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The Day the Music DiedThe Day the Music Died

Don McLean’s epic ballad “American Pie” commemorates the lives, the music, and the tragic plane crash that killed rock legends Buddy Holly, J.P. Richardson (The “Big Bopper”), and Richard Valenzuela (Ritchie Valens) along with their pilot, Roger Peterson. 
We finished our discussion of JC Williams’ “error producing conditions“ (EPCs) just in time to remember the anniversary of this horrible tragedy and use the events of that night to wrap up the lessons we learned using EPCs to predict the future. The takeaways from that crash are instructive even today to pilots.

Let’s trace the events of the crash through Don’s lyrics to see how the accident can really drive home just how predictable a tragedy can actually be. The song starts off recounting when it all happened “a long, long time ago, but I can still remember how.” It was way back in 1959 but it was on the same night that I’m sitting here working on this article, February 3. The lyrics go on telling more of the events that fateful night: “I can’t remember if I cried when I read about his widowed bride, but something touched me deep inside, the day the music died.” The accident indeed touched many people deep inside, and even today it’s considered the first and maybe one of the greatest tragedies rock and roll has ever suffered. Modern music critics view Holly as “the single most influential creative force in early rock and roll” and Rolling Stone magazine ranks him in the top ten on its list of the “Fifty Greatest Artists of All Time.” In a final tribute, Holly would become the first artist inducted into the Rock and Roll Hall of Fame in Cleveland, Ohio. The opening lines also refer to Holly’s “widowed bride,” Maria Elena, who was six months pregnant at the time of the crash. The “tragic news” about Maria Elena was that her acute loss led to a miscarriage two days after the crash that would add a fifth victim to the tragedy.

The lyrics go on, “February made me shiver, with every paper I’d deliver. Bad news on the doorstep, I couldn’t take one more step.” Holly and his band, The Crickets, were on a “Winter Dance Party” tour that took them to twenty-four Midwestern cities in less than a month. It turned out to be really “bad news” for the guys in the band who had to put up with long overnight travel in a rickety old bus that had a lousy heating system, and with outside temperatures dropping to −25°F it made everyone “shiver.” The bus also had a nasty habit of breaking down several times between stops. It got so bad that drummer Carl Brunch was hospitalized for frostbite on his feet – he “couldn’t take one more step” and missed the rest of the tour (and the plane wreck). Buddy was fed up with the creaky old bus and decided to charter a plane to take them from Mason City, Iowa, to Fargo, North Dakota, for their next gig. The Big Bopper and Ritchie Valens were on the plane because of a couple of odd twists of fate. Bandmate Waylon Jennings, who would go on to become a famous country music star, was scheduled to fly but gave his seat up to the Big Bopper, who was suffering from the flu and didn’t want to ride the cold bus. Guitarist Tommy Allsup flipped a coin with Ritchie Valens for the last seat – Valens won. All this had prompted Buddy to jokingly tell Jennings, “I hope your ol’ bus freezes up again!” Jennings shot back, “Well, I hope your ol’ plane crashes!” It was a prophetic statement Jennings said over and over in interviews that haunted him forever.

The band hired 21-year-old pilot Roger Peterson, who agreed to fly the guys to Fargo for $36 a person. Peterson was using a fork-tailed Beech Bonanza 35, N3794N, that night but he hadn’t flown it much, having logged only 128 hours as PIC. In the pitch-black darkness at 0100, Peterson taxied down Runway 17 at Mason City Municipal Airport and took off. The flight lasted four minutes. He flew into the dark night and directly into the blowing snow from an incoming blizzard. With visibility down to almost nothing, Peterson immediately lost visual references to the ground, became disoriented, and flew down instead of up. The plane plowed into a cornfield at over 170 mph, instantly killing everyone on board. The passengers were thrown from the wreckage and stayed there for ten hours before they could be found as snowdrifts blew over the crash site.

The crash resulted from a deadly cocktail of error-producing conditions. The Civil Aeronautics Board (forerunner of the NTSB) determined that “the probable causes of the accident were the pilot’s unwise decision to embark on a flight which would necessitate flying solely by instruments when he was not instrument certificated or qualified to do so. Contributing factors were serious deficiencies in adequacy and communication of the weather briefing, and the pilot’s fatigue as well as unfamiliarity with the instrument that determined the pitch angle of the aircraft.”

So let’s find the lessons to be learned from this tragedy. The first and also the most common EPC we talked about is fatigue. Not only was it 0100 when he started up the plane and took off, but Peterson had already flown for 17 hours that day. He agreed to fly the trip anyway. We have already seen that fatigue incrementally increases the risk of error and certainly contributed to the crash by impairing Peterson’s pilot skills, thinking skills, and problem-solving skills. The next EPC in this tragic scenario is lack of experience and unfamiliar circumstances. Peterson was a low-time aviator, having only accumulated a total of 711 flight hours. We don’t know how many hours of that was at night or in IMC; it couldn’t have been much because he wasn’t instrument certified. His logbook was found in the wreckage and showed a total of only 52 hours of dual instrument training. He obviously didn’t have the experience or skills to fly in instrument conditions on a dark moonless night and snowy whiteout conditions. It wasn’t that he hadn’t tried to get his instrument ticket, but Peterson failed his instrument flight check nine months prior to the accident and didn’t live to retake the test.

The next EPC is high risk, low frequency circumstances. The limited instrument flight training he had was with a different kind of instrument panel than was on the Bonanza he was flying. It was a common problem in the late ’50s that attitude indicators (AI) were not standardized; some had a fixed airplane symbol that the horizon bar moved around and others had a fixed horizon bar that the airplane symbol moved over. The AI in N3794N was a Sperry F3 with a pictorial presentation of pitch and bank angle using a stabilized sphere with free-floating movements of the airplane symbol. It presented its pitch information with sensing exactly opposite of what he was used to in the AI instruments in the other planes he flew. It was likely one of the reasons he flew the plane down into the ground instead of up into the sky when he entered IMC. This was confirmed by the CAB crash inspector, who reported the “rate of climb indicator stuck at -3,000 feet/minute descent.”

Another EPC that is very commonly cited as a contributing factor in NTSB statistics (it was one of the issues in the Tenerife tragedy we talked about a while back) is inadequate communication. Peterson had checked the weather but it was never communicated to him by the aviation weather briefer that there was a flash (Flash Advisory #5) weather advisory (forerunner of the “SPECI METAR” we have today) issued to take effect at 0040, just 20 minutes prior to his planned departure that warned of a “rapidly moving cold front with blizzard conditions, blowing snow, fog and visibility generally less than 2 miles.”  This lack of communication of critical flight information also contributed to his tragic decision to fly that night and possibly could have dissuaded Peterson from taking off in the first place.

We started our deep dive into EPCs with that old Casey Stengel quote about how hard it is to predict the future. But it’s easy to see after picking apart the factors of this crash that predicting the future isn’t hard or uncertain at all. Sure, we’re looking at all of these EPCs after the fact, but it really shows how important it is to hunt down and identify these conditions before you launch on a flight. There are all kinds of checklists and templates around to help to develop this skill. The FAA has one they call the “FRAT” checklist that stands for “flight risk assessment tool” linked here. Pick one of these available tools or just print out Williams’ list I cited last month and use it. Safely completing your flight requires extra vigilance when faced with any of these common sets of circumstances. If Roger Peterson had done any kind of an error-producing conditions assessment as part of his pre-flight planning he might likely have just said to himself, “Tonight’s not the night to fly.” All of us need to do an honest evaluation of possible EPCs, a mental “pre-brief” identifying when bad outcomes are more likely to occur, as part of our routine pre-flight assessment. By being on guard and anticipating times when bad things are more likely to happen, they can be avoided, the future will be right there to predict, and nobody will need to be lamenting, “Do you recall what was revealed the day the music died?

Kenneth Stahl, MD, FACS

Kenneth Stahl, MD, FACS is an expert in adapting principles of aviation safety to the healthcare industry for patient safety. He also writes and teaches pilot safety principles and error avoidance. He is triple board-certified in cardiac surgery, trauma surgery, surgical critical care and general surgery and holds an active ATP certification and a 20-year member of the AOPA. Dr. Stahl practices surgery full-time and is Healthcare Division President for Convergent Performance, an industry leader in teamwork, checklist and accountability training and consulting. He can be reached at [email protected]

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