Can You Survive a Metal Rod Through Your Head?

Short answer is yes. Yes you can. Let me tell you the story.

 On September 13, 1848 a 25-year-old man named Phineas Gage was working to help prepare a railroad track near Cavendish, Vermont. Part of his job involved removing heavy rocks that were in the path of the railroad. He was using an iron tamping rod to pack explosive powder into a hole. The rod was about a metre long, and 1.25 inches in diameter. Picture it. He is repeatedly shoving a metre long metal rod the width of a toonie into a hole full of explosive powder. You can guess what happened next. The powder detonated sending the rod hurtling upward towards Mr. Gage. The rod went through his left cheek and out the top of his head. The picture above is a photo of his skull and the actual rod involved (if you are reading this on your phone turn the phone to landscape to see the whole image horizontally). Take a look, it is helpful to picture just how big the rod was and how much damage was done. The rod was travelling with such force that it went entirely through his skull and landed 80 feet away.

 Imagine you’re Mr. Gage. A giant metal rod has gone through your cheek and out the top of your head. You’d expect there to be some consequences right? Interestingly, for Mr. Gage, not right away. Mr. Gage not only survived, but he was able to speak normally and within a few moments he was able to get up, and walk to a cart to be taken to the doctor.

 Soon after he was seen by Dr. John Harlow who noted that even later that night Mr. Gage was conscious, he was able to state the names of his friends and coworkers, and he was commenting that he felt that he would be back to work in a day or two!

 Unfortunately his good luck was not to last. Mr. Gage subsequently developed an infection and spent a month in a coma. He did gradually improve after that, and was able to leave hospital and return to his parent’s home. He spent some time recovering at his parent’s home and his doctors noted that while he had lost his vision in his left eye and had obvious scars he was overall in good physical health and appeared recovered.

Much of what we know about the brain we’ve learned from these studies of individuals who have had an injury. If you take a look at the picture of the skull and the rod above, you can easily picture how much of his brain was damaged.

Initially his doctors thought he had recovered without difficulty. He was walking, talking, and able to complete all his daily tasks. Maybe this part of the brain isn’t necessary?

But his family and friends described significant changes in Mr. Gage’s personality. Prior to his injury they said he was hard working, pleasant, a smart businessman, very energetic, and able to successfully organize and plan tasks. After his injury his friends say he was “no longer Gage”. Reports from his family and friends describe how he became surly, aggressive, and obstinate. He showed a lack of care for others, and became prone to episodes of swearing.

Mr. Gage’s experience prompted neurologist to start studying the role of the frontal lobes, and more specifically the prefrontal lobes (the part of the brain damage in Gage’s case). Through cases like Mr. Gage we began to understand what happens when we injure specific parts of the brain, and we can develop our understanding of the roles of the parts of the brain. We now know that the prefrontal lobes play an important role in regulating behaviour (so we aren’t swearing out of control), social awareness, emotional control, problem solving, and planning.

Interestingly, the frontal lobes are the last part of our brain to fully develop. Studies estimate that these areas become fully developed in our early 20s for women, and closer to our late 20s for men. I will just leave that observation there for you to think about.

 You might be wondering what happened to Mr. Gage. Reports are inconsistent but it appears he traveled for a while with the tamping iron acting as a circus side show to earn money. He also spent some time at the stagecoach driver in Chile. His health began to gradually deteriorate, however, and after suffering from a number of seizures he died on May 20, 1860 almost 13 years after his accident. His skull and the tamping rod are now on display at the Harvard University School of Medicine in Boston.