1848, Vermont, USA, railroad worker Phineas Gage was tamping an explosive charge into a pre-drilled hole in a granite rock face in order to blast a cutting for the Rutland & Burlington Railroad. Sparks from his tamping iron set off the explosive charge, firing the 13lb iron bar clean through his skull, taking out what we would now call his pre-frontal cortex.
Phineas Gage survived the accident to become an instant medical celebrity. When distinguished Harvard physicians came to study him, they were amazed to discover that he appeared to have suffered no mental impairment whatsoever. Except one. He was no longer able to behave in a socially appropriate way. He’d have sudden fits of rage characterised by the use of what the visiting Harvard physicians called ‘grossest profanity’. And that, say the textbooks brightly, is how we know that the pre-frontal cortex is the bit of the brain responsible for self-control, and for mediating socially appropriate behaviour.
But nobody’s looking at this from Phineas Gage’s point of view! If I was him, I’d be saying:
I’ve been listening to all you eminent physicians puzzling over what could possibly be causing my wild mood swings, and my regrettable slide into the use of gross profanity, and you know what’s just crossed my mind? An iron fucking bar. Now if a man cannot cuss when four feet of metal rod shish-kebabs his brain, when can he cuss? Trust me, when this happens to you, tarnation is not the word you are looking for. A darn won’t do you now. This is no Jumping Jehosaphat type of situ-fucking-ation. I nearly DIED!!!
His life was saved by first responder Dr Edward Williams, who found Phineas sitting on his porch fully conscious despite the hole in his head, from which he removed, as he later wrote, coagulated blood, shards of splintered skull and ‘approximately three ounces of brain material’.
Now what I want to know is how do you know when to stop taking the brain material out? I guess Dr Williams scooped out an ounce at a time. There’s Phineas sitting on the porch, and Dr Williams is standing over him with a tablespoon.
Dr Williams: I can see some loose and flappy bits of brain in there, Phineas, that are gonna have to come out. Now I’m gonna scoop out an ounce at a time. If at any point it feels sketchy, you just holler and I will immediately desist. Okay. First ounce coming out now… Hup! How was that?
Phineas: Didn’t feel a thing, Doc.
Dr Williams: Right, Phineas. Here we go. Second ounce – hup! – out it comes! Okay?
Phineas: Can’t say I feel any different at all, Doc. You go right ahead.
Dr Williams: Okay third ounce. Third ounce coming out now, hup! How’s that?
Phineas: I think the British people will welcome a state visit from President Trump.
Dr Williams: Gotta put that third ounce back. That’s the soul right there! That’s what separates us from the baboon. You need that third ounce!
Almost all brain science books tell the Phineas Gage story. But it is strange that those who claim to be experts on how the mind works should be unable to grasp that this young man’s state of mind might be down not just to his tattered brain but to what he thinks and feels about his tattered brain. Neuroscientific accounts never entertain the possibility that Phineas’s rage might be due to grief or shock or even simple pain from his shattered jaw and eye-socket. Instead, they tell the story of Phineas Gage as illustrating a sort of Dr Jekyll and Mr Hyde model of the human brain. There’s the snarling Mr Hyde, our animal self, the killer ape inside, the product of millions of years of evolution, the real us, barely restrained by Dr Jekyll, the late cortical add-on, product of a few thousand years of flimsy social contract. The iron bar that shoots through Phineas Gage’s skull rips a hole in this cortical crust allowing the sociopathic Mr Hyde to escape Dr Jekyll. Strange to say this has become the standard scientific model in all neuroscience textbooks, the curtain-raiser on the study of cortical localisation, the science of which bits of the brain do what. What is especially strange about the acceptance of this melodramatic version of events is that it is totally un-Darwinian.
For Darwin, brain trauma doesn’t reveal our true animal nature, it separates us from our true animal nature. For Darwin, as we have seen, snarling is no more atavistic than smiling, aggression no more human than sociability. ‘We have every reason to believe,’ argues Karl Popper in the same vein, that our ancestors ‘were social prior to becoming human’.*
* Karl Popper, Conjectures and Refutations:The Growth of Scientific Knowledge, 1962.
The Myth of the Supermax Brain
In the struggle for the survival of ideas, Robert Louis Stephenson’s fiction is selected over Darwinian fact. Jekyll and Hyde better fits the modern Myth of the Supermax Brain.
According to this myth, the prefrontal cortex operates like a supermax prison locking down the seething violent criminality of our true selves.
The Supermax Myth is popular because it ticks so very many boxes about how the mind ought to work. Here it seems is the bridge between Freudian psychology and modern neurobiology, between the psychoanalyst’s couch and functional magnetic resonance imaging. Such a strategically important bridge is always going to be defended with ferocity. Only fanatical loyalty to the Supermax Myth can, I think, explain V. S. Ramachandran’s curious hostility towards Phineas Gage. In Phantoms in the Brain, he tells us that after the accident Gage became ‘a worthless vagabond with absolutely no moral sense’.
The asperity is startling, not least because it flies in the face of the historical record. We know that the worthless vagabond continued to support his family, working on their smallholding in Enfield, New Hampshire. In the remaining thirteen years of his life, he took on a series of increasingly demeaning jobs, despite suffering seizures, blackouts and terrible headaches.
In what follows I am indebted to Malcolm Macmillan’s painstaking research into first-hand sources, archive material and contemporary witness statements as he single-handedly disinterred man from myth in his book An Odd Kind Of Fame: Stories of Phineas Gage.
One hot and dusty day in August, 1849, Dr John Jackson travelled from Boston to Enfield, New Hampshire to interview the Gage family. He’d been hoping to examine Phineas himself, but met only his widowed mother and brother-in-law, who told him Phineas was in Montpelier trying to get work with another railroad company ‘doing what he did before’.
I confess that I had to re-read that last phrase three times over, when I first came across it in An Odd Kind Of Fame. Doing what he did before …? Astonishingly, Phineas Gage was trying to find work as a blasting foreman! I guess he was hoping to impress the Montpelier railway company with his experience more than his skill. Then again, who better than he to instruct railway navvies on how really, really careful you should be when priming an explosive with your tamping iron? It is after all a moot point whether we listen more attentively to the one-armed or two-armed bomb disposal expert.
Dr Jackson stayed to interview Phineas’s mother Phebe Gage, still in black crepe since the death of her husband a few months earlier, and made notes of their conversation. Jackson began by asking Phebe Gage about her son’s recuperation, and jotted down her reply:
abt. February he was able to do a little work abt. ye horses & barn, feedg. ye cattle &c.; that as ye time for ploughing came he was able to do half a days work after that and bore it well.*
* Malcolm Macmillan, An
