Phineas Gage

The 1840s in the northeastern United States was an exciting and dangerous time, and it was all about the railroad lines that would eventually connect the enormous continent.

Although steam power had been around for a long time, the UK made the first successful steam locomotives during the earlier part of the century, and the promise of faster and more reliable transportation led to “Railway Mania”, where a vast network of railroads sprung up unbelievably quickly.

Investment dollars poured in across the pond, too, and while the US was vastly bigger than the UK, the enthusiasm fueling the desire to connect east and west, north and south became a mania of its own. While there was more rugged terrain in the US to cover, there was no shortage of bold, rugged investors and managers who were willing to push and drive (mainly) immigrant labor.

Phineas Gage worked on these railroads as a foreman, which meant that he was ultimately responsible for the dangerous work of clearing land and preparing the route for new rail lines.

This often meant blowing things up. This could be a bit dicey in the 1840s.

Typically, workers would drill holes into the rock they needed to remove from the pathway of the rail lines. These holes would then be filled with gunpowder.

Next, someone like Phineas Gage would us a “tamping iron”—a long iron rod—to pack the gunpowder deep into the rock, and then some sand would be smashed down on top of the gunpowder, creating a buffer.

Finally, a fuse would be inserted down to the bottom of the hole. Someone would light a fuse and run.

One day, while getting one of these blasts ready, Gage was tamping down gunpowder into one of these drilled holes. The tamping rod he was using was over 3 feet long, and more than an inch in diameter.

Suddenly, a spark ignited the powder prematurely, causing the tamping iron to shoot upwards with great force.

You might imagine this to be like an artillery shell being fired at close range at someone’s head. The rod entered Gage's face below his left cheekbone, going through his skin, muscle, and skull like a hot knife through butter, and exiting through the other side of his skull, at the top of his head.

The rod landed a considerable distance away.

Now, here’s where the story gets really interesting. If you are imagining a dead dude on the ground, dressed in 1840s attire, you may be shocked to hear that Phineas Gage was not only still alive, but still conscious, and apparently even lucid.

He was rushed to a doctor named John Harlow, who did his best to clean Gage up, probably draining and bandaging as well as he could. Dr. Harlow not only likely saved Gage’s life that day, but he also documented what he saw for future innovators in medicine to study.

Unfortunately, Gage had a brain infection and became comatose for a some period of time. When he awoke, it was as though he had a completely different personality.

Before the accident, Gage had been well-respected as a foreman. He was relatively patient and kind, and he was good at his job. He was reliable and socially adept.

After the accident, he was impulsive and curmudgeonly. He began swearing regularly, and no longer seemed to grasp how to interact with other people quite so well. People no longer perceived him as polite or respectful, but instead began to think of him as rude.

Gage became almost childish in his refusal to listen to reason, and he struggled to stick with any plans at all. He really seemed like someone else.

Before Phineas Gage, there were plenty of competing theories and unanswered questions as to how the brain worked. Here was dramatic evidence suggesting that different mental functions were localized in specific regions of the brain.

Clearly, the frontal lobe—the area the iron rod shot through—had something to do with personality and planning. This realization led to a lot of clumsy attempts to fix something physical whenever there was a mental disorder, including lobotomies that continued well into the 1950s.

It also helped to turn neuroscience into something credible and tangible. At just the right time, doctors were opening up their minds to the idea that physical regions of the brain were responsible for particular activities, and Gage’s case was the go-to example any time someone had suffered head trauma, especially to the frontal lobe.

Phineas Gage lived another 12 years after having that iron rod shot straight through his head. This part of his life isn’t incredibly well documented, but we can follow some bread crumbs.

After he lost his job, he probably struggled to maintain steady employment. During this more transient time, Gage seems to have traveled with the infamous tamping iron, probably charging money for onlookers.

Around 1852, Gage may have found some temporary peace after he moved to Chile, where he worked as a long-distance stagecoach driver. It seems like Gage was able to operate with enough social grace and efficiency during this time period.

Unfortunately, he began experiencing increasingly frequent epileptic seizures in the years leading up to his death. Phineas Gage died in 1860, while living with his mother and sister in California.

Clearly, his legacy lives on.