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Comment by rahkiin | Hacker News Reader

> “You have a system that is known for its ability to detect very small quantities of smoke,” Mr. Corbett said. “Yet the whole outcome of it is this clumsy human response. You can spend a lot to detect a fire, but it all goes down the drain when you don’t move on it.”

It seems to me that the biggest issue with the fire system was the lack of a graphical display of the alarm... with all the security cameras and screens likely to already be in place, why not add one with maps of the cathedral, showing up in red when an alarm triggers? The need to understand shortcodes it waiting for disaster...

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> It seems to me that the biggest issue with the fire system was the lack of a graphical display of the alarm

i agree that the lack of a graphic/synoptic display for the smoke detection system was a horrid flaw, especially when rapid response is needed.

However, i feel that the lack of an automatic extinguishing system was pretty grave too; given the excellent record of automatic fire sprinklers in containing -- if not fully extinguishing -- fires, well before the fire brigade arrives.

Of course, accidental activation is a serious concern, but this can be addressed, whether through the use of a double-interlock preaction scheme (where the piping is kept water-free with a valve that is opened only when the heat/smoke detectors signal a fire; and even once the pipes are filled with water, sprinkler heads need to be individually activated with heat) or using a gaseous clean-agent instead of water.

I've written a touch panel UI for a next-gen sprinkler system. The valves themselves used high-pressure mist to bind smoke particles and minimize liquid damage often associated with sprinklers, and could be individually shut off when needed. I think the rationale was that by minimizing collateral damage you could install sprinklers in places where they would be considered a liability.

I heard the largest end customers were shipbuilders and police stations; a few systems were installed in underground public spaces such as train stations.

(Don't ask if the police has ever used the water spray as a taming device in the cells. I don't really want to know.)

I doubt it would work. How is dealing with slippery wet angry prisoners an advantage over dry angry ones?

Totally off-topic, but this reminds me of a story from a psychiatric nurse I know. They apparently once had to deal with someone who decided to strip down, then cover themselves head to toe with some form of body oil they'd managed to get hold of. Hilarity ensued.

Honestly, oil and hilarity aren't too bad, all told. I've heard stories of prisoners and mental patients using blood, or poo.

I imagine the severity of the hilarity was dependent on whether or not one's job description implicitly included "preventing patients from using the corridor as an otter slide".

Water dries eventually.

There are many accounts of police abusing people for apparently purely sadistic reasons. Their behavior is not always rational.

First a disclaimer: I’m probably misinterpreting you, so I apologize in advance. I sincerely assume you have only the best intentions.

By my interpretation, your last paragraph seems to accuse police of very specific misbehavior, but without any evidence, and even with an explicit desire to avoid resolving your accusation one way or another.

I hope you agree that we should take every single accusation of wrongdoing extremely seriously: only then can we truly achieve accountability for bad behavior, while celebrating and rewarding good behavior.

Unfortunately, purely speculative accusations of specific wrongdoing like this compromises our ability in general to take accusations seriously! It also subtly harms the reputations of good people within the accused group, if the accusation is unfounded.

For example, imagine if I said out of the blue:

“I worked with <anilakar> through all April 2019. (Don’t ask me if <anilakar> ever stole a MacBook Pro from the Apple Store on April 5th 2019 at 3:45pm. I don’t want to know anything about whether that did or did not happen.)”

Hopefully this illustrates the potential harm of such comments.

If anilakar had a reputation for abusing their authority, then such a comment would not necessarily be out of place. Possibly rude and unneeded, but not out of place. Police as an organization routinely abuse their authority. I've personally suffered such behavior in jail.

anilakar worded their comment such a specific fashion as to avoid making any accusations. They are allowed to muse openly. Your comment is unnecessary.

> there was also a conservative approach to preserving the historic wooden structure in its unadulterated form. The designers were determined not to alter the attic with protective measures like sprinklers or fire walls.

> A willingness to sacrifice its pristine state for a compromise between what was possible 850 years ago and what is sensible today could have saved the spire, experts said...

> But the main reason to opt against fire walls, Mr. Mouton said, was because it risked “mutilating” the structure. “It’s true,” he said, that the idea had been floated at the time, “but it was discarded.”

> “It changes the appearance but also the elements, because to put up a partition you need to cut the wood. It’s mutilating,” Mr. Mouton said. Mr. Prunet added that sprinklers were not added because they would “drown the whole structure.” Instead, they said, the team had banked on prevention and detection. This was a conscious choice.

https://www.nytimes.com/2019/04/19/world/europe/notre-dame-f...

> Mr. Prunet added that sprinklers were not added because they would “drown the whole structure.”

Waiting for the fire department to show up and start spraying the structure with high-pressure hoses in order to contain a fire that got much larger in the intervening time because it wasn't being mitigated by a sprinkler system, on the other hand, doesn't seem to have damaged the structure at all.

Hindsight really is 20/20.

It's also interesting that fire mitigation measures were discarded in the interest of historic preservation. The charpente being a part of the building that basically nobody ever sees, the question arises, "preserving it for who?" Or had the preservation become an end in and of itself?

And the roof was not part of the original structure, it had been completely rebuilt, yes a long time ago, but still completely rebuilt. My guess is that if they had access to modern materials at the time, they would have opted for that.

Also, the tall spire was added (historically) fairly recently. It was not an original part of the roof that burned. So apparently, earlier people were not "afraid" of altering it.

That was a bonus in addition to the restauration works that took place mid-19th century.

> drown the whole structure

My house has a fire sprinkler system. Each nozzle is heat activated, in that the heat from a fire melts a plug allowing the water to flow. Only the hot valves activate, not everything.

The contractor told me which would I prefer, a sprinkler spraying some water around, or a firehose through the window?

I don’t think that’s really contradictory though. I’ve lived through many cases of the sprinklers being set off accidentally (frozen pipe burst, rc-helicopter blade impact, and idiots using it as a clothes hook) and “some water” isn’t the phrase I would use. I think it’s more like if someone threw a bathtub from the ceiling every minute until someone could shut it off? That can be pretty costly to mitigate afterwards—but then I’ve also seen houses where nothing of it could be saved. As your contractor said, one of those is probably much better.

> I’ve lived through many cases of the sprinklers being set off accidentally (frozen pipe burst, rc-helicopter blade impact, and idiots using it as a clothes hook) and “some water” isn’t the phrase I would use. I think it’s more like if someone threw a bathtub from the ceiling every minute until someone could shut it off?

That's why i specifically mentioned double-interlock preaction systems, where if someone hits the sprinkler and causes it to open, the only thing that comes out is compressed air (and a trouble/supervisory alarm sounds).

Mine are flush with the ceiling, there's nothing to hook onto. Just regular plumbing pipes can freeze, too. But the sprinkler pipes all run in interior walls - it's the ones in exterior walls that are likely to freeze. (I've had floods from frozen pipes in a non-sprinkled house - the pipes were in an exterior wall.)

Anyhow, at the time I did some research and found that nobody had died in a fire in the US in a room that had working sprinklers. It's pretty darn compelling.

> However, i feel that the lack of an automatic extinguishing system was pretty grave too

Or perhaps wrapping or covering the wood in mineral/stone wool insulation:

* https://www.youtube.com/watch?v=Bc_nPWMEdgs

* https://www.youtube.com/watch?v=KgO7zw7NWLc

Rockwool is the most popular product, so you'll see a lot of videos (like above) featuring them, but I'm sure there are others.

Of course an extinguisher system can also be added, but a bunch of batts could be done quickly and inexpensively for a quick win.

These all seem obvious now in hindsight, but that's always the way of things. People, even educated, intelligent, and earnest people are very bad at user interface design. Good UI design comes from experience, not foresight.

For example, the aviation industry has standard terms for things. "Takeoff Power" means full power. Can you guess what happened? A pilot needed to abort a landing, and yelled "takeoff power" to the copilot, who promptly chopped the power, an accident ensued. This phrase was then changed to (I think) "Full Power".

The Air Force didn't learn from that civil aviation incident until it happened to them, too, then they fixed it.

It seems obvious, doesn't it? Everybody missed it.

"Takeoff power" -> "Take off [the] power".

Interesting.

It all boils down to one of the simplest and most ignored truths:

Most people aren't great at their jobs, they're average or worse than average.

It's not possible for most people to be worse than average.

Only true where there is a normal distribution, the vast majority of people are less wealthy than the global mean of individual wealth for instance.

The vast majority of people have more than the mean number of legs per person.

Depends on what's meant by 'average'.

True for median, (by definition) but false for mean and mode.

Colloquially, average only ever means mean.

I'm inclined to agree that's what most people mean, (particularly non-STEM people) but it seems that's not what the poster I replied to above meant.

The 10x engineer exists only because of the proliferation of .1x engineers.

Yes, that’s why I didn’t say that.

> Most people aren't great at their jobs

Note that everybody missed the takeoff power thing. You can't fix it by hiring better people.

Everybody with power maybe. Who knows how many low level workers made a joke about it to their bosses and were chastised for not being team players.

It takes an entirely different mindset to properly give, receive, and execute concise instructions in real-time. People who have not had considerable practice at this tend to mess it up horrendously. As seen above, even people who are accustomed to doing it will still mess it up, big time! (This is why submarine bridge crew speak to each other in the highly stylized way they do. Also, try playing Artemis with noobs, and you'll see why as well.)

Many people do not have short-term clocks in their heads! Those same people also can't properly add-up in real-time the time-intervals of the manual processes they're doing and about to do. Even if you tell them they are going to run down a deadline and mess something up, they can't properly process what you tell them. It's like telling a pitch-deaf amateur musician that they're out of tune. They're either confused by the input, or they think you're making stuff up to annoy them.

(I remember taking some friends into low security space for the first time in Eve Online. Some player-killers show up in our system, and I tell them, "Warp to me now!" The reaction? The husband starts in on this involved argument with me about it, saying, that would end up with us in the middle of nowhere! Arrgh! Yes, that would've been the point!)

The same thing also goes for medium and long term time frames, which is relevant to programming, business, and startups.

They use the term "Max Power"

See https://books.google.com/books?id=0Lte8pweTa0C&lpg=PA54&ots=...

> UAL's Mr. Petty refused, writing back that the command would be confusing if a pilot by the name of "Max" was in the cockpit!

The reaction of a manager who's watched too many Simpsons episodes [0].

[0] https://www.youtube.com/watch?v=BSVms6cT9nk

Then use "Maximum"...

After the collision of two 747s on the runway at Tenerife, the term "cleared for takeoff" is now used only when the tower has approved the actual use of the runway for takeoff.

If also read of "Max Power" for the situation you are describing.

Yes and no.

There seem to be multiple points of failure on the critical path. Yes the interface might be sub-perfect, but there is also a human on the critical path, who started work at 7am, meaning he's been working for 12 hours now. There is a reason regulation usually mandates limited hours for safety critical jobs.

Why not automatically inform the fire department, ensuring that there is not one single critical path but an alternate option? Relying on the presence and correct reaction of a single security guard sounds like a less than perfect idea.

> Why not automatically inform the fire department, ensuring that there is not one single critical path but an alternate option?

I think this was the most confusing part of the response to me. Even my home security system calls the fire department by default and my condo isn’t an 850 year old landmark. It made me wonder whether the system produced a lot of false alarms that would make an immediate default response impractical.

That might be an issue. But then one might not need to send a whole fire brigade from t0. Maybe just send a single truck, or a single car.

This depends where you are, I suppose. Fire Brigades in urban areas typically dispatch two engines that take two different routes to ensure one route is not congested, and at least one engine is on a faster, if not shorter, path than the other. Even real-time route planning cannot mitigate an unexpected cause of congestion yet to occur.

Depends on area. Dense urban streets where contagion of fire may require this while a remote home in a rural may mean this route mitigation isn't necesary. However in both and all cases a rapid response is needed as lives are at risk.

> Even my home security system calls the fire department by default and my condo isn’t an 850 year old landmark.

Non-residential buildings are often charged for false alarms, so standard procedure is to have a human confirm things first:

* https://gps-securitygroup.com/the-role-of-security-guard-reg...

If confirmation is not done in x minutes, there is an automatic call though (with the requisite charge back for false alarms).

I would guess no prioritization of usability ("it's just an internal tool, we can train people, it's cheaper anyway"). This seems like a common pattern on software projects, especially company-internal ones.

For an example see https://www.theguardian.com/technology/2019/jul/13/margaret-...:

”I suggested a program change to prevent a prelaunch program being selected during flight. But the higher-ups at MIT and Nasa said the astronauts were too well trained to make such a mistake. Midcourse on the very next mission – Apollo 8 – one of the astronauts on board accidentally did exactly what Lauren had done. The Lauren bug! It created much havoc and required the mission to be reconfigured. After that, they let me put the program change in, all right.”

This was a great read, thanks!

Is selecting a prelaunch program much worse than selecting an incorrect post-launch program? Or was there still a major risk of selecting an unsafe post-lauch program?

The problem was that, with such limited memory available to the computer, it erased all the en-route navigational data to make room for the preflight data. So now you have a spacecraft on its way to the moon with no way to know where it is...

Yes, it's really surprising that a system which "took dozens of experts six years to put together, and in the end involved thousands of pages of diagrams, maps, spreadsheets and contracts" didn't contain something that I've seen in nearly all the reasonably large buildings I've been in, some which have probably been there for many decades:

https://static1.squarespace.com/static/53ca9e5ce4b0bcaba3c71...

It's sadly often the cases for public contract here... Very much often, the contractor has no interest or incentive in doing a "quick and proper" job. Company that deal with public contract get really good at dragging the duration of a project, and its cost, way up. They know that the state will want to continue the project and will continue funneling money until its finish in any case.

And when a project has some incentive (often financial penalty when deadline are not respected), company will give unrealistic deadlines to win the contract and then just run the penalty has normal cost of the projects. I know some project that had years of delay and were still profitable for the private company.

Obviously it's not always the case, but having work for both a state owned company contracting private contractor and for a private contractor seeking public contract, it has certainly made me not optimistic about any projects funded by public money.

You could also be IBM and make lots of money while never delivering anything: https://www.bloomberg.com/news/articles/2018-03-01/canada-to...

Not directly related but comical to me, I recently heard from someone working with IBM that they are really upset over the calls from Washington to regulate big tech. Upset because they aren’t mentioned by politicians or the media as big tech. It’s almost like they don’t really matter anymore.

When I worked for a research department of the government years back, I was told that IBM contracts were banned in an officially unofficial manner from too many botched projects in the past.

> really upset over the calls from Washington to regulate big tech. Upset because they aren’t mentioned by politicians or the media as big tech.

To be fair, most of the calls concern American big tech companies. Not sure IBM qualifies anymore.

https://www.nytimes.com/2017/09/28/technology/ibm-india.html

Or Sopra-Steria, or Cap-Gemini, even our national company have been really good at screwing up public projects :) .

There was even a project handle by Sopra-Steria that went so awry that even the Government said stop and went on to continue using their old solution. For them to do that takes a loooot of screwing up. Nevertheless, they were still contracted for other projects afterward :) .

I can see how that might be true in general, but would it really apply here? Even at my most cynical, I have a hard time believing a contractor would be so careless about Notre Dame, a major national symbol.

Firstly, calling Notre Dame a National symbol is a bit exaggerated. Honestly, for a lot of French not living in Paris, Notre Dame is just another Cathedral with a lot of advertisement because its Paris (France/French relationship with Paris is ... complicated).

Secondly, yes, most contractor focus on money, not really doing the best job they can (I mean, in many way, the fire is a proof of this). I work for, arguably, one of the most critical French industry. One that France rely on for security and, somewhat, energy. Some of the worker were proud of doing something for their country, but the decision from higher-ups were purely financial. And it is what is expected from them to be honest.

>Secondly, yes, most contractor focus on money, not really doing the best job they can (I mean, in many way, the fire is a proof of this).

I specifically said I wasn’t disputing the claim in general, only the extent to which a contractor would risk it like this in a high-profile case.

I find this often happens with any decision by consensus type of things.

Everyone has a concern or an area they take over. There's a reason most power structures end up with a single person being the decision maker. For better or worse, it seems there needs to be one person who is responsible for busting everyone's chops and asking the hard questions.

I've seen this psychology play out even in small non-profits where everyone has good intentions.

This is one of the reasons why in the UK, back in the early 1990s, it was recommended that construction projects (both public and private) switch to what is now called "NEC" contracts:

* https://www.designingbuildings.co.uk/wiki/NEC3

Most contracts are cookie cutter templates, so everyone is familiar with them and lawyers don't need to be called in to create bespoke solutions for every project. There are various options if fixed-priced or cost-plus is desired, and pre-agreed schedule is decided on so that payments only go out at specific milestones.

Can anyone from the UK comment on the pros/cons of the system?

NEC contracts are wonderful. I say this having worked on both the client and the contractor side.

Solves many, many problems and gets people working in collaboration. As a contractor I need to know the clients goals and as a client I need to help make the contract profitable.

All pros - no cons from me.

Was it a public contract? I thought the Archdioceses owned Notre Dame?

All cathedrals in France have been owned by the state since 1905. Smaller churches are owned by the local communes. This was done to remove the influence of the Catholic Church in French affairs by removing a source of income for them.

Small aside, there are / were no security cameras anywhere in the cathedral.

But that's really just an aside. You just need a 3D map of the cathedral with the position of the fire detectors marked, blinking red when a fire breaks out. After all they already had a unique ID, according to the article. That's not hard. But they had too many years and too much money to implement a usable solution.

Absolutely. The fire panels were banks of LEDs stuck on a wall in the guardian's house. As you say, presumably over the years the system was added to, and they hit a point where changing the entire system would have cost "too much", so they kept adding to a legacy solution..

Always a good idea isn't it? Someone somewhere was certainly applauded for this brilliant business case and decision making. Everybody pointing out the flaws not so much I would assume...

> they had too many years and too much money to implement a usable solution

Oh man, that hits home

> It seems to me that the biggest issue with the fire system was the lack of a graphical display of the alarm

The man monitoring the alarm, even though he had just started the job, says he did understand the code and where the alarm was and communicated that information to the guard. He does not claim that the problem was he didn't understand the code or there was anything wrong with the design of the alarm system. The guard on the other hand says the man monitoring the alarm told him the wrong location to go to.

Neither of these issues though are related to the subsequent decision to call his supervisor as the number of alarms going off increased, and then sit around and do nothing while waiting for a call back. Nor does this have anything to do with the design of the alarm display.

It doesn't even have to be graphical (although I guess that would be best), as long as the location is clear, or a map is on hand.

I do technical operations for a living. If I had a buck for every time I've seen an alert with unclear or non-actionable information, I would have retired ten years ago. This article describes a tragic situation, but it's not terribly surprising.

Other things I saw:

- people scared to talk about what happened because of blame issues - putting new employees in critical situations with only three days of training

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