Phineas Gage

September 13, 1848 – On this day, railroad foreman Phineas Gage suffered one of the most famous injuries in medical history.

While preparing an explosive charge to clear rock, Gage tamped blasting powder with a 13-pound iron rod. A spark ignited the powder, blasting the rod upward. It entered beneath his left cheekbone, passed through the top of his skull, and landed yards away.

Amazingly, Gage remained conscious. He spoke with his crew and walked to a cart that carried him home, where Dr. John Harlow treated his wounds. He endured infection and fevers, but by October he was on his feet again.

The accident cost him the sight in his left eye and left his face partially paralyzed. More striking, however, were reports of dramatic changes in his personality. Once known as a reliable, even-tempered leader, he was described afterward as impulsive, irritable, and profane—a case that suggested the brain’s frontal lobes help govern behavior and character.

Later evidence shows Gage adapted better than once believed. He worked for years as a stagecoach driver in Chile before returning to the U.S. in declining health. He died in 1860 after a series of seizures. His skull and the iron rod are preserved today at Harvard’s Warren Anatomical Museum, enduring symbols of how one man’s tragedy reshaped our understanding of the brain.