"This Phineas was proud, well-dressed, and disarmingly handsome."

May 13, 2014 1:03 AM

On Sept. 13, 1848, at around 4:30 p.m., the time of day when the mind might start wandering, a railroad foreman named Phineas Gage filled a drill hole with gunpowder and turned his head to check on his men. It was the last normal moment of his life. Other victims in the annals of medicine are almost always referred to by initials or pseudonyms. Not Gage: His is the most famous name in neuroscience. How ironic, then, that we know so little else about the man—and that much of what we think we know, especially about his life unraveling after his accident, is probably bunk.

—Phineas Gage, Neuroscience’s Most Famous Patient by Sam Kean.
posted by Kattullus (36 comments total)

Gage previously: 1, 2, 3 and 4.
posted by Kattullus at 1:12 AM on May 13, 2014 [1 favorite]

Excellent read. Thanks to both writer and poster.
posted by Wolof at 1:35 AM on May 13, 2014 [2 favorites]

The best comment on Gage that I remember reading pointed out that if you suffered a massive injury, lost your job, and got masses of public attention it's not unlikely your personality would flex somewhat, even regardless of neurology.
posted by Segundus at 3:27 AM on May 13, 2014 [9 favorites]

Good article, thanks for posting.
posted by HuronBob at 4:11 AM on May 13, 2014

It's a fascinating story, and one that I doubt I'll ever tire of hearing, but I'm a little unclear on the take-home message of this. The author suggests in the beginning that much of what is said about Phineas Gage is wrong, but at the end the conclusion is more that not so much is actually known, but that what is known is largely consistent with current instances of frontal lobe damage. So, although there's likely some mythologising going on, it seems to me that there aren't any grave inaccuracies in the story as it is usually told...

That said, the new spin on his later life is interesting. Neuroscience does seem to have had a hard time accepting the plasticity of the brain in later life. Amblyopia ('lazy eye') is an interesting case there, where it was thought that any changes in childhood were largely fixed during adulthood. Stereo Sue is an interesting case of plasticity in later life (she acquired 3D-stereo vision in her 40s, having not had it previously), popularised by Oliver Sacks.
posted by horopter at 4:19 AM on May 13, 2014 [1 favorite]

Phineas Gage might be my wife's most favorite historical figure. She's been begging me to take her to see his skull since we met, but we haven't managed it. I sent her this article last week and she just about lost her mind.

I really like the idea of a bloody and heavily-damaged Gage sitting on the porch, chatting with passers-by while he waits for the doctor. "Good day, sir. Pleasant weather we're having." "Indeed. Pardon me for mentioning it, but I do believe you've got a bit of gray matter on your lapel."
posted by uncleozzy at 4:55 AM on May 13, 2014 [1 favorite]

horopter, I think that what the story is getting at is that it's not acceptable from a scientific viewpoint to fill in what you think he was probably like, based on what we know about prefrontal lobe damage patients in general. It's possible that some of Gage's behavior was due to the damage, but it's also possible that the guy went out and partied down a little in celebration of the fact that he survived an accident that should have killed him, and that the Victorian-era doctor who saved his life disapproved of this.
posted by Halloween Jack at 5:10 AM on May 13, 2014 [4 favorites]

I am somewhat ashamed to admit that I now have "Poker Face" in my head. "Po-po-po-poker face..."
posted by juniper at 5:24 AM on May 13, 2014 [5 favorites]

"Here's business enough for you."

Chuck Norris wishes he was that hardcore.
posted by Rock Steady at 5:26 AM on May 13, 2014 [11 favorites]

I'm a little unclear on the take-home message of this


i understood it to mean that the historical assumption from the Gage case of "get pre-frontal lobe injury = lose personality to baser nature" is likely wrong and was based as much on sensational medical journalism as anything more substantial.

fascinating read regardless.
posted by young_son at 5:29 AM on May 13, 2014

I sent her this article last week and she just about lost her mind.

I see what you did there.

The Gage story simply fills me with horror. The thought of being conscious with a huge piece of metal through one's skull is just... the worst thing.
posted by GenjiandProust at 5:37 AM on May 13, 2014 [3 favorites]

I was actually going to post this yesterday but decided not to after seeing that Kattullus had previously made a pretty definitive Phineas Gage post just a couple years ago. Oh, well!
posted by Curious Artificer at 5:40 AM on May 13, 2014

I was actually going to post this yesterday

With frontal lobe damage, you'd have posted it anyway.
posted by Obscure Reference at 5:45 AM on May 13, 2014 [6 favorites]

I really enjoyed the tidbit about how the daguerreotype of Gage was discovered/identified on Flickr.
posted by Pizzarina Sbarro at 6:05 AM on May 13, 2014 [1 favorite]

GenjiandProust: The thought of being conscious with a huge piece of metal through one's skull is just... the worst thing.

Yeah, but -- contrary to my prior understanding of Phineas Gage -- it sounds like the tamping iron went through and through:

It then plowed through the top of his skull, exiting near the midline, just behind where his hairline started. After parabola-ing upward—one report claimed it whistled as it flew—the rod landed 25 yards away and stuck upright in the dirt, mumblety-peg-style.

I mean, that's still terrible, but at least he didn't have to ride back to town with it impaled in his head.
posted by Rock Steady at 6:33 AM on May 13, 2014 [3 favorites]

I really enjoyed the tidbit about how the daguerreotype of Gage was discovered/identified on Flickr.

Then you'll love the second 'previously' link.
posted by zamboni at 6:41 AM on May 13, 2014

With frontal lobe damage, you'd have posted it anyway.

My God, that's it! That's been the problem the whole time - that iron tamping rod that was blown straight through my head in the freak accident must have damaged a portion of my frontal lobes, thereby preventing me from making and following through on long-term plans and completing intermediary tasks!

Funny how I never thought of that before.

Oh look, a cat video. Ha, ha! That was great, I wonder if there's any more. Huh, sure enough...
posted by Curious Artificer at 6:51 AM on May 13, 2014 [4 favorites]

Gage’s skull and tamping iron are basically the only reason the Warren Museum still exists, says Hall, although calling it a “museum” seems generous. It’s really just two rows of 8-foot-tall wooden cabinets; one sits on either side of an atrium on the fifth floor of Harvard’s medical library.

Yes! I'm glad to see this in print, as I saw the "library" during my job orientation at HMS 10 years ago and was totally excited to have seen Gage's skull, but no one else seemed to notice much. Despite the log book, I'm not sure how accessible it would be to the general public - Harvard's pretty strict about access to their libraries. Those sign-ins could easily be students and employees. Just confirm that you can get in before you make the trip out to Boston (and then have to take the, ugh, E line).
posted by maryr at 7:52 AM on May 13, 2014

I thought the same thing, but evidently it is, indeed, open to the public.
posted by uncleozzy at 8:04 AM on May 13, 2014

i understood it to mean that the historical assumption from the Gage case of "get pre-frontal lobe injury = lose personality to baser nature" is likely wrong and was based as much on sensational medical journalism as anything more substantial.

There's still a very strong link between prefrontal cortical damage and impulsive aggressive behavior. It's sort of like how despite the fact that Kitty Genovese's murder circumstances were not necessarily the result of the bystander effect at play, it remains a real phenomenon.
posted by todayandtomorrow at 8:14 AM on May 13, 2014

Sam Kean is currently on the Diane Rehm Show.
posted by ChurchHatesTucker at 8:22 AM on May 13, 2014 [1 favorite]

Phineas Gage might be my wife's most favorite historical figure. She's been begging me to take her to see his skull since we met, but we haven't managed it. I sent her this article last week and she just about lost her mind. . . .

posted by uncleozzy

So auntiesharon wants to rock it old skull, eh?
 
posted by Herodios at 8:58 AM on May 13, 2014 [2 favorites]

Herodios, we need more puns here like we need a hole in the head.
posted by maryr at 9:01 AM on May 13, 2014 [6 favorites]

No need to go stamping your feet about it. It's not like MeFi sets a high bar for puns anyway.
posted by feckless fecal fear mongering at 9:03 AM on May 13, 2014

I always thought HM was neuroscience's most famous patient.

But anyway, this is great. I was taught all the completely wrong stories about his life in undergrad around 20 years ago.
posted by gaspode at 9:13 AM on May 13, 2014

Now everyone's blowing their top over bad puns.
posted by Halloween Jack at 9:14 AM on May 13, 2014 [1 favorite]

These puns make me wonder about what's going through some peoples heads here.
posted by Dr Dracator at 9:32 AM on May 13, 2014 [3 favorites]

This paper title! “Transcranial Brain Injuries Caused by Metal Rods or Pipes over the Past 150 Years”
posted by epersonae at 9:33 AM on May 13, 2014 [3 favorites]

These puns make me wonder about what's going through some peoples heads here.

I know. Next time, do a better job gauging what is or is not funny, us.
posted by Rock Steady at 9:38 AM on May 13, 2014 [2 favorites]

and then have to take the, ugh, E line

I read this while taking the E line. Maybe I can look at Phineas' skull after my exam today!
posted by Peevish at 10:22 AM on May 13, 2014 [2 favorites]

There's also that eponymous unit of measure; 1.25 inches shall be forever known as the Phineas gage.
 
posted by Herodios at 10:41 AM on May 13, 2014 [1 favorite]

Some fine phrasing in this piece:
"The first doctor to arrive could see, even from his carriage, a volcano of upturned bone jutting out of Gage’s scalp. "
posted by doctornemo at 11:00 AM on May 13, 2014 [2 favorites]

Or:
"He then extracted skull fragments from the wound by sticking his fingers in from both ends, Chinese-finger-trap-style. "
posted by doctornemo at 11:09 AM on May 13, 2014 [3 favorites]

I was going to alert you to this last week, Kattullus. Glad you found it!
posted by terrapin at 12:15 PM on May 13, 2014 [1 favorite]

gaspode, a lot of what you learned about H. M. Was probably wrong, or rather, over simplified, as well.
posted by maryr at 10:13 PM on May 13, 2014

This is a really cool story! Thanks for posting
posted by rebent at 11:35 AM on May 14, 2014