a genius explains

8/7/2019 A genius explains

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A genius explainsDaniel Tammet is an autistic savant. He can perform mind-boggling mathematicalcalculations at breakneck speeds. But unlike other savants, who can perform similar

feats, Tammet can describe how he does it. He speaks seven languages and is evendevising his own language. Now scientists are asking whether his exceptional abilitiesare the key to unlock the secrets of autism. Interview by Richard Johnson

Daniel Tammet is talking. As he talks, he studies my shirt and counts the stitches. Ever since the age of three, when he suffered an epileptic fit, Tammet has been obsessed withcounting. Now he is 26, and a mathematical genius who can figure out cube rootsquicker than a calculator and recall pi to 22,514 decimal places. He also happens to beautistic, which is why he can't drive a car, wire a plug, or tell right from left. He liveswith extraordinary ability and disability.

Tammet is calculating 377 multiplied by 795. Actually, he isn't "calculating": there isnothing conscious about what he is doing. He arrives at the answer instantly. Since hisepileptic fit, he has been able to see numbers as shapes, colours and textures. Thenumber two, for instance, is a motion, and five is a clap of thunder. "When I multiplynumbers together, I see two shapes. The image starts to change and evolve, and a thirdshape emerges. That's the answer. It's mental imagery. It's like maths without having tothink."

Tammet is a "savant", an individual with an astonishing, extraordinary mental ability.An estimated 10% of the autistic population - and an estimated 1% of the non-autisticpopulation - have savant abilities, but no one knows exactly why. A number of scientists now hope that Tammet might help us to understand better. Professor AllanSnyder, from the Centre for the Mind at the Australian National University in Canberra,explains why Tammet is of particular, and international, scientific interest. "Savantscan't usually tell us how they do what they do," says Snyder. "It just comes to them.Daniel can. He describes what he sees in his head. That's why he's exciting. He could bethe Rosetta Stone."

There are many theories about savants. Snyder, for instance, believes that we all possess

the savant's extraordinary abilities - it is just a question of us learning how to accessthem. "Savants have usually had some kind of brain damage. Whether it's an onset of dementia later in life, a blow to the head or, in the case of Daniel, an epileptic fit. Andit's that brain damage which creates the savant. I think that it's possible for a perfectlynormal person to have access to these abilities, so working with Daniel could be veryinstructive."

Scans of the brains of autistic savants suggest that the right hemisphere might becompensating for damage in the left hemisphere. While many savants struggle withlanguage and comprehension (skills associated primarily with the left hemisphere), theyoften have amazing skills in mathematics and memory (primarily right hemisphere

skills). Typically, savants have a limited vocabulary, but there is nothing limited aboutTammet's vocabulary.


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Tammet is creating his own language, strongly influenced by the vowel and image-richlanguages of northern Europe. (He already speaks French, German, Spanish,Lithuanian, Icelandic and Esperanto.) The vocabulary of his language - "Mnti",meaning a type of tree - reflects the relationships between different things. The word"ema", for instance, translates as "mother", and "ela" is what a mother creates: "life".

"Pike" is "sun", and "pive" is what the sun creates: "day". Tammet hopes to launchMnti in academic circles later this year, his own personal exploration of the power of words and their inter-relationship.

Professor Simon Baron-Cohen, director of the Autism Research Centre (ARC) atCambridge University, is interested in what Mnti might teach us about savant ability."I know of other savants who also speak a lot of languages," says Baron-Cohen. "Butit's rare for them to be able to reflect on how they do it - let alone create a language of their own." The ARC team has started scanning Tammet's brain to find out if there aremodules (for number, for example, or for colour, or for texture) that are connected in away that is different from most of us. "It's too early to tell, but we hope it might throwsome light on why we don't all have savant abilities."

Last year Tammet broke the European record for recalling pi, the mathematicalconstant, to the furthest decimal point. He found it easy, he says, because he didn't evenhave to "think". To him, pi isn't an abstract set of digits; it's a visual story, a filmprojected in front of his eyes. He learnt the number forwards and backwards and, lastyear, spent five hours recalling it in front of an adjudicator. He wanted to prove a point."I memorised pi to 22,514 decimal places, and I am technically disabled. I just wantedto show people that disability needn't get in the way."

Tammet is softly spoken, and shy about making eye contact, which makes him seemyounger than he is. He lives on the Kent coast, but never goes near the beach - there aretoo many pebbles to count. The thought of a mathematical problem with no solutionmakes him feel uncomfortable. Trips to the supermarket are always a chore. "There'stoo much mental stimulus. I have to look at every shape and texture. Every price, andevery arrangement of fruit and vegetables. So instead of thinking,'What cheese do Iwant this week?', I'm just really uncomfortable."

Tammet has never been able to work 9 to 5. It would be too difficult to fit around hisdaily routine. For instance, he has to drink his cups of tea at exactly the same time everyday. Things have to happen in the same order: he always brushes his teeth before he has

his shower. "I have tried to be more flexible, but I always end up feeling moreuncomfortable. Retaining a sense of control is really important. I like to do things in myown time, and in my own style, so an office with targets and bureaucracy just wouldn'twork."

Instead, he has set up a business on his own, at home, writing email courses in languagelearning, numeracy and literacy for private clients. It has had the fringe benefit of keeping human interaction to a minimum. It also gives him time to work on the verbstructures of Mnti.

Few people on the streets have recognised Tammet since his pi record attempt. But,

when a documentary about his life is broadcast on Channel 5 later this year, all that willchange. "The highlight of filming was to meet Kim Peek, the real-life character who


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inspired the film Rain Man. Before I watched Rain Man, I was frightened. As a nine-year-old schoolboy, you don't want people to point at the screen and say, 'That's you.'But I watched it, and felt a real connection. Getting to meet the real-life Rain Man wasinspirational."

Peek was shy and introspective, but he sat and held Tammet's hand for hours. "Weshared so much - our love of key dates from history, for instance. And our love of books. As a child, I regularly took over a room in the house and started my own lendinglibrary. I would separate out fiction and non-fiction, and then alphabetise them all. Ieven introduced a ticketing system. I love books so much. I've read more books thananyone else I know. So I was delighted when Kim wanted to meet in a library." Peek can read two pages simultaneously, one with each eye. He can also recall, in exactdetail, the 7,600 books he has read. When he is at home in Utah, he spends afternoons atthe Salt Lake City public library, memorising phone books and address directories."Heis such a lovely man," says Tammet. "Kim says, 'You don't have to be handicapped tobe different - everybody's different'. And he's right."

Like Peek, Tammet will read anything and everything, but his favourite book is a gooddictionary, or the works of GK Chesterton. "With all those aphorisms," he says,"Chesterton was the Groucho Marx of his day." Tammet is also a Christian, and likesthe fact that Chesterton addressed some complex religious ideas. "The other thing I likeis that, judging by the descriptions of his home life, I reckon Chesterton was a savant.He couldn't dress himself, and would always forget where he was going. His poor wife."

Autistic savants have displayed a wide range of talents, from reciting all nine volumesof Grove's Dictionary Of Music to measuring exact distances with the naked eye. Theblind American savant Leslie Lemke played Tchaikovsky's Piano Concerto No1, after he heard it for the first time, and he never had so much as a piano lesson. And theBritish savant Stephen Wiltshire was able to draw a highly accurate map of the Londonskyline from memory after a single helicopter trip over the city. Even so, Tammet couldstill turn out to be the more significant.

He was born on January 31 1979. He smiles as he points out that 31, 19, 79 and 1979are all prime numbers - it's a kind of sign. He was actually born with another surname,which he prefers to keep private, but decided to change it by deed poll. It didn't fit withthe way he saw himself. "I first saw 'Tammet' online. It means oak tree in Estonian, andI liked that association. Besides, I've always had a love of Estonian. Such a vowel rich

language."

As a baby, he banged his head against the wall and cried constantly. Nobody knew whatwas wrong. His mother was anxious, and would swing him to sleep in a blanket. Shebreastfed him for two years. The only thing the doctors could say was that perhaps hewas understimulated. Then, one afternoon when he was playing with his brother in theliving room, he had an epileptic fit.

"I was given medication - round blue tablets - to control my seizures, and told not to goout in direct sunlight. I had to visit the hospital every month for regular blood tests. Ihated those tests, but I knew they were necessary. To make up for it, my father would

always buy me a cup of squash to drink while we sat in the waiting room. It was a


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worrying time because my Dad's father had epilepsy, and actually died of it, in the end.They were thinking, 'This is the end of Daniel's life'."

Tammet's mother was a secretarial assistant, and his father a steelplate worker. "Theyboth left school without qualifications, but they made us feel special - all nine of us. As

the oldest of nine, I suppose it's fair to say I've always felt special." Even if his younger brothers and sisters could throw and catch better than him, swim better, kick a ballbetter, Daniel was always the oldest. "They loved me because I was their big brother and I could read them stories."

He remembers being given a Ladybird book called Counting when he was four. "WhenI looked at the numbers I 'saw' images. It felt like a place I could go where I reallybelonged. That was great. I went to this other country whenever I could. I would sit onthe floor in my bedroom and just count. I didn't notice that time was passing. It was onlywhen my Mum shouted up for dinner, or someone knocked at my door, that I wouldsnap out of it."

One day his brother asked him a sum. "He asked me to multiply something in my head -like 'What is 82 x 82 x 82 x 82?' I just looked at the floor and closed my eyes. My back went very straight and I made my hands into fists. But after five or 10 seconds, theanswer just flowed out of my mouth. He asked me several others, and I got every oneright. My parents didn't seem surprised. And they never put pressure on me to performfor the neighbours. They knew I was different, but wanted me to have a normal life asfar as possible."

Tammet could see the car park of his infant school from his bedroom window, whichmade him feel safe. "I loved assembly because we got to sing hymns. The notes formeda pattern in my head, just like the numbers did." The other children didn't know what tomake of him, and would tease him. The minute the bell went for playtime he would rushoff. "I went to the playground, but not to play. The place was surrounded by trees.While the other children were playing football, I would just stand and count the leaves."

As Tammet grew older, he developed an obsessive need to collect - everything fromconkers to newspapers. "I remember seeing a ladybird for the first time," he says. "Iloved it so much, I went round searching every hedge and every leaf for more. Icollected hundreds, and took them to show the teacher. He was amazed, and asked meto get on with some assignment. While I was busy he instructed a classmate to take the

tub outside and let the ladybirds go. I was so upset that I cried when I found out. Hedidn't understand my world."

Tammet may have been teased at school, but his teachers were always protective. "Ithink my parents must have had a word with them, so I was pretty much left alone." Hefound it hard to socialise with anyone outside the family, and, with the advent of adolesence, his shyness got worse.

After leaving school with three A-levels (History, French and German, all grade Bs), hedecided he wanted to teach - only not the predictable, learn-by-rote type of teaching.For a start, he went to teach in Lithuania, and he worked as a volunteer. "Because I was

there of my own free will, I was given a lot of leeway. The times of the classes weren'tset in stone, and the structures were all of my own making. It was also the first time I


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was introduced as 'Daniel' rather than 'the guy who can do weird stuff in his head'. Itwas such a pleasant relief." Later, he returned home to live with his parents, and foundwork as a maths tutor.

He met the great love of his life, a software engineer called Neil, online. It began, as

these things do, with emailed pictures, but ended up with a face-to-face meeting."Because I can't drive, Neil offered to pick me up at my parents' house, and drive meback to his house in Kent. He was silent all the way back. I thought, 'Oh dear, this isn'tgoing well'. Just before we got to his house, he stopped the car. He reached over andpulled out a bouquet of flowers. I only found out later that he was quiet because he likesto concentrate when he's driving."

Neil is shy, like Tammet. They live, happily, on a quiet cul-de-sac. The only aspect of Tammet's autism that causes them problems is his lack of empathy. "There's a saying inJudaism, if somebody has a relative who has hanged themselves, don't ask them whereyou should hang your coat. I need to remember that. Like the time I kept quizzing afriend of Neil's who had just lost her mother. I was asking her all these questions aboutfaith and death. But that's down to my condition - no taboos."

When he isn't working, Tammet likes to hang out with his friends on the church quizteam. His knowledge of popular culture lets him down, but he's a shoo-in when it comesto the maths questions. "I do love numbers," he says. "It isn't only an intellectual or aloof thing that I do. I really feel that there is an emotional attachment, a caring for numbers. I think this is a human thing - in the same way that a poet humanises a river or a tree through metaphor, my world gives me a sense of numbers as personal. It soundssilly, but numbers are my friends."

Phineas GageFrom Wikipedia, the free encyclopedia

Jump to: navigation , searchPhineas P. Gage [n 1]
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The second identified portrait of Gage,

seen here with his "constant companion during

the remainder of his life" his tamping iron.. [n 2]

BornJuly 9?, 1823 [n 1]

Grafton Co. , New Hampshire

DiedMay 21, 1860 (aged 36) [n 3]

In or near San Francisco, California [1]

Resting placeCypress Lawn Cemetery , California

Warren Anatomical Museum , Boston

Residence New England, Chile, California

OccupationRailroad construction foreman, blaster ,

stagecoach driver

Home town Lebanon , New Hampshire [n 1]

Spouse(s) None

Children None

ParentsJesse Eaton Gage

Hannah Trussell (Swetland) Gage [n 4]

Phineas P. Gage (July 9?, 1823 May 21, 1860) [n 1] was a railroad constructionforeman now remembered for his incredible survival of an accident in which a large
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iron rod was driven completely through his head, destroying one or both of his brain'sfrontal lobes , and for that injury's reported effects on his personality and behavior effects so profound that friends saw him as "no longer Gage."

Long called "the American Crowbar Case" once termed "the case which more than all

others is calculated to excite our wonder, impair the value of prognosis, and even tosubvert our physiological doctrines" [2] Phineas Gage influenced 19th-century thinkingabout the brain and the localization of its functions ,[3] and was perhaps the first casesuggesting that damage to specific regions of the brain might affect personality andbehavior.

Gage is a fixture in the curricula of neurology , psychology and related disciplines , andis frequently mentioned in books and academic papers; he also has a minor place inpopular culture. [n 5] Relative to this celebrity, the body of known fact about the case isremarkably small, which has allowed it to be cited, over the years, in support of varioustheories of the brain and mind wholly contradictory to one another. [n 6] A survey [4] of published accounts has found that even modern scientific presentations of Gage areusually greatly distorted exaggerating and even directly contradicting the establishedfacts.

A daguerreotype portrait of Gage "handsome...well dressed and confident, evenproud," and holding the tamping iron which injured him was identified in 2009 ( seebelow ). One researcher points to it as consistent with a social recovery hypothesis,under which Gage's most serious mental changes may have existed for only a limitedtime after the accident, so that in later life he was far more functional, and socially far better adapted, than has been thought. A second portrait came to light in 2010 ( seeright ).

Contents[hide ]

1 Gage's accident 2 Subsequent life and travels 3 Death and subsequent travels 4 Brain damage and mental changes 5 Distortion and misuse of case 6 Current research 7 Notes 8 References 9 Further reading

10 External links

[ edit ] Gage's accident

On September 13, 1848, 25-year-old Gage was foreman of a work gang blasting rock while preparing the roadbed for the Rutland & Burlington Railroad outside the town of Cavendish , Vermont . After a hole was "drilled" into a body of rock (via a laboriousprocess which today might best be thought of as chiseling )[5] one of Gage's duties was to
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d_misuse_of_casehttp://en.wikipedia.org/wiki/Phineas_Gage#Current_research%23Current_researchhttp://en.wikipedia.org/wiki/Phineas_Gage#Notes%23Noteshttp://en.wikipedia.org/wiki/Phineas_Gage#References%23Referenceshttp://en.wikipedia.org/wiki/Phineas_Gage#Further_reading%23Further_readinghttp://en.wikipedia.org/wiki/Phineas_Gage#External_links%23External_linkshttp://en.wikipedia.org/w/index.php?title=Phineas_Gage&action=edit&section=1http://en.wikipedia.org/wiki/Blastinghttp://en.wikipedia.org/wiki/Rutland_Railwayhttp://en.wikipedia.org/wiki/Cavendish,_Vermonthttp://en.wikipedia.org/wiki/Vermonthttp://en.wikipedia.org/wiki/Chiselhttp://en.wikipedia.org/wiki/Phineas_Gage#cite_note-OKFp25-27-10%23cite_note-OKFp25-27-10


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add blasting powder , a fuse, and sand, then compact the charge into the hole using alarge iron rod. Possibly because the sand was omitted, [5] around 4:30 PM:

the powder exploded, carrying an instrument through his head an inch and a fourth in[diameter], and three feet and [seven] inches in length, which he was using at the time. The iron

entered on the side of his face...passing back of the left eye, and out at the top of the head.[n 7]

Nineteenth-century references to Gage as "the American Crowbar Case" may misleadsome readers. For Americans of the time a crowbar did not have the bend or clawsometimes associated with that term today. Gage's tamping iron was something like ajavelin , "round and rendered comparatively smooth by use": [6]

The end which entered first is pointed; the taper being [twelve] inches long...circumstances towhich the patient perhaps owes his life. The iron is unlike any other, and was made by aneighbouring blacksmith to please the fancy of its owner. [n 8]

Weighing 131/4 lb (6 kg), this "abrupt and intrusive visitor"[n 9]

was said to have landedsome 80 feet (25 m) away.

Amazingly, Gage spoke within a few minutes, walked with little or no assistance, andsat upright in a cart for the 3/4-mile ride to his lodgings in town. The first physician toarrive was Dr. Edward H. Williams:

I first noticed the wound upon the head before I alighted from my carriage, the pulsations of thebrain being very distinct. Mr. Gage, during the time I was examining this wound, was relatingthe manner in which he was injured to the bystanders. I did not believe Mr. Gage's statement atthat time, but thought he was deceived. Mr. Gage persisted in saying that the bar went through

his head....Mr. G. got up and vomited; the effort of vomiting pressed out about half a teacupfulof the brain, which fell upon the floor .[7]

Dr. John Martyn Harlow took charge of the case about an hour later:

You will excuse me for remarking here, that the picture presented was, to one unaccustomed tomilitary surgery, truly terrific; but the patient bore his sufferings with the most heroic firmness.He recognized me at once, and said he hoped he was not much hurt. He seemed to be perfectlyconscious, but was getting exhausted from the hemorrhage. Pulse 60, and regular. His person,and the bed on which he was laid, were literally one gore of blood. [8]

Despite Harlow's skillful care ,[n 10] Gage's recuperation was long and difficult. Pressureon the brain [n 11] left him semi- comatose from September 23 to October 3, "seldomspeaking unless spoken to, and then answering only in monosyllables. The friends andattendants are in hourly expectancy of his death, and have his coffin and clothes inreadiness. One of the attendants implored me not to do anything more for him, as itwould only prolong his suffering..." [9]

But on October 7 Gage "succeeded in raising himself up, and took one step to his chair."One month later he was walking "up and down stairs, and about the house, into thepiazza ," and while Harlow was absent for a week, Gage was "in the street every dayexcept Sunday," his desire to return to his family in New Hampshire being

"uncontrollable by his friends...got wet feet and a chill." He soon developed a fever, butby mid-November he was "feeling better in every respect...walking about the house
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again; says he feels no pain in the head." Harlow's prognosis at this point: Gage"appears to be in a way of recovering, if he can be controlled." [10]

The Boston Post for September 21, 1848 (misstating the dimensions of Gage's tampingiron and overstating damage to the jaw). [n 7]

[ edit ] Subsequent life and travels

By November 25 Gage was strong enough to return to his parents' home in Lebanon,N.H., where by late December he was "riding out, improving both mentally andphysically." In April 1849 he returned to Cavendish and paid a visit to Harlow, whonoted at that time loss of vision (and ptosis ) of the left eye, a large scar on the forehead,and "upon the top of the head...a deep depression, two inches by one and one-half inches wide, beneath which the pulsations of the brain can be perceived. Partialparalysis of the left side of the face." Despite all this, "his physical health is good, and Iam inclined to say he has recovered. Has no pain in head, but says it has a queer feelingwhich he is not able to describe." [11]

Unable to return to his railroad work, Harlow says, Gage appeared for a time atBarnum's American Museum [12] in New York City (the curious paying to see,presumably, both Gage and the instrument that injured him) although there is noindependent confirmation of this. Recently however, evidence has surfaced supportingHarlow's statement that Gage made public appearances in "the larger New Englandtowns." [13] (On Gage's job-loss and public appearances, see more below. )

Gage later worked in a livery stable in Hanover, New Hampshire and then for someyears in Chile as a long-distance stagecoach driver on the ValparaisoSantiago route.After his health began to fail around 1859, he left Chile for San Francisco, where he

recovered under the care of his mother and sister (who had gone there from NewHampshire around the time Gage went to Chile). For the next few months he did farmwork in Santa Clara. [14]
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"Front and lateral view of the cranium, representing the direction in which the irontraversed its cavity... "[15]

[ edit ] Death and subsequent travels

In February 1860, Gage had the first in a series of increasingly severe convulsions, andhe died in or near [1] San Francisco on May 21 just under twelve years after hisaccident. He was buried in San Francisco's Lone Mountain Cemetery .[n 3] In 1866,Harlow somehow learned where Phineas had been and opened a correspondence withhis family, still in San Francisco. At his request they unearthed his patient long enoughto remove the skull, which was then delivered to Harlow back in New England. About ayear after the accident, Gage had allowed his tamping iron to be placed in HarvardMedical School's Warren Anatomical Museum , but he later reclaimed it and (according

to Harlow) made what he called "my iron bar" his "constant companion during theremainder of his life"; [14] now it accompanied the skull on its journey to Harlow. After studying them for his second (1868) paper, Harlow redeposited the iron, this time withGage's skull, in the Warren Museum, where they remain on display today. The ironbears this inscription: [n 12]

This is the bar that was shot through the head of M r Phinehas [ sic ] P. Gage at Cavendish,Vermont, Sept. 14, [ sic] 1848. He fully recovered from the injury & deposited this bar in theMuseum of the Medical College of Harvard University. Phinehas [ sic ] P. Gage LebanonGrafton Cy N-H Jan 6 1850.

Much later, Gage's headless remains were moved to Cypress Lawn Cemetery as part of a systematic relocation of San Francisco's dead to new resting places outside city limits.[16]
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[ edit ] Brain damage and mental changes

North-facing view of "cut" through rock along what was once the track of the R&BRR,3/4 mile south of Cavendish, Vt. Gage may have met with his accident while settingexplosives either here or at a similar cut nearby. [5]

Significant brain injury is often fatal, but Harlow called Gage "the man for the case. Hisphysique, will, and capacity of endurance could scarcely be excelled," and as notedearlier the iron's 1/4-inch leading point may have reduced its destructiveness. [n 10]

Nonetheless, the brain tissue destroyed must have been substantial (considering not onlythe initial trauma but the subsequent infection as well) though debate as to whether thiswas in both frontal lobes, or primarily the left, began with the earliest papers byphysicians who had examined Gage. [17] A 1994 study by Damasio et. al [18] (modeling not

Gage's skull but a similar one)[19]

concluded there was damage to the frontal lobes onboth sides, but a 2004 study by Ratiu et. al. [n 13] (based on CT scans of Gage's actual skull, and presenting a video reconstruction of the tamping iron passing through it)agrees with Harlow's view that the damage was most likely to the left hemisphere only.

Neurologist Antonio Damasio uses Gage to illustrate a hypothesized link between thefrontal lobes, emotion and practical decision-making. [20] But any theory that looks toGage for support faces the difficulty that the nature, extent, and duration of the injury'seffects on his mental state are very uncertain. In fact, little is known about what Phineaswas like either before or after his injury (almost none of it first-hand), [n 14] the mentalchanges described after his death were much more dramatic than anything reportedwhile he was alive, and even those descriptions which seem credible do not specify theperiod of his post-accident life to which they are meant to apply.

In his 1848 report, as Gage was just completing his physical recovery, Harlow had onlyhinted at possible psychological symptoms: "The mental manifestations of the patient, Ileave to a future communication. I think the case...is exceedingly interesting to theenlightened physiologist and intellectual philosopher." [21] And after observing Gage for several weeks in late 1849, Henry Jacob Bigelow , Professor of Surgery at Harvard ,wrote that Gage was "quite recovered in faculties of body and mind." [n 8] (Noting drylythat, "The leading feature of this case is its improbability," Bigelow emphasized thatthough "at first wholly skeptical, I have been personally convinced," calling the case"unparalled in the annals of surgery." [n 8] Bigelow's stature largely ended scoffing about
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Gage among physicians in general one of whom, Harlow later wrote, had dismissedthe matter as a "Yankee invention.") [22]

It was not until 1868 that Harlow gave particulars of the mental changes found today(though usually in exaggerated or distorted form see below ) in most presentations of

the case. In memorable language, he now described the pre-accident Gage as havingbeen hard-working, responsible, and "a great favorite" with the men in his charge, hisemployers having regarded him as "the most efficient and capable foreman in their employ." But these same employers, after Gage's accident, "considered the change inhis mind so marked that they could not give him his place again":

The equilibrium or balance, so to speak, between his intellectual faculties andanimal propensities, seems to have been destroyed. He is fitful, irreverent,indulging at times in the grossest profanity (which was not previously hiscustom), manifesting but little deference for his fellows, impatient of restraint

or advice when it conflicts with his desires, at times pertinaciously obstinate,yet capricious and vacillating, devising many plans of future operations,which are no sooner arranged than they are abandoned in turn for othersappearing more feasible. A child in his intellectual capacity andmanifestations, he has the animal passions of a strong man. Previous to hisinjury, although untrained in the schools, he possessed a well-balanced mind,and was looked upon by those who knew him as a shrewd, smartbusinessman, very energetic and persistent in executing all his plans of operation. In this regard his mind was radically changed, so decidedly thathis friends and acquaintances said he was 'no longer Gage.' [14]

Of the handful of available primary sources, [n 14] Harlow's 1868 presentation of the caseis by far the most informative, and despite certain errors in dating ( see below ) thereseems no reason to doubt its general reliability. [23] The description above, although notpublished until two decades after Harlow last saw Phineas, appears to draw on Harlow'sown notes made soon after the accident. [24] But other behaviors of Gage's which Harlowdescribes [25] appear to draw on later communications from Gage's friends or family, [n 15]

and it is difficult to match these various behaviors (which range widely in their impliedlevel of functional impairment) [n 16] to the period of Gage's life during which each waspresent. [26] This complicates reconstructon of what Gage was like during those severalperiods, a problem which takes on renewed importance in light of recent research ( see

below ) indicating that Gage's behavior at the end of his life differed significantly fromthat in the years immediately after the accident.

[ edit ] Distortion and misuse of case
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The left frontal lobe ( red ), the area damaged by Gage's tamping iron, according to Ratiuet. al. [n 13]

There is no question Gage displayed some kind of change in behavior after his accident,but books and articles usually describe these changes in terms well beyond anything

given by Harlow. Psychologist Malcolm Macmillan, in his book An Odd Kind of Fame:Stories of Phineas Gage , surveys scores of accounts of the case (both scientific andpopular), finding that they are varying and inconsistent, typically poorly supported bythe evidence, and often in direct contradiction to it. Accounts [4] commonly ascribe toGage drunkenness, braggadocio , "a vainglorious tendency to show off his wound," an"utter lack of foresight," inability or refusal to hold a job, and much more none of these mentioned by Harlow nor by anyone else claiming actual knowledge of Gage'slife. [n 14]

Harlow himself, writing in 1868 while in contact with Gage's mother, somehowmistakes the year of Gage's death as 1861, whereas Macmillan shows conclusively [n 3]

that Gage actually died in 1860 a striking if relatively unimportant illustration of thedifficulty of establishing even basic fact about the case. In another example, severalsources [18][ 27][ 28] state that Gage's iron had been buried with him, but in fact Harlow'saccount of how he obtained the iron does not say this. [14]

More substantively, Macmillan points out [29] that in a passage mistakenly interpreted [27]

as implying Gage could not hold a job after his accident "'...continued to work invarious places;' could not do much, changing often, 'and always finding something thatdid not suit him in every place he tried'" Harlow [14] is referring not to Gage's post-accident life in general, but only to the months between the onset of his convulsions andhis death.

Beyond the obvious importance of correcting the record of a much-cited case,Macmillan writes, "Phineas' story is worth remembering because it illustrates howeasily a small stock of facts becomes transformed into popular and scientific myth," thepaucity of evidence having allowed "the fitting of almost any theory to the smallnumber of facts we have." [30] A similar concern was expressed as far back as 1877,when British neurologist David Ferrier , writing to America in an attempt "to have thiscase definitely settled," complained that "In investigating reports on diseases andinjuries of the brain, I am constantly amazed at the inexactitude and distortion to whichthey are subject by men who have some pet theory to support. The facts suffer so

frightfully...."[31]

Thus in the 19th-century controversy over whether or not the various mental functionsare localized in specific regions of the brain, both sides found ways to cite Gage insupport of their theories. [n 6] Phrenologists made use of Gage as well, claiming that hismental changes resulted from destruction of his "organ of Veneration" and/or theadjacent "organ of Benevolence." [32]

It is often said [33] that what happened to Gage played a part in the later development of various forms of psychosurgery , particularly frontal lobotomy . Aside from the questionof why the unpleasant changes usually attributed to Gage would inspire surgical

imitation,[n 17]

careful inquiry turns up no such link, according to Macmillan:
http://en.wikipedia.org/wiki/Phineas_Gage#cite_note-ratiu_phineas-31%23cite_note-ratiu_phineas-31http://en.wikipedia.org/wiki/Phineas_Gage#cite_note-accounts-9%23cite_note-accounts-9http://en.wiktionary.org/wiki/braggadocio#Nounhttp://en.wiktionary.org/wiki/braggadocio#Nounhttp://en.wikipedia.org/wiki/Phineas_Gage#cite_note-reliablesources-33%23cite_note-reliablesources-33http://en.wikipedia.org/wiki/Phineas_Gage#cite_note-OKFp108-2%23cite_note-OKFp108-2http://en.wikipedia.org/wiki/Phineas_Gage#cite_note-return_of_phineas-29%23cite_note-return_of_phineas-29http://en.wikipedia.org/wiki/Phineas_Gage#cite_note-damasiodescartes-42%23cite_note-damasiodescartes-42http://en.wikipedia.org/wiki/Phineas_Gage#cite_note-43%23cite_note-43http://en.wikipedia.org/wiki/Phineas_Gage#cite_note-harlow1868p339-342-24%23cite_note-harlow1868p339-342-24http://en.wikipedia.org/wiki/Phineas_Gage#cite_note-44%23cite_note-44http://en.wikipedia.org/wiki/Phineas_Gage#cite_note-damasiodescartes-42%23cite_note-damasiodescartes-42http://en.wikipedia.org/wiki/Phineas_Gage#cite_note-harlow1868p339-342-24%23cite_note-harlow1868p339-342-24http://en.wikipedia.org/wiki/Phineas_Gage#cite_note-45%23cite_note-45http://en.wikipedia.org/wiki/David_Ferrierhttp://en.wikipedia.org/wiki/Phineas_Gage#cite_note-46%23cite_note-46http://en.wikipedia.org/wiki/Phineas_Gage#cite_note-conflicting-8%23cite_note-conflicting-8http://en.wikipedia.org/wiki/Phrenologyhttp://en.wikipedia.org/wiki/Phrenologyhttp://en.wikipedia.org/wiki/Phineas_Gage#cite_note-sizer1888-47%23cite_note-sizer1888-47http://en.wikipedia.org/wiki/Phineas_Gage#cite_note-48%23cite_note-48http://en.wikipedia.org/wiki/Psychosurgeryhttp://en.wikipedia.org/wiki/Lobotomyhttp://en.wikipedia.org/wiki/Phineas_Gage#cite_note-49%23cite_note-49http://en.wikipedia.org/wiki/Phineas_Gage#cite_note-49%23cite_note-49http://en.wikipedia.org/wiki/Phineas_Gage#cite_note-ratiu_phineas-31%23cite_note-ratiu_phineas-31http://en.wikipedia.org/wiki/Phineas_Gage#cite_note-accounts-9%23cite_note-accounts-9http://en.wiktionary.org/wiki/braggadocio#Nounhttp://en.wikipedia.org/wiki/Phineas_Gage#cite_note-reliablesources-33%23cite_note-reliablesources-33http://en.wikipedia.org/wiki/Phineas_Gage#cite_note-OKFp108-2%23cite_note-OKFp108-2http://en.wikipedia.org/wiki/Phineas_Gage#cite_note-return_of_phineas-29%23cite_note-return_of_phineas-29http://en.wikipedia.org/wiki/Phineas_Gage#cite_note-damasiodescartes-42%23cite_note-damasiodescartes-42http://en.wikipedia.org/wiki/Phineas_Gage#cite_note-43%23cite_note-43http://en.wikipedia.org/wiki/Phineas_Gage#cite_note-harlow1868p339-342-24%23cite_note-harlow1868p339-342-24http://en.wikipedia.org/wiki/Phineas_Gage#cite_note-44%23cite_note-44http://en.wikipedia.org/wiki/Phineas_Gage#cite_note-damasiodescartes-42%23cite_note-damasiodescartes-42http://en.wikipedia.org/wiki/Phineas_Gage#cite_note-harlow1868p339-342-24%23cite_note-harlow1868p339-342-24http://en.wikipedia.org/wiki/Phineas_Gage#cite_note-45%23cite_note-45http://en.wikipedia.org/wiki/David_Ferrierhttp://en.wikipedia.org/wiki/Phineas_Gage#cite_note-46%23cite_note-46http://en.wikipedia.org/wiki/Phineas_Gage#cite_note-conflicting-8%23cite_note-conflicting-8http://en.wikipedia.org/wiki/Phrenologyhttp://en.wikipedia.org/wiki/Phineas_Gage#cite_note-sizer1888-47%23cite_note-sizer1888-47http://en.wikipedia.org/wiki/Phineas_Gage#cite_note-48%23cite_note-48http://en.wikipedia.org/wiki/Psychosurgeryhttp://en.wikipedia.org/wiki/Lobotomyhttp://en.wikipedia.org/wiki/Phineas_Gage#cite_note-49%23cite_note-49


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[T]here is no evidence that Gage's case contributed directly to psychosurgery...As with surgeryfor the brain generally, what his case did show came solely from his surviving his accident:major operations could be performed on the brain without the outcome necessarily being fatal.[34]

[ edit ] Current research

The first known photograph of Gage (identified in 2009). [n 18]

By late 2008 an advertisement for a previously unknown public appearance by Gagehad been discovered, as well as a report of his physical and mental condition during histime in Chile, a description of what may well have been his daily work routine there asa stagecoach driver, and more recently an ad for a second public appearance. This newinformation suggests that the seriously maladapted Gage described by Harlow may haveexisted for only a limited time after the accident that Phineas eventually "figured outhow to live" despite his injury ,[35] and was in later life far more functional, and sociallyfar better adapted, than has been thought. [36]

Macmillan hypothesizes that this change represents a social recovery undergone byGage over time, citing persons with similar injuries for whom "someone or somethinggave enough structure to their lives for them to relearn lost social and personal skills"(in Gage's case, his highly structured employment in Chile). If this is so then along withtheoretical implications, it "would add to current evidence that rehabilitation can beeffective even in difficult and long-standing cases," according to Macmillan, [36] whoasks, if Phineas could achieve such improvement without medical supervision, "whatare the limits for those in formal rehabilitation programs?" [37]

In 2009 a daguerreotype portrait of Gage ( left ) was identified the first likeness of himknown other than a life mask taken around 1850. It shows "a disfigured yet still-
http://en.wikipedia.org/wiki/Phineas_Gage#cite_note-50%23cite_note-50http://en.wikipedia.org/w/index.php?title=Phineas_Gage&action=edit&section=6http://en.wikipedia.org/wiki/Phineas_Gage#cite_note-51%23cite_note-51http://en.wikipedia.org/wiki/Phineas_Gage#cite_note-52%23cite_note-52http://en.wikipedia.org/wiki/Phineas_Gage#cite_note-52%23cite_note-52http://en.wikipedia.org/wiki/Phineas_Gage#cite_note-52%23cite_note-52http://en.wikipedia.org/wiki/Phineas_Gage#cite_note-Macmillan_2008_p.831-53%23cite_note-Macmillan_2008_p.831-53http://en.wikipedia.org/wiki/Phineas_Gage#cite_note-Macmillan_2008_p.831-53%23cite_note-Macmillan_2008_p.831-53http://en.wikipedia.org/wiki/Phineas_Gage#cite_note-macmillan_more-54%23cite_note-macmillan_more-54http://en.wikipedia.org/wiki/Daguerreotypehttp://en.wikipedia.org/wiki/Daguerreotypehttp://en.wikipedia.org/wiki/File:Phineas_Gage_Cased_Daguerreotype_WilgusPhoto2008-12-19_Unretouched_Color.jpghttp://en.wikipedia.org/wiki/File:Phineas_Gage_Cased_Daguerreotype_WilgusPhoto2008-12-19_Unretouched_Color.jpghttp://en.wikipedia.org/wiki/Phineas_Gage#cite_note-50%23cite_note-50http://en.wikipedia.org/w/index.php?title=Phineas_Gage&action=edit&section=6http://en.wikipedia.org/wiki/Phineas_Gage#cite_note-51%23cite_note-51http://en.wikipedia.org/wiki/Phineas_Gage#cite_note-52%23cite_note-52http://en.wikipedia.org/wiki/Phineas_Gage#cite_note-Macmillan_2008_p.831-53%23cite_note-Macmillan_2008_p.831-53http://en.wikipedia.org/wiki/Phineas_Gage#cite_note-Macmillan_2008_p.831-53%23cite_note-Macmillan_2008_p.831-53http://en.wikipedia.org/wiki/Phineas_Gage#cite_note-macmillan_more-54%23cite_note-macmillan_more-54http://en.wikipedia.org/wiki/Daguerreotype


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handsome" Gage [38] with one eye closed and scars clearly visible, "well dressed andconfident, even proud" [39] and holding his iron, on which portions of the inscription(recited above ) can be made out. (For decades the daguerreotype's owners had imaginedthat it showed an injured whaler with his harpoon .)[40] Authenticity was confirmed inseveral ways, including photo-overlaying the inscription visible in the portrait against

that on the actual tamping iron in Harvard's Warren Anatomical Museum; and similarly,matching the injuries seen in the portrait against those preserved in the life mask. [39]

Macmillan cites the daguerreotype as consistent with the social recovery hypothesisalready described. [37] To better understand the question, he and collaborators are activelyseeking additional evidence on Gage's life and behavior, and describe certain kinds of historical material ( listed here ) for which they hope readers will remain alert, such asletters or diaries by physicians who their research indicates Gage may have met, or bypersons in certain places Gage seems to have been. [1] [36]

In 2010 a second image of Gage was identified ( see head of article ). This new image,copies of which are in the possession of at least two different branches of the Gagefamily, depicts the same subject as the daguerreotype identified in 2009, according toGage researchers consulted by the Smithsonian Institution. [n 2]
http://en.wikipedia.org/wiki/Phineas_Gage#cite_note-Twomey-55%23cite_note-Twomey-55http://en.wikipedia.org/wiki/Phineas_Gage#cite_note-wilgus2009-56%23cite_note-wilgus2009-56http://en.wiktionary.org/wiki/whalerhttp://en.wikipedia.org/wiki/Harpoonhttp://en.wikipedia.org/wiki/Phineas_Gage#cite_note-wilgus_meet-57%23cite_note-wilgus_meet-57http://en.wikipedia.org/wiki/Phineas_Gage#cite_note-wilgus2009-56%23cite_note-wilgus2009-56http://en.wikipedia.org/wiki/Phineas_Gage#cite_note-macmillan_more-54%23cite_note-macmillan_more-54http://www.deakin.edu.au/hmnbs/psychology/gagepage/PgQuestn.phphttp://en.wikipedia.org/wiki/Phineas_Gage#cite_note-GagepageQs-3%23cite_note-GagepageQs-3http://en.wikipedia.org/wiki/Phineas_Gage#cite_note-Macmillan_2008_p.831-53%23cite_note-Macmillan_2008_p.831-53http://en.wikipedia.org/wiki/Phineas_Gage#cite_note-millerhartleyimage-1%23cite_note-millerhartleyimage-1http://en.wikipedia.org/wiki/Phineas_Gage#cite_note-Twomey-55%23cite_note-Twomey-55http://en.wikipedia.org/wiki/Phineas_Gage#cite_note-wilgus2009-56%23cite_note-wilgus2009-56http://en.wiktionary.org/wiki/whalerhttp://en.wikipedia.org/wiki/Harpoonhttp://en.wikipedia.org/wiki/Phineas_Gage#cite_note-wilgus_meet-57%23cite_note-wilgus_meet-57http://en.wikipedia.org/wiki/Phineas_Gage#cite_note-wilgus2009-56%23cite_note-wilgus2009-56http://en.wikipedia.org/wiki/Phineas_Gage#cite_note-macmillan_more-54%23cite_note-macmillan_more-54http://www.deakin.edu.au/hmnbs/psychology/gagepage/PgQuestn.phphttp://en.wikipedia.org/wiki/Phineas_Gage#cite_note-GagepageQs-3%23cite_note-GagepageQs-3http://en.wikipedia.org/wiki/Phineas_Gage#cite_note-Macmillan_2008_p.831-53%23cite_note-Macmillan_2008_p.831-53http://en.wikipedia.org/wiki/Phineas_Gage#cite_note-millerhartleyimage-1%23cite_note-millerhartleyimage-1

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