Day 1: The Hole in Phineas Gage’s Head

originally published January 1, 2012

Since nothing sells better than graphic sex and nauseating violence, I was hoping Wikipedia would help me launch this project with something juicy. I tried to weave a sexy yarn into some prose about the Rugby Club Pobednik, but I was starting to creep myself out. Luckily, another click of the mouse brought me to Mr. Phineas P. Gage, the tamping-iron-through-the-head-guy. Perfect.

In 1848 Gage was a grunt worker in a work gang, laying down the roadbed for the Rutland & Burlington Railroad, a small line in the American northeast. Phineas was part of the blasting crew, which he no doubt hooked up with so he could pick up chicks (or whatever girls were called in the 1840s). He was 25, he was the crew foreman; Gage had it going on.

Pictured: A surefire chick magnet

I like the part of disaster bios when they paint the victim’s picturesque, ideal life before the incident, so I’m going to stretch this out. Let’s see… Gage had just won a case of sarsaparilla by betting on a cockfight tournament. His years-long letter-writing campaigns to establish both Wisconsin as a state and bring about the end of the Mexican-American War had recently been successful. Also, he had train tickets to head out to California to pan for gold ahead of the big rush, leaving on September 14.

There, that sounded convincing. All was rosy and glorious – everything was coming up Phineas. Then, on the afternoon of September 13, right as Gage was reflecting on his good fortune (and, for the sake of drama, let’s say he was also planning on releasing some dirty information that would have crippled Zachary Taylor’s current presidential campaign), it happened.

And it was probably Zach Taylor’s fault.

Gage had stuffed blasting powder into a hole in a rock, and was in the process of using a three-and-a-half-foot iron tamping rod to pack it in. The powder exploded, and the tamping rod –which was about an inch and a quarter in diameter – flew up through Gage’s head, then in a wide arc, landing about 80 feet away where it impaled a small squirrel. (Not really, but how cool would that be?)

This part of the story, as one might expect, gets a little grotesque. Gage was speaking within a few minutes. He stood up and walked unaided, then sat upright for the ride home. He even flipped off a construction worker and made a comment about how the chilly weather ‘goes right through you’. The tamping rod, which the report describes in classic old-timey medical journal-speak as “an abrupt and intrusive visitor”, was found “smeared with blood and brain.” Some lucky bastard retrieved it, possibly hoping to use it to invent eBay.

In Rod We Trust

Gage was medivacked via horse and buggy to his home. Dr. Edward H. Williams was the first physician on the scene. He tells how Gage was describing the story to the bystanders who had gathered in his bedroom, probably practicing for the numerous saloons he’d enthrall in the future. Doc Williams (because calling him that sounds more 1840’s-ish) then describes how Gage threw up, which pressed out about  “half a teacupful” of his brain onto the floor.

Dr. John Martyn Harlow took over the case about an hour later, most likely because Doc Williams was freaked the hell out. Doc Harlow was impressed at Gage’s lucidity: he recognized the Doc, and hoped casually that he wasn’t much hurt. Doc Harlow’s report contains one of the most singularly excellent sentences of this entire article: “His person, and the bed on which he was laid, were literally one gore of blood.” I’ve never heard the word ‘gore’ as a numerical quantifying measurement, but damn if it doesn’t work.

This world is three Gores away from environmental catastrophe.

Gage was near comatose as he recovered, but within two months he was up and walking around. The rod had entered his skull under his left cheekbone, shot up behind his left eye, then out through the top of his head. He had partial paralysis in his face, no sight out of his left eye, and he had lost the ability to pronounce the word ‘tapioca’.

There were personality changes of course – this case is notable in the field of brain study for a reason. He started swearing more often (and who could blame him), became fitfully impatient, and began devising elaborate plans for his future which were swiftly dropped when his attention shifted. One of Doc Harlow’s observations described Gage as having “the animal passions of a strong man.” So, there’s the tagline for the movie.

Gage’s legend was even more impressive than the truth – stories circulated about his refusal to hold a job, his gambling and thievery, his molesting young children. None of these stories are based in fact, and they did nothing but cloud the work of the doctors who were trying to figure out just how a person can survive with a well-ventilated left-frontal lobe.

While doctors and, yes, phrenologists (an article of weirdness unto itself) turned the facts about Gage and the myths about Gage into a sloppy and incomprehensible Phineas stew, the man himself had to keep on living. He returned to the railroad, but it didn’t work out. P.T. Barnum, always on the lookout for people who have had items propelled through their heads, exhibited Gage around New England for a while.

Gage worked for a livery stable in New Hampshire (where I’m sure he stabilized numerous livers), then headed down to Chile where he worked as a stagecoach driver. Keep in mind, the tamping rod never left Gage’s possession; the photo above features the actual object of his notoriety. There’s an unconfirmed rumor that Gage was buried with the rod, but no one has dug him up to check.

Might be kind of cool though.

His health began to falter in 1859, and Gage moved from Chile to San Francisco to live with his mother and sister (and presumably to look forlornly upon the gold rush he missed out on by one day, unless I just made that part up). He did some farm work, then suffered from severe convulsions which killed him in 1860. Doc Harlow had the skull exhumed, and it now sits in the Warren Anatomical Museum, part of Harvard’s Medical School.

There is a lesson to be learned in this, perhaps about care and precaution when working with explosives, possibly about keeping medical papers free of myth and colorful language. Mostly I think we just learned about the most bad-ass exhibit in Harvard, and why I need to go there to gawk at it. I’d set out next week, but my schedule is just a gore of appointments.

Did I use that right?

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