A serious work accident that changed the personality of a young worker.
In September 1848, the life of a young foreman of the railway line took a turn as a result of a terrible work accident.
At that time, his job consisted of blowing up rocks with explosives to allow the passage of train tracks, and for this he needed to place gunpowder and sand in a hole drilled in the stone.
Phineas Gage: a case study
Unfortunately, an error in the procedure caused that, when this worker tried to compact the powder placed in the cavity using a metal bar, a spark would jump. The explosion of the mixture occurred a few inches from the young man’s face and, as a result, the metal bar one meter long and about three centimeters in diameter pierced his skull before landing more than twenty meters from where he was found initially.
Phineas Gage, for this was the worker’s name, regained consciousness a few minutes later with a hole that traced a diagonal from one of his cheeks to the top of his head, just above his forehead. Much of his frontal lobes of the brain had ceased to exist as such. However, Phineas Gage not only survived this experience, but was able to regain most of his mental abilities and went down in history as one of the most studied cases in the fields of psychology, medicine and neuroscience.
Dr. Harlow and the medical miracle
Most of what we know about Phineas Gage is what Dr. Harlow, the treating physician, documented about him . This health worker was strongly impressed by the fact that Gage was conscious and able to speak the moment he entered his office, but was even more surprised that his patient recovered a few months after arriving, after having spent a stage of fevers and delusions.
Thus, after just 10 weeks, the functions of Gage’s brain seemed to have recovered almost automatically, as if the cellular tissues of the brain had been able to reorganize to compensate for the absence of several cubic centimeters of frontal lobe. However, Dr. Harlow was struck by something else: although objectively the foreman did not appear to have significant intellectual or movement deficits, his personality seemed to have changed as a result of the accident. Phineas Gage wasn’t exactly the same anymore.
The new Phineas Gage
When Gage went back to work on the construction site, the measured and friendly worker everyone knew had disappeared to make way for a short-tempered person, easily irritated, given to insults, with a propensity to waste and a very short-term view of the lifetime. He was, in general, an impatient and irreverent person, who was carried away by wishes resulting from a whim and who thought little of others.
He soon stopped working for the play and, a few months later, Phineas Gage went to work at the Barnum museum displaying himself next to the metal bar that had pierced his head. In the following years he was living in Chile, where he worked as a horse carriage driver, until he returned to the United States feeling deteriorated and somewhat ill. There the first epileptic seizures occurred to him, which would accompany him until his death in 1860.
Why is the case of Phineas Gage relevant?
This little historical episode is an obligatory stop in many university degrees related to neurosciences and behavior because, in fact, it was one of the first well-documented examples in which material changes in the brain were seen to modify not only cognitive abilities, but also aspects of psychology that have traditionally been associated with the “soul”, that is, with the way of being and the essence of human beings.
There is a theory that Phineas Gage became someone else not through a learning process or self-reflection, but by a very specific accident that physically modified his brain. What was later verified could have been an example of how the brain reorganizes itself to supply the material deficiencies produced by the explosion from the most limited resources available, but the collateral effects of this were noted in aspects that were believed that they were not as subject to the material world as, for example, memory.
In some way, the accident with the metal bar served to point out the biological bases on which rather abstract psychological processes are sustained, such as the management of emotions and decision-making. In addition, the case of Phineas Gage also served to reinforce the hypothesis that different areas of the brain are concerned with different aspects of behavior.
Possible Prefrontal Syndrome?
Today it is believed that Phineas Gage’s personality change may actually be an example of Prefrontal Syndrome, caused by impaired functioning of the frontal lobes. The frontal area of the brain plays an important role in linking present motivations to future goals, including the ability to set long-term goals, the ability to forego immediate rewards in favor of more ambitious projects, and the ability to take into account the consequences that the actions themselves have on the people around us and, in general, society.
This would explain why the new style of behavior of the Phineas Cage who had suffered the accident with the metal bar resembles in some respects the repertoire of behaviors expected in someone with a psychopathic personality. Psychopaths also seem to show neuronal activation dynamics in the frontal lobes that are different from the rest of the population, but in Gage’s case this would be caused by the reorganization of neurons after having injured the brain.
Another likely explanation for the Phineas Gage case
The idea that the brain injury was the root cause of Phineas Gage’s personality change is widespread, but there is also another alternative explanation: that the changes were due to the social impact of being disfigured.
As Zbigniew Kotowicz points out, it is very likely that at least part of your behavior changes were due to the social impact that comes with being seen by others as someone with a part of the brain missing. As always, it is difficult to separate the biological aspects from those of a social and cultural nature, and after all, the same thing happened to Gage that happened to Dr. Frankenstein’s monster in Mary Shelley’s novel could happen: that it was society, rather than his own nature, that transformed him into a foreign body.