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Phineas Gage: Historic Brain Injury Patient


Today, it is well known how strong the relationship is between someone’s brain and someone’s cognitive abilities (memory, decision-making, personality, etc.). This relationship is so apparent today that it almost feels silly to even question it. Its obviousness is evident when we consider traumatic brain injury and the devastating effects it has.

The ill effects of brain injury have not always been so obvious. A story from the LA Times reminds us of this. On July 16, 2009, they released news that a newly discovered daguerreotype, out-dated photographic image, was discovered of Phineas Gage, an early and well documented brain injury patient.

There is a plethora of knowledge about the brain that has been discovered in the past century. During the time of Gage’s life (mid 19th century), very little was actually known or understood about the relationship between the mind and brain. Many scholars were not even convinced that the brain had all that much to do with cognitive abilities, much less personality. Gage’s traumatic brain injury as well as the documentation of its effects highly influenced the way we understand the brain psychologically and physiologically.

Gage’s Brain Injury
In 1848, Gage found himself working as the foreman of a construction crew that was laying a railroad bed. While using powder to blast rock, an incident occurred where a charge unexpectedly went off sending a 13-pound tamper into Gage’s cheek and out of the top of his head landing 25 to 30 yards behind him. It is extremely surprising that Gage survived this incident even with the substantial brain damage he incurred. It was reported that he was only momentarily unconscious, however, he suffered brain injury that included the removal of most of the front of the left side of his brain.

Impact of Gage’s Story on Brain Injury Cases
The impact of Gage’s story of brain injury doesn’t come from the fact that he survived, rather, it comes from the ill effects that occurred after the incident. After a 10 week recovery, many of those close to Gage noticed a dramatic change in his personality. Where he was once thoughtful and reserved, he was now dim and vulgar. Many of his friends described him as “no longer Gage.”

The impairment of this brain injury was not limited to his personality. Gage no longer possessed the mental fortitude to continue working as a foremen from this brain damage. This case is one of the first, well-documented, studies of localized functioning in the brain. While science was able to benefit from the impact of Gage’s story, the legal aspects of brain damage were as well.

Before, legal accountability for workers’ injuries did not give special treatment to brain injury. The impact of stories such as Gage’s served to influence how we understand the devastating impact of brain damage in impairing an individual both physically and mentally. This led to the development of lawyers specializing in traumatic brain injury serving those who suffer brain damage as brain injury lawyers.

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