What happened next for famous brain injury patient Phineas Gage

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A newly discovered daguerreotype of Phineas Gage, the only image of the man known to exist, recalls one of the most bizarre incidents in railroading and neurological history. (Today’s story: ‘A piercing image of Phineas Gage.’)

Gage was the foreman of a construction crew laying a railroad roadbed in 1848, using powder to blast rock. As he was packing powder and sand into a hole in rock, the powder detonated, sending the 13-pound tamper into his cheek and out of the top of his head. It landed 25 to 30 yards behind him.

Surprisingly, Gage was unconscious only momentarily, if at all, though most of the front of the left side of his brain was destroyed. He made a full physical recovery over the following 10 weeks, but his personality was irreversibly altered. Whereas he had once been an intelligent and even-tempered worker, he had overnight become irreverent, grossly profane, obstinate, capricious and ill-tempered. His friends said he was ‘no longer Gage.’

Gage’s case influenced 19th century thinking about the localization of functions in the brain and was perhaps the first to tie specific behavioral attributes to localized areas of the brain. His case has subsequently been the subject of many books and scholarly papers. Some authors have stated that his experience provided insights into brain surgery, but most authors now agree that the only conclusive fact to arise from it was that surgery could be performed on the brain without being inevitably lethal.


Gage was never able to resume his job on the railroad. He spent some time at P.T. Barnum’s American Museum in New York City, where patrons apparently paid to see him, and made appearances in several large cities in New England. He later found work in a livery, eventually moving to Chile to pursue this occupation. In 1859, feeling unwell, he returned to the United States to live with his mother and sister. In February 1860, he began to suffer a series of increasingly severe convulsions, and he died in May of that year.

-- Thomas H. Maugh II