Descartes' Error: Emotion, Reason, and the Human Brain

Damasio begins with a retelling of Phineas P. Gage’s accident. In the summer of 1848, Gage was working as a supervisor on railroad tracks in Vermont. He was considered a stellar employee, efficient at his work and capable of leadership. However, an explosion during a moment of inattention caused an iron bar to pierce into his left cheek, cross the front of his brain, and exit through the top of his head. Miraculously, this freak accident did not kill him. News of the incident soon spread across the nation. Dr. Edward Williams, who evaluated it at the time, recalled that Gage was rational and forthright in answering his questions despite the opening in his skull. Though Gage survived the accident and an infection of his wound, his personality changed.

Damasio uses evidence from Gage’s physician, Dr. John Harlow, to recount Gage’s altered spirits after the accident. Far from the smart businessperson of old, he used profanities liberally, was irreverent and obstinate, and could no longer observe social conventions. His employer released him because he was no longer the same man. His poor discipline made it difficult to hold a consistent job and he consequently earned an income by becoming a circus attraction.