THE ROUGH GUIDE TO PSYCHOLOGYLEARNING FROM WHEN THINGS GO WRONG
Research with brain-damaged patients uses a kind of reverse engi-
neering approach, in which the functional role of a brain area is inferred
from what happens to a person when that area has been damaged. In
the nineteenth century this generally involved observing changes to a
patient’s behaviour and then, after they died, looking to see which part
of the brain had been damaged. One of the most famous case studies in
neuropsychology is that of Phineas Gage, a railway worker whose person-
ality changed after an accident sent a tamping iron straight through the
front of his brain (see box below). Today we don’t have to wait until a
patient has died to find out which part of their brain is damaged because
The truth about Phineas Gage
Phineas Gage, the nineteenth-century railway worker who survived
after his frontal lobes were shot clean through by a tamping iron, is
one of psychology’s most famous case studies, with his story having
become something of a popular legend. Films, plays, poems, even
Youtube sketches, have all been inspired by this tale about a man
whose personality was supposedly changed forever by his brain
damage.
Before the accident, so the story goes, Gage was a hard-working,
popular, friendly man, but post-injury he transformed into an aimless,
disinhibited, aggressive bully. The case of Phineas Gage is generally
used by textbooks and authors to demonstrate the localization of
specific behaviours and personality traits to the frontal lobes, and the
apparent permanence of changes brought about by damage to those
lobes. In recent years, however, the historian Malcolm Macmillan has
exposed just how little evidence Gage’s story is based on. For example,
no autopsy was performed on Gage and by the time his body was
exhumed, nothing was left of his brain.
Macmillan has also uncovered evidence that casts doubt on the
version of the Gage story as it is popularly told. Far from his injury
permanently changing him into an aggressive waster, Macmillan says
that Gage worked for several years post-injury as a stagecoach driver –
a demanding job that would have required intact social and cognitive
skills. Two recently discovered photographs of Gage appear to support
Macmillan’s arguments. Gage is seen as a smartly dressed, proud and
handsome man holding the tamping iron that made him famous.
Macmillan says his revised account of the Gage story fits with modern
evidence showing the possibilities of rehabilitation even after serious
long-standing brain injury.