Meet the man who was shot in the head with an iron rod – and SURVIVED: Scientists reconstruct the face of Phineas Gage as it was moments after freak accident 175 years ago

By James On Dec 13, 2023

A horrific accident that revolutionized our understanding of the brain has been brought to life by science using the skull of the man who survived.

Phineas Gage was paving the way for a new railroad in Vermont on September 13, 1848, when an accidental explosion turned his life upside down.

An iron rod was shot into his head, through his skull and out the other side, before he landed some 25 meters away 'smeared with blood and brains'.

Much of Gage's left frontal lobe was destroyed, but he lived another twelve years and his case became part of medical folklore.

Now we can see his face at the moment of impact, after his skull was used to complete a forensic reconstruction of his facial features.

A horrific accident that revolutionized our understanding of the brain has been brought to life by science using the skull of the man who survived

Much of Gage's left frontal lobe was destroyed, but he lived for another twelve years and his case became part of medical folklore

Phineas Gage: The man who was shot in the head with an iron bar and survived

In 1848, a 25-year-old Phineas P Gage was working as a railroad foreman in Vermont.

While he was pounding gunpowder, a metarod was shot through his head with such force that he was thrown back several feet.

Gage was semi-conscious for a month, but ultimately survived.

After the accident, his doctor, John Martyn Harlow, noted that Gage's friends considered him “no longer Gage.”

He became childish and ill-tempered, despite being well-mannered and well-liked before the injury.

He traveled with the tampon iron that had injured him and worked for a while as an exhibit in PT Barnum's circus.

Gage eventually died in May 1861 after a series of epileptic seizures after rejoining his family in San Francisco.

Forensic facial reconstructions usually show what a person looked like when they died, but in this case it captures a single moment from a person's life.

Cicero Moraes, author of the new study, said: 'In Gage's case, the facial expression is not the most important part of the trial, as we have at least two photos of him.

'The interesting thing about this project was the use of 3D technology and the knowledge gained from surgical planning to reconstruct the dynamics of the rod passing through the head.

“I want to understand what happened at that moment.”

Scientists can recreate a person's face from the skull by determining the likely depth of skin on different parts of the head, using data donated by living people.

Mr. Moraes also uses anatomical deformation, which virtually deforms a donor's face until it is compatible with the skull in question.

He has previously recreated historical faces with traumatic injuries, recreating the likeness of a man taking an ax to his mouth during the Battle of Visby in 1361.

But Mr. Gage's case required some extra work.

Cicero said: 'I virtually segmented the skull where it fractured at the time of the accident

'I simulated the passage of the beam where the injuries indicated, adjusted the pieces of the skull and thus obtained the basic dynamics of the accident.

“A high-resolution CT scan of a brain was imported into the scene and that brain was adjusted to best fit Gage's skull space.

Scientists can recreate a person's face from the skull by determining the likely depth of skin on different parts of the head, using data donated by living people

While he was pounding gunpowder, a metarod was shot through his head with such force that he was thrown back several meters

'I also imported a set of cerebral veins, well adapted to space.'

He continued: 'With all this together it was possible to animate the scene, seeing where the beam passed and which part of the brain it hit.

'It was also possible to create visual teaching material so that interested parties could better understand the severity of the accident.'

At the time of the accident, the obstacles were removed by drilling a hole in them, filling it with blasting powder and then tamping it down with an iron bar.

Gage was ordered to tamp it down, but his rod sparked against the rock, igniting the powder and causing a premature explosion.

His changed personality after the accident fueled the medical debate.

Some said it confirmed the idea that different parts of the brain performed different functions, while others said it showed how one part of the brain could take over for another if it were lost.

John Aggleton, professor of neuroscience at Cardiff University, told the BBC in 2011 that both were right to some extent.

“It alerted people to the fact that a part of the brain – the frontal lobes – that we associate with some kind of planning and intellectual strategies also played an important role in emotions,” he said.

After his accident, Phineas Gage made several public appearances before taking a job as a long-distance stagecoach driver in Chile

Sketches show how a metal rod shot through Phineas Gage's skull, destroying much of his frontal lobe and completely changing his personality

For Mr. Moraes, a Brazilian graphics expert, working on Gage's case was personal.

As a child, he watched his father commit suicide with a gun, and in 2011, Cicero's head was grazed by a bullet during an armed robbery, during which he also suffered a broken rib.

He said: 'When I was working on Gage I saw the history of someone who had been in a very serious accident but he didn't let it affect him.

“He is an example of how life can be cruel to us, but how we can fight and win even with very low probability. This case made me think about how much I have overcome in my past.

“In other words, this Phineas Gage project is a milestone for me because it represents overcoming.”

After his accident, Phineas Gage made several public appearances before taking a job as a long-distance stagecoach driver in Chile.

As his health deteriorated, he later moved to California, where he would die in San Francisco in 1860 at the age of 36.

Malcolm Macmillan, professor of psychology at the University of Melbourne, told the BBC that the epilepsy that killed Gage was likely a result of his injury.

Mr Moraes published his research in the journal OrtogOnLine.

TRAINING YOUR BRAIN TO CONNECT BAD MEMORIES

A 2020 study led by researchers from Dartmouth and Princeton found that people can intentionally forget past experiences by changing the way they think about the context of those memories.

The researchers showed participants images of outdoor scenes, such as forests, mountains and beaches, while they studied two lists of random words.

The volunteers deliberately manipulated whether participants were told to forget or remember the first list before studying the second list.

Immediately after they were told to forget it, the scans showed that they had 'washed out' the scene-related activity from their brains.

But when participants were told to remember the studied list instead of forgetting it, this washing away of scene-related thoughts did not occur.

The amount of people who washed away scene-related thoughts predicted how many of the studied words they would later remember, showing that the process is effective in facilitating forgetting.

To forget the negative thoughts that keep haunting you, researchers suggest eliminating the context of the memory.

For example, if you associate a song with a breakup, listen to the song in a new environment.

Try listening to it while you work out at the gym, or add it to a playlist you listen to before a night out.

This way, your brain will associate itself with a positive feeling.

If a memory of a scene from a horror movie haunts you, watch the same scene during the day.

Or watch it without sound, but play a comedy clip over the top.