On September 13, 1848, a young railway foreman named Phineas Gage was supervising the blasting of a cutting to clear the way for the new Rutland and Burlington Railroad near Cavendish, Vermont.

He was about to become the most famous man in the history of neuroscience – for all the wrong reasons.

Gage was using a tamping rod to pack explosive powder into a hole. The iron bar he was using was a metre long and weighed six kilograms.

He was momentarily distracted by workers behind him dumping a load of rock into a cart. As he looked over his right shoulder, Gage thrust the bar downwards. It struck rock, and a spark detonated the dynamite.

The explosion drove the tamping iron out of the hole and straight through Gage’s head. It blew out of the top of his skull and landed eighty feet away.

As the smoke cleared, there was an eerie silence.

Gage’s legs kicked, convulsively. And then, to the utter astonishment of his crew, he sat up. Though blinded in his left eye, he hadn’t even lost consciousness.

He was helped to his feet and walked to a nearby oxcart. He sat upright for the ride to his lodgings in town. A doctor, Edward Williams, was called. He found Gage sitting in a chair outside the hotel.

Gage’s first words were one of the great understatements in medical history.

“Well doctor,” Gage said, “here is business enough for you.”

Gage was dripping with blood but merely complained of feeling a little unwell. When the doctor examined the wound, he could see Gage’s brain pulsating. Gage started to explain to bystanders what had happened, then doubled over and retched. The effort squeezed another piece of his brain out of the wound and onto the ground.

Luckily for Gage, a physician called John Harlow was in town and came to lend assistance. Harlow was a graduate of the Jefferson Medical College in Philadelphia and had considerable experience in treating cerebral abscesses. Few doctors at the time had such experience – without Harlow, Gage would certainly have died.

the Cavendish cutting photo: Daniel G. Axtell

That evening Gage fell into a coma. For two weeks he fought for his life; the outlook appeared so grim that his family even ordered a coffin. But thanks to Harlow, he survived, and despite losing an eye, in January of 1849 he was well enough to go home to his parents’ home in New Hampshire to recuperate.

His physical health returned surprisingly quickly. Yet all was not well with Gage.

Before the accident, Gage was hardworking, efficient and easy-going. After the accident he was a different man. According to Harlow: “A child in his intellectual capacity and manifestations, he has the animal passions of a strong man…. his mind was radically changed, so decidedly that his friends and acquaintances said he was ‘no longer Gage.’ “

He became capricious, reckless and prone to shouting profanities that shocked and alienated those around him. The railroad company that had previously employed him, and which had previously thought him a model foreman, refused to take him back. Falling back on his farm skills he found work looking after stables near his home in New Hampshire.

He didn’t know it, but he was about to become a landmark in medical science. Before Gage, the brain’s inner workings were largely a mystery. Phrenologists thought someone’s personality could be measured by the bumps on their skull.

But Gage’s extraordinary story demonstrated that the functioning of the brain was compartmentalized. As neurologists now know, a person’s decision-making and social skills are largely dependent upon the frontal lobes, the same part of Gage’s brain that had been destroyed by the iron rod.

But there was another, even more astonishing, lesson to be learned. Because what is sometimes overlooked in the telling of Gage’s story is that his personality change was not permanent.

In 1852, Gage found employment as a long-distance stagecoach driver in Chile. A day’s work meant a 13-hour journey over 100 miles of poor roads, often in times of political instability and in a land whose language and customs Gage was a stranger to.

The job required that drivers “be reliable, resourceful, and possess great endurance. But above all, they had to have the kind of personality that enabled them to get on well with their passengers.”

In other words, Gage must have reverted to the kind of man he was before the accident. His brain had repaired itself. Today that phenomenon has a name; it is called neuroplasticity.

But what does Gage’s story mean? The segmentation of the brain was a revolutionary discovery back then. Is it relevant to readers and writers like us?

In fact, it is. We have since learned that in the cerebral cortex there is something called the right supramarginal gyrus. It controls empathy. Neuroscientists can even put electrodes on our heads and see it light up when stimulated with certain images (a child crying, for example.)

In psychopaths, it doesn’t light up at all.

How do you train this part of your brain to function better?

The best way – read stories. Fiction offers something unavailable to most of us – the opportunity to see and feel life through someone else’s eyes.

Raymond Mar, a psychologist at York University in Canada, recently published two studies that showed that fiction readers easily outperformed non-readers and nonfiction readers on tests of empathy.

But back to Gage. What happened to him? Unfortunately there are limits to how well the brain can repair itself.

He lived for a dozen years after his accident but then his health began to deteriorate. He moved back to San Francisco where his mother nursed him for his final few months. After suffering a series of epileptic seizures, Gage died on May 20, 1860, almost 13 years after his accident.

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  1. Those of us who live in Vermont are familiar with a basic version of Gage’s story. What we normally hear is a shortened version, ending with his physical recovery but early death 12 years later, the assumption being that he never really recovered. We know that his personality changed with the accident because of the impact that had on the science of the brain. What we don’t hear is of his personality rebounding and amazing second career as a coach driver in Chile, for which he appears to have been personally recruited. This elevates his story from a mere curiosity to a tale of endurance and strength of will. Thank you for digging deeper and letting us know the whole story.

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