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5. PHINEAS GAGE AND THE MYTH OF THE SUPERMAX BRAIN

In 1848, Vermont, USA, railroad worker Phineas Gage was tamping an explosive charge into a pre-drilled hole in a granite rock face in order to blast a cutting for the Rutland & Burlington Railroad. Sparks from his tamping iron set off the explosive charge, firing the 13lb iron bar clean through his skull, taking out what we would now call his pre-frontal cortex.

Phineas Gage survived the accident to become an instant medical celebrity. When distinguished Harvard physicians came to study him, they were amazed to discover that he appeared to have suffered no mental impairment whatsoever. Except one. He was no longer able to behave in a socially appropriate way. He’d have sudden fits of rage characterised by the use of what the visiting Harvard physicians called ‘grossest profanity’. And that, say the textbooks brightly, is how we know that the pre-frontal cortex is the bit of the brain responsible for self-control, and for mediating socially appropriate behaviour.

But nobody’s looking at this from Phineas Gage’s point of view! If I was him, I’d be saying:

I’ve been listening to all you eminent physicians puzzling over what could possibly be causing my wild mood swings, and my regrettable slide into the use of gross profanity, and you know what’s just crossed my mind? An iron fucking bar. Now if a man cannot cuss when four feet of metal rod shish-kebabs his brain, when can he cuss? Trust me, when this happens to you, tarnation is not the word you are looking for. A darn won’t do you now. This is no Jumping Jehosaphat type of situ-fucking-ation. I nearly DIED!!!

His life was saved by first responder Dr Edward Williams, who found Phineas sitting on his porch fully conscious despite the hole in his head, from which he removed, as he later wrote, coagulated blood, shards of splintered skull and ‘approximately three ounces of brain material’.

Now what I want to know is how do you know when to stop taking the brain material out? I guess Dr Williams scooped out an ounce at a time. There’s Phineas sitting on the porch, and Dr Williams is standing over him with a tablespoon.

Dr Williams: I can see some loose and flappy bits of brain in there, Phineas, that are gonna have to come out. Now I’m gonna scoop out an ounce at a time. If at any point it feels sketchy, you just holler and I will immediately desist. Okay. First ounce coming out now… Hup! How was that?

Phineas: Didn’t feel a thing, Doc.

Dr Williams: Right, Phineas. Here we go. Second ounce – hup! – out it comes! Okay?

Phineas: Can’t say I feel any different at all, Doc. You go right ahead.

Dr Williams: Okay third ounce. Third ounce coming out now, hup! How’s that?

Phineas: I think the British people will welcome a state visit from President Trump.

Dr Williams: Gotta put that third ounce back. That’s the soul right there! That’s what separates us from the baboon. You need that third ounce!

Almost all brain science books tell the Phineas Gage story. But it is strange that those who claim to be experts on how the mind works should be unable to grasp that this young man’s state of mind might be down not just to his tattered brain but to what he thinks and feels about his tattered brain. Neuroscientific accounts never entertain the possibility that Phineas’s rage might be due to grief or shock or even simple pain from his shattered jaw and eye-socket. Instead, they tell the story of Phineas Gage as illustrating a sort of Dr Jekyll and Mr Hyde model of the human brain. There’s the snarling Mr Hyde, our animal self, the killer ape inside, the product of millions of years of evolution, the real us, barely restrained by Dr Jekyll, the late cortical add-on, product of a few thousand years of flimsy social contract. The iron bar that shoots through Phineas Gage’s skull rips a hole in this cortical crust allowing the sociopathic Mr Hyde to escape Dr Jekyll. Strange to say this has become the standard scientific model in all neuroscience textbooks, the curtain-raiser on the study of cortical localisation, the science of which bits of the brain do what. What is especially strange about the acceptance of this melodramatic version of events is that it is totally un-Darwinian.

For Darwin, brain trauma doesn’t reveal our true animal nature, it separates us from our true animal nature. For Darwin, as we have seen, snarling is no more atavistic than smiling, aggression no more human than sociability. ‘We have every reason to believe,’ argues Karl Popper in the same vein, that our ancestors ‘were social prior to becoming human’.*

* Karl Popper, Conjectures and Refutations:The Growth of Scientific Knowledge, 1962.

The Myth of the Supermax Brain

In the struggle for the survival of ideas, Robert Louis Stephenson’s fiction is selected over Darwinian fact. Jekyll and Hyde better fits the modern Myth of the Supermax Brain.

According to this myth, the prefrontal cortex operates like a supermax prison locking down the seething violent criminality of our true selves.

The Supermax Myth is popular because it ticks so very many boxes about how the mind ought to work. Here it seems is the bridge between Freudian psychology and modern neurobiology, between the psychoanalyst’s couch and functional magnetic resonance imaging. Such a strategically important bridge is always going to be defended with ferocity. Only fanatical loyalty to the Supermax Myth can, I think, explain V. S. Ramachandran’s curious hostility towards Phineas Gage. In Phantoms in the Brain, he tells us that after the accident Gage became ‘a worthless vagabond with absolutely no moral sense’.

The asperity is startling, not least because it flies in the face of the historical record. We know that the worthless vagabond continued to support his family, working on their smallholding in Enfield, New Hampshire. In the remaining thirteen years of his life, he took on a series of increasingly demeaning jobs, despite suffering seizures, blackouts and terrible headaches.

In what follows I am indebted to Malcolm Macmillan’s painstaking research into first-hand sources, archive material and contemporary witness statements as he single-handedly disinterred man from myth in his book An Odd Kind Of Fame: Stories of Phineas Gage.

One hot and dusty day in August, 1849, Dr John Jackson travelled from Boston to Enfield, New Hampshire to interview the Gage family. He’d been hoping to examine Phineas himself, but met only his widowed mother and brother-in-law, who told him Phineas was in Montpelier trying to get work with another railroad company ‘doing what he did before’.

I confess that I had to re-read that last phrase three times over, when I first came across it in An Odd Kind Of Fame. Doing what he did before …? Astonishingly, Phineas Gage was trying to find work as a blasting foreman! I guess he was hoping to impress the Montpelier railway company with his experience more than his skill. Then again, who better than he to instruct railway navvies on how really, really careful you should be when priming an explosive with your tamping iron? It is after all a moot point whether we listen more attentively to the one-armed or two-armed bomb disposal expert.

Dr Jackson stayed to interview Phineas’s mother Phebe Gage, still in black crepe since the death of her husband a few months earlier, and made notes of their conversation. Jackson began by asking Phebe Gage about her son’s recuperation, and jotted down her reply:

abt. February he was able to do a little work abt. ye horses & barn, feedg. ye cattle &c.; that as ye time for ploughing came he was able to do half a days work after that and bore it well.*

* Malcolm Macmillan, An Odd Kind Of Fame: Stories of Phineas Gage, 2000.

Dr Jackson then asked after her son’s mental state. She replied that for the first few days after the accident her son was ‘childish’, but now he was back to his old self – except his memory was impaired. ‘A stranger would notice nothing peculiar’, she told Dr Jackson, but she did and so did the rest of the family.

Clearly, Phineas Gage after the accident was not the same man as before. Brain damage changed who he was, but did it extinguish who he was? Did it reveal for our edification some ancestral primate? Not for Phineas’s family at least. They saw in him the same industrious young man he had always been, eager to get on, and so impatient to be well again that he even ploughed a field before he was fully recovered. He was also, it seems, anxious to retain the hard-won status of blasting foreman, even if it meant he had to travel the sixty-five miles from Enfield to Montpelier in hopes of finding a firm who would hire him despite his disfigurement and, uh, track record.

This, then, is the raving wild man of neuroscientific myth, the worthless vagabond with absolutely no moral sense. Ramachandran’s belief in a mythology unsupported by evolutionary biology commits him to a version of events unsupported by the historical record. If Phineas Gage isn’t a worthless vagabond, then we have to abandon the Supermax Myth, the bridge between psychology and neurobiology, and completely rethink our conception of the brain. At this point Ramachandran’s acolytes helpfully suggest: ‘An Open Prison, perhaps?’ At which point one can only smile politely, tip one’s hat and bid them each good day.

In her brilliant essay Absence of Mind, Marilynne Robinson singles out for attention the ‘oddly stereotyped way’ in which brain books handle the issue of Phineas Gage’s swearing as if this somehow showed that the beast within had escaped. This is especially odd, she says, as what could be more human than swearing? So far as we know we are the only animals that do it.

That said, it will be a sad day if we finally decipher low frequency whale music only to discover that humpback whales are hurling long drawn-out expletives across the ocean at each other:

‘Yyeeewwww waaaaaannnkkkaaaaahhhhh!’

‘Yeeeeewww ffffuuuucckkkkkiiiinnggg bbaaaaassssttttaaaaaaard!’

To complement her argument, I’d just like to add another reason why I think the neuroscientific literature’s fixation on Gage’s swearing is odd. Railway navvies were as famously foul-mouthed as mule skinners. If a man was swearing among a gang of navvies, who would notice?

In 1838, an engineer working on the London-Birmingham Railway, said that English navvies were:

Possessed of all the daring recklessness of the Smuggler, without any of his redeeming qualities, their ferocious behaviour can only be equaled by the brutality of their language.

In The Railway Navvies, Terry Coleman puzzles over why there are not more reprints of Amercian navvy worksongs, and concludes that the songs were so sweary and blasphemous that they were ‘considered unprintable and so were lost’.

And yet every telling of the Phineas Gage story says that his co-workers were shocked by his swearing, and always includes the following po-faced quote from a navvy: ‘Gage isn’t the same Gage anymore’. These Blushing Railroad Workers of Vermont come across like Monty Python’s lumberjacks, who skip and jump and like to press wild flowers.

There is in fact a very good reason why contemporary observers attached great significance to Gage’s swearing. But this dramatic significance is lost to us so long as we use anachronisms like orbitofrontal cortex, ventromedial frontal lobe, or pre-frontal cortex. What the iron bar destroyed was not the ventromedial frontal lobe, but the Organ of Veneration, for the 1850s were the heyday of phrenology.

The Organ of Veneration

If we keep in mind that Phineas Gage’s Organ of Veneration has been destroyed, then the focus on his gross profanity begins to make sense. It wasn’t the swearing that got everyone’s attention, it was the swearing in front of his betters. No-one cares what oaths low people hurl at each other, but when ushered into the presence of someone venerable like Henry Bigelow, Professor of Surgery at Harvard Medical School, you keep a civil tongue in your head. To swear where you should venerate is a shocking abrogation of fundamental social norms, like a soldier patting his commanding officer on the bottom and saying, ‘What’s with all this ordering about, love? If you want to get on in this world, ask nicely.’

The Organ of Veneration is located front and centre on the phrenology chart, one of the largest single areas of the brain, a Spain to the Portugal of the Organ of Human Nature, for example. The Organ of Veneration’s pride of place reflects a nineteenth century concern with hierarchy and rank. No veneration, no order.

In the nineteenth century, phrenology was not the quackery it later became, but the cutting edge of neuroscience. Phineas Gage’s disaster allowed nineteenth-century medical science to refine the phrenological map. To this end, Dr John Harlow conducted an experiment to test the damage to his Organ of Comparison, which was close to the Organ of Veneration and as such lay in the tamping iron’s flight path.

Finding Phineas playing catch with a handful of pebbles, Dr Harlow offered to buy four of the pebbles from him for one thousand dollars. Gage politely declined the offer, possibly fearing that the doctor had suffered irreversible damage to his Organ of Comparison.

For great apes dollar bills and pebbles are equally meaningless. The Organ of Comparison lay in the part of the forehead that apes do not have. Dr Harlow is literally seeing how far from the human state into apehood Phineas has fallen. He is playing a kind of Ker-plunk of the brain: how many phrenological sticks can be removed before humanity falls away completely and we have a bipedal ape? Phineas Gage offered a particularly good starting place for such an inquiry by dint of his profession, because even in full health, the navvy was popularly, if half-seriously, describe as the missing link between apes and humans:

With fury and frenzy and fear,

That his strength might endure for a span,

From birth, through beer to bier,

The link ‘twixt the ape and the man.

‘The Navvy Chorus’, Songs of a Navvy (1912).

What did Dr Harlow make of Gage’s waving away a grand? Did he take it to prove that, whatever else the tamping iron wrecked, at least Phineas’s fundamental decency was still intact? Was this evidence that the accident hadn’t damaged his patient’s Organ of Conscientiousness (which was located halfway between the Organs of Sublimity and Firmness)? Alas, no. What Dr Harlow concluded was that Phineas Gage’s refusal to trade gravel for dollars demonstrated an inability to compare worth and worthlessness, which therefore proved that the Organ of Comparison was destroyed by the tamping iron, which means it must be just where the phrenological map said it was. One of the crucial barriers between ape and man was down.

Even allowing for the fact that phrenology – or Bumpology as its detractors called it – was considered by advocates such as Dr Harlow to be The One True Science of the Mind, I find this a puzzling conclusion. If Phineas Gage doesn’t know the meaning of money, if he thinks gravel is as good as gold, then why travel sixty-five miles to Montpelier for that job interview? Why get any kind of job at all, for that matter, when there’s so much valuable gravel lying about all over the place, just there for the taking?

How I wish Phineas Gage had pocketed those ten green hundred-dollar bills, tapped the side of his nose, and said: ‘And there’s plenty more where these pebbles come from, Doc!’ At that point Dr Harlow, blinking down at his palm and the four $250 dollar pebbles he now owned would say:

‘Actually it was just a test, Phineas.’

‘Say what?’

‘Please can I have my money back?’

‘You know, Doc, ever since the accident, if someone vexes me by like, fucking with my mind, I just go apeshit. Just lose it. Go fucking mental. I can’t keep a lid on my temper any more cos now I ain’t go no lid. Accident blew it off, know what I mean? I’m a fucking apeman, a wild man. So if someone like you was to, you know, say one thing and then the complete opposite? Well, let’s just say I wouldn’t be the only man in town with an iron bar in his head, you know what I mean? Now get off my property and take your mini fucking rockery with you!’

Nothing in the Phineas Gage story makes sense except in the light of phrenology, but phrenology is played down in popular retellings because Gage’s accident is supposed to represent a decisive break with the past. With a big bang and a cloud of smoke the new science of cortical localisation is born. A couple of years later in 1861 Paul Broca publishes ‘Sur le principe des localisations cérébrales’, in the Bulletin de la Société dAnthropologie, in which he announces to the world how reason and emotion are divvied up in the brain:

The most noble cerebral faculties have their seat in the frontal convolutions, whereas the temporal, parietal and occipital lobe convolutions are appropriate for the feelings, penchants and passions.

Broca’s schema betrays how both the new science of cortical localisation and the old science of bumpology share a common ancestor in the ancient Greek idea that Reason is a charioteer controlling the wild beasts of Passion. A line straight as a tamping iron runs from this Greek idea, through Broca relegating emotion to a penchant, and all the way to the Myth of The Supermax Brain. This tradition, I think, helps explain why Ramachandran bares his canines in such a ferocious snarl at the ‘worthless vagabond with absolutely no moral sense.’

Incidentally, no-one ever accuses the Rutland and Burlington Railroad Company bosses of having absolutely no moral sense, even though they never paid Phineas Gage one red cent in compensation. But that’s probably because rail bosses destitute of human decency were seen as just one more occupational hazard in the working life of a railway navvy, as this nineteenth-century American railroad song makes clear:

Last week a premature blast went off,

A mile in the air went Big Jim Goff.

When the next pay day came round

Jim Goff a dollar short was found.

When he asked what for, came this reply:

‘You’re docked for the time you was up in the sky!’