The Curious Case of Phineas Gage and the Metal Bar

In September 1848, the life of a young foreman of the railway line turned upside down after a terrible work accident.

At that time, his job consisted of blowing up rocks with explosives to allow the passage of train tracks, and 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 face of the young man 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 initially.

Phineas gagesince this was the name of the worker, he regained consciousness a few minutes later with a hole that of him traced a diagonal from one of his cheeks to the top of his head, just above the front. Much of their frontal lobes of the brain they 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 the 

neurosciences.

Dr. Harlow and the medical miracle

Almost everything we know about Phineas Gage is what the Dr. Harlow, the doctor who treated you. This paramedic was strongly impressed by the fact that Gage was conscious and able to speak the moment he entered. his consultation, but he was even more surprised that his patient recovered a few months after arriving, after having passed a stage of fevers and delusions.

In 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 managed 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 seem to have significant intellectual and movement deficits, his personality seemed to have changed as a result of accident. Phineas Gage was no longer exactly the same.

The new Phineas Gage

When Gage went back to work on the play, the measured and cordial worker everyone knew had disappeared to make way for a short-tempered person, easily irritated, given to insults, with a propensity to waste and with a very short-term vision of life. 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 later years he was living in Chile, where he worked as a horse-drawn carriage driver, until he returned to the United States feeling run down 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 a mandatory stop in many university careers related to neurosciences and behavior because, in fact, it was one of the first examples well documented in which it was seen how material changes in the brain modified not only cognitive abilities, but also aspects of psychology that have traditionally been associated with the "soul". say, to 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 found later could have been an example of how the brain reorganizes itself to supply the material deficiencies produced by the explosion of resources. more limited available, but the collateral effects of this were noted in aspects that were believed not to be so subject to the material world as, for example, the memory.

Somehow the metal bar accident served to signal the biological bases on which rather abstract psychological processes are sustained, such as managing emotions and making decisions. 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 projects ambitious and the ability to take into account the consequences that their own actions have on the people around us and, in general, the 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 aspects of the repertoire of behaviors expected of someone withpsychopathic personality. Psychopaths also seem to show neuronal activation dynamics in the frontal lobes different from the rest of the population, but in the case of Gage this would be produced 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 his behavior changes were should be due to the social impact that comes with being seen by others as someone who lacks a part of the brain. As always, it is difficult to separate the biological aspects from those of a social and cultural nature, and I could have the same thing happened to Gage after all that happened to Dr. Frankenstein's monster in the Mary Shelley's novel: that it was society, rather than his own nature, that transformed him into a body strange.