Phineas Gage in the Flesh

The only known photograph of famed head case Phineas Gage was discovered last month (on Flickr of all places!). Jack and Beverly Wilgus had the above daguerreotype for thirty years before realizing what it was. As they describe the image's history at their website:

We called it "The Whaler" because we thought the pole he held was part of a harpoon. His left eye (we have flipped the picture since the daguerreotype is a laterally-reversed mirror image) is closed so we invented an encounter with an angry whale that left him with one eye stitched shut.

We would still be telling that story if it had not been posted on our flickr daguerreotype set. It got some attention and comment from members of the whaling group. The consensus was that it was a wonderful image but he was not holding a harpoon. We then had a comment* that turned the disappointment to excitement, "...maybe you found a photo of Phineas Gage? If so, it would be the only one known."

Phineas Gage is famous for the injury he suffered when a tamping iron (which he's holding) exploded upwards and was sent upwards through his cheek bone and out the top of his head. Amazingly, Gage survived, but developed distinct personality differences that have made his case famous in psychology and neuroscience ever since.

As Mo at Neurophilosophy describes in his excellent essay on Phineas Gage:

Gage did, according to Harlow, retain "full possession of his reason" after the accident, but his wife and other people close to him soon began to notice dramatic changes in his personality. It wasn't until 1868 that Harlow documented the "mental manifestations" of Gage's brain injuries, in a report published in the Bulletin of the Massachusetts Medical Society:

"His contractors, who regarded him as the most efficient and capable foreman in their employ previous to his injury, considered the change in his mind so marked that they could not give him his place again. 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 of advice when it conflicts with his desires, at times pertinaciously obstinent, yet capricious and vacillating, devising many plans of future operation, which are no sooner arranged than they are abandoned in turn for others appearing more feasible. In this regard, his mind was radically changed, so decidedly that his friends and acquaintances said he was 'no longer Gage.'"

Thus, the damage to Gage's frontal cortex had resulted in a complete loss of social inhibitions, which often led to inappropriate behaviour. In effect, the tamping iron had performed a frontal lobotomy on Gage, but the exact nature of the damage incurred to his brain has been a subject of debate ever since the accident occurred.

The accidental discoverers of the photograph have now begun a lucrative business licensing Gage's photograph and selling his likeness on everything from greeting cards to refrigerator magnets. I wonder how the pre-injury Gage would feel knowing that he would one day be famous, not for the person he was, but for who an injury caused him to become.

H/T Jennifer Bazar

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That's pretty cool. It's like looking at history in the face. He's the reason why many neuroscientists (myself included) got interested in the field. Thanks for the post.

This blog not only succeeds in what I doubted a single author could accomplish -- the blog is, in fact, a useful and balanced overview of the state of medical education -- but also is exactly what the author promises a blog about the pursuit of excellence in medical education, construed above all in ethical terms.

Um, thanks? This is not a blog about medical education though. You might have considered adapting this boilerplate accolade when posting your advertisement.