Skipping stones and NH Paper Mill

From: Michael Mulligan Date: Sun Feb 20, 2005 1:33 pm Subject: Re: [rootcauseconference] RE: Evidence Question #1


I mean what is the function of a RCA or any of the other problem analysis?

Are you people dealing with the “idealogs of objective philosophy” managers who demand absolute proof –especially if you run up against one of their interest? Maybe it goes; before you attack me as incompetent manager before the accident and attack the system of self interest that sustains my power –you will have to have absolute proof based on complicated set of rules for evidence gathering. So is RCA based upon looking through the rear view mirror –based on the extraordinary processes of evidence qualification?

I remember working on the issue on our local nuclear plant of high river water temperatures during the drought of 1998/99. We knew the upstream temps were getting near the design limits –and on a national level, we wondered what the meaning of magnitude of licensing changes that up’d the limits by a few degrees in the depths of the NE droughts. You will remember the results of the European adventure with a summertime heat wave –with this threatening the operation of many French nuclear power plants.

So my 6 year old son asked me of go throw rocks in the waters of the Ashuelot River –just a small stream nearmy house. We are skipping stones in the river, and I am mulling the meaning of the extraordinary low flowsof the river, as I see only a sliver of stream water in the Ashuelot -you know my mind is spinning wondering what the meaning of all this is in the issue of global warming. I am really involved with monitoring the flows of the rivers on the USGS web pages during these times.

It is a this point that I notice the water has a milky tint to it. I remember being upstream a few miles the day before looking at the same river –with my mind spinning on the issues of droughts and low flows. I then think in my minds eye that yesterday’s water was clear, while today’s has a milky tint to it.

It came from the puny upstream paper/tissue mill. I called the state environmental people –they are so disorganized I got disconnected from their office phone system six times before I talked to the pollution office. I remember finally getting the inspector to meet me at the site–he tells me with a straight face that this stream of milky white substances bubbling out of the rocks below the sludge lagoon, with him saying straight face to me “everyone thinks this is pollution, but I know it isn’t because I’ve tested it.” I tell him all the little streams that are feeding the river are dry now –we are in a historic drought –how can it be a natural spring. This is coming from that leaking lagoon above us.

This ended up with a 300 to 400 million dollar fraud case and bankruptcy against the CEO of the corporation -believe it was the forth largest tissue maker in the USA.I got them to build a new lagoon. I couldn’t imagine the consequences of this with looking at that tinted water with my son.

So from the get-go I acted on filaments of information –none of it was qualified. Matter of fact, if you would have asked me to put it in a qualified process, it would have inhibited me from acting on the slivers of truth that I though I saw. You understand, my mind was spinning on a completely different issue –but that spinning mind and the innocent pleasure of my son got me to the edge of the stream –one who I had walked by for weeks. So if you would have asked me to qualifythe evidence -you would have limited my minds ability to allow the opportunity of chance.

So let’s say I didn’t have an interest with the river temperatures at the nuclear power plant –I wouldn’t have had the information foundation of the special conditions at hand, or the minds interest that got me to the point of detecting that subtle milky appearance of the water. What gets you to the point, where a thought from the back of your mind says that something is wrong with the color water? How does the mind connect all these subtle differences in unrelated areas by chance? Think about all that wasted neural activity that is designed to catch that 1 and 10,000 chance of success. I tell you something, there is an enormous amount of thinking that goes on in the subconscious level -and it smashes throught the rules that we build.

I think that by depending on the mindset of the typical rules of evidence –you limit these interconnection in you mind.

But I guess the problem is, how do you persuade the guy next to you to see what you see. I guess we got to that point when the CEO was removed.thanks,mike