How to Escape a Death Spiral

“Death spiral!” President Trump tweeted in May, about the Affordable Care Act. It had been a common accusation of Republicans even earlier. Media, pundits, and think tanks all weighed in on whether or not the label applies to Obamacare and its health-care exchanges.

Today, death spiral means “a marketplace spinning out of control,” as FiveThirtyEight’s Anna Maria Barry-Jester puts it. It’s an accusation that demands an urgent response. In a death spiral, destruction is so near and so inevitable that any attempt to avoid it becomes valid. By evoking the dwindling seconds before a plane crash, every other option looks better by comparison.

Yet death spirals have another story to tell. Before the death spiral was a figure of speech, it was a physical problem aviators needed to solve: how to keep from crashing when they flew through clouds or fog. How they solved real death spirals in the air might help explain how to resist the narrowed choices metaphorical death spirals impose.

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In the early decades of flight, aviators were bedeviled by bad weather. Those who encountered poor visibility mid-flight told harrowing tales of disorientation and confusion. Surrounded on all sides by milk-white fog or hazy darkness, pilots entered a world where nothing behaved as it should. When they observed the plane slipping into a gentle descent, they corrected to gain altitude, only to find the plane diving downward faster. Or, when they were certain the plane was flying level, the turn indicator would register a turn to the right. What the instrument registered as level, meanwhile, felt like a turn to the left.

Under these conditions, bailing out often became the best option. Those who didn’t often joined their plane as it crashed into the ground.

Lost in the clouds, these pilots had fallen prey to a form of sensory disorientation known as a death spiral, or, more commonly, a graveyard spiral. The term describes an almost instinctive set of maneuvers pilots undertake when they lose sight of the horizon. The graveyard spiral begins when a plane flying in these conditions enters a gentle turn. As it turns, the plane will begin to descend, picking up speed.

Death spirals occur because the pilot feels the descent but not the turn. That has to do with the way the human body relies both on the visual and vestibular systems to perceive its orientation in space. As fluid moves through the small canals in the inner ear, the brain registers the body’s shifts in position. The fluid moves when the head turns, creating the sensation that the vessel under control is doing the turning. In mid-flight, though, the fluid can settle in place. If this happens, a turn can feel like level flight. In this situation, a pilot who follows the instruments and levels the plane’s wings feels, with absolute certainty, that the craft is turning in the opposite direction.

A pilot who recorrects to what feels level in his or her body simply reinitiates the spiral dive. Likewise, pulling back on the yoke to gain altitude without leveling the wings only tightens the plane’s downward spiral. Without a clear view of the horizon to correct against, the pilot can become so disoriented that a total loss of control results, ending in a crash. An Air Safety Institute scare-tactic training video, “178 Seconds to Live,” follows a pilot through the disorientation of a classic graveyard spiral.

Once it became clear that aviators were becoming disoriented in the clouds, they set themselves to the task of figuring out how to avoid it. This was the birth of what is known as “instrument flight.” Planes already carried basic instruments, such as turn and bank indicators, but these were primarily seen as navigational devices—implements that helped pilots reach a destination rather than keep the plane in the air. To tame the death spiral, these devices had to become part of how aviators kept control of the plane.

In 1932, William Ocker and Carl Crane published Blind Flight in Theory and Practice, a detailed guide to flying by instruments through darkness and fog. Ocker and Crane’s method relied on giving the pilot a visual reference against which to double-check the body’s fallible sensations. A turn and bank indicator shows the wings’ departure from level flight, and an artificial horizon visually represents the plane’s relation to the ground.

But designing and implementing instruments was the easy part. It was harder to teach pilots to believe what their instruments reported over (and against) the persuasive sensations they felt in their bodies. Here Ocker and Crane ran up against aviators’ long-standing belief that they controlled the plane, at least in part, through their superior “air sense”—their body’s special ability to maintain its equilibrium in flight. The idea that skillful flight depended on the body’s perception of its own weight and relative position, sometimes called “deep sensibility” or kinesthesia, was a truism among pilots. (Aviators referred to this skill as their ability to “fly by the seat of the pants,” a phrase that connoted, perhaps falsely, skill more than luck.)

Ocker and Crane started demonstrating the limits of the pilot’s body, spinning skeptical pilots in chairs until they were dizzy, or showing them the curves their bodies traced when they tried to walk a straight line without the aid of vision. They even blindfolded homing pigeons and threw them out of a plane to demonstrate that even nature’s best fliers would lose all sense of orientation without sight. (The pigeons spiraled helplessly, Ocker and Crane reported, until they finally spread their wings parachute-style and floated, unharmed, to the ground.) This “inherent spiral tendency” lived in everyone, Ocker and Crane argued, and it would show itself if not restrained by a competing vision of the horizon. Hence the aviator’s need for instruments: They gave back the horizon clouds and fog had obscured.

A wary stance toward bodily perceptions would become a guiding principle for instrument flight. Early U.S. military training documents instructed pilots that their inner ears provided information that was “not at all reliable,” for instance. Ocker and Crane gave pilots a set of practical lessons in how to reference them to keep control of the plane. As pilots learned to trust their instruments, flight through clouds and fog became commonplace, safe, and mundane. The death spiral, meanwhile, was replaced by a simpler imperative: Check your instruments, and believe them.

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Pilots still talk about death spirals, especially to warn amateurs of the dangers of flying into fog and haze. More commonly, though, the term claims that a social organization is on the brink of collapse: small towns, department stores, utility markets, liberal-arts colleges, Apple before Steve Jobs’s return as CEO, the island of Puerto Rico (pre- and post-Hurricane Maria), even the State Department under Rex Tillerson.

The use that is most resonant today—the death spiral as what ails insurance markets—traces back to a 1998 article by two economists describing an “adverse-selection death spiral,” in which insurance plans become financially unsustainable when there are too few healthy, low-cost subscribers enrolled. Economists and businesspeople have played a leading role in the death spiral’s transition to metaphor, converting the individual danger pilots faced into a shorthand for market forces endowed with the inevitability of natural law. They draw on the death spiral’s sense of urgency, meanwhile, to heighten the stakes of corporate failures. The term demands drastic action while rationalizing choices that might follow that imperative.

But its metaphorical life abandons the work that made death spirals in aviation avoidable—the steady, mundane habit of cross-referencing one’s fallible perceptions to the reality of the horizon. As a metaphor, the death spiral is all problem and no solution; it preserves the original’s diagnosis but abandons its cure.

This absence seems particularly lamentable in current discussions of the ACA, given how intensely felt most people’s policy positions seem to be. The death spiral works as a metaphor in this case because it fits neatly into a larger narrative of scarcity. That young healthy people are not buying health insurance on the exchanges seems a rational choice, given their precarious financial state. When the majority of Americans worry they will be unable to maintain their standard of living, the idea that benefits like Obamacare are about to collapse under their own weight makes intuitive sense similarly to how aviators’ bodies rationalize their false perceptions in the air.

The death spiral’s lesson is that logic that seems intuitive needs to be calibrated against measured reality. The perception that the ACA is in a death spiral, for example, requires calibration against the realities of spending decisions and wealth distribution. America pays more than any other industrialized country for its health care, which nevertheless does less to extend its citizens’ lives. About half of the nation’s discretionary spending goes to the military. Great wealth is concentrating in the hands of a diminishing few.

Against this horizon, the urgency and narrowness implied by the ACA’s supposed death spiral looks less insistent. If the aviators win more options when checking their bodily impulses against the horizon, so too the citizenry might find more room to maneuver by expanding its view of possible maneuvers.

I don’t mean to make this process sound easy; it’s not. There’s a reason that the aviator and writer Wolfgang Langewiesche, writing in Harper’s in 1941, described instrument flight as “the castigation of the flesh translated into aeronautical terms.” Orienting their bodies to a horizon that was obscured required pilots to resist the sensations that keep humans upright at every moment. Likewise, resisting the death spiral as metaphor requires pushing back against the normal and the everyday.

Metaphorical death spirals lure people toward forced (and false) choices—choices that endorse actions in concord with fear. It’s not that it feels good to believe disaster is imminent; it’s that it feels real—the perceptions bodies and minds feel intuitively ground people’s thoughts and actions. Perhaps this is why the death spiral is such a powerful metaphor today, when catastrophe feels like the background to everyday life. But there’s also hope in the death spiral: Crashes aren’t inevitable—so long as there’s instrumentation to help find a horizon.