by Elaine Hirsch
This is a guest post by Elaine Hirsch who describes herself as "kind of a jack-of-all-interests, from education and history to medicine and videogames. This makes it difficult to choose just one life path, so she is currently working as a writer for various education-related sites and writing about all these things instead." Read more of her work at onlinephd.org.
There’s a photo of Phineas Gage that, when the reader discovers the story behind it, is astonishing. A handsome and well-dressed man sits holding what looks like a long and dangerous spear. The only thing that’s odd is one of his eyes is missing. As it turns out, what put out his eye is the spear-like object he’s holding. But there’s more and worse to come. The spear, which is actually what was called a tamping rod, not only took out Gage’s eye but went straight through his head and came out the other side of his skull. Yet the man is still living, and seemingly whole and healthy despite the loss of his eye and a chunk of his brain. How can this be? Gage's case is one of the most famous neurological oddities ever documented, and in psychology education from high schools to online PhD programs it remains a celebrated and fascinating fixture.
The story is this: in September, 1848 Gage was a foreman on a railroad construction job in Vermont. He was about 25 at the time. The job involved blasting rocks to make way for the railroad and one of his jobs was to put blasting powder, fuses, sand and a charge into a hole that had already been bored into the rock. An iron rod was used to tamp the ingredients into the hole. Gage was no doubt used to this job, as he was the one who decided where the initial holes would be drilled and how much explosive to put in them. However, one afternoon the charge prematurely went off, probably because he neglected to put sand in the hole and was distracted by his men. The 13.25-pound tamping rod still in the hole was shot completely through Gage’s head, and landed some twenty yards away.
That Gage survived such a horrific accident was miraculous. He was actually able to walk away from the accident, and upon examining him Doctors Edward Higginson Williams and John Martyn Harlow found him amazingly lucid even as he hemorrhaged and his traumatized brain began to protrude from the hole in his skull. But even a small injury to the brain is dangerous, and Gage soon lapsed into a state of restlessness and delirium (he likely contracted meningitis as a result of his injury and subsequent infection). His friends and family not surprisingly expected him not to survive. However, by November Gage was able to walk around and claimed to feel pretty much recovered, and he moved back to his parents’ home in New Hampshire. Aside from the loss of the eye and some scars, he seemed to be completely recovered. It soon became apparent, though, that he wasn’t quite as recovered as he may have initially seemed.
Gage never returned to his job at the railroad, though he was probably physically capable of it. The problem was his mental state. Before, he had been responsible and handy, but after the accident he became profane, unreliable, inconsiderate, and perverse. However, whatever happened to him mentally either eased or wasn’t severe enough to prevent him from holding other jobs, including giving lectures and taking a job as a stagecoach driver in remote Chile. Even his doctors didn’t speak much about his personality or intellectual changes. In 1848 no one really knew how the brain worked, past the reasonable conclusion that if it were damaged the way Gage had damaged his, a person couldn’t really be expected to survive. Harlow did publish a report on Gage’s psychological state, but it was in 1868, eight years after Gage died, and not much attention was paid to it at first.
Scientists still don’t know exactly which parts of Gage’s brain were destroyed, but given the changes in his personality they’ve made educated guesses. Harlow decided that given the trajectory of the tamping rod the damage to the frontal and middle left lobes of Gage’s brain had been irreversible and that their functions had been taken over by his brain’s right hemisphere. By the 1980s, CT scans could be used on Gage’s skull to more precisely map the damage. Researchers did conclude the injury was mostly to the left hemisphere of his brain, but the right hemisphere had been damaged as well.
Some psychologists believe that despite his brain injury, Gage found enough structure in his life to make what’s called a “social recovery,” regaining much of the resourcefulness he lost in the accident. The discipline, modicum of courtesy and respect due his passengers, and a very set routine could have retrained his injured brain. Even today, a highly structured environment is regarded as beneficial in rehabilitating patients with brain injuries.
Theoreticians stand by varying theories about the effects of brain damage. Some still see such damage as was caused to Gage as not only catastrophic, but irreversible. Some believe the brain can heal itself in remarkable ways, even after trauma on the order that Gage suffered. Gage died in February of 1860. At the request of Dr. Harlow he was disinterred and his damaged skull removed. It remains on display at the Warren Anatomical Museum in Harvard Medical School, its secrets still not completely deciphered.
Comments