Egas Moniz

The Curious Case of Phineas Gage & The Frontal Lobe

The human brain went through an unprecedented growth that more than doubled its mass in a little over two million years, transforming it from one and a quarter pound to 3 pounds.

During the growth spurt the brain didn’t grow proportionately.  The major growth was centered around an area called the frontal lobe.  The frontal lobe is the most recent addition to our brain and it allows us to imagine the future, sometimes referred to the “planning part of our brain.”

Until recently, scientists have thought the frontal lobe doesn’t serve much of a purpose, because people who have damaged their frontal lobe seem to function just fine.

Phinaes Gage was a foreman for the Rutland Railroad.  In 1848 there was a small explosion that launched a three and a half foot long iron rod into Phineas’ left cheek, driving it through his cranium and out of the top of his skull.  His frontal lobe was completely destroyed, but it didn’t seem to have much of an affect on Phineas. After the explosion, Phineas picked himself off the ground and asked one of this coworkers if he would escort him to the doctor.

Phineas lived a normal life after the incident.  He lived, saw, spoke, worked, and traveled without a problem.  If the rod had struck any other part of his brain he might have gone blind, lost the ability to speak, or died.

The curious case of Phineas Gage led neurologists to believe that humans could get along just fine without a frontal cortex.  One neurologist was wrote in 1884, “Ever since the occurrence of the famous American crowbar case it has been known that destruction of these lobes does not necessarily give rise to any symptoms.”

In the 1930’s, a Portuguese physician named Antonio Egas Moniz furthered proved how one could function just fine without the frontal lobe, and even made the case we may be better without it.  When Egas Moniz performed frontal lobotomies on monkeys he noticed that it had calming effects on them.  Later Egas Moniz tried this procedure on human patients with the same results.  Frontal lobotomies became standard treatment for people suffering severe cases of anxiety and depression. Egas Moniz even won the Nobel Prize for Medicine in 1949 for his surgical techniques.

People with frontal lobe damage seemed to be no worse than they were before the damage and sometimes even seemed to benefit from it. But there was one thing people with frontal lobe damaged couldn’t do – they couldn’t plan for the future.  People with frontal lobe damage were able to do everything a person with a fully intact brain could do but were woefully inadequate when it came to planning.  As such, people whose frontal lobe damage are described by those who study them as being “bound to present stimuli” or “locked into immediate space and time.”

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