I can’t help but be overwhelmed by evidence of the tremendous forces to which Columbia was subjected—heating, melting, tearing, shredding, ionization, and impact.
But I’m also amazed at the massive undertaking to bring Columbia home and understand how she perished. The display frames for the RCC panels hold large as well as minuscule pieces of the shuttle’s wing. Just one frame provides evidence both of the high quality and diligence of the search efforts—that searchers could find pieces of material smaller than a thumbnail out in the wilderness—and the care and skill of our reconstruction engineers, who took these tiny pieces and painstakingly rebuilt the wing. It is akin to assembling a dinosaur skeleton from shattered bits of fossil.
Whenever I visit, I look at the room as a whole and contemplate what it represents. Here lies 40 percent of America’s first space shuttle—the collective effort of thousands who designed, built, and maintained her. Here is the vessel that flew 127 women and men on twenty-eight missions into space. Here is the wounded vehicle that fought valiantly to the bitter end to try to bring her last seven crew members home. Here, in this volume the size of two or three average houses, rests the results of the collective efforts of twenty-five thousand people who searched every square foot of a debris field the size of Delaware and Rhode Island combined during three months of 2003. Preserved here is the work of the hundreds of people who processed, cleaned, examined, and cataloged every one of the eighty-four thousand pieces recovered.
Here is a warning of the dangers of complacency and suppressed debate.
And here lies hope people will learn from Columbia to make spaceflight safer—although it will never be routine.
Chapter 14

THE BEGINNING OF THE END
The dangers inherent in human spaceflight resurfaced only a few months after the Columbia accident—while the search-and-recovery operations were still underway. The next space shuttle flight after Columbia was supposed to bring home the ISS Expedition 6 crew of Kenneth Bowersox, Nikolai Budarin, and Donald Pettit in early March of 2003. With shuttle flights suspended indefinitely, NASA and Russia decided to send the Expedition 6 crew home in May aboard the Soyuz TMA-1 spacecraft docked at the station.
The Soyuz undocked on May 3. A computer error caused the guidance system to malfunction during reentry. The ship went into a ballistic trajectory instead of a controlled descent, subjecting the crew to more than eight times the force of gravity. Ground stations lost communications with the ship when an antenna tore loose during reentry.
The Soyuz descent module landed in a remote area 276 miles short of the targeted landing site. [1] NASA, “Expedition 6 Crew Returns Home,” May 3, 2003, https://www.nasa.gov/missions/shuttle/soyuz_landing_update.html .
Without a working radio, the crew had no way to contact the recovery forces and let them know where they were and that they were okay. Several tense hours passed before the recovery teams located the ship and extracted the crew. The men sustained minor injuries during their harrowing fall to Earth, but were otherwise unharmed.
The Columbia Accident Investigation Board released its report on August 26, 2003. The investigators blamed the loss of Columbia as much on NASA’s politics and culture at the time as on hardware failure. The report chided the White House and Congress for squeezing NASA’s budgets so tightly that safety was at risk. The report cited issues in NASA’s transparency, diligence, and oversight dating back to the Challenger disaster (and even the Apollo 1 accident in 1967), but which were never fully and permanently corrected in NASA’s culture.
The CAIB documented how NASA had permitted the “normalization of deviance” to put both Challenger ’s and Columbia ’s crews in harm’s way. The Challenger accident was the result of a known systems issue in the shuttle’s solid rocket boosters that had not been corrected. There had been partial burn-through of the O-rings on several previous missions—including the second flight of the space shuttle—but the details of the problem and the potential catastrophic outcomes never came to the attention of the launch decision makers. Lower-level engineers and managers did not allow the issue to be brought forward. Their desire to meet the launch manifest—and each organization not wanting to be the reason for standing down—trumped sound engineering practices of full and open discussion. Human and organizational failures doomed Challenger just as surely as the O-ring failure.
Similar conditions led to the Columbia accident. Foam shedding from the external tank was not within the design specifications for the space shuttle, but it had happened repeatedly over the years. Based on the shuttle’s demonstrated ability to survive hits from launch debris, managers justified continuing to fly while pursuing a new design. A mission four months before Columbia ’s flight also suffered damage from external tank foam, and yet the issue was not even addressed at Columbia ’s flight readiness review.
Clearly, changing organizational culture—and making those changes stick—is much harder than improving technology.
We were working on fixing the foam problem, but in hindsight, not nearly as aggressively as we should have been. NASA chose to press on in order to meet the unrealistic and self-imposed deadline of completing the core of the ISS by February 2004. The urgency to finish the ISS overrode the urgency to fix a potential safety issue.
NASA’s decisions—and nondecisions—ultimately caused the loss of Columbia , took the lives of her crew and two searchers, endangered citizens on the ground, resulted in the expenditure of hundreds of millions of dollars for a recovery and reconstruction effort, and delayed ISS assembly missions for three years.
Senior NASA officials expressed surprise throughout the investigation as they learned about the concerns people said they had tried to raise while Columbia was in orbit. Leaders said they had no idea serious issues were not being elevated to their attention, when policies were clearly in place to encourage open and honest discussion. As with Challenger , the agency’s culture eroded over time into one of “prove to me why it’s not safe to fly.” It created a fear to speak up and be a dissenting voice, which ultimately stifled debate and killed the crew. Administrator O’Keefe also said that he was disappointed to learn that no one had called a safety hotline or alerted high-ranking officials about their concerns—a system that was already in place to allow anyone to escalate issues anonymously and without fear of retribution. [2] Jim Banke, “NASA’s O’Keefe Promises Study of Safety Reporting System,” Space.com, May 22, 2003, quoted in Liston, KSC Chronology of KSC for 2003 , 109–10.
In addition to the deeply embedded cultural issues at the agency that still needed to be fixed, the CAIB pointed out that the shuttle’s design was inherently flawed. Too many problem scenarios were possible from which a shuttle crew had no way to escape or survive. The risk could be mitigated somewhat, but in the CAIB’s opinion the Shuttle Program was “operating too close to too many margins.” [3] CAIB Report , 118.
The CAIB recommended that NASA accelerate steps to replace the space huttle.
Administrator O’Keefe embraced all of the CAIB’s recommendations and assured the board NASA would implement them. It was tough medicine to take, but we needed it.
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