Phineas Gage

A person’s cognition is a very important function making a person what and who the person is; it is responsible for how the individual functions, and how the person reacts to their environment. A person’s cognition makes up different parts of the person’s brain in order to work together allowing the individual to function properly.  Damage to one of these parts of the brain can disrupt a person’s functioning and how the person acts or reacts to their world. The following presentation will cover Phineas Gage who underwent an accident at a railroad yard where a steel rod shot through his skull. The presentation will talk about the accident, the behaviors of Gage before and after the accident, any deficits that resulted, and the treatments that Gage had available or went through.  Finally, this presentation will explain why the accident Gage had was so important in the study and understanding of how a person’s brain works and functions.

Phineas Gage was a well-liked and respected railroad foreman in 1848 when an explosion at work caused an accident.  The result was that Gage ended up with a steel rod that shot through his left cheek, through his frontal lobe and out of the top of his skull (Hernandez, 2008).  What should have probably killed Gage didn’t and he survived the accident as well as made a full recovery a year later. Despite the extensive damage to the brain Gage managed to only lose the sight in his left damaged eye (Macmillian, 2000). The doctor who treated Gage after the accident believed that Gage had no hope for survival in the following days despite Gage being very alert and lively during treatment.  Gage made a strong enough recovery not long after the accident and was sent home from the hospital in order to continue recovering under the care of his family and a physician. Within a year Gage was fully recovered according to his doctor and was able to return back to work despite the protests of others that knew Gage and believed he wasn’t fully recovered.  According to those that knew Gage they believed he was suffering behavioral issues and because of this he was not fully recovered from the accident (MacMillian, 2000).

Before the accident Gage was well-liked as well as respected as a businessman and foreman of the railroad.  Afterwards however he changes becoming more obstinate, impatient, some described him as grossly disrespectful, and disturbed (Hernandez, 2008). Gage’s damage to his brain was in the cerebrum which is made of for different lobes or areas.  Each of the lobes of the cerebrum has different cognitive functions which it is responsible for like a person’s problem solving, learning, or speaking; and in the case of Gage the frontal lobe was responsible for personality and emotions (CNBC, 2009).  After the accident Gage changed from the well liked and loving man that he was into a completely different person, which was quickly apparent to family and friends that knew Gage prior to the accident.  These individuals described Gage as another person with a new personality, mindset, and completely different behaviors then he had prior to the accident and it was a dramatic change from what he was before (MacMillian, 2000).

Gage was a completely different person following the accident, using profanity tremendously in speaking with other people, he’d lost is patience and would become impatient quite easily, he was very obstinate, prone to throwing fits, was impertinent, and did not take advice from others (MacMillian, 2000). Individuals would describe his behavior and his personality as childlike in both capacity and manifestations.  Before the accident Gage was extremely professional and well-respected, liked by his workers, family, friends, and would never use profanity or speak mean to any individual.  Following his accident Gage was completely different with the way that he treated people. Gage became quick to anger and temper, had tantrums when he didn’t get what he wanted, and Gage began to use profanity constantly.

In the study of cognitive psychology it entails the cognitive and mental states of a person as it applies to the person’s acquisition of as well as use of language, memory, perception, learning, decision making, and attention (Willingham, 2007). A person’s cognitive function is a process of intellectual aspects within a person which allows the person to do things like perceiving, learning, remembering, and reasoning.  Individuals are able to have ideas, comprehend things, and be aware of themselves as well as the environment and people that surround the individual.  Cognitive functioning is a critical part of a person’s existence as this allows the person to perform all the mentioned functions like thinking, speaking, or reasoning which are needed in the person’s life daily.  Excluding some cases people are able to grow, develop, and learn new ideas through cognitive functions where the person’s brain plays a critical role (Willingham, 2007).  Cognitive functions can become impaired or damaged as a result of a significant injury to the person’s brain.

Gage’s doctor stated that at a checkup four weeks after the accident Gage had the ability to recall events from the accident but when it came to times and dates he had trouble (Harlow, 1999). Gage also had issues when it came to money, dimensions, and displayed changes which could have been the result of the damage he suffered cognitively. MacMillan (2000), stated that Gage would have had several obstacles that he would have to overcome as a result of the accident including infection to the wound, confusion, epilepsy, and he developed ptosis in his damaged eye and ended up losing his vision in it. When Gage’s behavioral problems became known and issues from it arose Gage was fired from his job and couldn’t come back to it.  Gage was fortunate to survive the accident which could have claimed his life easily and was able to regain communication and motor coordination.  This was in despite of the personality and behavioral changes that Gage underwent following the accident. Another result of Gage’s accident came in the form of epilepsy which lead to Gage’s death from epileptics (MacMillan, 2000).

When it came to the treatment of Gage following the accident, there was only limited capabilities available from doctors and what they were able to do for him. Gage’s doctor reported that he treated Gage in a hotel room daily to remove blood clots from the brain area, as well as brain fragments and skull fragments around the exit would (Grieve, 2010). Gage’s doctor reported that the procedure to close the wound was done without medicine or sanitation efforts.  The doctor described probing the wound and cavity of Gage’s head without using gloves on his hands and when he was done he used adhesive strips and a nightcap in order to close the wound (Grieve, 2010). The doctor used simple dressings on the wounds that Gage suffered on his hands, arms, and face.  This was all that was done treatment wise for Gage.  In the end Gage developed an infection, suffering from epilepsy after the accident, and died (Grieve, 2010). 

Gage’s head injury was devastating to Gage but resulted in good as the resulting case lead to studies on the functionality of the prefrontal cortex.  Neylan (1999), stated that in the case of Gage it was the most influential case as it allowed for understanding and knowledge that a person’s behavior is lined to the brain and different structures within the brain. Researchers took and used Gage’s skull in a CT to reconstruct how the damage would have been done to Gage’s brain and skull.  The CT spatially aligned the skull fragments which were disarticulated by the rod (Van Horn, Irimir, Torgerson, Chambers, Kikinis, & Toga, 2012). This study allowed researchers to recreate how the steel rod likely went into Gage’s face and brain being able to digitally impose the rod’s entrance and exit.  With that information the researchers could digitally recreate the path of the rod through Gage’s brain and be able to identify the areas that would have been impacted by the rod and where damage in the brain would have occurred as a result of the rod (Van Horn, et. al., 2012). 

The injury that Gage suffered and the resulting changes that happened behaviorally to Gage led to discoveries about the links cognitively between a person’s brain, behavioral syndromes, and different areas of the brain and lobes being responsible for different functions as well as what damage to the lobes would do to the functions (Neylan, 1999). Gage’s injury allowed for understanding and insight into how a person’s brain functions and what happens when the brain is injured or damaged in some way. MacMillan (2000), states that Gage’s injury was a craniocerebral injury encompassing both an enter and exit opening in an single brain parenchyma area.  This is described as a very serious injury to the head as skull fragments are propelled into a person’s brain and can increase the amount of damage that is done to the brain matter as well as making surgery very difficult even by today’s standards.

A person’s cognition is a very important function making a person what and who the person is; it is responsible for how the individual functions, and how the person reacts to their environment. Phineas Gage was a well-liked and respected railroad foreman in 1848 when an explosion at work caused an accident.  The result was that Gage ended up with a steel rod that shot through his left cheek, through his frontal lobe and out of the top of his skull (Hernandez, 2008).  Gage’s damage to his brain was in the cerebrum which is made of for different lobes or areas.  Each of the lobes of the cerebrum has different cognitive functions which it is responsible for like a person’s problem solving, learning, or speaking; and in the case of Gage the frontal lobe was responsible for personality and emotions (CNBC, 2009).  Following his accident Gage was completely different with the way that he treated people. Gage became quick to anger and temper, had tantrums when he didn’t get what he wanted, and Gage began to use profanity constantly. Gage’s doctor stated that at a checkup four weeks after the accident Gage had the ability to recall events from the accident but when it came to times and dates he had trouble (Harlow, 1999). When it came to the treatment of Gage following the accident, there was only limited capabilities available from doctors and what they were able to do for him. Neylan (1999), stated that in the case of Gage it was the most influential case as it allowed for understanding and knowledge that a person’s behavior is lined to the brain and different structures within the brain.

Reference

CNBC. (2009). Center for the neural basis of cognition: integrating the sciences of mind and brain. Retrieved from http://www.cnbc.cmu.edu/research

Grieve, A. W. (2010). Phineas P Gage -- 'The man with the Iron bar'. Trauma, 12(3), 171-174

 Harlow, J.M. (1999, Spring). Passage of an iron rod through the head. The Journal of Neuropsychiatry and Clinical Neurosciences, 11(2), 281-283

Hernandez, C. (2008). Phineas Gage. Retrieved from http://www.associatedcontent.com/article/831073/phineas_gage_pg3.html?cat=4

Macmillan, M. (2000). Nineteenth-century inhibitory theories of thinking: Bain, Ferrier, Freud (and Phineas Gage). History Of Psychology, 3(3), 187-217. doi:10.1037/1093-4510.3.3.187

Neylan, T.C. (1999, Spring). Frontal lobe function: Mr. Phineas Gage's famous injury. The Journal of Neuropsychiatry and Clinical Neurosciences, 11(2)

Twomey, S. (2010). Finding Phineas. Smithsonian, 40(10), 8.

Van Horn, J., Irimia, A., Torgerson, C., Chambers, M., Kikinis, R., & Toga, A. (2012). Mapping connectivity damage in the case of Phineas Gage. Plos One, 7(5), e37454. doi:10.1371/journal.pone.0037454

Willingham, D. T. (2007). Cognition: The thinking animal (3rd ed.). Upper Saddle River, NJ: