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Brain Injury and Personality: The Phineas Gage Case

Updated on January 31, 2013
Phineas Gage with the tapping iron that pierced his frontal lobe.
Phineas Gage with the tapping iron that pierced his frontal lobe. | Source

The Accident

Like most men in Cavendish, VT during the fall of 1848, Phineas Gage worked for the railroad. But, unlike some of the other men on the job, Phineas was a natural born leader and was quickly named foreman of the local project. He had the perfect balance of firmness and compassion, and had an uncanny ability to compromise and settle conflicts. He was, by all accounts, a great and personable man. But, on the morning of September 13th, everything would change.

Phineas and his crew had to blast rock in order to make room for the tracks. This process required “tapping” a hole into the rock with a metal rod, setting the gunpowder into the hole, and then lighting a fuse. This gave the workers ample time to leave the area while the rock exploded. But, on this tragic morning, something went horribly wrong. A spark ignited the gunpowder early and sent the “tapping iron”, a 3 and ½ foot iron rod weighting close to 14 pounds, straight through Phineas’ face and out through the top of his head. The iron rod landed 80 yards away.

What happened next surprised everyone; Phineas stood up and asked what happened. How can a man, who just had a large metal spike slice through his brain, defy conventional logic and not only survive, but get up and act “normal”? Lucky for us and the future of psychological research, the doctor who oversaw Phineas’ case, Dr. Edward H. Williams, took copious notes.

Phineas' Condition

Despite the doctor’s notes, many questions remained unsolved until decades later. In the years after his accident, many questions remained: How did he not die? How could he still talk? How could he walk with all but the slightest of limps? But, the biggest question of the time was how could a man with such a great temperament and demeanor, turn into such a “monster”? The biggest change, as indicated by Dr. Williams’ notes, is that Phineas had trouble controlling his emotions; he was mean, inappropriate, and inconsiderate. We now know the answers to these questions and they give us excellent insight into how the brain works.

The case of Phineas Gage showcases one of the most unique brain injuries in history.
The case of Phineas Gage showcases one of the most unique brain injuries in history. | Source

The Answers

Phineas did not die because he did not bleed very much. The force of the blow was so powerful that it left a relatively clean and smooth wound. There was no excess blood or bone matter to interfere with the brain matter that remained intact. We occasionally see a wound like this in the current media such as a carpenter who has an accident with a nail gun. Usually, they can recover because of the force of the nail gun creates a clean wound. In contrast, someone with a bullet wound is at far more risk for permanent injury because the bullet breaks apart.

Still, with a hole in the head, one would expect there to be drastic consequences. In general there are, but it all depends on what brain parts are impacted. In Phineas’ case, because the spike only impacted his frontal lobe, all of his sensations, memories and language abilities stayed intact, for these are located in other parts of the brain. Although much of it still remains a mystery, we do know that the frontal lobe has a few major functions, one of which is control of our motor skills. All of our skeletal and muscle movements are controlled by a thin strip of tissue in the back of the frontal lobe. But, in the case of Phineas Gage, very little of it was touched by the tapping iron, hence explaining why he could still walk with only a slight limp (he would even use the tapping iron that injured him as a cane).

The second function of the frontal lobe is found in our ability to organize and process information. For example, before we do a puzzle, we may organize the pieces in a way that helps us attack the “problem”. People with certain types of frontal lobe damage can no longer do this; they just jump right into problems without doing any planning. But what does this have to do with Phineas’ change in personality? It’s quite simply actually, what happens if we don’t have the ability to plan and organize our emotions? If we didn’t, what kind of person would we be? Imagine saying everything that crossed your mind. Imagine telling people exactly what you were thinking, all of the time. What would people’s reaction to you be? Without a doubt it would be a negative one, and it would not surprise me if people started labeling you as a monster.

Phineas' limbic system was cut off from his frontal lobe.
Phineas' limbic system was cut off from his frontal lobe. | Source

But very few people with frontal lobe injuries act so aggressive towards others, which makes us look at Phineas’ unique injury further. Because of the location of the injury, we now know that he lost the connection between his frontal lobe (organization) and the limbic system, the place in our brain where our most “primitive” emotions lye. Within the limbic system we have our primal thoughts and emotions: anger, agression, sex, hunger, thirst, etc. Without the ability to organize these thoughts and desires, Phineas essentially started acting more like a wild animal than a rationale, civilized human being. If fact, it is also documented that Phineas got along better with animals than humans after his injury.

What Happened To Phineas?

After a brief period after his accident, Phineas lived with his family in New Hampshire, but soon left to join the circus. Soon thereafter, he left for Chile where he drove a stagecoach for a living. Towards the end of his life, he returned to the United States where he settled in San Francisco to be close to his sister. Twelve years after his accident he passed away at the age of 36.

At the request of doctors who knew of his case, his body was exhumed and his skull and tapping iron were presented to the Harvard Medical School Museum, where they remain today.

A Contemporary Phineas Gage

His Place In History

Phineas Gage will forever be remembered in the history of psychology. Not only was his story horrifying and interesting, but his injury was unique. At his expense, we have learned more about the structure of the brain and how it works. .

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    • rajan jolly profile image

      Rajan Singh Jolly 4 years ago from From Mumbai, presently in Jalandhar,INDIA.

      This is an amazing account of an injury that though grave did not lead to severe incapacitation or death but changed the personality totally. Thanks for sharing this true account.

      Voted up, interesting.

    • Boulism profile image
      Author

      Boulism 4 years ago from Short Beach, CT

      Thanks for reading Rajan, it is quite amazing really that he didn't die.

    • rasta1 profile image

      Marvin Parke 4 years ago from Jamaica

      Very nice evaluation of this case study. I learnt some new information.

    • mbyL profile image

      Slaven Cvijetic 4 years ago from Switzerland, Zurich

      great hub boulism! I don't have much time to write more but I shared it!! Hope it helps you ;)

    • Boulism profile image
      Author

      Boulism 4 years ago from Short Beach, CT

      Thanks for the support!

    • profile image

      PRAVIN,,,, 4 years ago

      VERY NICE RESEARCH FOR NEUROPSYCHOLOGY,,,,

    • That Grrl profile image

      Laura Brown 4 years ago from Barrie, Ontario, Canada

      My brother has a brain injury which seems to have changed his temperament. Not drastically he does get angry/ upset easier. However, I don't know how much of that is just from the pain of the injury itself. It happened when he was a boy, now he is 45+, but it has never healed well. He was hit a little upwards on the forehead, between his eyes. It was a metal rod which they added to baseball bats to make them hit harder. My brother was a kid watching the game with our Grandfather. I'm interested in brain injury cases because of this. But, I only know so much about my brother's experience. He doesn't want us to be worried so he doesn't tell us very much.

    • Muttface profile image

      Muttface 4 years ago from Portugal

      Excellent stuff!

    • Evan Smiley profile image

      Evan Smiley 3 years ago from Oklahoma City

      I had heard about this in school once, but it was great to actually in depth about it! Thank you for the hub!

    • Thief12 profile image

      Thief12 3 years ago from Puerto Rico

      I've always been mystified by this case. Really cool and interesting. Not for him, though. I imagine it would've been quite tragic for him and his family to see that change and not know exactly how to deal with it.

    • PsychGeek profile image

      PsychGeek 2 years ago from UK

      This is such an amazing story and I remember it being the first case study I ever read about in psychology and I was gripped from there. This case has opened so many doors and opportunities into the possibilities and complexities of the brain and the human mind. Great Hub - thanks for sharing!

    • Larry Rankin profile image

      Larry Rankin 23 months ago from Oklahoma

      The Gage injury is one of the most historically interesting ones.

      Great hub.

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