Phineas Gage survived a 13-lb rod — and largely recovered

On September 13, 1848, near Cavendish, Vermont, a 13-pound iron tamping rod was blasted through the skull of railroad foreman Phineas Gage, and he survived to become neuroscience’s most famous patient. An accidental explosion drove the bar in under his left cheekbone and out through the top of his head, landing many yards away.

Gage was conscious within moments, talked, and walked to the cart that took him into town. The iron had wrecked much of his left frontal lobe. His physician, John Harlow, treated him, and ten weeks later Gage went home to Lebanon, New Hampshire. Friends said he was “no longer Gage”: the reliable foreman had become impulsive and profane, an early clue that the frontal lobes help govern personality and self-control.

Was Phineas Gage ruined for life?

No; that is a later embroidery. Writers and textbooks turned the case into a cautionary tale: a drunken, violent drifter who spent the rest of his life exhibiting himself at fairgrounds and died penniless. Psychologist Malcolm Macmillan, who combed the surviving records, found that picture grossly exaggerated. Gage did appear for a time at Barnum’s American Museum in New York, but the record also shows him working at a livery stable in New Hampshire, then spending years in Chile driving stagecoaches, a job that meant rising early, caring for horses and handling passengers on a fixed schedule.

Gage “was in the enjoyment of good health, with no impairment whatever of his mental faculties.” — a doctor who knew him in South America

Macmillan and his co-author Lena argue that the highly structured routine of coaching probably aided his recovery, much as modern brain-injury rehabilitation relies on structure.

How did Phineas Gage die?

After a series of epileptic seizures. His health failed in 1859; he joined his mother in San Francisco and died on May 21, 1860. His body was exhumed in 1867, and his skull and the tamping iron are on display at Harvard’s Warren Anatomical Museum.