Brain Injury and Phineas Gage

Phineas Gage worked for the railroad at the end of the 19th century.  His job was to fill holes with blasting material to allow the railroad to blast out material to level its new rail bed.  He did this by using a five or six foot rod to tamp the explosives into the hole.  Phineas was described as a model employee, kind, courteous and a good family man.  One day, while tamping down the explosives, the material exploded.  This shot the tamping rod out of Phineas’ hands upward through his skull.  Looking that the pictures you can see that the rod entered Phineas’ face just below the eye, and shot through his skull, brain and all, and out the top of his skull.  Although Phineas lost his eye, the rod did not kill him.  Amazingly, the rod going through his head did not even cause him to lose consciousness.

Phineas Gage suffered a severe brain injury in a time when physicians’ knowledge of neurology, and how the brain works was in its infancy.  This construction accident would have far reaching impact on what we now know about injury of the brain, both physical and psychological.  Phineas eventually recovered physically recovered from the event.  However, his family began to notice almost immediately that Phineas was a changed man.  He began to cuss like a sailor.  He started drinking like the stills were going to run out.  He lost interest in what, before the construction accident, made him happy.  He started to make mistakes at work.  He started to miss work and eventually lost his job.

Scientists studying Phineas’ case came to realize that an injury to the brain has adverse consequences far beyond simply the physical injury.  They began to realize that an injury to the brain causes changes in cognitive function (how we think), in personality, in control, and in many other functions that we take for granted.  It turns out that the rod injured Phineas’ frontal lobe.  This is the part of the brain that controls our cognitive ability known as executive function. (Executive function is similar to RAM memory in a computer, it is what lets us do many different things at the same time).  Pineas’ injury impaired his ability to do many things at the same time and thus interfered with his ability to do his job.

The frontal lobe also controls disinhibition.  This is what stops us from doing socially inappropriate things such as cussing inappropriately.  Phineas’ brain injury interfered with his disinhibition and he began to act socially inappropriately.  We have learned that some brain injury enhances underlying personality traits.  Phineas reportedly drank socially prior to the construction accident, but after he could not control his drinking.  This may well be caused by enhancement of this personality trait combined with impaired disinhibition.

Brain injury can be caused by  car accidents, highway accidents, truck accidents, slip and fall, motorcycle accidents and the drunk driver.  John P. Young is a former member of the Board of Directors of the Brain Injury Association of Indiana, serving as its Chair for two years.  Mr. Young has twenty years of experience helping Hoosiers and their families deal with brain injury.  Call him and let him help you and your family.

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