Wednesday, 11 December 2013

The Hot and the Dead – Phineas Gage

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If it ever occurred to you to become famous for sticking an enormous great metal rod through your skull, I feel duty-bound to advise you against such an irresponsible course of action. I mean, it’s been done. Impaling your own head is so yesterday. You’d only be embarrassing yourself.

One of the great pioneers in the highly specialised field of Surviving Remarkable Head Injuries was Phineas Gage, who was a handsome but otherwise unremarkable American railroad worker and small explosives expert until fate stepped in with an almighty wallop.

While working as a foreman during the construction of the Rutland & Burlington Railroad in Vermont, part of 25-year-old Gage’s job involved blasting away rocks by drilling holes into them, then filling them with blasting powder. He had his own, custom-made tamping iron to poke everything into the hole properly, which he’d always done safely until September 13, 1848.

On that day, Gage’s big stick struck a spark and ignited the explosives, sending the 1.1 metre, 6kg piece of iron rocketing back towards his face, pointy end first. Having passed through his left cheek, it proceeded behind Phineas’ eye through his left frontal lobe, then out through his forehead with a rather untidy shattering of skull, before landing about 25 metres away. And there, a medical report stated, “this abrupt and intrusive visitor” was found “smeared with blood and brain”. *

So there, dear reader, you may assume we have reached the “dead” part of "The Hot and the Dead". Yet, in the case of Phineas Gage, we have only reached the “Hot and Everybody Thought He Should Be Dead But He Wasn’t For Quite Some Time, Much Later Than Expected Really” stage of his history. He not only survived the trauma, he went on to walk, talk, work and be relatively normal for twelve more years. Perhaps the part of his brain that was skewered was the part in charge of saying “Well bugger me, there’s a massive hole in my frontal lobe. I should probably die or something.”

Sure, he was a bit wobbly at first, but he managed to sit up during the ox-cart trip home and was able to speak to local doctor Edward Williams thirty minutes after the accident. Being stoic and chipper doesn’t always prevent disgusting things from happening, however, such as bleeding profusely and throwing up a little bit. As Dr Williams described, “the effort of vomiting pressed out about half a teacupful of the brain, which fell upon the floor.” **

There were good days (the ones when his brain tissue stayed inside his head) and bad days (the ones when he lost consciousness and his family bought him a coffin), but a couple of months post-cranial-perforation, Gage was more or less up and about, and insisting people call him “Your Holiness”.***

In 1852, four years after the head thing, Gage was well enough to return to work, and he became a stagecoach driver in Chile, a job he held for seven years. He returned to the US when his health began to decline, doing occasional farm work and living with his family. In 1860, 12 years after his accident, he began to have severe and increasingly frequent convulsions, which lead to his death in May of that year.

Now, I don’t want to go into too much detail about the physical or psychological impact of Gage’s accident, (because I prefer to concentrate only on a subject’s Hotness and Deadness, with a little bit of biographical filler in between), but it’s safe to say he is a remarkable case. Doctor John Harlow, who treated Phineas’ condition and studied him in great detail, described his condition 7 months after the incident thus:

His physical health is good, and I am inclined to say he has recovered. Has no pain in head, but says it has a queer feeling which he is not able to describe.

That’s not to say that Phineas didn’t attempt to describe how he felt. But “It’s that feeling you get after you’ve had an enormous length of solid metal pushed through your cranium at great speed, y’know?” fell too frequently on deaf ears.

There is some question about whether or not Gage’s personality was changed markedly as a result of his head-kebabbing. Reports exist of changes commensurate with frontal lobe damage, such as an inability to temper strong emotions and an increased penchant for profanity. Such reports have made him the darling of First Year Psychology lecturers for many decades. But time, and the effect of exaggeration on the coolness of a story, have made it almost impossible to determine how apparent Gage’s psychological strangeness was, if it existed at all. As far as verifiable evidence shows us, he behaved like someone who may have been miffed about having a substantial brain injury.

But enough of scientific speculation. Let’s talk about hotness. How many people do YOU know who’ve survived a pole through the face and still have swoony good looks? I bet it’s hardly ANY. But this guy. This guy does the dreamy/droopy thing enormously well, I think. Did it win him the hearts of suitable lovers? Hard to say. Little is known of any romantic engagements Gage may have had, but one can imagine any number of beddable companions, enchanted by his devastating good looks, captivating story and impressive pole, being turned away with the wave of a hand and a whispered, “Not tonight, dear. I have a headache.”

* Coincidentally, this is precisely the state in which cockroaches may be found at my house, shortly after I have performed the Get The Fucker Off My Toothbrush dance and done a weird squealy thing with my voice.

** Note to neurology patients: If your specialist isn’t referring to your brain tissue in terms of teacups, it might be wise to seek more professional advice.

*** This is just one of the many, many puns available regarding Phineas Gage and his Massive Rod. I have chosen to exercise considerable restraint here, because most of the puns are tasteless, insensitive or simply awful. And let’s face it, we need more bad puns like we need a hole in the oh never mind.


Shelley Stocken

Shelley Stocken is a freelance writer when she’s not feeding, clothing and wiping family members.

Follow her on twitter @shellity