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

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

June 13, 2024

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

At that time, his job was to fly rocks with explosives to allow the passage of the 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 meant that, when this worker tried to compact the gunpowder placed in the cavity using a metal bar, a spark would jump. The explosion of the mixture occurred a few centimeters from the young man's face and, as a result, the metal bar one meter long and about three centimeters in diameter went through his skull before landing more than twenty meters from where he was initially.

Phineas Gage , because this was the name of the worker, he regained consciousness a few minutes later with a hole that traced a diagonal from one of his cheeks to the top of his head, just above his forehead. Much of his frontal lobes of the brain had ceased to exist as such. However, Phineas Gage not only survived this experience, but he 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 neurosciences.

Dr. Harlow and the medical miracle

Almost everything we know about Phineas Gage is what he documented about him Dr. Harlow , the doctor who treated him. This health worker was impressed by the fact that Gage was conscious and able to speak at the time he entered his office, but he was more surprised that his patient recovered within a few months of arriving, after having passed a stage of fevers and delusions.

In this way, after only 10 weeks the functions of Gage's brain 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 the foreman objectively did not seem to have significant intellectual or movement deficits, his personality seemed to have changed as a result of the accident. Phineas Gage was not exactly the same anymore.

The new Phineas Gage

When Gage went back to work on the work, the measured and cordial worker that everyone knew had disappeared to make way for a person with a bad temper, easy to irritate , given to insults, prone to waste and a very short-sighted view of life. He was, in general, an impatient and irreverent person, who let himself be carried away by desires that were the fruit of a whim and that he thought little of others.

He soon stopped working for the work and, a few months later, Phineas Gage went to work at the Barnum Museum, showing up 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 deteriorated and somewhat ill. There the first epileptic attacks occurred, which would accompany him until his death in 1860 .

Why is the case of Phineas Gage relevant?

This small historical episode is a mandatory stop in many university careers related to neuroscience and behavior because, in fact, it was one of the first well documented examples in which it was seen how material changes in the brain modified not only cognitive abilities, but aspects of psychology that have traditionally been associated with the "soul", that is, to the way of being and the essence of human beings .

The theory exists that Phineas Gage happened to be another person not already through a learning process or the self-reflection, but by a very concrete accident that physically modified his brain. What was proved later could have been an example of how the brain reorganizes itself to supply the material deficiencies produced by the explosion from the most limited resources available, but the side effects of this were noted in aspects that were believed that they were not so subject to the material world as, for example, memory.

Somehow, the accident of the metal bar served to signal the biological bases on which rather abstract psychological processes are based , as the management of emotions and decision making. In addition, the case of Phineas Gage also served to reinforce the hypothesis that different areas of the brain deal with different aspects of behavior.

Possible Prefrontal Syndrome?

Nowadays it is believed that the personality change of Phineas Gage can be, in fact, an example of Prefrontal Syndrome, originated by the alteration of the functioning of the frontal lobes . The frontal area of ​​the brain plays an important role in linking present motivations to future objectives, which includes the possibility of situating long-term goals, the ability to forgo immediate rewards in favor of more ambitious projects, and the ability to Take into account the consequences that the acts themselves have on the people around us and, in general, society.

This would explain that the new behavior style of the Phineas Cage that had suffered the accident with the metal bar resembled in some aspects to the repertoire of expected behaviors in someone with psychopathic personality. The 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 the neurons after the brain was injured.

Another probable explanation for the case of Phineas Gage

The idea that 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 behavioral changes were due to the social impact that comes from being seen by others as someone who is missing a part of the brain. As usual, it is difficult to separate the biological aspects from those that are social and cultural in nature , and I could that Gage had the same thing happened to him that happened to the monster of Dr. Frankenstein in Mary Shelley's novel: that it was society, more than its own nature, that transformed it into a foreign body.

Stabbed in the Brain: Phineas Gage (June 2024).

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