The Miraculous Survival of Phineas Gage

What doesn’t kill you makes you stronger. Except in the case of Phineas Gage, which after an accident in 1848 had become many things but strong. The man survived by passing an iron rod through his skull, therefore becoming a great curiosity in medical science and a celebrity among the general public, albeit an irritant.

What happened to Phineas Gage?

Gage was an ordinary man, which is probably why his extraordinary existence did not make newspaper headlines. He was a foreman by profession, and a great man at that. He was smart and friendly at the same time, qualities that made him a valued employee and a respected leader among his team. In September 1848, Phineas was deployed to the United States as part of a railroad bed-cutting crew on the Rutland and Burlington Railroad in Cavendish, Vermont. On the thirteenth day of the month, he was assigned the task of stuffing gunpowder into a rock, which had to be dismantled for the process of construction. The work required the handling of a 43-inch-long iron rod as thick as “an inch and a quarter” in diameter, but the young man was also adept at his job.

He was going about his work—using a tamping iron to pour the powder into the hole—when the spark was ignited by friction between the rod and the rock. It took just a split second to cause the explosion. The explosion caused the rod of Gage’s hand to pierce through his left cheek through high pressure in his skull. It destroyed his left eye, and passed through the left side of his brain to the other side.

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The above account may sound fatal, but Phineas Gage transcended it with some convictions. Within minutes the man was back on his feet, talking, walking and asking for help. In town, his case was attended by Dr. Edward H. Williams, who was assisted by Dr. John Harlow during the week-long treatment. It was Harlow who gave full details of the case to the Boston Medical Surgery Journal.

phineas gage 1

The recovery period included two weeks in a semi-conscious state and a dose of drugs. But soon Gage made a full recovery and ended up donating the stick that pierced him to Harvard University. The man who should have died was up and running by mid-November, ready to go back to work. But the railroad company refused to take back his favorite employee, as his brain injury clearly affected his state of mind.

Harlow reported that the man had retained his wisdom and intelligence, even his memory. But there was a big change in his personality. Being “the most efficient and capable foreman” he became a shrewd and flaky man, irritable, capricious and disobedient. He was no longer himself, and became unable to do the job with responsibility or commitment. Soon Gage was being seen in circuses in New England, boasting his face and his stick, and later went to work amongst the costume stables and horses in Chile. He also exhibited himself at Barnum’s American Museum in New York City, and some say that people paid to see the anomaly. The major condition he developed was epilepsy, which soon increased in frequency as well as severity.

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a) The skull of Phineas Gage on display at the Warren Anatomical Museum at Harvard Medical School. b) The figure shows the potential rod trajectory. Photo: wikimedia

Gage died of an epileptic seizure on May 21, 1861, nearly 12 years after the accident. Harlow suggested that his mother donate his skull to the university, which she did. For years Phineas continued to inspire revelation in medical science and wonder about the capabilities of the human body. A new school of thought emerged that studied the relationship between mind and brain. Before Phineas’ accident, the frontal lobes were known to influence or control human behavior. Improvements and psychological changes to this unusual prey prompted David Ferrier and Burkhart to study how the frontal lobe did not alter physiology but influenced behavior and personality.

Psychologist Malcolm Macmillan, one of Phineas Gage’s greatest researchers, suggests that many of his conclusions about his case remain unconfirmed by solid evidence. For example, not much is known of his personality before the accident, and what is known is attested only by the accounts of his relatives. Again, the degree of change remains questionable for its veracity. In Malcolm’s view, Gage’s story is important as a testament to how some facts turn into anecdotes and scientific myths over time.

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Phineas Gage after the accident.

Few would know what Phineas looked like in life, but soon the world got to know what he looked like with his face mask. The common man was immortalized in his death, and his remains are still in Harvard Medical School’s Warren Anatomical Museum.


# “An Odd Kind of Fame: Stories of Phineas Gage” by Malcolm McMillan

, no more gage”: an iron bar through the head

, The effect of the rod of iron through the head on Phineas Gage and personality

, Phineas Gage: Neuroscience’s Most Famous Patient

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