On the afternoon of September 13, 1848 an explosion rocked the construction site at the Rutland & Burlington Railroad in Vermont. The black powder charge went off unexpectedly, sending a 13 lb iron tamping rod through the skull of a young railway worker. The bar entered his face, shot out the top of his head and landed some 80 feet away “smeared with blood and brain.”
Astonishingly, he was not dead. Phineas Gage, 25 years old at the time, was rushed into the care of the nearest doctor. Gage remained miraculously conscious and even spoke with his rescuers and the doctor that first attended to his injuries, leading said doctor to at first disbelieve his story. It was only after Gage paused in his storytelling to vomit and “about half a teacupful of the brain” fell out of the wound, onto the floor, that he was convinced. He was rushed into surgery.
Reasonably enough, family and friends expected him to die at any moment, and went about obtaining a coffin and making funeral arrangements while Gage languished in a semi-comatose state for several days.
The good news, as it turned out, was that Gage pulled through and would not need that coffin for another twelve years. He lost vision in his left eye, and had “a deep depression, two inches by one and one-half inches wide, beneath which the pulsations of the brain can be perceived” - but was otherwise, physically at least, fine.
The bad news is that the accident turned him into a total jerk.
As his doctor described:
“The equilibrium or balance, so to speak, between his intellectual faculties and animal propensities, seems to have been destroyed. He is fitful, irreverent, indulging at times in the grossest profanity (which was not previously his custom), manifesting but little deference for his fellows, impatient of restraint or advice when it conflicts with his desires, at times pertinaciously obstinate, yet capricious and vacillating, devising many plans of future operations, which are no sooner arranged than they are abandoned in turn for others appearing more feasible. A child in his intellectual capacity and manifestations, he has the animal passions of a strong man. … his mind was radically changed, so decidedly that his friends and acquaintances said he was “no longer Gage.”
Gage lived out the rest of his days between exhibiting himself as a sideshow curiosity, and, oddly enough, becoming a one-eyed, slightly addled, long-haul stagecoach driver in Chile. As one does. We would like to hear stories from those days.
He ended his days in San Francisco, where epilepsy - likely associated with his brain injury - finally claimed his life in 1860.
His skull, tamping rod, and a life mask are on display at the Warren Anatomical Museum in Boston, but he left his heart (and the rest of his body) in San Francisco, now residing in a mass grave in Colma’s Cypress Hills cemetery.
UPDATE: We have been reminded that we would be remiss not to point out recent research which questions whether Gage’s personality changes were more subtle and/or more short lived than originally reported. Since his later life suggests some ability to adapt and cope, Gage may have recovered somewhat and eventually been no longer “no longer Gage.”
ONE BODY, TWO FINAL RESTING PLACES
WARREN ANATOMICAL MUSEUM
Boston medical museum housing the skull, life mask, and tamping rod of Phineas Gage.
COLMA NECROPOLIS EXPLORATION
Our October 2011 visit to the sprawling Colma Necropolis, where just under 2000 living residents share their city with 1.5 million dead, including most of Mr. Gage.
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