Heroes and Safety Culture

An old friend of mine died relatively young last year: still in his 50's. He came off his motorcycle while riding alone in the Highlands. The police investigation was unable to define a specific cause, there being no other vehicles involved. He just came off his bike on an empty road and died suddenly and alone. I was shocked and very sad and, yes, surprised: you do not expect people you know to die from disaster in our society. The other D's yes: disease and decay. But not disaster. But yet disasters happen, big and small. Which is why we try to manage safety.

Bill (not his real name) was a scuba diving mentor to me and many others in the late 90's in the Scottish wreck diving scene. Almost every memory I have of him is vivid, because he was larger than life. The kind of guy who would be played by Bruce Willis in a movie. A tough, good-guy: brave, very skillful and always doing something exciting! One of the first things he ever said to me was, "This is not blue water resort diving. Cold water diving, especially with wreck penetration, is an extreme sport, and we need to be very mindful of safety. Our own and that of others. That's why we're taking you back to basics." I had a PADI resort qualification and Bill was not impressed with it: he took me back to basics and trained me for 3 months with a strong emphasis on risk assessment and safe behaviour. "You're only ready when these skills are instinctive and you can show me consistently that you know the protocols," he said.

Bill was a brilliant diver: he had the best buoyancy control, the best airway control and the best emotional control and he got that way by diving deeper, in stronger currents, at darker sites, further inside wrecks than the rest of us. The problem, however, is that being the best at something hazardous involves taking bigger risks.

Here's a typical memory. We were diving in the winter of 2000 on the wreck of the SS Kintyre. It's a hazardous site and there have been multiple SIFs over the years. The issue is a combination of depth, cold, exertion and very strong currents. If you lose focus you can literally be swept away down a slope very fast to lethal depth. I've always been scared of it. Still am. You follow a disused sewage pipe down from the shore to around 30 metres at which point you pick up a rope (that divers maintain) that takes you deeper and is tied to the bows of the wreck, at which point the dive really starts. It was pitch black and I could feel the current tugging at us. We made it onto the bows and swam around in the shelter provided by the structure. The current was getting stronger. At this point, Bill signalled to me with an open hand, pointing deeper into the darkness and current: "Shall we?" he was asking. I signalled back, "No, this is plenty." He gave the OK - no pressure - and we continued to potter before returning and completing the dive. But I was left with the truth that, even after all that training, skills transfer and mentoring, Bill was just braver than me. He would have taken that risk. I was unwilling to.

Generalising for a moment, the problem is that the highly skilled people are often the big risk takers. They become skilled by doing battle with the circumstances that arise as a result of running the risks. In other words, dangerous behaviour can, in some circumstances, make you stronger. Until it doesn't. Until your bad day. Over the years, we've had a few minor bends and bumps and bruises in the club, but no SIFs. We have a safe culture based on decent behaviour, understanding of the risks, lots of training, assiduous sticking to protocols and care for each other. Bill looked after me that day on the Kintyre and we had many dives subsequently as I got a little bit braver and more confident. But never as brave as him. In our club, that was ok. We all dived in buddy pairs, looking out for each other, and knew each other's limits and "never broke the rules on club dives." We always reported in on any little thing that went wrong and then analysed it and shared the 'reminder' with everyone. It was - and remains - a careful culture that allows for some element of controlled risk taking and derring-do, but without putting pressure on everyone to aspire to that. We just looked after each other while being truthful and honest about our limits, and I guess that's close to the essence of safety culture.

Over the intervening decades I have, unfortunately, witnessed several very serious, life-changing incidents. All involving divers who were not in our organisation but happened to be sharing a boat with us in Scapa Flow or the Sound of Mull. When you've seen someone clutching their head and whining in agony like an animal while they can't move their legs, you don't forget it. A common 'incident profile' is that of the young man taking risks but without the skills to consistently survive them. Young men trying to become like Bill, trying to be heroic, hungry for achievement and approval. That is something in our DNA, inherent in human nature. We are the risk takers who came down from the trees to fight it out with sabre tooth tigers. We rightly admire those individuals who most strongly manifest courage. Yet therein lie the seeds of tragedy: it can sometimes be that in seeking to be the best that we run the biggest risks.

I suspect that Bill died while pushing his limits until something unexpected happened. There was no background of obvious reckless behaviour, no near misses or small injuries. Just one bad day for someone who, for decades, had kept himself and others safe. My conclusion is that Heinrich's triangle doesn't really apply in safe cultures or, at least, is not particularly helpful without large data sets. The incident pit is the better model for individuals or hazardous situations where there is not much data. In hazardous environments, risks can accelerate unbelievably quickly.

It needs to be critically understood within a culture of safety that risk-taking always exists and derives from human nature - individually and in groups. Informal leaders who are inclined to take risks need to understand this and the duty of care they have to themselves, to others and to their organization. And we all need to learn to temper our instinctive admiration for bravery with an understanding of the correlated risk-taking that it almost always involves. In other words, the braver you are, the greater your responsibility to take care of yourself and those around you.

Guess who taught me that.

#safetyculture