Phineas Gage
Sorry, Phineas phans — there’s no evidence that his extraordinary case had any effect on the history of psychosurgery. There is sufficient evidence, however, that he was hot.
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Small Peculiar
It's comedy yttrium! Updated every Tuesday.
As a longtime researcher on Phineas Gage, I love the cartoon — always glad when someone helps set the story straight about the (non-)relationship between the Gage case and lobotomy.
But one thing needs to be clear: there’s no question Gage did undergo some kind of personality change after his accident. What’s become a complete mess of mythology in the 150+ years since is the usual presentation of the nature and extent of those changes. Gage apparently wasn’t the same easy-going guy he’d been before the accident, but there is zero evidence (zero!) of the psychopathic, nonworking near-criminal usually portrayed.
And more importantly, my colleague Malcolm Macmillan and I have uncovered new evidence that even the moderate dysfunction seen in Gage immediately post-accident had to a large extent faded away — or he’d learned to compensate somehow — by the end of his life. See http://en.wikipedia.org/wiki/Phineas_Gage.
Matthew L. Lena (Boston)
But you can’t deny that he was hot! I am right about that!
More seriously, thank you very much for stopping by and commenting. In all my research about Gage I kept running into references to your colleague’s book, which I have not yet had a chance to read but would like to. Poor Phineas and the body of myth surrounding him are a real piece of Americana. Like the story of lobotomy, he makes us think seriously about the nature of the self. (And if it’s true that Phineas underwent some personality changes after the accident and then reverted to his pre-accident self, that’s particularly interesting to me as a lobotomy wonk: the exact same thing happened to some lobotomy patients.)
I thought the stuff about Gage’s personality changing didn’t come up until 1868, though, when Harlow published additional details about the case. That’s what I was referring to when I said there was no “contemporary” mention of any personality changes. Am I wrong about that?
Is there evidence that the personality change was due to the direct brain trauma? The prolonged pain associated with a severe injury could have done the trick on its own, couldn’t it?
eyeteeth: There were definite references to Gage’s mental changes relatively soon after his accident. Concluding his hasty writeup of Gage’s amazing physical recovery, Dr. Harlow wrote in late 1848, “The mental manifestations of the patient, I leave to a future communication. I think the case…is exceedingly interesting to the enlightened physiologist and intellectual philosopher” (whatever that last bit might mean!). And the American Phrenological Journal (13:89, 1851), “[T]hat there was no difference in his mental manifestations after the recovery, is not true. We have been informed by the best authority that [he is now] gross, profane, coarse, and vulgar, to such an extent that his society was intorable to decent society. Before his injury he was quiet and respectful…” (There is some reason to believe that Harlow himself wrote those words, or that they were written by someone in close communication with Harlow.) The issue isn’t so much that Harlow’s 1868 report (with the famous passage beginning, “He is fitful, irreverent, indulding at times in the grossest profanity…”) came eight years after Gage’s death — there’s every reason to believe what he reports is reliable, since he was apparently working from information gathered from people who knew Gage directly (including himself). It’s all the stuff written in the 100 years after that — nothing more than various people’s ideas of what they think Gage *should have* been like, based on the symptoms of other patients with frontal-lobe injuries — that is so ridiculously hyperbolic (someone even wrote that Gage molested children!).
Mr. Rosengart: The question of the extent to which Gage’s behavioral change was due to physiological insult to the brain, versus strictly psychological reaction to the incident (anger at the capitalist exploiters who had put him in harm’s way has been suggested, for example) is one I am not well qualified to address. However, the moderate changes we are on good grounds in believing *were* present in Gage (at least in his early post-accident years) are certainly consistent with the physiological effects possible after of frontal-lobe injury, so a physiological basis for those changes seems a warranted working assumption. (The mythical, exaggerated changes often described in Gage, such as alcohol abuse and failure to hold a job, are also seen in some frontal-lobe patients as well — it’s just there’s no evidence that Gage in particular ever manifested those more troubling behaviors.)
PS: I should have mentioned as well (for Mr. Rosengart) that in fact, Gage did not seem to suffer any chronic pain. Twice (1849 and 1868) Harlow specifically wrote that Gage told him he has “no pain in the head” (or anywhere else, presumably, since Phineas’ head would seem to be what we need to worry about).