The curious case of Phineas Gage and the metal bar on his head

In September 1848, the life of a young railroad foreman changed after a terrible work accident.

At that time, his job was to blast rocks with explosives to allow rail tracks to pass, and he needed to place gunpowder and sand in a hole drilled in the stone.

Phineas Gage: a case study

Unfortunately, a procedural error resulted in this worker attempting to compact the gunpowder placed in the cavity with a metal bar, and a spark was ignited. The explosion of the mixture occurred a few inches from the young man’s face and, as a result, the metal bar about three feet long and about three inches in diameter pierced his skull before landing more than twenty feet from where it was originally.

Phineas GageAs that was the worker’s name, he regained consciousness a few minutes later with a hole that ran diagonally from one of his cheeks to the top of his head, just above his forehead. Much of their frontal brain lobes 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 medicine. neuroscience.

Dr Harlow and the medical miracle

Almost everything we know about Phineas Gage is what he left documented about her on Dr Harlow, The doctor who treated him. This paramedic was very impressed that Gage was conscious and able to speak the moment he entered his consultation, but was more surprised that his patient had recovered a few months after his arrival, after “ going through a period of fevers and illusions. .

This way, after just 10 weeks, Gage’s brain functions 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 returned to work on the part, the measured and cordial worker that everyone knew had disappeared to make way for a person in a bad mood, easy to irritate, Insulted, prone to waste and with a very short-term view of life. He was, in general, an impatient and irreverent person, who let himself be carried away by desires following a whim and who thought little of others.

He quickly stopped working for the piece, and a few months later, Phineas Gage went to work at the Barnum Museum exhibiting next to the metal bar that had stabbed his head. He later lived in Chile, where he worked as a horse-drawn carriage driver, until he returned to the United States feeling deteriorated and somewhat ill. the the first epileptic seizures happened to him, that would accompany him until his death in 1860.

Why is the Phineas Gage case relevant?

This little historical episode is a must-see in many academic careers related to neuroscience and behavior because, in fact, it was one of the first well-documented examples to see how material changes in the brain not only impair cognitive abilities. , but also some aspects. of psychology traditionally associated with “the soul”, that is to say to the way of being and the essence of human beings.

There is the theory that Phineas Gage became another person no longer through a process of learning or self-reflection, but through a very specific accident that physically altered her brain. What was verified later may have been an example of how the brain reorganizes itself to compensate for the material impairments produced by the explosion from the more limited resources at its disposal, but the side effects of this have been noticed in aspects that were believed not to be as subject to the material world as, for example, memory.

Somehow the crash of the metal bar served as a signal the biological bases on which rather abstract psychological processes rest, Such as emotion management and decision making. In addition, the case of Phineas Gage also served to reinforce the hypothesis that different areas of the brain process different aspects of behavior.

Possible prefrontal syndrome?

Today, it is believed that Phineas Gage’s personality change could 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 connecting current motivations to future goals, which includes the ability to set long-term goals, the ability to forgo immediate rewards in favor of more ambitious projects, and the ability to take responsibility for the consequences that the acts themselves have on the people around us and, in general, on society.

This would explain why the new style of behavior of the Phineas Cage who had suffered the crash with the metal bar looked like certain aspects of the repertoire of expected behaviors in a person psychopathic personality. Psychopaths also seem to show a different dynamic of neuronal activation in the frontal lobes than in the rest of the population, but in Gage’s case, this would be produced by the reorganization of neurons after brain injury.

Another probable explanation for the Phineas Gage case

The idea that brain damage was the root cause of Phineas Gage’s personality change is widespread, but there is also another alternate 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 some of his behavioral changes were due to the social impact of being seen by others as someone who lacks a part of the brain. Like always, it is difficult to separate the biological aspects from those of a social and cultural nature, And I could see that in the end, Gage got the same as Dr. Monster. Frankenstein in Mary Shelley’s novel: that it was society, rather than his own nature, that turned him into a strange body.

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