Newly discovered image offers fresh insights about medical miracle, or Phineas Gage was hot
For a century and a half, the saga of Phineas Gage has captivated brain researchers, psychology students, even buskers, their lugubrious odes memorializing the railroad man whose brain was pierced by an iron bar.
Gage lived to tell his story, heralded as a scientific curiosity by Boston doctors and the thrill-seeking hoi polloi of the day. He became a central figure in medical folklore, a mainstay in textbooks as one of the earliest case studies of brain injury and its influence on personality.
Time, though, has not been kind to old Phineas, his skull peering from behind glass at Harvard’s medical school. Modern writers have imagined him as mangled and morose, a once-reliable Vermont laborer transformed by the grotesqueness of his injuries into a profanity-spewing stranger.
But a photo made widely public last week - believed to be the only known image of Gage - casts the legend in a distinctly different light. It depicts Gage - holding the tamping iron that rocketed through his skull - as a man assured, maybe even rakish. He appears strikingly handsome, almost contemporary, with a stylish haircut that falls neatly above the ears.
Only his left eye, closed and slightly protruding, and a snaking scar on his forehead betray the trauma perpetrated by the tamping iron.
Still, as with all things Gage, the photo, published in the Journal of the History of the Neurosciences, also deepens the mystique that enshrouds the man.
“He’s a medical miracle. When you see the real tamping iron alongside the skull, it beggars belief that anyone could have survived,’’ declared Malcolm Macmillan, the Australian psychologist who wrote an authoritative examination of Gage.
“But we still want to know what was he really like after the accident. If anybody has a great-, great-, great-grandfather’s diary up in the attic with the secrets of Phineas, I would be very pleased to hear from them.’’
Gage was a 25-year-old foreman, fit and well-regarded, as his crew dug a railroad bed near Cavendish, Vt. Late on the afternoon of Sept. 13, 1848, he wielded a specially made iron - it measured 3 feet 7 inches long and weighed 13 pounds - to pack blasting powder into rock.
An explosion erupted.
“And we think the tamping iron went all the way through the skull - like a missile,’’ said Dr. Ion-Florin Talos, a researcher at Brigham and Women’s Hospital.
Talos and Dr. Peter Ratiu took sophisticated medical scans of Gage’s skull and the tamping iron to create a three-dimensional computer model. It showed the tool entering beneath Gage’s left cheekbone before passing through the brain’s left frontal lobe and exiting the left side of his head.
The researchers concluded that as the tapered end of the tamping iron burrowed into Gage’s head, it caused the left side of his face and forehead to hinge outward. Gage’s face snapped back into place as the bar departed, landing about 25 yards away.
Remarkably, the tamping iron missed crucial vessels in Gage’s head and spared brain regions that regulate functions necessary for survival.
“It’s kind of a wonder,’’ Talos said, “and wonders are always fascinating.’’
After the accident, Gage, still conscious, was ferried by ox cart to an inn. Sitting on the veranda, Gage exhibited remarkable lucidity, tinged by humor, telling one doctor, “Here is business enough for you.’’
A little more than a year later, Gage was paraded through Harvard, examined by faculty who, until they met him, were incredulous that anyone could withstand such an injury.
As their doubts faded, they poured plaster to create a life mask of Gage’s head that remains, along with the skull and tamping iron, on display at the Warren Anatomical Museum inside the medical school’s library.
Gage later reportedly traveled to Chile, where he drove a heavily laden stagecoach. He died in 1860 in California - where he’d gone to live with family - after suffering seizures.
“The thing I always find remarkable,’’ said museum curator Dominic W. Hall, “is that the medical community, the history of science community, even popular society are still very much intrigued by Gage.’’
The case generated such acclaim that the physician who tended Gage’s wounds, Dr. John Harlow, recounted the story in two medical journals, 20 years apart. He provides a glimpse of his famous patient’s personality after the injury - a description that has fueled myth-making.
According to Harlow, Gage, after the accident was “fitful, irreverent, indulging at times in the grossest profanity, (which was not previously his custom).’’ And, in a declamation that has become an idiomatic shorthand for the horrors of brain trauma, Harlow reports that friends concluded, “Gage was no longer Gage.’’
“But,’’ Macmillan said, “that must have been, I believe, for only the two, three, four years after the accident.’’ Gage’s ability to travel to Chile and preside over a stagecoach, Macmillan and other students of Gage argue, suggests time and labor helped restore his faculties.
Still, much about Gage exists in the realm of supposition. That is why Macmillan was so staggered in April when he received an e-mail from a Maryland couple, Jack and Beverly Wilgus.
They were writing to tell the psychology professor that they possessed what they believed was a photograph of Gage. “I could hardly believe it,’’ Macmillan said.
The Wilguses - he’s a photography professor, she’s a retired web designer - had owned the photo for at least three decades. It was a favorite in their collection of photos known as daguerreotypes, created through a stunningly elaborate picture-making process used in the United States in the 1840s and ’50s.
“He’s got a certain presence about him,’’ Jack Wilgus said.
But no one knew, exactly, who he was. The Wilguses theorized that the instrument the man is shown holding was a harpoon and that he was an injured whaler. Beverly Wilgus decided to post the photo in 2007 on the picture sharing website Flickr.
Viewers told them that was no harpoon.
A year later, someone wrote suggesting the photo might be Gage.
“I went to Google and did a search for Phineas Gage,’’ Beverly Wilgus said. “It was like, ‘Where has this person been all our lives?’ ’’
With the help of Macmillan in Australia, and Hall, the museum curator in Boston, they compared the facial structure in the picture with the plaster mask, overlaying one image upon the other. A close examination of the instrument clutched by the man showed an inscription matching the engraving on the tamping iron, which reads in part, “This is the bar that was shot through the head of Mr. Phineas P. Gage.’’
The Brigham’s Talos and Macmillan said they also believed the photo was authentic and, quite probably, an image of Gage. “I’m 99.9999 percent convinced that it is - to use an Australian expression - fair dinkum,’’ Macmillan said. “That means absolutely genuine, true.’’
The discovery, the Wilguses said, represents the confluence of technologies that were all the rage for their times: daguerreotypes in the mid-19th century and the Internet in the early 21st century.
It also allows the couple - at long last - to better understand the beguiling man whose image beamed at them from a specially built glass case.
“He’s been living with us for a long time as one of our favorite daguerreotypes,’’ Jack Wilgus said. “So it’s like finding a relative you liked all this time and finding out who he really is.’
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When I saw this in vintagephoto, I could not resist posting it here. There is not a psychology student in the world who won't stop and make a thoughtful noise at this.