Phineas Gage: A Gruesome but True Story About Brain Science

In September of 1848, 26-year-old Phineas Gage was working as a foreman on construction of a section of railroad tracks in Vermont.

The gang is blasting their way through a section of granite when Phineas has a terrible accident. He is tamping gunpowder into a hole with his tamping iron (a 3.5-foot rod with one blunt end and a sharp point at the other.) He and his gang have done this thousands of times before, but this time something goes wrong. The tamping iron slips from his grasp, slides down into the hole, and creates a spark that ignites the gunpowder. The hole acts as a rifle barrel and blasts the tamping iron skyward. Unfortunately, Phineas is still leaning over the hole. It takes a moment for his men to realize, but the tamping iron has entered Phineas's skull just below the left cheekbone and exited just over his left eye, before it lands over thirty feet away.

Phineas continues to talk and give orders to his men while he bleeds profusely. His men load him into a wagon and drive him slowly back to town, where he gets out of the wagon, climbs the steps to the hotel where he has a room, and sits down to wait for the country doctor to arrive.

So begins the story of the injury that killed Phineas Gage, but not until more than eleven years later.

Phineas healed physically (mostly), but those who knew him reported his personality greatly altered, and he carried his tamping iron around like a “security blanket.” He struggled with angry and violent outbursts after his accident and no longer seemed to be able to “read” social cues.

Meanwhile, in this age of medical misinformation, and before the advent of the study of psychology, Phineas Gage was studied in minute detail. He was poked and prodded by doctors and “phrenologists” alike. Articles were written about him in medical journals. He traveled to Boston in 1850 to be interviewed by the Boston Society of Medical Improvement. Some of the doctors don't believe that he could have survived what eyewitnesses state happened...they thought his story was a hoax!

Phineas even went on the road briefly and toured with Barnum's American Museum, a nice name for a sideshow of “freaks.” He returned to his mother's home in New Hampshire, hired on as a stagecoach driver in Chile, and returned to his mother's house again in San Francisco (she has moved to be near her married daughter) in 1859. At this time, he began to suffer from seizures, an effect of his former injury, that eventually killed him in 1860.

Phineas's “case” is still studied extensively by doctors and psychologists to this day.

Recently, his skull has been used to recreate his brain injury in an MRI. And if you want to see his skull and tamping iron for yourself, just ask at the front desk of Harvard's collection of medical curiosities. Someone will show you right in!

What a fascinating case! And a surprisingly humorous and positive description of a gruesome and tragic event. Medical history and diagrams of the brain are interspersed throughout, enhancing any study of the history of medicine. Important personages like Louis Pasteur and Anton van Leeuwenhoek are mentioned briefly, begging for further research.

I recommend this short but meaty volume for anyone interested in the history of medicine, the history of psychology, the history of railroads, the history of sideshows, or anyone who “rubbernecks” at traffic accidents.

Of course, my age recommendation is just a recommendation as I have no sensitive or squeamish readers. Be sure to make an informed decision for your family.

CONTENT CONSIDERATIONS

Graphic details of brain injury and medical procedures are described