What doesn’t kill you makes you stronger. Except in the case of Phineas Gage, who became a lot of things but strong after an accident that ought to have killed him in 1848. The man survived the passing of an iron rod through his skull, hence becoming a legendary curiosity in medical sciences and a celebrity among the common population, albeit an irritable one.
What Happened to Phineas Gage?
Gage was an ordinary man, which is probably why his extraordinary survival made no newspaper headlines. He was a foreman by profession, and a great one at that. He was smart and genial at the same time, qualities that made him a valued employee and a respected leader among his crew. In September 1848, Phineas was stationed at Cavendish, Vermont in USA as part of a crew cutting a railroad bed at the Rutland & Burlington Railroad. On the thirteenth day of the month, he was assigned the task of stuffing gunpowder into a rock that was to be blasted for the process of construction. The task required handling a 43-inch long iron rod, as thick as “an inch and a fourth” in diameter, but the young man too was deft at what he did.
He was going about his job—using the tamping iron to shove the powder into the hole—when friction between the rod and the rock caused a spark to flare. All it took was a split second to cause an explosion. The blast caused the rod in Gage’s hand to pierce through his left cheek into his skull through and through with high pressure. It destroyed his left eye, and exited from the other side after passing across the left front of his brain.
It’s More Strange Than Sad
The above account may sound deathly, but Phineas Gage got through it with a few convulsions at most. Within a few minutes the man was up on his feet, talking, walking and asking around for help. In the city, his case was looked at by Dr Edward H. Williams, who was assisted by Dr John Harlow during the weeks-long treatment. It was Dr Harlow who gave a full account of the case to the Boston Medical Surgery Journal.
The period of convalescence involved two weeks in a semi comatose state and doses of medicines. But soon Gage had recovered fully and ended up at Harvard University to donate the rod that had pierced him. The man who should have been dead was up and walking by mid November, ready to go back to work. But the railroad company refused to take their favourite employee back, for the injury to his brain had conspicuously affected the state of his mind.
Harlow reported that the man had retained his cognition and intelligence, even his memory. But major changes had occurred in his personality. From being "the most efficient and capable foreman" he went to being a shrewd and flaky man, irritable, capricious and insubordinate. He was no longer himself, and became unable to hold a job with responsibility or commitment. Soon Gage was being spotted at circuses across New England, boasting his face and his rod, and would afterwards go on to work at livery stables and among horses in Chile. He exhibited himself in Barnum's American Museum in New York City as well, and some say that people paid to watch the anomaly. The major condition that he developed was epilepsy, which soon increased in frequency as well as severity.
A) The skull of Phineas Gage on display at the Warren Anatomical Museum at Harvard Medical School. B) This figure shows the possible rod trajectory. Photo: Wikimedia
Almost 12 years after the accident, Gage died on May 21, 1861 from an epileptic seizure. Harlow suggested that his mother donate his skull to the University, which she did. For years Phineas continued to inspire revelations in medical sciences and wonder about the capabilities of the human body. A new school of thought emerged studying the correlation between the mind and the brain. Before Phineas’s accident, the frontal lobes were not known to influence or control human behaviour. The recovery and psychological changes in this unusual victim motivated the likes of David Ferrier and Burkhardt to study how the frontal lobes did not change physiology but affected behaviour and personality.
Psychologist Malcolm Macmillan, one of the greatest researchers of Phineas Gage, suggests that many of the conclusions about his case remain unbacked by concrete evidence. For instance, not much is known about his personality before the accident, and what is known is substantiated only by the accounts of his kin. The degree of change, then, remains questionable for its veracity. In Malcolm’s eyes, Gage’s story is important as a testament to how a few facts turn into anecdotes and scientific myths over time.
Phineas Gage after the accident.
Only a handful of people would have known what Phineas looked like in life, but soon the world knew what he looked like with his face mask. The ordinary man was eternalised in his death, and even today his remains rest in the Warren Anatomical Museum at Harvard Medical School.
References
# “An Odd Kind of Fame: Stories of Phineas Gage” by Malcolm Macmillan
# No longer Gage”: an iron bar through the head
# Phineas Gage and the effect of an iron bar through the head on personality
# Phineas Gage: Neuroscience’s Most Famous Patient
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