This is the picture of Phineas Gage, an American railway track worker of 1848, who was responsible for inserting explosives into a rock wall that had to make way for a new section of track.

While engaged in the meticulous work of railroad construction, Phineas Gage experienced a moment that would etch his name into the annals of medical history. One ordinary day, as he focused intently on his task, someone called out his name, capturing his attention. This distraction proved fateful. Normally, the procedure required covering the explosive powder with sand before using the tamping iron to pack it down—this prevented sparks. However, in that brief moment of distraction, Phineas, his mind elsewhere, skipped this crucial step and plunged the iron directly into the hole. The metal struck rock, creating a spark that ignited the powder below.

The explosion that followed was monumental. The force propelled the tamping iron—3 feet long and weighing 13 pounds—through Phineas’s cheek, behind his left eye, and out through the top of his skull, before landing 30 meters away. Against all odds, Phineas Gage survived this harrowing accident. Astonishingly, he never lost consciousness; when the doctor arrived, Gage conversed with him, able to speak and perform calculations as if the iron rod had not just passed through his brain.

At a first glance, the doctor noticed that Gage was relatively unscathed, barring the gruesome physical evidence of the rod’s passage. However, it soon became apparent that the injury had profound effects beyond the physical. Although Gage retained his cognitive abilities, his capacity for rational decision-making had diminished. The accident had damaged his prefrontal cortex, an area of the brain known to play a crucial role in processing human emotions.

This realization challenged the prevailing notion of the time that effective decision-making was purely a matter of logical, emotionless analysis. Gage’s case illustrates that emotions are integral to our decision-making processes, serving as the fuel that drives us to act upon our rational conclusions. Gage’s story not only marked a significant chapter in the understanding of the brain’s function but also highlighted the complex interplay between emotion and reason in shaping human behavior and decisions.