DARK HISTORY WITH DEVEN: Phineas Gage

Deven discusses one of the most infamous work-related injuries in history, and how it connects to mental health care in that era!

In 1848, at a railroad construction site in Vermont, Phineas Gage, a 25-year-old foreman, survived a brain injury that would alter how scientists understood personality and behavior.

Gage was preparing explosives to clear rock when the blasting powder ignited too soon. A three-foot iron tamping rod was driven upward, entering his left cheek, passing behind his eye, and exiting through the top of his skull. The rod destroyed part of his frontal lobe before landing several yards away. Gage did not lose consciousness. He spoke within minutes and was able to walk with help.

People who knew Gage reported changes in his behavior. Before the accident, he was described as capable, reliable, and even-tempered. Afterward, he became impulsive, profane, and inconsistent. He struggled with planning, emotional control, and social judgment. Friends said he was “no longer Gage.”

At the time, this shift had no clear explanation. Nineteenth-century medicine treated personality, judgment, and moral reasoning as separate from the physical brain. Gage’s injury challenged that view. His memory and general intelligence appeared intact, yet his behavior and decision-making changed. The case suggested that specific regions of the brain governed functions once attributed to character alone.

Later accounts of Gage’s life complicate the story. He was not rendered incapable of work. Years after the accident, he held a position as a stagecoach driver in Chile, a job that required routine and responsibility. This period suggests some adaptation, though some reports indicate his difficulties persisted.

The importance of Phineas Gage does not lie in the violence of his injury, but in what it revealed. His case offered early evidence that impulse control, judgment, and social behavior are tied to brain structure.

The iron rod that passed through Gage’s skull is still preserved. It remains a reminder that survival does not guarantee restoration, and that identity depends on fragile physical systems.

Deven VanKirk was raised in the Midwest, and has lived all over the eastern half of the US. He’s been a horror fan for as long as he can remember. He enjoys hiking and camping, when he’s not reading or writing. Currently he resides in southern Illinois with his wife, son, and two dogs.

PLEASE NOTE: The views and opinions of the staff of Memento Mori Ink do not necessarily represent those of Memento Mori Ink or Crystal Lake Publishing. Thank you for understanding.