Phineas Gage’s friends expected him to die at any moment. His family had prepared a coffin for him. Surely no one could survive an accident such as his.
Gage was 25 years of age on September 13, 1848, the day of his fateful accident. He was the foreman of a work gang blasting away rock in preparation for a railway. Gage’s team had responsibility for the blast: they drilled a hole in the rock, added gunpowder, a fuse, then sand, and then tamped the sand down with a rod before lighting the fuse. Gage was in charge of the tamping.
Gage was experienced in his duties. He had his own tamping iron, made according to his specifications. It was 3 feet, 7 inches long, 1 ¼ inches in diameter at one end, and tapered to ¼ inch at the other. It weighed 13 ½ pounds.
On this particular day, however, Gage was momentarily distracted by another matter. He didn’t notice that the other workman had not yet added the sand, and he began tamping, bringing his iron into direct contact with the gunpowder. The sparks created resulted in an explosion that drove the tamping iron directly into Gage’s head.
It’s not known whether or not he lost consciousness, but within minutes he was up and able to walk. Friends helped him to a cart, where he sat upright for the ¾ mile trip back to his boarding house. A local doctor, Edward H. Williams, was sent for.
Dr. Williams noticed the wound right away — he could see Gage’s brain pulsing at the top of his head. He thought Gage was mistaken about what had happened though; it seemed too incredible to be true. Surely the iron bar couldn’t have passed completely through his head.
It had, though. It had entered right below his left cheekbone, passed behind his eye, and exited from the top of his head. Gage got up while Dr. Williams was there and vomited; the act forced out about a “half teacupful” of brain matter.
About an hour later, Dr. John Martyn Harlow took over the case. He noted that Gage was alert, had no memory loss, and hoped “that he was not much hurt.” His pulse was regular, but he seemed exhausted — no doubt in part because of the loss of a great deal of blood.
Gage removed some of the smaller bone fragments, but replaced the larger ones and applied a wet compress, binding the whole thing up with adhesive tape. A few days later, Gage’s brain developed what Harlow called a “fungus,” and Gage ran a fever and became semi-comatose. Harlow drained an abscess under Gage’s scalp, and he began to recover. By October 7, he was able to sit up, and after another month he was walking again.
Gage’s injury had happened in Cavendish, Vermont, but his family was in New Hampshire. By the end of November he was able to return to them, and rapidly began to mend. The following April he returned to Cavendish, where he visited Dr. Harlow, who noted that Gage had lost vision in his left eye, and had a deep depression on the top of his head, under which it was possible to see his brain pulsate. He seemed to be in good condition, and said his head didn’t hurt, but it did have a strange sensation, one he was unable to describe.
What happened to Gage after this is a little confused. Most of what we know of his life after the accident comes from Harlow’s publications, some of which were published years after Gage died, and some of which seem to be contradicted by direct evidence. According to Harlow, Gage’s personality was much altered after the accident, so much so that his former employers were unwilling to employ him. Whereas before Gage was characterized as dependable, responsible, and well-liked, after his accident — according to Harlow — he was impatient, obstinate, and tending to profanity. Harlow said that Gage’s friends said that he was “no longer Gage.”
Harlow said that Gage supported himself for a time by appearing in Barnum’s American Museum — a fact of which there is no evidence — and by displaying himself in public appearances — which has been proven. After regaining his strength, he worked for about 18 months for a livery stable in Hanover, New Hampshire, and then for seven years as a stagecoach driver in Chile, on the Valparaiso to Santiago route.
His health began to fail in 1859, and he returned home to his mother and sister, who had moved to San Francisco. Recovering somewhat, he worked on a farm in Santa Clara. In 1860, he began to have epileptic seizures, and died on May 21 — 12 years after his accident.
Information about Gage’s later life is scarce, and what exists seems to have been somewhat sensationalized. Allegations of Gage’s being a drunkard were made by some, which seem to have no basis in reality. He was also accused of mistreating his wife and children, although he had no wife or children. Accusations of his being a liar and a braggadocio seem to stem from fanciful stories that he told to his sister’s children.
Gage’s was the first case which seemed to definitely link personality with certain areas of the brain, and the case was used to support a host of theories. The later 19th century was a time when scientists were arguing about whether or not certain areas of the brain performed specific functions, and Gage’s case was seized as evidence that it did — consequently, the more outrageous his post-accident behavior seemed, the better. Phrenologists, too, were still around, arguing that Gage’s changes had occurred because of the destruction of his “organ of Veneration” and his “organ of Benevolence.”
A daguerreotype of Gage was discovered in 2009, showing a well-dressed and confident young man holding the tamping rod that had changed his life. (The owners of the daguerreotype had believed for years that the picture was of an injured whaler holding a harpoon.) Identification was made by means of comparing the inscription on the rod with that on the actual rod, now owned by the Warren Anatomical Museum at Harvard. In addition, a known life mask of Gage matched the injuries shown in the daguerreotype. A second image of the same man, discovered in 2010 and with copies owned by two different branches of the Gage family, would seem to further authenticate his identity.
Sources: Chase’s Calendar of Events, 2011 Edition: The Ultimate Go-To Guide for Special Days, Weeks, and Months, Editors of Chase’s Calendar of Events; http://en.wikipedia.org/wiki/September 13; http://en.wikipedia.org/wiki/Phineas_Gage; http://neurophilosophy.wordpress.com/2006/12/04/the-incredible-case-of-phineas-gage/; http://www.deakin.edu.au/hmnbs/psychology/gagepage/Pgstory.php; http://www.smithsonianmag.com/history-archaeology/Phineas-Gage-Neurosciences-Most-Famous-Patient.html; http://brainconnection.positscience.com/topics/?main=fa/phineas-gage; http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1114479/.