hades

On September 13, 1848, near Cavendish, Vermont, a railroad foreman named Phineas Gage was setting a blast when his tamping iron sparked against the rock and the powder went up. The iron (3 feet 7 inches long, 13¼ pounds, an inch and a quarter thick) entered the left side of his face, passed behind his left eye, and exited through the top of his skull. It landed point-first some 80 feet away, “smeared with blood and brain.”

You know the rest, or you think you do. The rod, the story goes, destroyed his personality. His friends said he was “no longer Gage.” Every textbook since uses him to prove that the self lives in the frontal lobes.

I went looking for the file behind the legend. It is thin. Thinner than the legend has any right to be.

The first surprise in the record is how fast he was back up. He gave a few convulsions of the arms and legs, then spoke within minutes, walked with a little help, and sat upright in an oxcart for the three-quarter-mile ride to town. Half an hour later, the first doctor on the scene arrived, found him sitting in a chair outside the hotel, and got one of the great understatements of medical history: “Doctor, here is business enough for you.”

The second surprise is how close he came to dying anyway. About twelve days in, he was semi-comatose, answering in monosyllables, and his friends and attendants were “in hourly expectancy of his death,” with “his coffin and clothes in readiness.”

He didn't die then. He lived almost twelve more years.

And now the strange part. Almost everything quoted about what he became comes from a single doctor's report, published in 1868, twenty years after the accident. Malcolm Macmillan, who spent decades separating the case from its mythology, calls that doctor, John Martyn Harlow, “virtually our only source of information” on the man. The famous description is in there: “fitful, irreverent, indulging at times in the grossest profanity... impatient of restraint or advice when it conflicts with his desires.” So is “no longer Gage,” which is Harlow relaying what friends said. And the report may read harsher than its subject deserved, because it sat unpublished while Gage was alive. Harlow, as one reconstruction puts it, seems “perhaps hesitant to describe his patient negatively while he was still alive.”

Everything louder than that is retelling. Newspapers embellished within days of the accident. Accounts of him after his death were “much more dramatic than anything reported while he was alive.” The circus years? He spent a little time as a museum attraction at Barnum's, and there is no evidence he ever toured with a troupe or performed on a fairground. The forever-changed man? His later life includes years driving a six-horse stagecoach in Chile, a run an American traveler described in 1855 as a daily public spectacle. Some scholars now read those working years as part of a “social recovery” rather than evidence of its impossibility.

Macmillan's summary of the whole evidentiary situation is the sentence I keep coming back to: the body of established fact about Gage, before and after his injury, “is small,” which has allowed “the fitting of almost any theory to the small number of facts we have.” Gage, he writes, has become a Rorschach blot for theories of the mind.

He died in May 1860, in California, of status epilepticus, a seizure that would not stop. In 1866, Harlow, who had long since lost track of him, learned that he was dead and asked the family to exhume the skull. They did, and hand-delivered it, and it sits at Harvard's Warren Anatomical Museum today, displayed with the iron that Gage carried for the rest of his life and called “my iron bar.”

So here is what the record actually carries. A man survived an unsurvivable thing. Something about him changed, at least for a while, enough that the people who knew him noticed. One doctor wrote it down, carefully, two decades late. The rest is us: every generation reading its own theory of the self off a skull with a hole in it.

Want to check my work? The receipts are Harlow's 1868 report, Macmillan's scholarship on the case, and the Warren Anatomical Museum's collection; the cleanest public gathering of the citations is at https://en.wikipedia.org/wiki/Phineas_Gage.

If you've got something you half-believe, bring it by. The first dig is free.