Man Walks into a Bar (sort of)…
Stepping back from this blog for a while has allowed me to realise something about its content – given its name, it is notably lop-sided, misleading even. By which I mean it contains a considerable portion of skepticism on a wide variety of topics, but startlingly little material which may be classified “neuro”-related. So, with that in mind, I will endeavour to redress this imbalance over the coming months with a series of posts of a distinctly neurosciencey bent. But don’t be alarmed – they won’t be very technical, or overly detailed, or otherwise impenetrable; all I intend to do is tell a few stories. intriguing stories about remarkable people, people who have expanded our understanding of the brain and how it works.
Let’s start with the tale of Mr. Phineas Gage (1823-1860).
Phineas was a railroad worker, a foreman whose job it was to oversee the laying of a new track for the Rutland & Burlington Railroad through the state of Vermont where autumns were rusty and pastel-coloured. It was a major undertaking, and one aspect of Phineas’ position involved the blasting of rocks from the proposed route of the tracks. A hole would be drilled into the offending outcrop, explosive powder poured into the cavity, then sand poured on top, and the whole cocktail pushed deep into the rock using a long metal rod called a tamping iron. The rod was nearly an inch and a half in diameter, and over three feet long, with one end flat for tamping, the other pointed. It was Phineas who usually did the tamping.
One September afternoon in 1848, as his team were blasting through an area of countryside near the town of Cavendish, a dreadful accident occurred. Perhaps someone forgot to add the sand, we can’t be sure, but whatever the cause, as Phineas tamped down into the hole, the iron rod sparked off the rock, igniting the powder and driving the tamping iron out – like a bullet from a gun – at tremendous speed.
It entered Phineas’ head just below the left cheekbone, travelling upwards. Severing the optic nerve but missing the eye, it continued its destructive path through his brain, ablating portions of the left frontal lobe before exiting through the top of his head. It was said that the rod landed over 100 feet away, although this may be exaggerated. Remarkably though, this injury did not kill Phineas – he was unwell for a long period following, suffering from a severe infection immediately after the incident and teetering at death’s door for several months. But, over time and with care from a dedicated physician, Dr John Harlow, he did eventually recover, regaining much of his independence.
But the most remarkable thing about Mr Gage was the dramatic change in his behaviour and personality after the drastic loss of frontal tissue. While it is difficult to distinguish fact from myth in this regard – stories about him becoming a drunk, a gambler and a violent, profane blackguard have definitely been fabricated – what we can be certain of is the fact that he was a changed man afterwards. He was now easily distracted, found it difficult to focus his attention for long or organise his time, and had difficulty in breaking off from an activity he was engaged in – for example, if slicing a loaf of bread, he might continue to cut through the bread board (this is known as perseveration, a common feature of people who have suffered a frontal brain injury). Here was quite compelling evidence for what functions were carried out by the areas of cortex obliterated in Gage’s brain; the frontal lobes, it seemed, were responsible for attention, engagement in tasks, organising behaviour. This unfortunate accident inadvertently shed light on the previously guarded secrets of the brain.
Gage lived for another 12 years following the injury. It was said that he spent some time in P.T. Barnum’s museum, appearing for the public with his tamping iron (which he kept with him for the rest of his days) as a curio. Later he spent time working in a stables, and then as a stagecoach driver in Chile. He eventually died in 1860 in San Francisco following a series of severe convulsions. And there the story appeared to end; his enduring legacy was to endure ongoing fame in textbooks on medicine and neuroscience, psychology and cognition, as scientists pointed to the strange case of Phineas Gage as one of the earliest clues to the functions of the brain, and as an example of how we can learn so much about the intact brain from the study of the injured one. Generations of students have been educated in the sciences knowing the name and fate of Phineas Gage, but none ever knew his face.
Until 2008. In that year, Jack and Beverly Wilgus, a couple who ran an antique photograph company in the US, posted on their website of stock an image of a well-dressed and handsome man with a sewn-shut left eye and holding a long pole. It was a daguerreotype, an early type of photograph using a shiny surface, which they called The Whaler in the belief that the rod was a whaling harpoon, and that the facial scars the man displayed were linked to a violent encounter at sea. People soon contacted the Wilgus website informing them that the pole was not a harpoon, and some wondered if the man might possibly be Gage.
They compared the man’s face to the life-mask of Gage; the scars matched. The compared the rod to the tamping iron, which is on display in the medical museum which also has Gage’s skull; the inscription also matched. It reads:
“This is the bar that was shot through the head of Mr Phineas P. Gage at Cavendish, Vermont, Sept. 13,1848. He fully recovered from the injury & deposited this bar in the Museum of the Medical College of Harvard University. Phineas P. Gage Lebanon Grafton Cy N-H Jan 6 1850.”
Finally, after 160 years, the face of Phineas Gage, the man who inadvertently paved the way for much of modern neuroscience, was revealed to the public. It was widely believed that this was the only existing image of Gage following the accident, but within two months, a distant relative of Gage’s brother, Tara Gage-Miller, contacted the Wilgus family with a pocket portrait of the same man, who she knew as a strange historical relative. She knew of the story of his injury, but had no conception of the massive public interest in her distant uncle.
So, out of sheer serendipity, new generations of students will now learn the story of Phineas Gage, but he will no longer be an abstract, vague spectre of a nineteenth century railway man. They can at last look on the face of a simple and proud man who had much taken from him, but who gave back more than he could ever have dreamed.
You can see the photographs here:
http://brightbytes.com/phineasgage/index.html
http://brightbytes.com/phineasgage/new_image.html
and read more about his story here:
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