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Phineas Gage and the Accidental Lobotomy

January 24, 2010

The story of Phineas Gage is familiar to anyone who has taken a neurobiology or psychology course.

Is this an image of Phineas Gage holding the tamping iron that made him a medical curiosity? From National Public Radio.org

He’s the poster child for how to become a medial curiosity. In 1848 Phineas Gage was 25 years old and working as a foreman on a railroad in Cavendish, Vermont. One day he was tamping black powder into a blast hole when the powder ignited and sent the three-foot metal rod straight through his head.

Amazingly, Gage survived. He did not lose consciousness after the accident and was able to walk and talk as coworkers rushed him to a nearby inn to be treated by a doctor. Dr. John Martyn Harlow performed one of the first known neurosurgeries to remove the rod from Gage’s skull and brain. This case was one of the earliest indications that functions in the brain are compartmentalized (that is, different parts

of the brain control different things — speech, personality, memory, physical function, etc.) and that major surgery could be done on the brain without necessarily killing the patient.

Gage recovered physically, surviving not only the brain injury and surgery but also an infection related to the surgery. But reports from the day say his personality changed dramatically. He went from friendly, outgoing and dependable to withdrawn, short-tempered and “childlike.” I don’t know about you, but I might get a little crabby too if I was injured on the job, then fired and turned into a medical curiosity. Gage did suffer damage to one or both of his frontal lobes, the highest functioning part of the brain, which is thought to control personality, impulse control, and social behavior. Today, historians think that reports of Gage’s personality shift could be exaggerated and admit that there is not much reliable information about Gage’s personality either before the accident or after his recovery. It’s known he continued to live independently, working in Chile as a stagecoach driver until almost the end of his life. He died in 1860 at the age of 36 after a series of seizures (related to the brain injury? We do not know.).

Harvard University owns and displays the tamping iron, a cast of Gage’s head made after the injury and his skull. But an image of Gage in life had never been found. Until recently. NPR did a story today on a daguerreotype of a man that may be Phineas Gage. In 2008 by Jack and Beverly Wilgus posted the image on Flickr. The Wilgus’s thought he might be a whaler holding a harpoon. Another Flickr user suggested that it could be Gage, and historians are in the process of confirming this idea and linking the photo to the story and artifacts from the case.

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