the man who survived an IRON BAR through his brain | Phineas Gage

Added: 2026-05-05

[00:00:00]In 1848, a railway foreman named Phineas Gage survived an accident that should have been instantly fatal. An iron tamping rod blasted straight through his skull, entering beneath his cheek and exiting out the top of his head.

[00:00:15]Miraculously, he lived, but the man who walked away was no longer the same. Once responsible and well-liked, Phineas became impulsive, erratic, and unrecognizable to those who knew him.

[00:00:28]His survival and subsequent transformation posed a question that would change science forever. Could damage to a specific part of the brain actually change who you are? It's a question we mostly know the answer to today, but in 1848 it was a complete mystery. Phineas's story didn't just defy life and death. It actually helped launch modern neuroscience. That is right you guys. So, we're in for a classic Georgia Marine medical mystery/history episode. We know these are my favorite to research and write.

[00:01:01]So, I hope you guys find this as interesting as I did. And I am going to warn you right now that this is not one for the squeamish. I know lots of you like to tune into my videos whilst eating your dinners. So, I'm going to warn you right now. Wait until after you finished eating for this one. Okay.

[00:01:17]Phineas P. Gage was born around the 9th of July 1823 in Grafton County, New Hampshire. We don't have loads of information about him before his accident. He was just a normal guy, but we do know that he did have a decent enough education. He was literate at the very least. The best description we have of him before comes from his doctor who described him as a perfectly healthy, strong, and active young man with a nervous billious temperament. We don't tend to pay much mind to phologies for temperaments. these days. But in the 1800s, this was a belief system that a lot of doctors abided by. It was the idea that bodily symptoms were linked to personality. So lymphatic people were sluggish, sanguine people were active or passionate, nervous people were perceptive, and billious people like Phineas were energetic and strong.

[00:02:08]Ironically, the doctor also described Phineas as having an iron will as well as an iron frame. He was very muscular.

[00:02:16]As he became an adult, he turned to work with explosives, likely starting on local farms and mines before being employed to work on the construction of the Hudson River Railway at the age of 25. His job title was blasting foreman, which is just incredible. He was in charge of the controlled use of explosives on this project. He basically had to blast through rock to make space for this railway line. His employers described him as the most capable foreman. He was a shrewd and smart businessman. He was very energetic and persistent in executing all of his plans of operation. He was very passionate about his job. He enjoyed blowing things up and even commissioned his own tamping iron, which is basically this heavy long iron rod used to compact the blasting powder into bore holes made in rocks during construction. It had one rounded end for tamping down the powder and a pointed end for preparing fuses. It was a multi-use tool and it was very important to Phineas to do his job. On September 13th, 1848, Phineas was out doing his job, planning the blasting of rocks and then doing the blasting of rocks. It was just south of Caendish in Vermont. He would basically bore a hole deep into a rock, add blasting powder, and then clay or sand on top of it to contain the blast. He'd then push it all down deep with his iron rod, and then he would set the explosion. It was around 4:30 p.m. that day when he was distracted by some men working behind him. Now, the number one rule of working in explosives is never to get distracted. But all Phineas did was look over his shoulder. However, in doing so, he brought his head directly in line with the blast hole and the tamping iron. Now, this shouldn't have been a big deal. He hadn't even set the explosive yet. However, in a one ina million chance, the tamping iron just so happened to spark against the rock. And likely because Phineas hadn't added the sand yet, the powder just exploded, causing the iron rod to blast up right out of the hole, right into the left side of Phineas's head. It tended at an upward angle through his left cheekbone, passing behind his eye, through the front left side of his brain, and then directly out of the top of his skull.

[00:04:25]The explosion was so intense that it blew the rod all the way through. It didn't lodge itself in his head. It went through and landed about 25 meters behind him. And all of this happened in a second. And we're not talking about a small, thin, light rod here either. It was 3.2 cm in diameter, 1.1 m long, and weighed 6 kg directly through his head.

[00:04:50]Phineas was knocked over by the force of the blast, but it's not thought that he so much as even lost consciousness. Had anything the slightest of movement been different here, it's very likely that Phineas would not have survived. It was the perfect accident. Well, perfect for his survival. He probably would have preferred personally that it didn't happen at all, but it did and he survived it. Immediately after, he was able to speak and walk over to a nearby horse and cart so he could be taken into town to see a doctor. On the cart ride, he was able to make some notes about his crew's work hours and wages. And upon being greeted by Dr. to Edward Williams.

[00:05:26]He remarked, "Doctor, here is business enough for you." According to Williams' notes, the injury was just about as gruesome as you might imagine. It was an open wound to his brain, described as an inverted funnel. When at one point Phineas got up to vomit, a half teacup full of his brain was forced out of the hole on top of his head and just splattered down to the floor. Yeah, I really hope you're not eating. But despite this, some sources suggest that Phineas was so unaffected by the accident in the immediate hours afterwards that he told the doctor that he didn't wish for any of his friends to visit him because he was going to be back at work in a day or two. A doctor, John Harlow, took over the case later that evening, and he noted that Phineas had heroic firmness despite the extent of his injuries. He was perfectly conscious, but he was getting exhausted from the extensive blood loss, and he was also throwing up blood as well.

[00:06:20]However, it wasn't quite that simple as soon Phineas developed an infection which is unsurprising really. From the 23rd of September, he ended up in a semicomaos state during which his doctor described fungus growing out of the wound which was in hindsight infected tissue. He also apparently smelt awful and was completely unable to form words in this time. His friends and family were warned to prepare for his imminent death to prepare his coffin and some of the attendants even begged Dr. to Harlow just to let Phineas die that it would be a kindness to him. But Harlow refused.

[00:06:54]He tended to the wounds daily and within 24 days Phineas was able to get himself back out of bed and from there his recovery snowballed. Day by day his intellectual functioning showed small signs of improvement whilst physically he was soon entirely functional again.

[00:07:11]Dr. Harlow noted how interesting it was what Phineas seemed to be able to do and not do intellectually. He showed understanding of time. He knew how much time had passed since his accident. He knew how the accident occurred. But things like money, counting it, and estimating the size of coins was something that seemed to escape him completely. Phineas also seemed unable to make any sensible choices for himself. In freezing November weather, he would go out and refuse to wear a coat and sensible boots. This previously very sensible man thought he knew better and as a result caught a fever from which he had to recover again. Within just 10 weeks of the accident though, Phineas was fully up and about. He was soon able to return home to New Hampshire to the care of his parents where he was told to rest and recuperate, but it seems he did very little of that. He was very physically active. 7 months after the accident, Dr. Harlo went to visit him at home and did find him physically recovered, although he did bore the scars of his ordeal. He had lost his eyesight in his left eye.

[00:08:12]He had partial facial paralysis and a very large scar on his forehead from the draining of the abscesses. He also had the entry and exit scars as would be expected. Although below the exit scar on top of his head, you could see his brain pulsing. Vinnie is reported having no pain per se, but instead a queer feeling in his head. In mid 1849, he felt strong enough to go back to work.

[00:08:38]Only this time, no contractors would employ him because this previously respectable, hardworking man was now an entirely different person. Now, it is suspected that the changes are a bit dramatized. Most of the reports of Phineas's change came from after his eventual death. So, we do take all of this with a pinch of salt, but we do know that Phineas's previous contractor refused to take him on again because his change in personality was so marked.

[00:09:06]Reports say he became restless, impatient, and his impulse control disappeared. He was described as having the grossest profanity and was pertinently obstinate yet capriccious and vacasillating. We just don't use words like they used to anymore. What a delicious sentence that one is.

[00:09:23]Basically, he became immovably stubborn, unpredictable, and indecisive. His emotional control was reduced to that of a child. Although he had the animal passions of a strong man, which is a dangerous combination, his personality changed so much that friends and family no longer recognized him as the same man as before. He was no longer Phineas.

[00:09:45]However, what is interesting is that he had little problem making new friends and connections after this point. After all, he was wholly different to those who knew him before, but those who met him after didn't think much of him.

[00:09:58]Perhaps he was a bit brash, a bit impulsive, but some people are just like that. Seeing as this was the 1800s, there aren't solid reports of Phineas's improvement over the years, like yearon year. We only really have solid reports of what he was like before and what he was like in the year or so after. There is some evidence to support the fact that as the years went by, Phineas's condition improved a lot and his personality did eventually calm down again. In the years after the accident, he became somewhat of a fascination. He was a living museum exhibit and he traveled around putting himself on show as a curiosity. And from all the evidence, it seems like he advertised this, did this himself. He wasn't necessarily part of a trope or circus.

[00:10:40]He just knew that people would be interested and he could profit from it.

[00:10:43]and he wasn't really able to get any other job, so he just made people pay to see him. After his accident, he donated the iron rod to an anatomical museum, but he did get hold of it again some years later, and instead it became his constant companion. Once he got it back, he didn't go anywhere without his iron rod, his emotional support, iron rods.

[00:11:02]He was eventually able to live a fully independent life again and even did move to Chile where he worked as a stage coach driver. It's thought that this routine would have been very good for him. him a daily structure that allowed his brain to rebuild broken pathways.

[00:11:16]But when his health began to fail around 1859, he returned back to the USA and settled in San Francisco where he was cared for by his mother and sister. He did get better. He was eventually able to go back to work again with a farmer.

[00:11:29]But around February 1860, he started to suffer with epileptic seizures. These were severe enough that he had to cease work once again. And on the 18th of May 1860, he started having a series of seizures that he would never recover from. On the 21st of May, he died as a result of one of these seizures, which undoubtedly started thanks to the damage in his brain. So whilst the accident didn't kill him at the time, it did eventually. Phineas Gage was a fascinating case study at this time for doctors and scientists who believed that the human brain worked as a whole. That damage to any part of the brain damaged the whole brain. They believe that personality, emotions, memory, functional skills all came from the brain as a whole, not from specific regions within the brain, which is what we know nowadays. But Phineas's case proved otherwise. It begged the question, what exactly had that iron rod destroyed within Phineas's brain that changed his entire personality, but still left him as a fully functional human? For many years, Phineas wasn't considered a medical case as much as he was a medical curiosity. As I said, he was unable to get a job again after the accident. So in November 1849, Phineas was invited to Harvard Medical School in Boston, where he was closely assessed by doctors who had previously been very doubtful that the rod had actually passed through his brain. They did a series of tests and exams to make sure that it did, and they were shocked when they realized that Dr. Harlow had been telling the truth. I can't explain how much of a big deal this was to scientists, to doctors at this time, because they just couldn't fathom that an injury to the brain could cause this and somebody could still be alive. The doctors could explain what had happened to him, but they couldn't explain why at all. But thankfully, Dr. Harlow had kept a detailed record of Phineas's behavior before and after the accident. It was fascinating that whilst his judgment and impulse control, his personality had all changed, his intelligence hadn't. And this laid the foundations of our modern-day understanding of the human brain. In 2012, new research estimated that 11% of Phineas's frontal lobe and 4% of his cerebral cortex were destroyed. But of course, they didn't have the language for that at this time.

[00:13:44]Frontal lobe wasn't a thing, wasn't an idea. This case had a massive influence in early neurology and was one of the first pieces of evidence that we had for the idea of brain localization. this idea that the brain isn't one single organ, but a collection of specialized regions, each with its very own role.

[00:14:03]The brain isn't one system. It's lots of different systems all joined together in one organ. The specific changes noted in Fineia started to confirm very early theories that specific parts of the brain were responsible for specific functions, and the left front part might just be involved in personality. This seems so obvious knowing what we know now, but in 1848, this idea was revolutionary.

[00:14:28]Today, we know the frontal lobe is the brain's behavior and emotional control center. It gives us our higher level cognitive skills like planning, reasoning, decision making, emotional regulation. The cerebral cortex is responsible for things like consciousness, thought, emotion, memory, and voluntary movement, which are all quite important things, I'd say. And Phineas's story also confirms something else that was quite unsettling for people at this time because there was this idea that who you are is more of a spiritual thing. I mean, they thought the brain dealt with your bodily functions, but your personality or spirit was well spiritual. And Phineas Gage confirmed that that wasn't the case. Everything of who you are, everything that makes you you is held inside this one organ. It's a physical thing. And that physical thing can be changed. Imagine being a scientist in the 1800s realizing that for the first time. It must have been wildly unsettling. I mean, it's making you feel weird thinking about it even now, isn't it? It's making me feel weird. When Phineas Gage died in 1860, his story, his contribution to science was far from over. Dr. Harlow traveled to California upon hearing the news and held an autopsy of his own. With the family's permission, he preserved the skull, complete with the iron rod holes. And today, you can see Phineas's skull and his iron rod on display at Harvard Medical School's Warren Anatomical Museum, if you want to. He left a huge legacy on this earth. Who knows where we'd be in our understanding of the human brain if that explosive powder hadn't accidentally sparked that day.

[00:16:05]But Phineas's legacy isn't just scientific, it's philosophical. If a physical injury can change your personality, your entire sense of self, what does that say about who we all are?

[00:16:17]Are we all fixed and unchanging? Or are we the products of our brain? Or are our brains products of us? Almost two centuries later, and the brain still remains a relative mystery. There's still so much we don't know about how it works. It's crazy, isn't it? How one accident on one day 200 years ago has shaped the entire world as we know it today. The butterfly effect is such a real thing. If Phineas had been one inch to the left, one inch to the right, if the people behind him hadn't distracted him, what would we understand about the brain today? There's no way of knowing.

[00:16:53]Thank you so much for tuning in today.

[00:16:55]As always, if you've got any other requests for cases or historical stories that you want me to tell on this channel, then please leave them in the comments down below, and I will see you in the next one. Bye, guys.