Neurology, week 5

phineas_gage_-_1868_skull_diagram.jpgOur Sherman’s march through the brain continues as we cover the aspects of consciousness and unconsciousness. Although impossible to ‘define’ consciousness adequately, we did collectively fight the good fight and covered the anatomical components of consciousness as well as the mechanisms that cause unconsciousness. This week also begins our first foray into relating physical brain structure with behavior.

Of course – when one begins to talk about the physical brain and behaviors associated with certain areas, the story pf Phineas Gage is inevitably told. I have heard it a couple of times before in other classes. The story goes, that sometime in 1848, one Phineas P. Gage was working with a construction crew working on the railroad outside of a small town in Vermont. While Phineas was tamping down some gunpowder, the powder exploded and blew the tamping rod through Phineas’ head (see picture). Phineas survived the blast and the massive injury to his head with loss of vision in one eye and some facial paralysis…as well as some facial disfigurement, which I suppose was not completely unexpected (again – if you haven’t already, look at the picture). What was unexpected was the massive change in Phineas’ personality. Where he had been hard-working, responsible and cordial he was now “fitful, irreverent, indulging at times in the grossest profanity“. The doctor examining Phineas during this time noted:

In this regard his mind was radically changed, so decidedly that his friends and acquaintances said he was ‘no longer Gage

Supposedly this is the first time there was actual evidence that suggested that damage to the frontal lobes could alter aspects of personality and social behavior. Whether this is true or not, I don’t know but it must have been quite interesting for the early neurologists to be able to relate physical damage in a specific area of the brain to an alteration of outward behavior.

Phineas aside there are a number of school related things that are beginning to gather steam. The first of which is the rural placement, which I have talked about previously (here) and the second is the choosing of the third year rotations. Both of these are “big” medical school choices although truthfully neither really is, as both will be decided by a lottery at the end of the day…at least the illusion of choice is there. I am really looking forward to to the rural placement and clerkship year right now, because the classroom learning is becoming too routine and tedious in its own way. A change would definitely be nice!


3 responses to “Neurology, week 5

  1. Your post about Phineas Gage reminded me of my first year Psychology course. It’s such an incredible story – giving new meaning to a splitting headache. You might be interested in this short little video that shows a digital reconstruction of the injury.

    Also – I noticed you have a link to my blog on your Doc Blogs page. Thanks for your interest. I’ve recently changed the title, and url – so perhaps you could update it when you get a chance?
    It’s now “Medical Illustration Studio Blog”, and the url is

    I’ve added your blog to my blog roll – and will check in occasionally. Keep blogging.

  2. Thanks for the comment. I’ve updated the doc blogs page so it has your current url. For those who haven’t checked out the Medical Illustration Studio Blog yet – go now, it’s well worth the time…

  3. Generally I do not post on blogs, but I would like to say that this post really forced me to do so, Excellent post!

    I’m Out! 🙂

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