The Impact of Phineas Gages Accident on Brain Surgery - Case Study Example

Running Head: THE IMPACT OF PHINEAS GAGE’S ACCIDENT The Impact of Phineas Gage’s Accident on Brain Surgery The Impact of Phineas Gage’s Accident on Brain Surgery Throughout the course of history, many scientists and researchers have been made famous due to the importance and enormity of their discoveries and inventions. However, this case is different as Phineas Gage is not a scientist, nor was he a researcher or in the field of science. Also, he did not become famous through any work that he has made. Rather, it was by sheer accident—literally. This paper will tell the story of Phineas Gage and how his accident provided great insight and scientific evidence as to the importance of the frontal lobes of the brain and how this influenced brain surgery as it is today. The Accident and its Effect on Phineas Gage During the month of September 1848, Phineas Gage, a twenty-five year old construction foreman, gained nationwide recognition through an accident that should have left him dead (Bellows, 2006 and Sabbatini, 1997). He unintentionally detonated a dynamite that he was setting to eliminate large rocks that was unnecessary to the railway structure they were creating (Bellows, 2006). The dynamite explosion “rocket[ed] his tamping rod through his cheek, eye, and skull and decimat[ed] the orbitofrontal and sections of the ventromedial cortex of his brain” (Cacioppo and Bernston, 2005, p.20). The fact that he survived the supposedly fatal accident earned his case the scientific and medical curiosity of medical professionals (Damasio, et al., 1994 in Cacioppo and Bernston, 2005, p.21). The most significant part of his case was that his personality was totally altered after the accident, hence, the famous line “Gage was no longer Gage” (Sabbatini, 1997). To be more specific, Sabbatini (1997) explained that Gage has become “extravagant and anti-social, a fullmouth and a liar with bad manners, and could no longer hold a job or plan his future.” This prompted his physician, Dr. John Harlow, to document the radical changes in his personality (Damasio, et al., 1994 in Cacioppo and Bernston, 2005, p.21). Other than the extreme change in his personality and attitudes, Harlow noted that his learning capabilities, speech, and intelligence, as well as his physical health, remained the same as before the accident, but that “the equilibrium or balance, so to speak, between his intellectual faculty and animal propensities” has been severely damaged (Damasio, et al., 1994 quoted in Cacioppo and Bernston, 2005, p.22). Even twenty years after the accident and seven years after gage’s death, Harlow still continued to pursue the study of the case and concluded that there was a direct correlation between Gage’s cognitive and behavioral transformations and the damage in the frontal region of his brain (Damasio, et al., 1994 in Cacioppo and Bernston, 2005, p.22). Therefore, the frontal lobes of the brain, which was at that time not considered to have any specific function, was correlated to certain aspects like speech and, in Gage’s case, the ability to rationalize and make decisions that are socially and morally acceptable—that when damaged will affect the normal functioning of these faculties (Maroney, 2006). The Effect on of the Accident on Neurology However perceptive Dr. Harlow’s observations and theories were about the brain as gleaned from Gage’s case, he was not given much scientific acknowledgment as Broca and Wernicke’s theories on the brain having specific areas where speech, language, and other motor functions are located are deemed more logical, where the idea that there may be a certain area in the brain reserved for moral reasoning may have sounded ludicrous at that time (Damasio, et al., 1994 in Cacioppo and Bernston, 2005, p.22). Also, Broca and Wernicke’s theories were accompanied with autopsy reports, while Dr. Harlow had nothing but mere observations (Damasio, et al., 1994 in Cacioppo and Bernston, 2005, p.22). After the famous case of Phineas Gage, there have been other patients who have exhibited the same severe personality transformation as that of Gage and autopsy reports showed that there are lesions or damages to the prefrontal cortex of the brain (Schaffhausen, 2007). This illustrates how moral reasoning and rationality are centered on a particular area of the brain, specifically the prefrontal cortex. More than a century later, Hanna and Antonio Damasio (1994 cited in Cacioppo and Bernston, 2005 and Schaffhausen, 2007) reconstructed the accident, with the help of Gage’s exhumed skull (by Dr. Harlow) and found that Dr. Harlow was right with his observations. Of course, the Damasios have the hi-tech imaging tools that were not present during the time of Dr. Harlow. Furthermore, Maroney (2006) noted that: Though many brain areas now have been shown to be involved with emotional perception, processing, regulation, and expression, damage to the ventromedial portions of prefrontal cortex—the areas damaged in Gage—has been shown to interfere with “social and emotional competence while not affecting cognitive competence in other domains.” This demonstrates the importance and weight of Phineas Gage’s accident on the study of brain functions. Although it can be said that this particular discovery would have been researched and studied later on, it was still due to Gage’s accident and Dr. Harlow’s notes and observations that light was shed on the rational and moral functions of the prefrontal cortex. “Gages case was among the first indications that the brain is not just specialized for walking, talking and the like, but also contains regions tailored for more complex behaviors such as reasoning, adapting to social convention and planning future events” (Schaffhausen, 2007). The Implications on Brain Surgery With Gage as a standard, many scientists, doctors, and neurologists have delved into the localized areas of the brain, specifically the prefrontal cortex, in order to further study and point out what exact functions, such as rationality and emotions, are localized in what areas of the brain. The Damasios have contributed greatly to this as their reconstruction of Gage’s accident, together with the analysis of other patients with similar brain lesions or damages, found that the orbitofrontal and sections of the ventromedial cortex of the brain are the ones responsible for rational decision making and the processing of emotion (Sabbatini, 1997 and Maroney, 2006). Their study also included a “modern-day Phineas Gage” named Elliot who exhibited the exact personality transformation as Gage after “surgery for a brain tumor in which portions of his frontal lobes were removed” (Maroney, 2006). Upon the establishment of the specific locations of functions in the brain, thanks to Gage’s enlightening case, aseptic methods of operating were developed in order to, as much as possible, preserve the functions of the brain in cases like Elliot’s wherein a brain tumor developed in his brain (Deakin University, 2007). Although Gage’s accident’s contribution to brain surgery may be described as indirect, it is still very important as Dr. M. Allan Starr, an American neurologist, explored the case and advocated the use of the mental and personality changes that Gage experienced as a way of diagnosing frontal tumors (Deakin University, 2007). This was in the late 19th century wherein the neurological imaging tools that are available today were not yet invented. And so, the first successful brain surgery of removing a tumor from the left prefrontal cortex, wherein “operative interference has been so directly dictated by the existence of mental symptoms,” was performed in 1894 by Starr and his colleague, McBurney (Deakin University, 2007). Although this form of diagnosing frontal tumors was later on discredited in that it was found in the early 20th century that prefrontal lobotomies or the removal of the whole portion of the lobe containing the tumor have little effect on the patients behavior, Gage’s case still helped modern brain surgery as it pointed out the specific areas of the brain that controls specific functions like rationality and emotions (Deakin University, 2007). Thus, Gage’s case showed the neurologists and surgeons what not to remove or the full consequences of the act of removing a certain part of the brain. Again, the impact may have been indirect, but it is nonetheless very significant. References Bellows, A. (2006). Phineas Gages Brain Injury. Retrieved December 12, 2007 from http://www.damninteresting.com/?p=231 Cacioppo, J. T. and Bernston, G. G. (2005). Social Neuroscience: Key Readings. New York: Psychology Press. Deakin University (2007). Phineas Gage and Brain Surgery. Retrieved December 12, 2007 from http://www.deakin.edu.au/hmnbs/psychology/gagepage/PgSurger.php Maroney, T. A. (2006). Emotional Competence, "Rational Understanding" and the Criminal Defendant. American Criminal Law Review, 43(4), 1375+. Sabbatini, R. M. E. (1997).The Amazing Case of Phineas Gage. Brain and Mind Magazine, June. Schaffhausen, J. (2007). The Strange Tale of Phineas Gage. Retrieved December 12, 2007 from http://www.brainconnection.com/topics/?main=fa/phineas-gage Read More