveyed with equipment from the radiotherapy clinic; an emergency receiving and decontamination facility was set up in a local stadium. W, the physicist who had initially discovered the contamination, was contacted by an individual who had intended to cut up the source for C with an oxyacetylene torch (but had luckily forgot), who explained several useful details to the investigation.

International teams were sent in to decontaminate and treat the victims of the disaster. There is not a great deal that can be done in cases of radiation sickness: therapy consisted of dealing with the acute period of bone marrow suppression and subsequent immune deficiency, treating the burns, removing radiation from the body (decorporation), and general support. It's rather terrible to consider that many of these patients recontaminated their skin repeatedly by sweating; the cesium in their bodies found its way out in everything. Chelation with Prussian blue helped a significant number of the victims, a point which recalls the hopeless suggestion of treating Louis Slotin with methylene blue after his deadly exposure to plutonium criticality.

The final count of persons with significant contamination, out of the hundred thousand screened, was two hundred and forty-four. Most of those were lucky and received fractionated doses--spread over a long time period, giving the body's tissues a chance to attempt to recover from the damage. Some were not. The dead of Goiânia had to be buried in lead coffins surrounded by concrete.

Cesium didn't just destroy people in Goiânia, it destroyed property and livelihoods. Seven houses had to be demolished, so badly contaminated they could not be made safe. Topsoil was removed by the ton. In total 85 houses had to be decontaminated.

More than anything Goiânia stands as a blazingly vivid example of the importance of keeping sources secured. A number of factors conspired to make this accident as deadly as it was: criminal negligence on the part of the radiotherapy clinic which failed to remove and secure the capsule from the teletherapy unit, the nature of the radioactive material--its mysterious and magical blue glow entranced people, significantly increasing the scope of the disaster, and its powdery nature was easily dispersed and easily soluble--and the remote location of the disaster site. But the lesson of Goiânia applies to all source capsules, not just cesium in remote and unsophisticated locations.

Sadly, it's not a lesson that's been learned particularly well. In the years since Goiânia, unsecured radiation sources have caused at least four radiological accidents around the world. In Samut Prakarn, Thailand, a disused cobalt-60 teletherapy head was partially dismantled, taken from an unsecured storage location, and sold as scrap metal–in February of 2000. It's still happening. It will continue to happen as long as those in charge of radiation sources fail in their responsibility to keep them secure.

In many ways the eighties were a great time for death by radiation. You had Chernobyl, you had the 1983 Ciudad Juarez accident in Mexico–eerily similar to Goiânia–you had the Therac-25 linear accelerator deaths; but it hasn't stopped. People need to pay more attention to things that have happened, if they want to live very much longer; and people who take the responsibility to treat their fellow humans with lethal radiation must take the responsibility to prevent their fellow humans from dying of it.

Information in this article is from the IAEA report on the incident, available at www-pub.iaea.org/MTCD/publications/PDF/Pub815_web.pdf, and from Wiki.

“No, I cannot say that I have:” a clueless crew and a firetrap ship, the SS Noronic

2009-06-16T13:26:00.006-04:00

Nothing can beat the Apollo 1 launchpad fire in terms of flame propagation speed, but the cataclysmic fire that destroyed the SS Noronic in 1949 as she sat beside the docks of Toronto’s Pier 9 was impressively rapid nonetheless. The focus of investigations into the Noronic fire was not the point of origin--that was fairly obvious from eyewitness accounts--or the actual source of ignition: it was the rather horrifyingly laissez-faire attitude of the crew members regarding what to do in the case of a fire in dock.

The official "Report of Court of Investigation into the Circumstances Attending the Loss of the S.S. Noronic" contains quite a lot of direct quotes from examination of the various officers, included into the narrative to make the point abundantly clear: there was no official instruction given to crew members regarding their duties in case of fire in dock, and no attempts made to develop or distribute same, because “the ship had been running from 1913 without mishap.”

The Noronic, built (as mentioned) in 1913, was a cruise and package freight ship plying the Great Lakes. She had two sister ships, the Huronic and the Hamonic; this last, suffering under an even sillier name than Noronic, burned out in 1945. No apparent lessons were learned from the loss of the Hamonic, as demonstrated very clearly in the behaviour of the Noronic’s crew prior to and during the disaster.

She was vast for the time, capable of carrying six hundred passengers and two hundred crew on her five decks, and considered one of the most beautiful and luxurious cruise liners in Canada. Part of her luxury came from the fact that her interior walls were paneled in beautifully polished wood, into which thirty years of lovingly applied lemon-oil varnish had soaked. Some of the wood (the passenger accommodations on D deck) was painted rather than varnished, but the majority of the walls in the upper decks and communal areas were treated with this highly flammable oil.

She was also, being built prior to regulations passed in 1939, lacking the requisite fire-resistant bulkheads the regulations called for. The Chairman of the Board of Steamship Inspection was allowed to exempt existing ships from compliance with the regulations where it was “impracticable or unreasonable” to retrofit the ship to comply. In this case it was rather obviously “expensive” to do so, and Noronic remained a totally period-accurate vessel.

The series of legal loopholes through which the Noronic sailed to escape the installation of vital safety systems is impressive. Not only was she allowed to go around without fire-resistant bulkheads, she also did not have to comply with Regulation 3 of section 405 (1) c of the Canada Shipping Act, requiring “every ship…which is engaged on an international voyage, [to be provided with] an approved fire alarm or fire-detecting system which will automatically register at one or more points or stations in the ship, where it can be most quickly observed by officers and crew, the presence or indication of fire in any part of the ship…not accessible to a fire patrol system.”

Fire patrol meant that the crew was detailed to regularly make exhaustive rounds of the ship throughout the day and night to catch any hint of fire on board; the regulations stated that “all spaces in a passenger ship, except such spaces as cargo spaces, baggage and store rooms, may as a general rule be regarded as accessible to the patrol,” thereby exempting them from the requirement that an automatic alarm or detection system be fitted. Noronic was not considered international, as she only puttered around on the Great Lakes—an “inland voyage.” Even had she been considered “international” due to her route between Canada and the States and thus required to comply with Regulation 3, the Board of Steamship Inspection ruled in 1938 that Regulation 3 only applied to ships making international voyages on the ocean. Either it didn’t apply, or it didn’t apply.

Noronic did in fact have a manual fire alarm system that ran off batteries, of the in-case-of-fire-break-glass type. This alarm rang bells located a) in the officers’ quarters, b) on the port side of D deck, and c) in the engine room on E deck, registering the location of the pulled alarm. It did not activate the klaxons located around the ship which would alert passengers and crew to an emergency: in order to sound those someone would have to go up to the pilot house above A deck to manually flip the klaxon switch. The first and second officers informed investigators that it was “the duty of the officer on watch, upon hearing the bell alarm, to proceed to the locality from which the alarm had been given for the purpose of investigating whether the fire was serious enough to require the sounding of the klaxon alarm and, if he so concluded, then to return to the pilot hours above A deck where he would throw the switch which sounded the klaxon horns. If the officer on duty was away from the pilot house, the wheelsman who should be there was expected to find the officer on duty and report to him as to the locality at which the alarm had been sounded. To obtain this information he would first have to go to the bath-room in the mates’ quarters where the indicator was located.”

I quote the report again directly: It is, of course, obvious from the above that considerable time might be lost between the giving of the alarm at the point where the fire was first discovered and the giving of the klaxon alarm which could only be sounded from the pilot house.

No shit.

It goes on like that. There were supposed to be hydrants located all around the ship so that “at least two powerful jets of water can be rapidly and simultaneously brought to bear upon any part of each deck or space occupied by passengers or crew,” but the inspectors thought, eh, it’d be good enough if you could just run a hose down from the deck above if there weren’t enough hydrants on any given deck (even though the actual wording of the regulations states that “the hydrant shall be so placed on each deck that the fire hoses may be easily coupled to them").

It's apparent that nobody in a position to enforce safety regulations ever actually thought a fire could break out on the Noronic. Certainly they made every effort to weasel out of providing even the most basic of safety systems, taking advantage of the fact that as Noronic was merely sailing on a lake and not the ocean she did not strictly fall under the regulations requiring fire patrol. Whether this is due to some unknown dangerous quality in salt water as opposed to fresh is not explained. The report mentions tartly that in the judge’s opinion the regulations requiring ships to be equipped with working hydrants and extinguishers imply that there also should be crew members provided by the ship’s owner to use the aforementioned apparatus. Without an automatic fire detection system or a sprinkler system on board, Noronic really could’ve used a fire patrol. What they got was this:

Two crew members designated “Special Officers” switched off at 6-hour intervals to walk around the ship with a time clock and punch a series of keys located at various points on board “on the hour.”

Yeah. In 1942 Canada Steamship Lines issued a list of duties to be completed by the Special Officers, including:

“Each night from 9:00 PM until 6:00 AM the watchman clock shall be punched punctually on the hour. The dials are carefully checked by the Purser and the reason for not punching or the dials not being marked must be explained satisfactorily by the officer. During the round of punching, it is your duty to stop any excessive noise by passengers that are boisterous…Upon completion of your round and all passengers are quiet [sic], return to the rotunda where you are easily found should you be needed…”

The round of time-clock punching took about 15 minutes, which meant that for 45 minutes out of every hour there was pretty much zero fire patrol going on. One of Noronic’s Special Officers said that he thought he wasn’t supposed to do the patrol at all when the ship was in port, but remain instead at the gangplank; the other one understood his duty to be completing the rounds each hour and then returning to the gangplank. In fact neither of them were on board the night of the fire: both Special Officers’ rounds were conducted by a pair of wheelsmen who took the shortest possible routes between the time clocks.

This lack of clarity amongst officers and crew comes up over and over again throughout the investigation. This officer understood that this other officer was supposed to do something, but didn't check with anyone to see if this was in fact the case; that officer thought he was supposed to do this other thing but in point of fact was supposed to be somewhere else entirely and had no idea what to do in case of emergency. The card in the passengers' accommodations regarding fire stated confidently that the ship was equipped with "modern fire prevention apparatus" and patrolled "day and night by experienced watchmen." Or inexperienced wheelsmen doing the watchmen's jobs for them, either way.

Fire and lifeboat drills were regularly held on board the Noronic when she was moored in Duluth. Every Tuesday at ten in the morning, the signal was given for fire drill and the crew members assigned to "fire stations" (hydrants) gathered at their posts. The objective of the drill was to get to the hydrant, get the hose down from its rack, and couple the hose to the hydrant. Sometimes on the outside fire stations they'd squirt the hoses overboard, but obviously not indoors. A few crew members were expected to get the extinguishers down and wave them about, maybe discharge one or two. That was it for fire training of the crew.

In 1945, the General Manager at Canada Steamship Lines was apparently made aware of the fact that his ships were practicing a thoroughly useless excuse for a fire drill, and sent out a memo with an updated list of rules. The memo stated that the enclosed Lifeboat and Fire Drill Regulations were (I quote) serious business, and that masters of all passenger steamers must study them carefully and instruct all crew members accordingly. Let's see how the Norons did:

1) MUSTER STATIONS: The Master will designate locations of muster stations throughout the ship to which members of the crew will report for lifeboat and fire drills (and make sure all crew members know where these stations are and which signals call for them to muster).

1) a ALARM SIGNALS: General or Fire Alarm is indicated by one long, three short, one long blasts on whistle or alarm. Proceed at once to fire drill assigned station. Man Boats Alarm is indicated by General Alarm followed by two short blasts on whistle or alarm. Proceed at once to boat drill assigned station.

The Noronic's crew members each carried a blue card on which was printed his crew number, his fire station number, and his boat number. It clearly states the types of alarm and what one should do upon hearing them. However, in practice, the fire drill signal was a continuous blast on the klaxon horns, while the lifeboat drill signal was identical to the official "general or fire alarm" signal. Crew members had to learn to ignore the info on the blue card.

Passengers did not take part in either drill. The only information they received on what to do in case of fire was on the instruction cards in their rooms. The crew were the only ones who had any idea of emergency procedures, and their grasp on same was tenuous at best.

2) MUSTER LISTS: The Master will have a muster list prepared including the information of all crew members and their muster stations, as well as "full particulars" of the signals required to call members of the crew to muster. This list shall be posted in conspicuous places throughout the ship including the crew's quarters and every officer's room.

There was no such thing as a "muster list" on board the Noronic, nothing signed by the Master, and nothing hung in any officer's room. A "chart" of crew members apparently hung in the maids' quarters, in the crew's stairway aft, on either B or C decks, and in the crew's rec room. The first officer, Gerald Wood, used this chart to prepare a list of crew members and their blue card numbers, boat numbers, and hydrant numbers, and gave a copy to the chief steward. The captain was completely ignorant of all of this and only knew about the typed list because he looked over Wood's shoulder as he was filling it out. Who's on board? Whose job is it to do what? Who knows?

3) MUSTER CARDS: A card indicating the muster station for each crew member must be placed in his berth in such position that it cannot be obscured by baggage or clothing.

The only thing remotely similar to this in use on the Noronic was the blue card, which was kept wherever the crew felt like keeping it.

There was also a rule stating that the Master had to appoint Senior Officers to various parts of the ship in order to help direct passengers to their muster stations if necessary. Here is where the testimony really gets interesting: Captain Taylor said that he'd allocated the first officer to C deck, second officer to A deck, third officer to B deck, and chief steward and purser to D deck. Wood, the first officer, denies any allocation was made, and then proceeds to flip-flop like a gaffed pike (unsurprisingly, he stated that he had never seen or heard of the Serious Business memo):

Q: Was there any allocation that you know of of senior officers allocated to certain locations for the purpose of mustering passengers?

A: No there was not.

Q: Did you make any allocation?

A: No.

Q: Did anyone else to your knowledge?

A: Not that I know of.

Q (really trying here): Now I want to be fair with you. I thought the Captain did say to us that he had allocated certain senior officers in accordance with this and he said the allocation was the chief officer to C deck....do you know anything about that?

A: Well yes, I would be in charge of C deck.

Q: (wondering what he's smoking): Well that is what he told us, that you were in charge of C deck--then must that not mean that you were allocated in some way to C deck?

A: Yes, I would be allocated.

Q: How would you be allocated and what instructions did you have with regard to C deck?

A: I think by this chart [which indicated his duty was free to move about the ship].

(some back and forth about whether or not this allocation is the same as on other ships)

Q: Now what do you say as to whether or not any station was allocated to you as the first officer under this regulation?

A: Well he may have told me to go to my allocation on C deck.

Q: (between clenched teeth) Well he may and then I suppose he may not, but I am trying to get from you whether he did.

A: Well I have been there a number of years.

Q: Then is your statement to me that you do not know whether the Captain in the case of fire had told you that you were to go to C deck?

A: I am pretty sure--I might say that the captain did not tell me this year. He could have back in 1944 or 1945.

Q: Did you always go to C deck on fire drill?

A: No, I go all over the ship.

Q: Then you were really not allocated to C deck?

A: Not to stay there.

Q: Well was anybody allocated to C deck?

A: Well I think the officers were free--wherever we could be the most help.

This confusion is heightened by "the chart," which states that Wood was in fact in charge of deck A. Balancing out various testimonies against one another it becomes abundantly clear that this "chart" had become so obsolete by 1949 that it had nothing to do with any organization or lack thereof on board the ship and in fact the captain had no idea it existed at all. We are dealing with governmental levels of confusion here. The captain and first officer, when asked about duties to be performed by the officers and men at the fire hydrant stations, contradicted one another and made up answers to explain what the rest of the crew not assigned to hydrants would be doing (running away, is my guess).

The slipperiness of officials when faced with questions about the Noronic extends way up the ladder. General Manager of the line Captain Reoch had to admit under examination that in fact when he wrote the Serious Business memo he did not take into consideration the fact that, if a fire occurred while the ship was tied up to a dock, directing all the passengers to the muster stations on C deck would not do them a blind bit of good as the only gangplanks to the dock were on E deck three floors below. "Was it your intention under these rules when you drew them up, that in the event of a fire at a dock, the passengers from D deck would go up or be directed to C deck and then go back down to D [and then E] deck to get off onto the dock?" he was asked. After some squirming and repeated requests to answer the question, Reoch finally admitted that he didn't think that the rules he'd indicated would be followed in case of a dockside fire--or, more accurately, he'd not bothered to consider the possibility.

The really damning bit is when they are asked why they didn't increase the number of crewmen on fire patrol while the ship was tied up. "If there had of [sic] been any signs of an emergency, yes, but there was no reason why they would have. I can't see any reason why they would."

Maybe because you're in a floating firetrap lacking rudimentary safety systems, steeped in decades' worth of flammable varnish, and inhabited by people who are coming back from Toronto bars drunk off their tits and probably waving around lit cigars?

There was no way of knowing which crew members were on or off the ship while she was in port, as they were free to go ashore at any time they were not on duty. If there had been any organization amongst the crew for dealing with emergencies, it went directly out of the porthole as soon as crew members began to go ashore unremarked.

So we have the perfect setup for disaster. On the night of September 17, 1949, something in a linen closet on C deck aft caught fire. The closet contained bed linen, towels, and cleaning materials, as well as a box for rubbish and wastepaper collected from the cabins, and a switchbox controlling some of the stateroom lights. The presence of the box is controversial: a maid stated that the rubbish box was never placed in the linen closet; the chief steward said it might have been there, and an eyewitness stated that it was there. If the fire was due to a smouldering cigarette butt, this box would have represented a perfect point of origin. Passengers mentioned seeing maids smoking cigarettes in the linen closet during the voyage; in the absence of a major electrical fault it seems likely although not certain that a carelessly discarded butt was responsible for killing somewhere between 118 and 139 people.

A passenger, Don Church, noticed a haze in the starboard corridor around 2:30 a.m. and followed it to the linen closet, where he saw smoke coming from the sides and top of the locked closet door. He heard a faint crackling, rustling noise, and assumed someone was inside; this would have been the fire talking to itself. Church, unable to open the door, ran forward yelling that the boat was on fire and encountered the head bellboy, Earnest O'Neill. O'Neill ran back with him to the locker, whereupon their stories diverge: O'Neill stated that he ran back to the steward's officers to fetch the closet key, then went to fetch a fire extinguisher before unlocking the door. Church stated that he just unlocked the door as they arrived.

They opened the door and saw that the wall was in flames and a hanging sheet was beginning to burn. The extinguisher barely slowed it down: almost as soon as the door was opened, flames poured out along the ceiling, feeding on the beautifully polished wooden paneling. Church and O'Neill went for a fire hose, but when Church opened the valve nothing came out. At this point he thought sod this for a game of soldiers and went off to fetch his family and got the hell out of it.

O'Neill only now broke the glass on the fire alarm and ran down to E deck to find a wheelsman and inform him of the fire. It's uncertain how much time really elapsed between the discovery of the fire and the sounding of the alarm, but time was definitely lost in trying to put out the fire with ineffective means. If O'Neill had sounded the alarm at once instead of messing about with extinguishers, several senior officers could have responded at once and taken charge of the fire equipment: C deck was the most well-staffed in terms of hydrant stations. He didn't. The fire raged out of control.

The wheelman O'Neill had woken in turn woke Wood, who quickly sounded the klaxon alarm and pulled the whistle, which stuck open and drowned out the klaxons. By now the starboard side of the boat was "full of fire," and he could not go aft farther than the first three cabins on the port side, where he "banged on the windows" and shouted.

Just before Wood sounded the whistle, a night watchman on the pier was appalled to see flames breaking through a window on the ship's starboard side. He ran inside and called the fire department and gave the alarm, then called the police; someone else standing at the door told him to call for ambulances as well. After he'd told the police to send all the doctors and ambulances they could, the watchman--a Mr. Harper--went back outside to find a mass of flame engulfing the starboard side of the ship. Now the whistle was blowing--Wood had sounded the alarm--and the fire department was arriving. By now it was 2:41 a.m., eleven minutes since Church first saw the smoke, and half the ship's decks were on fire.

The man who had told Harper to call for ambulances was one of the first to escape the burning ship. He had seen people badly burned--a woman with her hair burned away, people with faces and arms scorched and bubbling. It was still only minutes after the fire had begun, and already it was lethal.

The captain was informed of the fire some time between 2:30 and 2:35, according to his testimony, but the times don't match up; he claims to have gone out to yell for help from the outside deck and observed people on the pier, but Harper the watchman had seen the fire begin to erupt and made the alarm call when there had been no other people on the dock.

There is considerable flip-flopping from Wood regarding the instructions he had given to the crew members as to what they ought to do in case of fire: should they notify the officer on watch or just any officer, should they use a hose or an extinguisher first, did he actually tell them anything at all. "Would this be fair," he was asked, "and now correct me if I do not say it correctly--that so far as the education of the crew in the event of fire was concerned, all they had was what they saw on the printed chart in the crew's quarters, which took them to their various stations in the event of hearing the alarm--is that all they had--apart from what you have just said as to what you might have told any particular member of the crew--does that cover the whole field?"

"Yes, that covers it."

There was no organization, and therefore there was no clear and evident list of duties for each member of the crew to perform. Some of the fifteen men on duty tried harder than others to waken passengers and shepherd them over the side on ropes and Jacob's-ladders; by now the fire department was there en masse and trying to reach the ship with aerial ladders, but so many people leapt on the first of these--Aerial No. 5--that it snapped and spilled the lot of them into the harbour. Other passengers leapt straight into the water, some of them screaming as they burned, some of them in eerie silence. Many people were asleep when the fire broke out, and woke only to find their cabins ablaze and the only way out blocked by a window-screen they could not break; some were pulled from burning cabins from the outside by crew members or fellow passengers who had broken the screens away.

GenDisasters offers a collection of quotes from eyewitnesses. Mildred Briggs of Detroit, one of the survivors, said the flames spread as if in a matchbox. "The fire just welled up along the corridors and spread faster than any fire I've ever seen," she said.

"There was a mob of men and women surging back and forth," said another survivor, Alberta Agia of Detroit. "Men were pushing women around, and many were knocked to the floor. The screaming filled the air. There was so much panic that I don't know how these people found anyway to safety. I slid down a rope."

Men rushed out in their nightclothes. One man got ashore naked.

Henry Maurer and his wife were sound asleep when someone pounded the door. When they reached the outside rail, his wife started down a rope ladder, "but it became horribly twisted from so many trying to get on it. She got tangled and trapped. I swung down on a rope to her side and got her free, and we both managed to get to the dock."

Sylvia Carpenter of Detroit said she screamed and headed for the outside rail when she saw smoke and flame billowing along the passageways.

"A rope was tossed over the rail and I put a hitch knot on it to hold it to a stanchion," she said. "As I did so, three men pushed in front of me and shoved some screaming women out of the way. They went down the rope."

The fire burned intensely enough to heat the steel hull white-hot. Glass melted from portholes; metal slumped and warped. Enough water was poured in by the firefighting equipment to list the burning ship toward the dock; operations had to be halted until the list righted itself, as the Noronic settled to the bottom of the harbour with only her top decks above the surface. By five in the morning the fire was out, but they had to let the hull cool before venturing inside to find the bodies.

Everything that could be consumed inside the hull was consumed. Luxurious fittings were reduced to ash, ceilings and columns melted and warped. All the stairways in the boat save one were utterly destroyed.

The fire stripped away identities, turning human bodies to calcined bone fragments; some victims were nothing but a skull or spine. There are touchingly gruesome tales of searchers entering the ship to find embracing skeletons in the hallways and the remains of the cabins. The remains had to be removed by shoveling them onto tarpaulins, as they crumbled when picked up. New advances in forensic odontology (including the use of X-rays) had to be made to identify Noronic victims; articles on the techniques developed as a result of this disaster are still being published today in forensic journals.

Newspaper articles covering the disaster began, as newspaper articles of this sort tend to do, with horrified pronoun-deficient headlines: 200 DIE ON FIERY SHIP. GREAT LAKES QUEEN BURNS. HOLOCAUST SINKS PLEASURE CRUISER AT TORONTO DOCK. 400 HOLIDAYERS ESCAPE FLAMING DEATH AMID SCENES OF HORROR.

The final conclusion of the Court report into the disaster placed the blame on the failure of the owners and captain in:

a) Holding a continuous fire patrol of the ship, instead of a cursory time-clock round every 45 minutes
b) Maintaining any organized system while the ship was in dock with passengers aboard by which “information as to the outbreak of fire could be promptly dispatched to some point from which men trained in the methods of dealing with fire could be immediately dispatched to the locality,” or “effective fire alarm and fire procedure”
c) Taking the threat of fire at a dock seriously and allowing all but fifteen of the crew to go play on shore and be potentially unavailable in the case of emergency
d) Developing and practicing any plan for waking and evacuating passengers in the case of a fire while in dock
e) Training the crew on what to do in case of fire or how to operate the extinguishers and hoses.

Or, to put it more baldly, being about as prepared for a dockside fire as a jumbo prawn would be to handle a credit-default swap. The scope of the failure to prepare for or anticipate anything of the sort is breathtaking. The owners knew perfectly well that there was no functional plan in place for dealing with this kind of disaster, and so did the captain–and there was nothing stopping him from taking any steps to remedy the situation. It’s the equivalent of driving a car with half the lug nuts loose and just sort of hoping the damn wheels won’t come off.

The Noronic fire may not have been preventable, but the loss of life associated with it was. Nobody ever did determine what started it, but my money’s on an indifferently butted cigarette tossed into the refuse box in the linen closet, which then spread rapidly throughout a ship lacking in regulation fire-resistant bulkheads, a ship lined with highly inflammable varnished wood, a ship without automatic fire-detection or sprinkler systems, a ship whose fire alarm system was Goldbergian in its unnecessary complexity and multiple stages, and a ship manned by a totally insufficient and untrained skeleton staff. The bellboy O’Neill could possibly have saved the ship had he sounded the alarm before attempting to put the fire out himself–but he didn’t. The story of the Noronic is a litany of “I didn’t,” “I don’t know,” “I cannot say that I have,” and “I can’t see any reason why they would.”

Captain Taylor lost his license for a year; an unknown number of people lost their lives. The steamship company paid out something like $3 million to the families of the victims. Rather horribly, another Canadian passenger ship, the SS Quebec, experienced a similar fire a year later: the Quebec fire was ultimately determined to be the result of arson and started in a linen locker. None of the safety regulations written after Noronic were put in place aboard Quebec, and the crew were just about as useless in trying to fight the fire and evacuate passengers. That was it for Canada Steamship Lines’ passenger cruises on the Great Lakes.

It’s too easy to make fun of the Noronic’s name, which I will now reveal is most likely in reference to Lake Noron, Quebec. It’s too easy to point out that “no we didn’t” and “moronic” overlap quite efficiently, so I will just leave you with First Officer Wood’s deathless turn of phrase:

“I think in cases of emergency, the officer goes where he can be the best help.”

In this case, over the side.

Information in this article is taken from the following sources:

CanadianHistory.suite101.com

www.centrenaufrages.ca, Courage Tales 5, accessed June 16, 2009

GenDisasters.com

Lost Liners

Report of Court of Investigation into the Circumstances Attending the Loss of the S.S. "Noronic" (1949), located at Tales of Tragedy and Triumph: Canadian Shipwrecks, a virtual museum exhibition at Library and Archives Canada

The Walkerville Times

Wiki

I love the smell of corporate negligence in the morning: the Boston Molasses Flood

2009-06-12T14:15:00.007-04:00

Clichés tend to become clichés for a reason. “Slow as molasses” is generally an apt statement: molasses is highly viscous and therefore flows at a slow rate of speed. Comparing something slow to the movement of molasses is valid.

Except when the molasses is going thirty-five miles an hour.

Ninety years ago, Boston’s North End was the home of the city’s busiest center of commerce: the North End Paving Yard and the Commercial Street Wharf. Freighters from all over the world crowded against one another, taking on or discharging cargoes–livestock, tea, coffee, wool, raw materials for a hundred different trades; locomotives shunted freight cars to and from the wharf to deliver or receive goods from the ships. Stonecutters chipped and shaped pavement blocks in the Yard. Successive waves of immigrants had settled in the neighborhood, and the patter of stevedores and dockhands and blacksmiths and drivers varied from Italian to Irish. There was a lot of work to be had, and a lot of workers competing for it.

One of the landmarks of the North End waterfront was the United States Industrial Alcohol Company’s fifty-foot-high storage tank, holding the molasses the company used to distill its product. This tank, capable of holding over two million gallons of molasses, was used to store molasses from freight tankers before discharging it to railway tank cars for transportation to USIA’s distillation plant. It had been built in a tearing hurry during the month of December, 1915, after lengthy delays in negotiation regarding leasing the land for the tank site and securing permission for the construction. USIA needed the tank ready to accept a shipment of molasses by December 31, and by jingo it was completed in time.

It wasn’t tested to see how the construction held up, of course, because it would have taken days and dollars to fill it up with water: the individual responsible for the construction of the tank, Arthur P. Jell, happened to be the treasurer of USIA’s subsidiary Purity Distilling, and was well aware of the amount the company stood to lose if they wasted any time. Jell instructed that the tank should be filled with water to the level of six inches, enough to cover the joint at the base of the construction, and when this did not result in leaks he declared the tank safe for use.

In point of fact it leaked like an enuretic hamster. In February 1916, two months after completion, the tank was observed to be leaking molasses from its seams, dribbling the stuff in slow streams down the outside to pool around the base in quantities sufficient for children to come and scoop it up in pails. The leaks had been reported to the company, and Jell ordered the tank recaulked twice and painted brown to hide the leaks.

Stephen Puleo’s comprehensive book on the disaster, The Dark Tide, describes one employee, Isaac Gonzalez, as feeling the tank vibrate and hearing it groan every time a shipment of molasses was pumped in. According to Puleo, Gonzalez was deeply concerned about the tank’s structural integrity, and when he was warned after mentioning the leakage that voicing further complaints or concerns to management would get him fired, he took it upon himself to do what he could to lower the risk of disaster. This included sleeping in an office next to the tank so as to be able to sound an alarm in case of imminent rupture. On one of the nights he spent in the office by the tank, he received an anonymous phone call stating that the tank would be blown up with dynamite and everyone who worked there would be killed.

This last was more of a worrisome threat than might be imagined. At the time, USIA’s ethanol was being used in manufacturing munitions for the war in Europe; it was thought that the anti-war anarchists who had been operating in the area might target the plant. After that phone call Gonzalez no longer slept by the tank; however, Puleo’s book offers a vivid description of his nightly visits to the plant to secretly release molasses into the harbor and ease the pressure within the tank:

Working quickly, Isaac twisted open a valve and began releasing molasses into the harbor, and along with it any gasses that had built up inside the tank. After ten minutes, he closed and tightened the valve. He had no idea how many gallons of molasses had been dumped, and practically speaking knew it would make little difference in the overall capacity of the tank, which held over two million gallons when it was full. Isaac also knew that he would be fired, prosecuted, and most likely sent to jail if Mr. Jell ever found out about these late-night visits. But dumping the molasses helped clear his head and made him feel less helpless. (Puleo, p.5)

Over the next two years the tank continued to dribble molasses and make alarming groaning noises when the supply was pumped in, but nothing more. Most likely no single factor can be blamed for its disastrous failure: a combination of shoddy and rapid construction, lack of maintenance or safety oversight, freak temperature changes, and general bad luck was probably responsible.

The temperature on the 15th was forty-three degrees Fahrenheit, unseasonably warm for January; on the 12th it had been two degrees, on the 13th sixteen, and on the 14th it had jumped from sixteen to forty. Fermentation may have taken place within the tank as the temperature rose sharply, producing carbon dioxide and increasing the tank’s internal pressure beyond its structural limits. Whatever was responsible, the result was the same.

Half past noon on Wednesday, January 15, a low rumbling noise like a train passing by shook the ground, accompanied by a rapid staccato machine-gun roar as the tank rivets shot away from their plates and the bottom of the massive tank ruptured, spewing out approximately 2,300,000 gallons of molasses. The force of the escaping fluid split the remains of the tank in half.

In a 1965 article originally printed in Yankee Magazine, John Mason describes the first moments of the disaster:

[In] less time than it takes to tell it, molasses had filled the five-foot loading pit, and was creeping over the threshold of the warehouse door. The four loaded freight cars were washed like chips down the track. The half-loaded car was caught on the foaming crest of the eight-foot wave and, with unbelievable force, hurled through the corrugated iron walls of the terminal.
The freight house shook and shivered as the molasses outside, now five feet deep, pushed against the building. Then the doors and windows caved in, and a rushing-roaring river of molasses rolled like molten lava into the freight shed, knocking over the booths where freight clerks were checking their lists.

Like madmen they fought the on-rushing tide, trying to swim in the sticky stuff that sucked them down. Tons of freight—shoes, potatoes—barrels and boxes—tumbled and splashed on the frothy-foaming mass, now so heavy the floors gave way, letting tons of the stuff into the cellar. Down there the workers died like rats in a trap. Some tried to dash up the stairs but they slipped and fell—and disappeared.

As the fifty-eight-foot-high tank split wide open, more molasses poured out under a pressure of two tons per square foot. Men, women, children and animals were caught, hurled into the air, or dashed against freight cars only to fall back and sink from sight in the slowly moving mass.

Having wiped the freight house off the face of the Earth, the molasses lahar proceeded to take out part of the El support, destroying a section of track, knocked over a fire station, filled up a Public Works building, and turned a number of houses into gluey matchwood, moving at an estimated thirty-five miles per hour.* Twenty-one people died, either crushed to death or drowned in molasses–which if you stop to think about it is a peculiarly horrible way to die–and a hundred and fifty more were injured in the disaster. Two of the dead could not be identified, too battered and candied for recognition.

Unlike floods of, say, water, the molasses flood’s clean-up took weeks. Squirting water on the ankle-deep goo did nothing at all; firemen eventually had to use salt water to blast molasses from the streets and walls, washing it down into the harbor (which was brown and redolent of sugar for months). It took 87,000 man-hours to clean up the mess, and a further six years before the ensuing trial was completed and a report published. USIA, unsurprisingly, was found responsible for the disaster through an insufficient “factor of safety,” meaning they didn’t build the damn tank strong enough to hold its contents. Which Isaac Gonzalez pointed out to Arthur Jell in 1915.

Today the site of the tank has been turned into a playground, next to a park; there’s a small plaque at the entrance to the park commemorating the flood:

On January 15, 1919, a molasses tank at 529 Commercial Street exploded under pressure, killing 21 people. A 40-foot wave of molasses buckled the elevated railroad tracks, crushed buildings and inundated the neighborhood. Structural defects in the tank combined with unseasonably warm temperatures contributed to the disaster.

They say that on hot days you can still smell ninety-year-old molasses in the air. It’s still there, of course, in the joints between bricks, in the ground, in the earth. It’s the sweet smell of criminal negligence–less sickly than trichloroethylene, but no less accusatory.

* Cecil Adams of The Straight Dope discusses the speed of the flow (note that Adams apparently supports the conspiracy theory that USIA decided to fill up the tank to distill molasses into grain alcohol for liquor before Prohibition killed the market for good):

I consulted with Gareth McKinley, professor of mechanical engineering at MIT, and established that the theoretical maximum rate of flow for a (roughly) 50-foot column of liquid, ignoring density and viscosity, was 38 mph. Surprisingly, molasses's stiffness would have slowed things only a bit--making certain assumptions about Reynolds number and whatnot that I expect some gratitude for not sharing, the flow rate would have been mostly a function of inertia (i.e., mass) rather than viscosity. Bottom line: 35 mph was a pretty good guess.

Information in this article was taken from the following:

John Mason, “Eric Postpischil's Molasses Disaster Pages, Yankee Magazine Article,” Eric Postpischil's Domain, 29 August 2007, accessed 12 June 2009

Edwards Park, “Eric Postpischil's Molasses Disaster Pages, Smithsonian Article,” Eric Postpischil's Domain, 29 August 2007, accessed 12 June 2009

Puleo, Stephen, "Dark Tide: The Great Boston Molasses Flood of 1919". Beacon Press, 2004, preview available at Google Books

and of course

Wiki

Lake Peigneur: d’oh on a scale that’s hard to imagine

2009-06-11T11:35:00.004-04:00

Think about salt for a moment. In recent years it’s gone from the standard fine-crystal iodized stuff that came in cardboard canisters and was not generally considered a subject for rhapsody to a whole new world of artisanal seasonings: much like bread, salt has become fashionable, and salt snots now argue with one another over the relative benefits of flake salt, fleur du sel, French grey salt, Hawaiian pink salt, or Indian black salt (“an unrefined mineral salt. It is actually a pearly pinkish gray rather than black, and has a strong, sulfuric flavor. Uses: Use in authentic Indian cooking”).

Before there was saltnews.com, you got your salt from industrial salt mines. Rock salt, or halite, the stuff that rots the undercarriage of your car in winter, represents ancient salt deposited in marine basins as water evapourated. Over time, the salt beds were covered with layers of sediment and compressed. Salt is less dense than the surrounding rock, and it has a tendency to push upward in blobby formations called salt domes (topographical modeling of these formations looks a lot like the bottom of a lava lamp as it warms up). These domes can be absolutely massive, shouldering aside mountains as they bubble to the surface.

As the salt domes squash and displace strata around and above them, pockets are formed between salt and rock where oil and natural gas can collect. Salt mining operations, therefore, are often found right next to oil/gas drilling operations–including under the Gulf Coast. Mostly this does not present a problem. Mostly.

Imagine a salt mine that is busily chipping away at a salt dome that happens to be directly under a shallow lake. The miners know perfectly well where they can and cannot dig; the tunnels extend far below the lake itself, and the mine is producing a healthy crop of salt for the Diamond Crystal Salt Company. It’s November 21, 1980, and the most bizarre man-made natural disaster in decades is about to occur.

The area of New Iberia, Louisiana, is dotted with oil wells. Texaco is having a whale of a time poking holes in the ground and seeing what they hit; one of these probing wells is located three hundred yards offshore in 11-foot-deep Lake Peigneur. The presence of salt domes in the area makes it likely that they’ll find pockets of oil beneath the lake, and the presence of the salt mine in the area has made Texaco do some careful calculations so as not to infringe on Diamond Crystal’s territory.

Somebody apparently forgot to carry the three.

On the morning of November 21, the men on the exploratory rig in Lake Peigneur were happily drilling away in the hopes of striking it rich. Over a thousand feet below the surface, the drill bit was chewing its way through rock when it hit something with a considerably different texture and seized up; as the men tried to free it, wondering what was going on, the rig itself suddenly tilted alarmingly toward the water, and they heard some strange and ominous popping sounds.

Wisely, the operators cut loose their barges and got the hell out of it, and watched from the shore as their whole rig continued to tilt and collapse beneath the surface. They knew the lake was only about eleven feet deep, so the disappearance of five million dollars’ worth of equipment was impossible.

So was the fact that a massive whirlpool developed over their drill site.

In the Diamond Crystal mine, something like 1,230 feet below the surface, water was roaring down the Texaco drillshaft into a mine gallery through a hole fourteen inches wide--a hole which rapidly became much larger as the blasting stream of water dissolved the salt. I don’t know the calculations to work out exactly how forceful the initial jet of water would have been, given the width of the drillshaft, the diameter of the opening, and the distance from the surface, but I think it can be safely assumed to be intense.

An electrician in the mine was the first to see the flood approaching, and sounded the alarm: incredibly, all of the miners managed to escape as the water dissolved away supports and collapsed shafts, swirled and frothed and roared in the darkness of the tunnels, driving air before it with such force as to blow the heads off the mineshafts and then send geysers shooting four hundred feet into the air. Excellent emergency planning and mine-evacuation drills were credited with the survival of the miners. Others attribute it to divine providence.

On the surface, onlookers watched in fascinated horror at the demonstration of what happens when you pull the plug at the bottom of a lake. By now the whirlpool was massive, a quarter-mile across, powerful enough to reverse the Delcambre Canal leading to the Gulf of Mexico and suck eleven barges helplessly down into the drowned caverns of the mine. Another drilling platform, quite a lot of an island, and a nearby parking lot vanished as well. As the lake drained away (with what must have been the loudest sucking sound ever heard) the water from the canal poured 164 feet into the lakebed, creating the tallest waterfall in Louisiana.

As children, most people have watched bathwater swirl away down the plughole and wondered on some level whether it would suck them down too; what child hasn’t anxiously asked its parent what would happen if someone pulled the plug on the ocean? I don’t envy the children who were around to watch Lake Peigneur go down the drain. If that can happen, what else have the grownups lied about?

The lake water took about three hours to drain into the mine. After that, water from the Gulf of Mexico via the Delcambre Canal continued to flow into the crater that had been the lakebed, filling up vast and unknown caverns under the earth, replacing freshwater with salt, moving silently through the holes where men had dug and joked and cursed. It took two days before the water level finally rose to the point where the pressure equalized and the suction eased off: nine of the eleven sunken barges resurfaced, leaving the tug and the Texaco rig somewhere in the flooded mine workings.

There are no obvious reports to be found on the internets about investigation into the accident, and–-hilariously–-no official responsibility could be taken, as there was no longer any actual evidence of the Texaco drill shaft breaking through into the salt mine. Texaco paid Diamond Crystal and a neighboring business several million in out-of-court settlements anyway, but the disaster itself erased the evidence required to legally convict its perpetrators.

I have to wonder who was responsible for the miscalculation that sent the drill bit into the mine. I have to wonder what he or she thought when the lake started to go down the drain. This is not just “d’oh,” this is “d’oh” on a scale that changes ecosystems.

Remember, boys and girls, double-checking one’s sums can save a lot of hassle. Next time you’re deciding between pink, black, brown, smoked, kosher, or grey salt to put on your purple Chinese space potato fries, remember how lucky you are not to have to rely on boring old mined rock salt, and the hazards associated with salt mining.

(It’s okay to laugh at Lake Peigneur. It’s a little difficult not to.)

Information for this post was taken from Wiki (yes, I know) and the excellent Damn Interesting article on it. Unfortunately I can't get my hands on any official reports.

What went right: how sirens work

2009-06-08T13:52:00.003-04:00

Living as I do in the outskirts of Baltimore’s thriving crack district, I hear a lot of sirens. In fact I am rather inured to the sound of sirens after four years of

WHOOOOOOooooooooooOOOOOOOOOOOOoooooooooooOOOOOOOOOO BRAAAAAAAAAA BRAAAAAAAAAA WEEEEEOOOoooooooOOOOOOooooo

but I always sort of wondered what actually made that noise, and how, and if it was really the same as the air-raid sirens you hear in old movies. I don’t know if any of you have looked into the world of sirens, but there’s a corollary to the law of if-it-exists-there-is-porn-of-it: if it exists, there is a small and deranged cadre of people who collect it for purely nonsexual reasons. Good examples of this include vacuum tubes, power-line insulators, and the whole spectrum of the siren family from horns and whistles all the way up to the most ridiculous noisemaker of them all, about which more later.

There are two sorts of siren, for most purposes, and the fire trucks that go under my window multiple times per evening (WHOOOOoooooooooooooOOOOOOOO BRAAAAAAAAAA BRAAAAAA) are equipped with the pneumatic type, plus an air horn, while the police cars (NNEEEEEEEEEEEEEEEEEEEEEEEEEEEeeeeeeeeeeeeEEEEEEEEEEEEEEEEEEEEeeeeeeeeeeeeEEEEEEEEEEE WOOP WOOP EEEEEEEEEEEE) have electronic sirens. The electronic ones can replicate the wail of a pneumatic siren but have a much tinnier sort of noise, higher and more nasal than their mechanical cousins.

Pneumatic sirens work on a principle so simple it’s funny. Sound is perceived as the result of air pressure variations hitting our little tiny delicate eardrums and billowing them in and out, so anything that causes a regular disturbance in airflow will make noise, viz. blowing raspberries. That is in effect what happens when you spin up a pneumatic siren. An impeller fan (rotor) turns inside a slotted housing (stator), sucking air in and blowing it out again through the slots in the stator drum. As the rotor turns, it chops the air-stream coming out of the stator slots into regular bursts. Each time the rotor and stator holes align, a burst of air is forced through. The frequency of these bursts is the pitch of the siren. The alternating pressure wave propagates through the air and drives everybody nuts unless they’ve lived on Lombard Street and have learnt to ignore sirens for the most part.

These are the sirens you will be familiar with from the war films, the mournful minor-third wail of the British Carter air-raid siren and the single tone of the US Federal Thunderbolt. They take a lot of power to spin up to their maximum RPM/pitch, but can do this quickly; there’s no brake on the shaft, so once power is cut off it takes a long time for the siren to spin down out of audio frequency. You’ll notice this next time you hear a fire-truck or a volunteer-firehouse siren spin down: it sounds thoroughly desolate and discouraged. WOOOOOOOOOOooooooooooooooooooooooooooooooooooooooooooooo.

Both the Carter and the Federal are dwarfed by the apotheosis of all sirens, the ridiculous, majestic, and rather scary Chrysler Air Raid Siren. VictorySiren.com has a lot more information about this behemoth, but I shall outline a few of the more salient details for you, because it is just absolutely unbelievable:

This siren is powered by a 180-hp V8 hemi from Chrysler’s industrial engine line. It runs a compressor capable of pushing 2610 cubic feet of air a minute through a rotor spinning at a maximum of 4600 rpm and forcing it out of its six aluminum throats at four hundred miles an hour. Under optimum conditions it can be heard more than thirty miles away. At one hundred feet from the monster its output is 138 dB. It is the loudest sound signaling device ever built. It is also the size of a car and weighs over five thousand pounds.

Looking at the Chrysler siren and listening to clips of it being run is looking into another era. I can’t think of another object that exemplifies the American approach to the Cold War: it’s huge, massively powerful, well-designed, and completely paranoid.

And I want one.

Image credits: airraidsirens.com & Anthony Pollard on airraidsirens.com

Death in a cloud: the Bhopal disaster

2009-06-05T10:18:00.002-04:00

Even a brief foray into researching the causes, immediate consequences, and long-term repercussions of the gas disaster at Bhopal in 1984 quickly demonstrates that in order to cover all the aspects of the event fully one would need to write a book, not a blog post. Since other people with access to primary sources have already done this for me, and I refer here to Ingrid Eckerman's fantastic The Bhopal Saga, I will try to avoid doing so, although this is going to be long.

Bhopal is the capital of the Indian state of Madhya Pradesh, located more or less in the middle of the country. It's the second-biggest city in the state, and is--or was--known as the City of Lakes for the multiple natural and man-made lakes in and around the city itself. Union Carbide India Limited (UCIL) had built a chemical manufacturing plant in East Bhopal City in 1969, the same year the ValuJet DC-9 plane was built, which was owned partly by Union Carbide Corporation (UCC) and partly by Indian authorities, although Union Carbide owned all the designs and processes used at the site.

UCIL Bhopal's main product was the insecticide carbaryl. Sold under the trademark Sevin, carbaryl is one of a group of chemicals called carbamates which happen to be cholinesterase inhibitors, meaning that they prevent the enzyme cholinesterase from breaking down the neurotransmitter acetylcholine and therefore do extremely unkind things to the human nervous system; without cholinesterase getting rid of the acetylcholine sitting around in synaptic clefts, the nerves controlling our muscles don't stop firing, causing neuromuscular paralysis and eventual death. So we can see that carbaryl and its relatives aren't necessarily something you want large quantities of in your back yard; however, much like methamphetamine, the process used to make this nasty substance is even more dangerous and poisonous than the substance itself. One particular compound required to make carbaryl at the Bhopal plant is methyl isocyanate, or MIC. MIC killed an unknown number of people, probably between 8,000 and 10,000, in and around Bhopal on the night of December 2-3, 1984--and continues to claim victims today, as survivors of the Bhopal disaster slowly succumb to exposure-related illnesses.

I cannot emphasize enough how absolutely nightmarish the Bhopal plant was--and is to this day--in terms of toxic chemicals. MIC will kill you, but so will chlorine, phosphene, methyl carbamyl chloride, monomethylamine, cyanuric acid, hydrogen chloride, and all the other multisyllabic substances involved in and resulting from the production of carbaryl. Over here in the States when we think of toxic chemicals Woburn and Love Canal and Valley of the Drums and Hinkley come to mind: what happened at Bhopal casts all the chemical accidents in the US far into the shade. Here was not a royal fellowship of death, but a treasure-house of it; an Aladdin's cave of substances inimical to human life and health, all sitting within a hundred yards of the poorest shanties of Bhopal.

In order to make Sevin, you need to combine chlorine and carbon monoxide to form phosgene, then combine that with monomethylamine and chloroform to produce methyl carbamyl chloride (and hydrogen chloride gas). You then break down the methyl carbamyl chloride into methyl isocyanate, which you react with alpha-naphthol and carbon tetrachloride to finally produce carbaryl. There is a separate process by which you can make carbaryl without using MIC, but it costs more, so it wasn't an option.

Now do that on an industrial scale with profit as the priority, with poorly maintained equipment, poorly trained or untrained workers, poorly trained or untrained supervisors ignorant of the physiological effects of the substances they were handling, and set your manufacturing plant within pebble-throwing distance of residential neighborhoods without telling the inhabitants what your process involves or what to do in a chemical-release emergency (other than that you make "medicine" for crops), and you’ve got UCIL’s operation at Bhopal to a T. UCIL did provide Bhopal hospitals with some resuscitation equipment, but provided no emergency procedures for gas-release incidents.

MIC, as a crucial ingredient in the carbaryl manufacturing process, was required in large amounts on the site. When the plant was built, UCIL only manufactured carbamate pesticides from concentrated ingredients shipped in from the US: however, in 1980, UCIL equipped the Bhopal plant with the necessary setup to manufacture it from chlorine (brought in from external suppliers) and carbon monoxide produced on-site. MIC was stored in two of three main tanks, designated 610, 611, and 619; the Union Carbide manual stated that only two of the tanks were to be used for storage at any given time, that the tanks' contents be refrigerated to five degrees centigrade or below and kept under a controlled pressure of nitrogen gas, and that the tanks and fittings should be made out of stainless steel and not any other alloy (including carbon steel).

The tanks were designed with a relief valve vent header (RVVH) which led directly to a vent gas scrubber (VGH) which bubbled the escaping gas through a solution of lye to neutralize it before burning it off from the plant's flare tower or releasing it from the stack. In the event of a tank reaching its pressurization limit (40 pounds per square inch over atmospheric pressure, or psig), a rupture disk would burst, a relief valve would open, and the gas would be released to the vent scrubber. As MIC reacts with water, a nitrogen pressurization system was built in to ensure the dry nitrogen atmosphere inside the tanks wouldn't become contaminated with moisture from the air: if a tank's pressure fell below 2 psig, nitrogen would be pumped into the tank through a connector to a second line running from tank to scrubber, the process vent header (PVH). We have at this point two main routes for gas to escape from any one of the three MIC storage tanks: the RVVH and the PVH.

Piping in the plant was prone to developing clogs due to corrosion or deposited salts from the chemicals running through them, and washing out of the pipes with water was a commonplace task. A barrier, called a slip-bind or slip-blind depending on your source, should have been inserted into the pipes in question to ensure water didn't escape the section being washed out. This very important safety procedure was apparently left out of the written instructions provided to workers for washing out the pipes, according to Eckerman, who cites the Union Research Group of Mumbai (Bombay)'s 1985 report, The role of management practices in the Bhopal gas leak disaster.

In addition to the incomplete procedure instructions, the Bhopal plant lacked a rather damning number of security measures that a similarly purposed US Union Carbide plant considered necessary for operation, contrary to UCC's initial insistence that Bhopal was run to the same standard as its stateside plants. Eckerman offers a table of the security features at UCC's plant in Virginia that were not available/implemented in Bhopal, including:

--Non-MIC carbaryl production process (patented by UCC)

--Storage of MIC only in small quantities, in small vessels, for short times

--Fully-computerized four-stage alarm system

--Monitoring of chemical inventory

--"Knock-down" tank to handle MIC overflows before they could be released

--Emergency VGS with extra capacity

--VGS and flare tower available at all times, not just when MIC was being produced

--Refrigeration with backup refrigeration system to keep MIC at -10 degrees C

--Exclusive stainless steel construction

--Location downwind, outside of town

--Siren/alarm system pointed outward and capable of alerting residents of town

In the initial years of the Bhopal plant's self-sufficient MIC/carbaryl production era, it was run by an American engineer who was committed to safety. In 1982, he was replaced with an Indian engineer educated in the States, directly subordinate to a financial controller most interested in reducing/controlling the company's losses. This is when it started down the garden path to hell, and the first few steps along that path were to screw up staffing/hiring policies for the MIC plant and fire a bunch of employees, as well as cutting down training from 6 months to 8 weeks--which, according to some of the workers, were barely sufficient to give them the necessary skills. When one worker complained about being asked to take on the role of a full-fledged operator after 5 weeks of training, he was apparently allowed to complete the final three.

On the night of the disaster, there were no trained engineers on the site. And this is not making Play-Doh or putting the lids on pies, this is life-and-death stuff they're dealing with.

Eckerman's list of malfunctioning, disconnected, or nonexistent safety systems at Bhopal reads like a disaster movie's build-up stage. Surely no one could have let this go on in real life? Surely all these systems could not be malfunctioning this badly at once? Didn't anyone care?

Probably they did, but it was more than their jobs were worth to complain. The Bhopal plant had been granted a license to produce something like 5,000 tons of pesticide a year. In point of fact they were selling around 2,000. People who knew the Indian market had asked that a smaller plant be built, but this had been bulldozed over by UCC, with the predictable result that Bhopal was run at a loss and the UCIL management was constantly trying to cut costs and raise profits: thus the staffing cuts, thus the replacement of stainless valving and pipes with carbon steel, thus the draining of the MIC refrigeration unit and the use of the system's freon in other plant operations. One after one after one, the systems that should have prevented Bhopal's disaster were deliberately shut down, either to save money or because they just weren't working right.

Unsurprisingly, there had been "warning" accidents in the months leading up to December 84. MIC exposure accidents, leaks of MIC, chlorine, monomethylamine, phosgene, and carbon tetrachloride (sometimes in combination); rather dreadfully, Eckerman mentions that "a journalist...had listened to the workers' discussions about the dangers at the factory--toxic gases, deadly leaks, and the likelihood of explosions. After having done some research, he started to write articles in the local press, warning of the hazards associated with the plant. His final article, which appeared just five months before the disaster, was titled 'Bhopal on the Brink of a Disaster.' No one took any notice. He also sent letters where he summarized the findings of his investigations to the Chief Minister and the Chief Justice of the Supreme Court, and requested them to close down the factory. He got no answer."

Tank 610, which would eventually kill something more than twenty thousand people, was causing problems long before the accident itself. Eckerman writes that on October 21, 1984, less than two months before the disaster, it could not be pressurized; managers switched to tank 611, more biddable, to continue Sevin production. Nobody bothered to find out why 610 misbehaved. On November 30 (or 26, depending on sources) nitro pressure in 611 fell, making them wonder what the hell was wrong with these here tanks in this here plant and causing an investigation that ended with the replacement of a faulty valve on tank 611--and the abandonment of 610. "Operators later told journalists that every time nitrogen was pumped in [to tank 610], it leaked out again through an unknown route."

Let's skip ahead, shall we? Tanks 619, 611 and the recalcitrant 610 are entombed in a concrete mound some distance from the Sevin unit and flare stack. On the night of the accident, the following conditions existed:

1) Tank temperatures were not being logged

2) The vent gas scrubber (VGS) was not in use (this does not entirely fit with some reports of the sodium hydroxide scrubber solution registering a temperature, on the morning after the accident, that indicated a reaction had taken place)

3) The refrigeration system on the MIC tanks was not in use and could not be activated as its refrigerant had been nicked for use elsewhere onsite

4) A slip bind was not used when the pipes were being washed

5) The concentration of chloroform in 610 was too high

6) The tank was not pressurized with nitrogen (or anything else)

7) The tank's high-temp alarm was not functioning

8) The evacuation tank (619) was not empty

There are several major reports covering the incident itself, which most people agree began with water washing of some of the pipelines of the plant. Supervisors on duty at the time were not familiar with the factory's complex maintenance procedures, and knew nothing about MIC or phosgene: in fact the supervisor was convinced that there could not be a leak when production of MIC had been stopped.

The 1988 Arthur D. Little Inc. report, which UCC used to support the sabotage theory, states the following:

"Shortly before the end of the second shift, at 10:20 p.m., the pressure in Tank 610 was reported to be at 2 psig. The shift change occurred at 10:45 p.m., and everything was normal until 11:30 p.m., at which time a small leak was reported downwind and in the area of the MIC production unit. The MIC supervisor said that he would deal with the leak after tea, which began at 12:15 a.m. The tea lasted until 12:40 a.m. at which time all was normal. At that point, the control room operator observed the pressure rise suddenly in Tank 610, and within minutes the indicator was off the gauge's scale. At 12:45 a.m., the safety valve on the tank opened, and gas came out of the stack of the vent gas scrubber. The operators ran to the tank and found it rumbling, and the concrete over the tank was cracking. The fire squad sprayed the stack to knock down the gas, and the reaction subsided an hour or so later. The workers claimed to have no idea as to why the pressure rose in the first instance. According to this account, the incident occurred suddenly and inexplicably."

This is at best disingenuous. Water--a considerable amount of it, thousands of pounds--entered tank 610, and there was evidence of an MIC leak before the main catastrophe that was going to be dealt with "after tea." The boy whose job it was to bring the control room operators their nice tea for their break noted that there was a seriously taut atmosphere and nobody for some reason actually took him up on his tea offer. This was uncharacteristic.

The thing about water and MIC is that they react like eighties movie teenagers and produce a hell of a lot of heat. They produce even more heat in the presence of iron, which would have been present in the contaminant water due to pipe corrosion (carbon steel was used in place of stainless to keep costs down). MIC is such an unstable chemical that it reacts with itself under the right circumstances, and in tank 610, it was gleefully doing so in an exothermic sort of way, creating more heat with every single atom undergoing change, and in a very short time this pressure exceeded the 40 psig tank rupture disk, releasing MIC and a bunch of other chemicals directly to the vent gas scrubber. Which would have meant something, had the VGS a) been working or b) been capable of handling a release of this magnitude.

Times for the various events occurring during the disaster vary. Here's a summary from Eckerman directly off Google Books, which contradicts the timeline Wikipedia presents:

20:30 (8:30 PM): Press in 610 noted as 2 psig. Operator told to wash out lines close to MIC tank(s). Presumably, not provably, operators failed to install slip-binds (due to incomplete instructions) and allowed water to flow freely through the piping of the relief valve vent header and/or the process valve vent header. Various accounts state that operators did not use slip-binds, that they noticed water was not coming out of bleeder lines and shut off the water flow, and that supervisors then ordered them to resume the flow.
22:00 (10:00 PM): Approximate time when water began to enter (presumably unpressurized) tank containing 42 tonnes of MIC minus refrigeration. Reaction begins.
22:30 (10:30 PM): one report states that workers told to use water to continue to clean lines (i.e. keep tap running) and that night shift would turn it off; new operators came on duty, poor bastards, and logged 610's pressure as 2 psi. Alternate reports state that shift change occurred at 10:45 or 11. Some reports mention throat and eye irritation from a MIC leak close to the area where the lines were being washed around 10:45.
23:00 (11:00 PM) One report marks the first report of an MIC leak by a field operator by the VGS; operator said later that the press was 2 psi, but in other reports is mentioned as saying that the 2 psi reading was 3 hours old.
23:30 (11:30 PM) Last transfer of MIC to the Sevin unit. Seems to have come from tank 610 not 611. In addition:
-'The operators on ground level noticed dirty water spilling from a higher level in the MIC structure and MIC in the atmosphere. The MIC and dirty water were coming out of a branch of the RVVH. The pressure safety valve had been removed and the open end of the RVVH branch line was not blinded.'
-'The operators found brownish water and steam coming out from a drain-cock eight yards off the ground. The supervisor recommended turning off the taps after the tea break. The team left for the staff cafeteria.'
The really telling point is 12:15 PM, when the transfer of MIC from tank 611 to the Sevin unit occurred, which UCC investigators concluded to be an attempt by MIC operators to remove water from the tank. We don't know how the water got in there: we just know it did, and while the Arthur D. Little company and UCC continue to maintain it was due to one or more disgruntled operators squirting water into the MIC tank (despite the fact that doing this would most likely kill him or her very horribly) rather than sheer incompetence, there is no conclusive evidence for the sabotage.

All the reports seem to agree that 12:15 is when things started to go very badly wrong. Pressure in tank 610 was rising through 30 psig and off the scale, which pegged at 55; when control room operators and supervisors ran to have a look at it, they found the tank moving, rumbling, cracking the concrete over it with its vibration and heat expansion, and so hot as to flash cooling water off into steam. One report states that the tank stood on end and fell back again, but did not burst. They ran like hell back to the control room and turned on the VGS system, but couldn't verify that it was working.

It was now 12:30, and clouds of lethal gas were spewing from the plant stack and spreading rapidly through Bhopal. Accounts differ on when the siren was sounded, anywhere from 12:15 to 1 AM, but it was shut off shortly thereafter. Attempts were made to knock down the gas release by spraying water at it, but the sprays couldn't reach high enough to make a difference. One worker was killed when he tried to climb the stack assembly and somehow shut off the release; he was almost immediately overcome by the gas and fell off, breaking several bones. By 1:30, workers were running for their lives: people who lived close to the plant were already dying.

Tank 610 continued to pour MIC and a host of other toxins into the night air until it was empty; some reports mention that the safety valve reclosed (as the pressure fell below 40 psig) around 2:30, and the emission stopped. By now 42 tonnes of deadly gas were flowing through Bhopal, blinding and choking people in their beds.

MIC is heavier than air; it hugs the ground, rolling downhill. The weather conditions on the night of the accident were as bad as they could be: a temperature inversion trapped the gases close to the ground, and there wasn't enough wind to blow the cloud away. There's been considerable controversy over the role played by hydrogen cyanide (HCN) in the deaths at Bhopal: MIC breaks down into HCN at high temperatures, and tank 610 may have reached sufficient temperatures to allow this reaction. Cyanide was found in the bodies of some Bhopal victims, and scientists have merrily argued about which of the many gases making up the lethal cloud was responsible for the deaths, which strikes me as missing the point.

The people of Bhopal were awakened by acute pain in their eyes, noses, and throats; coughing uncontrollably, blinded by tears, vomiting, they fled into the streets to escape. People were trampled to death in the rush to evacuate. Mothers lost their babies when they were literally pulled from their arms by the force of people struggling to push through the crowd. Because MIC is so heavy, concentrations of it were worst right over the ground; the shortest people--children--got the heaviest doses. Many of those who did not die at once succumbed at the grossly unprepared hospitals, drowning as pulmonary edema filled their lungs with fluid or suffocating as their devastated bronchi went into intractable spasm. Doctors had no idea what was responsible for the injuries; eye drops and cough medicine were handed out and glucose drips set up. Bodies were everywhere, piled on one another, littering the streets.

Dawn brought with it evidence of the extent of the disaster. Thousands of bodies--of livestock as well as people--lay where they had fallen. Within a few days every tree in Bhopal lost its leaves, and the grass turned yellow: a blight of biblical proportions. Police trucks carried bodies to be dumped in the river; others were stacked into funeral pyres. Official procedure for identifying the dead was left behind in the rush to clear the city of the dead; we don't know how many people died that night, but initial reports listed the death toll at over two thousand. That figure jumped to 8,000 and then to 10,000 as more and more died of their injuries. All in all, UCIL killed more than twenty thousand people with one accident.

In the wake of the disaster, UCC was faced not only with attempting to address the devastating leak that had occurred, but with preventing another leak. Tonnes of MIC still remained in the other holding tanks, and it was determined that the thing to do was to convert this into Sevin as soon as possible. "Operation Faith" was conducted on December 16, but this time rigorous safety measures were in place and the inhabitants--remaining inhabitants--of Bhopal were evacuated prior to the procedure. Bhopal residents had absolutely no trust left for the authorities; everyone who could fled the city with all their belongings.

It is beyond the scope of this write-up to cover the reaction to Bhopal, or the years which followed. Suffice it to say that this must not be forgotten, that the rest of the world must know about it, tell the next generation what happened. Those who died at Bhopal mattered, and the grossly negligent maintenance and staffing of the UCIL plant that killed them also matters. Remembering Bhopal is remembering that accidents like this can happen, and that the corporations responsible for accidents must make preventing such accidents their priority; that profit does not trump human lives, and that decisions made in a boardroom affect the everyday existence of hundreds of thousands on the other side of the world.

And that's what went wrong.

Information in this post was taken from the following sources:

Eckerman, Ingrid (2004). The Bhopal Saga — Causes and Consequences of the World's Largest Industrial Disaster. India: Universities Press. ISBN 81-7371-515-7. Available via Google Books.

Kalelkar AS, Little AD. (1998) Investigation of Large-magnitude incidents: Bhopal as a Case Study..PDF available. London: The Institution of Chemical Engineers Conference on Preventing Major Chemical Accidents (Arthur D. Little Report)

Labunska I, Stephenson A, Brigden K, Stringer R, Santillo D, Johnston P.A. (1999). The Bhopal Legacy. Toxic contaminants at the former Union Carbide factory site,Bhopal, India: 15 years after the Bhopal accident. PDF available. Greenpeace Research Laboratories, Department of Biological Sciences, University of Exeter, Exeter UK

Stringer R, Labunska I, Brigden K, Santillo D. (2002). "Chemical Stockpiles at Union Carbide India Limited in Bhopal: An investigation". Greenpeace Research Laboratories. PDF available.

What warning label where? ValuJet Flight 592

2009-06-03T12:19:00.002-04:00

Unless you spend a great deal of time in a chemistry lab or dabble in rocket propulsion, the concept of oxygen as a dangerous substance may not be immediately self-evident. Nor does the word “oxidizer” carry the same weight as, say, “explosive.”

Pressurized pure oxygen was responsible for the vicious rapidity of the flame propagation in the Apollo 1 launchpad fire. More recently, oxygen and the chemical reaction responsible for producing it killed a hundred and ten people and dug a crater in the bedrock of the Florida Everglades.

I was sixteen when ValuJet Flight 592 slammed into the swamp at over five hundred miles an hour. I remember hearing about it, and watching the pictures of the recovery effort on the news. They didn’t find many big pieces of anything, including people; a small amount of human tissue was strongly suspected of belonging to the first officer, but it wasn’t in any condition to provide proof. Eventually 68 of the 110 people aboard were identified. They’re still there, the victims of Flight 592. They’re in the mud, in the cracks in the bedrock, in the murky water.

ValuJet was one of the first low-cost airlines offering cheap fares with no frills, and its fleet was made up of aging McDonnell-Douglas DC-9 and MD-80 jets. It had a contract with several maintenance and repair facilities around the country to perform service and overhauls on its planes, three of which were qualified to provide heavy maintenance. One of these, located in Miami, was SabreTech.

The accident itself

On the afternoon of May 11, 1996, a Douglas DC-9-32, N904VJ, owned and operated by ValuJet Airlines, Inc. as flight 592, took off from Miami International Airport on a flight to William B. Hartsfield Atlanta International. Six minutes later, the crew requested an immediate return to Miami due to smoke in the cockpit and cabin. The interphone connecting the cabin and cockpit wasn’t working (one of many equipment failures plaguing ValuJet planes); contrary to regulations, the flight attendants had to open the door to communicate with the pilots, introducing smoke to the cockpit. Shouts in the background of “fire, fire, fire, fire” can be heard on the recording, coming from the cabin. Just before 2:14 PM, ten minutes after takeoff, the plane vanished from Miami radar.

When emergency personnel arrived at the scene they faced considerable challenges: the wreck site was a quarter-mile from the nearest road, located in a seven-foot-deep swamp in which visibility was approximately nil, and the plane had hit the ground with such force as to render it into lots of tiny little bits, surrounded by mud, sawgrass, and alligators. Nevertheless, through a very great deal of hard work on the part of a large number of searchers and the cooperation of various law enforcement agencies, enough fragments of wreckage were found, identified, and reassembled into a model of the accident aircraft to begin to offer some answers into the cause of the wreck.

Investigators knew that a fire had played some part in the disaster, although where it was located or what had caused it was still unknown. As they pieced together the shreds of the DC-9 fire damage began to appear, located in what had been the forward cargo bay of the plane. Wiring controlling the aircraft’s flight surfaces and engine thrust was burnt through, indicating that the crew had most likely lost control of the plane as the systems died. When the CVR and FDR were finally recovered, the data indicated that progressive control system failure following an initial anomaly had occurred, and this was corroborated by the discovery that the left-side floorboards had melted and collapsed, affecting the captain’s control cables.

Checking with SabreTech and ValuJet records, they found that the forward cargo bay on the accident flight had contained five boxes of "company materials" (COMAT) and a couple of landing-gear wheels, none of which theoretically should have started a fire; however, further investigation revealed that the contents of the COMAT boxes were listed as "Oxy Cannisters [sic] 'Empty'," at which point they began to realize that in all likelihood this had been a completely preventable tragedy.

Emergency oxygen on board commercial passenger airliners is provided not by pressurized oxygen tanks but by chemical oxygen generators. These are cylinders about the size of a tennis-ball can, containing a mixture of sodium chlorate, barium peroxide, and potassium perchlorate. If the cabin loses pressure the compartments holding these things will open, dropping those dinky plastic oxygen masks over the passengers’ heads; pulling on the masks tugs on a lanyard attached to the oxygen generator’s firing pin, setting off a little percussion cap. This produces enough energy to trigger the chemical reaction within the generator core whereby the sodium chlorate is reduced to sodium chloride and oxygen is given off in gas form; it’s a nice, elegant little reaction which does away with the need to carry dangerous pressurized tanks over passengers’ heads and allows the oxygen system to take up very little space.

However, this reaction is exothermic. Powerfully so. An activated oxygen generator is capable of reaching temperatures of five hundred degrees while it’s working; for this reason it is vitally important that when you are carrying these things around or storing them you put a safety cap over the firing pin, preventing them from being triggered by mistake. This would seem to be common sense.

The investigation into ValuJet’s and SabreTech’s shipping and labeling policies and history revealed that not only were the oxygen generators being carried in the accident aircraft’s forward cargo bay not empty or secured for transportation, they were also not appropriately marked, had not been identified as hazardous materials, and were in fact not recognized by maintenance personnel as dangerous. They had been stacked in the cardboard boxes without safety caps, covered with a layer of bubble wrap, and shoved into the cargo bay along with the spare wheels. Apparently these generators had been removed from ValuJet planes when they passed their expiration dates, then left sitting around minus safety caps for several weeks until personnel were told to clean up the storage rooms for an upcoming site visit/audit, whereupon they were packed into boxes–still sans safety caps, as apparently these were unavailable–and sat around some more until someone finally asked if he should send them to Atlanta and was told “okay, that sounds good to me.”

According to the stock clerk, he identified the generators as “empty canisters” because none of the mechanics had talked with him about what they were or what state they were in, and that he had just found the boxes sitting on the floor of the hold area one morning. He said he did not know what the items were. Nobody had bothered to read the ‘reason for removal’ tags on the generators.

Tests on similar oxygen generators in a mockup of the DC-9’s forward cargo bay demonstrated that not only was an activated generator in a cardboard box capable of starting a fire, within ten minutes of ignition the temperature on the ceiling of the cargo bay was reaching temperatures over 3,000 degrees F. Aluminum’s melting point is around 1,220 F, higher or lower depending on the alloy. There was no way the floor of the passenger compartment could withstand this kind of fire.

The forward cargo bay was supposedly fire-resistant due to its lack of ventilation, which would cause a standard fire to use up the available oxygen and burn out fairly quickly. However, not only did the oxygen generators reach ignition temperature, they also, well, generated oxygen, which fed the fire. Regulations didn’t require smoke/fire detection systems in cargo compartments of this type, nor any kind of fire suppression systems.

Going back to the battered black boxes, investigators found that at 2:10 pm, six minutes after takeoff and right before all the electrical systems went to hell, an unidentified sound was recorded on the CVR. According to the FDR, just before the sound, the airplane was climbing through 10,634 feet at 260 knots indicated airspeed. Simultaneous with the noise on the CVR, the FDR recorded a 33-knot decrease in indicated airspeed and a pressure altitude drop of 817 feet. The FDR airspeed and altitude data returned to normal values within 4 seconds. Altitude and speed data recorded on the FDR are based on readings from the static port on the left-hand side of the DC-9 (a small port open to the atmosphere, which registers the pressure of the outside air on the plane as it moves).

An increase of 69 pounds per square foot (psf) sensed by a static pressure sensor on the airplane would result in an 817-foot decrease in altitude (as recorded by the FDR). Further, an increase of 69 psf in static pressure would result in a decrease in airspeed of about 40 knots, which is consistent with a curve fit of the airspeed decrease recorded on the FDR. The brief anomaly in the readings is, therefore, consistent with a momentary jump in the static system pressure. What would cause this sudden pressure increase?

How about a bursting landing-gear tire in the forward cargo bay?

Tests showed that in fact one of the tires recovered from the crash site which was torn open could have produced this level of pressure increase as it blew during the fire. By calculating the length of time it took for the fire to heat up the tire to bursting point in a recreation of the cargo bay, investigators could work out roughly when the fire began–possibly as late as during the airplane’s takeoff roll. Almost immediately after the tire blew, the wiring bundles running under the cabin floor burned through and the crew began to lose control of the plane, as the fire ate its way into the passenger compartment.

Imagine it. You’re in a plane that was built the year Neil Armstrong walked on the moon, bound for Atlanta on a sunny afternoon in May. You’ve been delayed in departure for over an hour and you are probably overjoyed when the damn thing takes off; as usual, you’re looking out the window at the runway flashing by and wondering if the plane is going to make it into the air at all–and, as usual, it does, and the vast hand of inertia presses your butt into your seat as the captain climbs through two thousand feet and begins to bank left. If you’re on the left side of the cabin you can look down and see Miami lazily baking in the afternoon sun.

Then you smell something funny. Something burning. It’s coming from the front of the cabin, and it’s getting worse. People are starting to sound panicky up there, and now there’s flames, visible flames dancing on the floor, and you are in an airplane that is on fire. Perhaps the floor’s gone soft and is beginning to sag, too hot to touch; the carpet’s melting. Flames lick at the seats, and people have begun to scream; and now there’s smoke, black smoke rolling along the ceiling. You can’t get out: there’s nowhere to go. The flight attendants try to alert the cockpit, but the interphone isn’t working. They bang on the door and finally open it–which you absolutely must not do in a case of smoke in the cabin. The oxygen masks have not dropped. By now the crew are losing control and have radioed for an emergency return to Miami, and people are burning alive as the fire spreads and the temperature in the cabin soars. Without control over the engines, flaps, slats, ailerons, or rudder, Flight 592 is helplessly plummeting toward the ground.

Probably the passengers and crew were unconscious by the time of impact, overcome by heat and toxic fumes. Probably none of them were able to see the ground rushing up at them, or feel themselves blown apart by the force of the crash. Had any number of people done their jobs right, it wouldn’t have happened at all; had the SabreTech mechanics properly labeled the generators when they removed them from the aircraft, had they activated them and safely expended the cores as the manufacturer’s and other airlines’ procedures required before shipping them as hazardous materials, this would not have happened. ValuJet and SabreTech had received several warnings as a result of negligent or insufficient safety oversight, and despite the obvious necessity had not made changes to their operating procedures that would have prevented the accident from occurring.

ValuJet never recovered from the crash. In 1997 it merged with low-cost carrier AirTran Airways, and discarded the ValuJet name entirely. Today AirTran’s fleet is among the youngest in the field, with an average age of less than 4 years; in July 09 it will be serving 62 locations in the States. Since ValuJet bought AirTran and took on the AirTran name, the airline has not experienced any fatal accidents and is generally considered among the safest commercial airlines in the country. Lessons learned from the crash wrote new rules regarding oxygen generator disposal, COMAT and hazardous material transportation, compliance inspections, fire detection and suppression systems, and cargo bay design. Flight 592 could have been prevented; the changes made in the industry as a result of the tragedy will hopefully prevent anything like it from happening again.

Information in this post is taken from the official NTSB report.

Welcome and introductions

2009-06-01T15:52:00.000-04:00

This blog is the result of a long-standing interest in the whys and wherefores of disaster, both manmade and natural. I enjoy researching how things happened, what cascade of coincidences had led up to the circumstances under which disaster was inevitable, and what the investigations into these events have taught us for the future. Documentary series such as Seconds from Disaster are fantastic resources for the casual investigator; however, digging around the web can often provide official disaster investigation reports, which give a more in-depth understanding of the sequence of events.

Enjoy, and do let me know if you have a favourite disaster you'd like to have presented.

Let's start this out with a bang, not a whimper: what went wrong at the King's Cross tube fire.

2009-06-01T15:40:00.001-04:00

Only last night I found myself lost
By the station called King's Cross
Dead and wounded on either side
You know it's only a matter of time
--Pet Shop Boys

I used to smoke. I smoked until the end of October of last year, and for the most part while I was doing it I damn well enjoyed it and wanted to be doing it. When I stopped wanting to smoke, I stopped smoking.

Since then I’ve managed to stay on the wagon except for one experimental pack, and I didn’t enjoy that enough to consider taking it up again. But even when I was a confirmed smoker, I made sure my damn matches were out when I put them in the ashtray or dropped them to the tarmac. I lit with a lighter if possible, but if I used matches I shook them out.

Imagine knowing you killed thirty-one people because you didn’t bother to shake out your match. Imagine turning on the telly once you got home and realized that it could have been your match that started one of the worst underground fires since the Couronnes disaster in 1903. Imagine the feeling of that realization.

I wonder who it was, and whether they ever knew they had been responsible.

On the evening of November 18, 1987, the disaster began with very little drama. Far beyond the point where any action could have saved the station, the scope of the conflagration was not understood: only after a little “cardboard-box-sized” fire roared into flashover and incinerated people where they stood in the King’s Cross tube ticket hall did anyone have the slightest idea just how bad an escalator fire could get.

To begin at the beginning it is important to understand the layout of King’s Cross-St. Pancras station. This is one of the great spaghetti junctions of subterranean London, connecting the British Rail stations of King’s Cross and St. Pancras with the Piccadilly, Victoria, Metropolitan & Circle, and Northern tube lines. Building this thing must have been an incredible engineering feat; in the tube line ticket hall model we can see some of the complexity of the station design, and in the money shot we can get a comprehensive look at just what a warren of tubes and tunnels and escalators and shafts this place presented.

We must remember that a lot of the technology in the Tube stations dated back to the beginning of World War II. On the night of November 18, 1987, the escalators leading from the Piccadilly Line to the King’s Cross tube ticket hall were—like all the other escalators in the system—largely made of wood. Varnished wood. Thin, worn, varnished wood, under which ran a ceaseless procession of metal chain wheels and track wheels lubricated with grease that had not been inspected or changed since before the cabbage crates came over the briny. In the intervening decades, grime and dirt and dust and bits of paper and sweetie wrappers and hair and rat fur and more grime and more dirt and more dust had settled into this grease, stirred in by the ceaseless wheels, forming a dark pudding of lubricant and matter.

Some time before 7:30 P.M., somebody, presumably a passenger leaving the Piccadilly Line platforms via escalator 4 to the main tube ticket hall, stood on the right side of the escalator and lit a cigarette with a match. He or she dropped the match without making sure it was out, and it fell between the side of the escalator and the running track. Underneath the wooden steps, this match landed in the highly flammable grease mixture. This sludge caught on fire, and continued to burn merrily, lighting the undersides of the steps on fire and causing tongues of flame to lick up on the right-hand side of the escalator about halfway up. The ignition of the grease wasn’t noticed at once. Around 7:30, a passenger reported seeing small flames and wispy white smoke to authorities in the tube ticket hall.

The staff on duty that night were unfamiliar with the King's Cross station. Several staff members were off duty or on limited duty due to illness. Passengers were told, as the fire seemed to be small and not dangerous, to leave the station via the Victoria Line escalators nearby. Trains continued to stop at the station and passengers continued to disembark. Just before the first fire engines had arrived at the station, at 7:43 pm, trains were first warned not to stop at King’s Cross.

At this point nobody, not the firemen investigating the situation nor the passengers moving through the station, was aware of what would happen next. The fire in the Piccadilly Line escalator shaft was growing out of all proportion, consuming the paint on the walls and ceiling as it expanded. At 7:45 pm—-we know exactly when, because the digital clock in the ticket hall stopped working as its wires were burnt through-—the flames roaring up the Piccadilly Line shaft exploded into the ticket hall in a violent flashover, igniting every surface in the room. Passengers who had been directed to bypass the Piccadilly escalators via the Victoria escalators found themselves arriving in a chamber suddenly filled with a floor-to-ceiling blowlamp flame roaring from the shaft to their right. Paint and synthetic materials in the room, burning, gave off intensely toxic fumes that asphyxiated those who were not burnt to death.

Firemen had arrived at King’s Cross about two minutes prior to the flashover. During this period various firefighting teams became separated from one another, unable to communicate by radio as these units did not work underground, and unable to reach one another visually due to the thick black smoke. Disoriented and suffering from the intense heat, firefighters and passengers alike struggled to find exits.

At the time of the flashover several transport policemen were still directing passengers to leave the station via the Victoria Line escalators, unaware of the danger. Once they realized the ticket hall above was in flames, these officers did their best to rescue injured passengers and evacuate them from the station via alternate exit routes, but found several of these locked off. It’s possible that more people could have been saved if the exits to the station had all been clear. When the fire was finally contained and extinguished, at 1:46 the next morning, thirty passengers and one fireman were dead.

With a disaster of this magnitude the public was extremely vehement in its demands for answers and solutions. Obviously, the fact that the escalators were made of flammable wood had played a major part in the fire, but was the wood itself solely to blame? Investigators examined the unburnt parts of Piccadilly Line escalator #4, where the fire had begun, and found some disturbing results. The fire of November 18 had not been the first such incident on this escalator: multiple scorch marks in the paint on the undercarriage of the escalator frame indicated that small fires had started many times under this particular escalator, and had-—by sheer luck—-not propagated further. The possibility of arson was investigated and dropped. When the state of the grease and filth under the escalator tracks was discovered, investigators tested this sludge to see whether a carelessly dropped match could ignite it, and on the first attempt managed to cause a fire that licked up through the escalator steps and grew until seven or eight minutes later it was extinguished.

They knew how the fire had started, now. After a fire at Oxford Circus station some little time before, smoking had been prohibited in Underground stations. However, passengers ignored the ban and routinely lit up on the escalators on their way out of the station. Burnt matches and smoker’s materials were found under the right side of the elevators leading out of King’s Cross. It was most likely a discarded match that had sparked the blaze.

But why had a fire that had seemed at first to be nothing more than a couple of little flames and some wispy smoke turned into an inferno capable of killing thirty-one people? Investigators turned to Oxford University to request a computer model of the fire and its propagation. What they found seemed so incredible they asked if the computer scientists hadn’t forgotten a major variable such as gravity: the model showed the flames from the burning escalator steps lying down as they crept up the incline, flowing along the level of the steps and scarcely peeking above the handrails-—effectively hiding the magnitude of the fire from anyone looking at it from an angle. This would later become known as the “trench” effect. The model showed the hot gases from this flame path spiraling up and clockwise round the top of the tunnel, blasting out into the ticket hall with lethal force.

Despite skepticism, investigators created a scale model of the escalator involved in the fire. Under controlled conditions, they lit the model on fire and observed how the flames behaved. Surprisingly enough, the model fire behaved exactly as the computer had predicted, with the fire lying down along the trench of the escalator and erupting with considerable violence into the model ticket hall above.

Eventually, it was concluded that the fire progressed along the following lines. Beginning with the accidental ignition of grease and dirt below escalator 4 approximately halfway up, the fire burned for some little time and apparently did not appear particularly serious or dangerous to police and fire personnel on the scene. However, it quickly began to spread up the escalator, lying along the level of the steps as per the “trench effect,” until the heat it produced plus the pyrolyzates resulting from heat damage to paints, varnishes, and other substances formed sufficient hot gases to flow violently upward into the ticket hall in a sudden burst of flame generally termed a flashover.

Could the thirty-one people who died in King’s Cross have been saved had any one of a number of key individuals acted differently? Perhaps. But as a result of the King’s Cross fire, not only were wooden escalators throughout the Underground required to be replaced with metal, but communications strategies between station personnel, police, and emergency response teams were clarified and streamlined; fire-suppression sprinkler systems in Underground machinery were required to upgrade to meet new regulations; and firefighting theory the world over gained a new and important understanding of flame progression up an inclined plane in an enclosed environment.

Perhaps they didn’t die entirely in vain. But can you imagine what it must be like to have been one of the people to discard a lit match on Piccadilly Line Escalator 4 the night of November 18, and to realize that it might have been your match to blame for all those deaths? Can you imagine what that must feel like?

I have to wonder who that was, and whether they knew, and whether they’re alive now—and what they feel, every time the anniversary comes round.

All images are borrowed without permission and transferred to my own hosting from the official investigation into the disaster. Read it; it’s a fascinating document and well capable of wasting a lunch hour or two.