Graveyard Shift

Horrifying Facts About Phineas Gage, Whose Brain Was Impaled With An Iron Rod 

Laura Allan
Updated September 15, 2017 46.8k views 15 items

Even if you're not a psychology or neurology student, you may have heard of the fascinating case of Phineas Gage. Never before in history was there an accident where a person's brain was injured terribly but not fatally, leaving them with few lasting health problems but with a totally different personality. This man, who was impaled by an iron rod, not only lived through a horrible accident, but went on to have an active life, where he walked, talked, and even held jobs without trouble - and yet, he was profoundly changed. 

Also called the "American Crowbar Case," the case of Phineas Gage is unique. In the accident, parts of Gage's brains were destroyed, fell out, or died within his skull. It took skilled doctors a month to put him right again, and this all happened in the mid-1800s! Hardly a time of medical expertise. 

So, if you're curious how a man who had an iron rod in his brain could survive, and how his case shaped the medical and psychological world today, read on. Just be aware, what happened to Phineas Gage is bound to make you cringe.

He Worked On Railroads During The Industrial Revolution
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Photo: National Library of Ireland on The Commons/flickr/No known copyright restrictions

Back in the early and mid-1800s, railroad work was one of the most dangerous jobs a person could have. The industrial revolution was in full swing, which meant that new machinery, meant to make railroad construction and operations go faster, was being implemented and updated regularly. Unfortunately, many of these new inventions and techniques could be dangerous, and there were few to no safety protocols. During the mid-1800s, thousands of rail workers died every year, and tens of thousands were injured on the job.

This, however, is where Phineas Gage made his living. He was a railroad foreman in 1848, and was well-respected in his position. He worked regularly with explosives for rail machinery and blasting, and was regarded by employers as a good business man, intelligent, and very hard working. All of this didn't stop things from going horrifyingly wrong one September.

An Explosion Caused His Horrible Accident
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Photo: Chicago, Rock Island, and Pacific Railroad/via Wikimedia Commons

In 1848, Phineas Gage was merely 25 years old, and he was already the foreman of the Rutland & Burlington Railroad, just south of Cavendish, Vermont. Work was going well that afternoon, and all the machinery and explosives were working according to plan. Phineas and his men were setting a blast, which involved boring a hole deep into an outcropping of rock, adding blasting power and a fuse, then using a tamping iron (which looks like a giant metal javelin) to pack it deep into the rock.

As sometimes happens, Gage let his guard down while doing this routine task, and became distracted. He put himself in front of the blast hole, right in front of the tamping iron, which was not yet packed with clay to prevent ignition. He was looking over his shoulder to speak with some men, and had just opened his mouth to say something, when the iron caused a spark against the rock. This spark ignited the powder and there was a massive explosion. Gage was just being careless and in the wrong place at the wrong time.

A Railroad Spike Passed Fully Through His Head
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Photo:  EEng/via Wikimedia Commons

It's worth saying that the tamping iron was javelin-like, because that's precisely how it behaved. The force of the explosion behind the spike drove it out with incredible force, and it headed straight for Gage. The 13-pound spike entered the left side of his face, right through the side of his cheek and open mouth (because he had been about to speak), and went up into his head. It went through the bone, the brain, and then out the other side. But it didn't stop there. All three feet, seven inches of the rod went through his head, then out the other side, and landed roughly 80 feet away, smeared with blood and brains.

As is to be expected, Gage collapsed onto the ground, convulsing.

He Sat Up And Began To Talk Almost Right Away
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Photo:  Eeng/via Wikimedia Commons

At this point, Gage's fellow workers expected him to be dead. When a metal spike goes through your head entirely, bits of skull and brains fly out, and blood starts to go everywhere, you expect a person to be 100% dead. Miraculously, however, Gage was not only alive but aware of what was going on around him. After only a few minutes, he sat up and spoke, then rose and, with little assistance, walked to an ox cart to be driven into town. It was almost a mile ride, and he sat upright for the entire time, and he knew how to get home. Upon arrival there, he simply sat in a chair and waited for the doctor to arrive. Hardly the kind of actions you'd expect from someone with a literal gaping hole in their head.