He died on May 21, 1860, of an epileptic seizure that was almost certainly related to his brain injury. But ultimately, the brain damage he'd sustained probably led to his death. Gage lived for a dozen years after his accident. "Even in cases of massive brain damage and massive incapacity, rehabilitation is always possible." This chapter of Gage's life offers a powerful message for present day patients, he says. Gage went on to work as a long-distance stagecoach driver in Chile, a job that required considerable planning skills and focus, Macmillan says.
"That personality change, which undoubtedly occurred, did not last much longer than about two to three years." There is something about Gage that most people don't know, Macmillan says. Van Horn JD, Irimia A, Torgerson CM, Chambers MC, Kikinis R, et al./Wikimedia Two renderings of Gage's skull show the likely path of the iron rod and the nerve fibers that were probably damaged as it passed through. Gage's famous case would help establish brain science as a field, says Allan Ropper, a neurologist at Harvard Medical School and Brigham and Women's Hospital. At the time, phrenologists were still assessing people's personalities by measuring bumps on their skull. "He was the first case where you could say fairly definitely that injury to the brain produced some kind of change in personality," Macmillan says.Īnd that was a big deal in the mid-1800s, when the brain's purpose and inner workings were largely a mystery. This sudden personality transformation is why Gage shows up in so many medical textbooks, says Malcolm Macmillan, an honorary professor at the Melbourne School of Psychological Sciences and the author of An Odd Kind of Fame: Stories of Phineas Gage. "He is fitful, irreverent, indulging at times in the grossest profanity, which was not previously his custom," wrote John Martyn Harlow, the physician who treated Gage after the accident. But the tamping iron destroyed much of his brain's left frontal lobe, and Gage's once even-tempered personality changed dramatically.
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