Neuroscience’s Most Famous Patient

The story of Phineas Gage himself would be fascinating enough without the century-and-a-half of mythology and obsession that have flourished around the tale of this 19th century railroad foremen whose skull was impaled by an iron rod at the speed of a bullet, and lived for almost a dozen years afterward. Slate has an engrossing account of Gage and the inquiries and theories that have proliferated across various scientific communities ever since.

One of the most interesting aspects of the latest scientific conclusions about Gage’s accident and ultimate recovery is that because the injuries were sustained in the pre-frontal cortex rather than the limbic brain, where the amygdala resides, Gage was for all intents and purposes entirely functional. This astonished the medical profession at the time, and for more than a century thereafter.

For those of us familiar with the most recent scientific inquiry into the emotional brain, however, it isn’t all that surprising. As we reveal in The 7 Triggers to Yes, injuries sustained to the limbic brain render subjects utterly incapable of making even the most rudimentary decisions. Many basic daily functions are compromised under such conditions. Injuries to outer portions of the brain, on the other hand, may be responsible for many other types of afflictions, including sometimes severe personality changes, but basic functional behavior is often unaffected.

If he wasn’t the first, Phineas Gage was at least the most celebrated example of the human brain’s capacity for plasticity and recovery – as long as the trauma doesn’t impact the emotional centers.