The Man With a Hole in His Brain

Back in 1848 in the North-Eastern United States,
there was an ordinary young man who had a pretty extraordinary accident. You may have heard of Phineas Gage, the railway
foreman who had a one metre iron rod blasted through his skull—and survived. It’s pretty
graphic, think bits of skull and brains bursting out of his head. This is my friend Anna from Gross Science,
who’s going to take you through the gory details. Part of Gage’s work constructing railroads
was to sprinkle dynamite into blasting holes. One afternoon, he accidentally stamped the
iron rod into a hole filled with dynamite… And it blasted off. Into his head. It tore through his left cheekbone, passed
behind his left eye, through his frontal lobe, out the top of his head and landed almost
8 metres away. Medical records suggest he was conscious the
entire time—he went and saw a physician who stuck his fingers in either side of the
wound to pick out pieces of skull and loose brains. But it wasn’t so clear cut. His brain developed
a fungal infection and the physician punctured tissue inside of Gage’s nose to drain the
wound. Okay, enough of you— Miraculously, Gage survived this massive head
injury and he appeared normal. He could still talk, walk and function as he did before. But those who knew him said “Gage was no longer
Gage,” he was rude and impatient. The rod had penetrated his frontal lobes, responsible
for higher mental functions like social behaviour and planning, and Gage could have had what
we now know as frontal lobe disorder. Although we don’t have a lot of evidence about
Gage’s story – only a few doctor’s reports are published in medical journals. Some say
his behavioural changes are grossly exaggerated. But those medical reports did contribute to
modern neurology. They supported emerging theories that our cerebral functions were
localised and that certain conditions could be linked to brain damage. More recent studies
in people with brain lesions suggest the orbital frontal lobe, part of Gage’s brain that was
damaged, is super important in decision making. And in 2012, researchers reconstructed scans
of Gage’s 189 year old skull to show that most damage was to his frontal lobe. But the
passage of the rod would have interrupted the connectivity of many different brain areas,
making Gage’s behaviour changes similar to those suffering from Alzheimer’s Disease. Brain injuries don’t just come from trauma,
they can also be caused by a disease. Check out Gross Science where Anna explains how
the herpes virus can hide in your neurons—and what happens next. And if you don’t already, subscribe to BrainCraft,
for a new brainy episode, that’s not entirely gross, every Thursday.

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