Why Brain Scientists Are Still Obsessed With The Curious Case Of Phineas Gage ?

JON HAMILTON

Image result for images of the brain

It took an explosion and 13 pounds of iron to usher in the modern era of neuroscience.

In 1848, a 25-year-old railroad worker named Phineas Gage was blowing up rocks to clear the way for a new rail line in Cavendish, Vt. He would drill a hole, place an explosive charge, then pack in sand using a 13-pound metal bar known as a tamping iron.

But in this instance, the metal bar created a spark that touched off the charge. That, in turn, “drove this tamping iron up and out of the hole, through his left cheek, behind his eye socket, and out of the top of his head,” says Jack Van Horn, an associate professor of neurology at the Keck School of Medicine at the University of Southern California.

Gage didn’t die. But the tamping iron destroyed much of his brain’s left frontal lobe, and Gage’s once even-tempered personality changed dramatically.

“He is fitful, irreverent, indulging at times in the grossest profanity, which was not previously his custom,” wrote John Martyn Harlow, the physician who treated Gage after the accident.

This sudden personality transformation is why Gage shows up in so many medical textbooks, says Malcolm Macmillan, an honorary professor at the Melbourne School of Psychological Sciences and the author of An Odd Kind of Fame: Stories of Phineas Gage.

“He was the first case where you could say fairly definitely that injury to the brain produced some kind of change in personality,” Macmillan says.

And that was a big deal in the mid-1800s, when the brain’s purpose and inner workings were largely a mystery. At the time, phrenologists were still assessing people’s personalities by measuring bumps on their skull.

Gage’s famous case would help establish brain science as a field, says Allan Ropper, a neurologist at Harvard Medical School and Brigham and Women’s Hospital.

One Account Of Gage’s Personality Shift

Dr. John Harlow, who treated Gage following the accident, noted his personality change in an 1851 edition of the American Phrenological Journal and Repository of Science.

“If you talk about hard core neurology and the relationship between structural damage to the brain and particular changes in behavior, this is ground zero,” Ropper says. It was an ideal case because “it’s one region [of the brain], it’s really obvious, and the changes in personality were stunning.”

So, perhaps it’s not surprising that every generation of brain scientists seems compelled to revisit Gage’s case.

For example:

  • In the 1940s, a famous neurologist named Stanley Cobb diagrammed the skull in an effort to determine the exact path of the tamping iron.
  • In the 1980s, scientists repeated the exercise using CT scans.
  • In the 1990s, researchers applied 3-D computer modeling to the problem.

And, in 2012, Van Horn led a team that combined CT scans of Gage’s skull with MRI scans of typical brains to show how the wiring of Gage’s brain could have been affected.

“Neuroscientists like to always go back and say, ‘we’re relating our work in the present day to these older famous cases which really defined the field,’ ” Van Horn says.

And it’s not just researchers who keep coming back to Gage. Medical and psychology students still learn his story. And neurosurgeons and neurologists still sometimes reference Gage when assessing certain patients, Van Horn says.

“Every six months or so you’ll see something like that, where somebody has been shot in the head with an arrow, or falls off a ladder and lands on a piece of rebar,” Van Horn says. “So you do have these modern kind of Phineas Gage-like cases.”

Two renderings of Gage’s skull show the likely path of the iron rod and the nerve fibers that were probably damaged as it passed through.

Van Horn JD, Irimia A, Torgerson CM, Chambers MC, Kikinis R, et al./Wikimedia

There is something about Gage that most people don’t know, Macmillan says. “That personality change, which undoubtedly occurred, did not last much longer than about two to three years.”

Gage went on to work as a long-distance stagecoach driver in Chile, a job that required considerable planning skills and focus, Macmillan says.

This chapter of Gage’s life offers a powerful message for present day patients, he says. “Even in cases of massive brain damage and massive incapacity, rehabilitation is always possible.”

Gage lived for a dozen years after his accident. But ultimately, the brain damage he’d sustained probably led to his death.

He died on May 21, 1860, of an epileptic seizure that was almost certainly related to his brain injury.

Gage’s skull, and the tamping iron that passed through it, are on display at the Warren Anatomical Museum in Boston, Mass.

Scientists say your “mind” isn’t confined to your brain, or even your body

FREE YOUR MIND

Image result for mind blown gif

You might wonder, at some point today, what’s going on in another person’s mind. You may compliment someone’s great mind, or say they are out of their mind. You may even try to expand or free your own mind.

But what is a mind? Defining the concept is a surprisingly slippery task. The mind is the seat of consciousness, the essence of your being. Without a mind, you cannot be considered meaningfully alive. So what exactly, and where precisely, is it?

Traditionally, scientists have tried to define the mind as the product of brain activity: The brain is the physical substance, and the mind is the conscious product of those firing neurons, according to the classic argument. But growing evidence shows that the mind goes far beyond the physical workings of your brain.

No doubt, the brain plays an incredibly important role. But our mind cannot be confined to what’s inside our skull, or even our body, according to a definition first put forward by Dan Siegel, a professor of psychiatry at UCLA School of Medicine and the author of a recently published book, Mind: A Journey to the Heart of Being Human.

He first came up with the definition more than two decades ago, at a meeting of 40 scientists across disciplines, including neuroscientists, physicists, sociologists, and anthropologists. The aim was to come to an understanding of the mind that would appeal to common ground and satisfy those wrestling with the question across these fields.

After much discussion, they decided that a key component of the mind is: “the emergent self-organizing process, both embodied and relational, that regulates energy and information flow within and among us.” It’s not catchy. But it is interesting, and with meaningful implications.

The most immediately shocking element of this definition is that our mind extends beyond our physical selves. In other words, our mind is not simply our perception of experiences, but those experiences themselves. Siegel argues that it’s impossible to completely disentangle our subjective view of the world from our interactions.

“I realized if someone asked me to define the shoreline but insisted, is it the water or the sand, I would have to say the shore is both sand and sea,” says Siegel. “You can’t limit our understanding of the coastline to insist it’s one or the other. I started thinking, maybe the mind is like the coastline—some inner and inter process. Mental life for an anthropologist or sociologist is profoundly social. Your thoughts, feelings, memories, attention, what you experience in this subjective world is part of mind.”

The definition has since been supported by research across the sciences, but much of the original idea came from mathematics. Siegel realized the mind meets the mathematical definition of a complex system in that it’s open (can influence things outside itself), chaos capable (which simply means it’s roughly randomly distributed), and non-linear (which means a small input leads to large and difficult to predict result).

In math, complex systems are self-organizing, and Siegel believes this idea is the foundation to mental health. Again borrowing from the mathematics, optimal self-organization is: flexible, adaptive, coherent, energized, and stable. This means that without optimal self-organization, you arrive at either chaos or rigidity—a notion that, Siegel says, fits the range of symptoms of mental health disorders.

Finally, self-organization demands linking together differentiated ideas or, essentially, integration. And Siegel says integration—whether that’s within the brain or within society—is the foundation of a healthy mind.

Siegel says he wrote his book now because he sees so much misery in society, and he believes this is partly shaped by how we perceive our own minds. He talks of doing research in Namibia, where people he spoke to attributed their happiness to a sense of belonging.

When Siegel was asked in return whether he belonged in America, his answer was less upbeat: “I thought how isolated we all are and how disconnected we feel,” he says. “In our modern society we have this belief that mind is brain activity and this means the self, which comes from the mind, is separate and we don’t really belong. But we’re all part of each others’ lives. The mind is not just brain activity. When we realize it’s this relational process, there’s this huge shift in this sense of belonging.”

In other words, even perceiving our mind as simply a product of our brain, rather than relations, can make us feel more isolated. And to appreciate the benefits of interrelations, you simply have to open your mind.