More About Phineas Gage, especially after the accident

by Malcolm Macmillan

What happened to Phineas after his accident?

Because Beverly and Jack Wilgus have summarised how Phineas’ brain was damaged, I will focus here on what happened to him immediately after, and in the long-term. I especially want to raise the possibility that Phineas made some kind of long-term recovery. Not that he was ‘cured,’ of course, but that he was able to live independently and otherwise support himself, perhaps even to enjoy life.

The immediate effects

Doctor John Martyn Harlow of Cavendish took charge of his treatment, which lasted about 3 months, until Phineas was well enough to return to his parents’ farm in Lebanon, New Hampshire. Dr. Harlow’s 1848 report suggested recovery was complete and in August 1849 his family confirmed that view with Dr. JBS Jackson. In 1868, Harlow described a darker outcome: Phineas’ contractors would not give him back his job. His personality had altered: he had become impulsive, unreliable, unable to carry out his plans, was profane and now lacked deference towards others. So marked was this change, that his friends said he “was no longer Gage.”

Fancy and truth

Most of the accounts of the rest of Phineas’ life paint a picture of a permanently unstable if not an uncontrollable personality. The trouble is they are either gross exaggerations or complete fabrications. None is independently documented. Taken together, these descriptions are of a once-temperate, mild, friendly, and genial Gage who was a favourite with his peers and elders, and who was industrious and reliable. According to them, this Phineas was transformed into a boastful, unpredictable, moody, depraved, slovenly, quarrelsome, aggressive, and drunken bully who had fits of temper, and whose sexuality was impaired. This Phineas is a waster who does not settle down and is unwilling to work. For most of the rest of his life he exhibits himself as a human freak with circuses or on fairgrounds and dies and penniless in an institution.

But what does Harlow, until now almost the only source of information about him, actually tell us? It is that Phineas gave lectures and exhibited himself and his tamping iron throughout New England; worked as an ostler at Jonathan Currier’s Hanover Inn in Dartmouth, NH, for 18 months; and then went to Valparaiso to work as a stage-coach driver. After about another 5-6 years Phineas became ill and returned, probably in 1859, to his family, then resident in San Francisco. After again regaining his health, his mother said he “was anxious to work” and did so as a farm labourer in Santa Clara County. In February 1860 he began to have epileptic seizures and only after they had begun did he become restless, dissatisfied with his employers, moving often from one job to another. The seizures became more frequent and he died in May 1860 of repeated attacks (status epilepticus). Phineas had survived his accident for eleven and a half years.

Could Phineas have made a ‘social’ recovery?

Little in Harlow’s 1868 report squares with the fanciful picture. Although changed in important ways, what happened to Phineas was very different. Even the psychological changes that Harlow described may have held for only the 3-4 year period after the accident, rather than for the rest of his life.
There are reports of people with brain injuries as severe as Phineas’ who were able to relearn lost social and personal skills without formal rehabilitation therapy. What happened to them was that someone or something structured their worlds in such a way that, although not ‘cured,’ they were able to live independently and in some cases to return to work. Many made quite spectacular ‘social’ recoveries.

I have said elsewhere I think it possible that happened to Phineas. (Phineas Gage: Unravelling the myth. The Psychologist, 21: 836-839). Consider the demands of coach-driving: its routine imposes a repetitive and fairly rigid daily structure and a description of the daily tasks of a driver on the very route Phineas may have driven (Valparaiso-Santiago-Valparaiso) clearly shows this. Phineas had little choice over his tasks: he had to rise early in the morning, prepare himself, and groom, feed, and harness the horses; he had to be at the departure point at a specified time, load the luggage, charge the fares and get the passengers settled; and then had to care for the passengers on the journey, unload their luggage at the destination, and look after the horses. The tasks formed a structure that required control of any impulsiveness he may have had.

Even before going to Chile, Phineas seems to have been able to look after himself while travelling and exhibiting himself; he earned enough to be independent, and to work for a long period for Jonathan Currier. The 1850s daguerreotype found by Jack and Beverly Wilgus certainly seems to show a confident Phineas, squarely facing the world. On his return to USA and after recovering, he was anxious to work. Phineas seems only to have become restless and dissatisfied with his employment after the seizures began late in his life. Although my argument is frankly speculative, it is supported by the results of modern rehabilitation programs like those in the BBC Radio 4 Case Study broadcast and discussion on Phineas.

John Fleischman has put this thesis pithily: Phineas “figured out how to live.” The thesis is extremely important for modern sufferers of injuries to the brain. If Phineas could make a social recovery by himself, what are the limits for those in formal rehabilitation programs?

Evidence and questions

Without your knowing, you may have documents that provide the evidence needed to answer this and related questions. Do you have any letters, diaries, or journals of families who knew or knew of Phineas in New England, in Chile, or in San Francisco? Does anyone have, for example, great-great-great-grandparents who lived in the towns of New England he visited and who wrote a letter about how Phineas behaved? Or have a distant relative who was in Valparaiso or Santiago roughly in the period 1852-1859, or know of a local historian who has studied migration there or knows about stage-coach lines?

1. Phineas before the accident

Where did Phineas Gage grow up? Was it on the farm of his mother’s parents in or near Lebanon NH.
Where did Phineas go to school and how much education did he have? It could have been in Lebanon, East Lebanon, Grafton, or Enfield (all NH).

What did Phineas work at before working for a contractor on the R&BRR? On farms, the isinglass (mica) mines in Grafton, NH, and/or on the Northern Railroad that ran through New Hampshire?

How much was Dr. Harlow influenced by phrenology? Nelson Sizer and Lyman Buell said they had given phrenological lectures in Cavendish under Harlow's auspices in the tour they made in New England in the 1840s. One of your distant relatives living in Vermont might have known Harlow or even attended the lectures.

2. The accident

Do you have any diary entries, letters, or newspaper accounts of Phineas’ accident itself? It would be good to find the original Ludlow Free Soil Union report but even better to find a more personal first-hand account.
What role did Dr. E. H. Williams play in treating Gage? See my entry on Dr. Williams.

3. Phineas in New England after the accident

Exactly where and when did Phineas travel in New England exhibiting himself and his tamping iron, and how did he behave? Some newspaper accounts by people who met him in 1848-1849 have been found and there are two announcements of his tour (one undated, the other from August 1852) and he may have still been in New England as late as 1854.

What kind of work did Phineas do for Jonathan Currier at the Hanover Inn in Dartmouth, NH? Was he only a stable hand but did he also learn to drive coaches for Currier? You might have a letter or similar from a relative who lived in Hanover at that time who saw Phineas that tells how well he got on with customers at the Inn.

4. Phineas in Valparaiso or Santiago (Chile) after the accident

How and when did Phineas travel to Valparaiso? Even as late as 1854 he might have been part of the gold rush to California. You may have accounts of journeys, either around Cape Horn or across the Isthmus of Panama, that mention Phineas as a travelling companion.

Did Phineas work for the one employer for the whole of the nearly seven years he was in Chile? Your answer would help establish how settled or otherwise he had become.

Do you know anything about the doctors Henry and William Trevitt who practiced in Valparaiso? Some time before 1860 Henry was reported as saying in Ohio that he had seen a Phineas “with no impairment of his mental faculties.” Do you know if the letters and other papers etc of Henry or William have survived or something else about them?