A genius explains

Daniel Tammet is an autistic savant. He can perform mind-boggling mathematical

calculations at breakneck speeds. But unlike other savants, who can perform similar
feats, Tammet can describe how he does it. He speaks seven languages and is even
devising his own language. Now scientists are asking whether his exceptional abilities
are the key to unlock the secrets of autism. Interview by Richard Johnson

Daniel Tammet is talking. As he talks, he studies my shirt and counts the stitches. Ever
since the age of three, when he suffered an epileptic fit, Tammet has been obsessed with
counting. Now he is 26, and a mathematical genius who can figure out cube roots
quicker than a calculator and recall pi to 22,514 decimal places. He also happens to be
autistic, which is why he can't drive a car, wire a plug, or tell right from left. He lives
with extraordinary ability and disability.

Tammet is calculating 377 multiplied by 795. Actually, he isn't "calculating": there is

nothing conscious about what he is doing. He arrives at the answer instantly. Since his
epileptic fit, he has been able to see numbers as shapes, colours and textures. The
number two, for instance, is a motion, and five is a clap of thunder. "When I multiply
numbers together, I see two shapes. The image starts to change and evolve, and a third
shape emerges. That's the answer. It's mental imagery. It's like maths without having to
think."

Tammet is a "savant", an individual with an astonishing, extraordinary mental ability.

An estimated 10% of the autistic population - and an estimated 1% of the non-autistic
population - have savant abilities, but no one knows exactly why. A number of
scientists now hope that Tammet might help us to understand better. Professor Allan
Snyder, from the Centre for the Mind at the Australian National University in Canberra,
explains why Tammet is of particular, and international, scientific interest. "Savants
can't usually tell us how they do what they do," says Snyder. "It just comes to them.
Daniel can. He describes what he sees in his head. That's why he's exciting. He could be
the Rosetta Stone."

There are many theories about savants. Snyder, for instance, believes that we all possess
the savant's extraordinary abilities - it is just a question of us learning how to access
them. "Savants have usually had some kind of brain damage. Whether it's an onset of
dementia later in life, a blow to the head or, in the case of Daniel, an epileptic fit. And
it's that brain damage which creates the savant. I think that it's possible for a perfectly
normal person to have access to these abilities, so working with Daniel could be very
instructive."

Scans of the brains of autistic savants suggest that the right hemisphere might be
compensating for damage in the left hemisphere. While many savants struggle with
language and comprehension (skills associated primarily with the left hemisphere), they
often have amazing skills in mathematics and memory (primarily right hemisphere
skills). Typically, savants have a limited vocabulary, but there is nothing limited about
Tammet's vocabulary.
Tammet is creating his own language, strongly influenced by the vowel and image-rich
languages of northern Europe. (He already speaks French, German, Spanish,
Lithuanian, Icelandic and Esperanto.) The vocabulary of his language - "Mänti",
meaning a type of tree - reflects the relationships between different things. The word
"ema", for instance, translates as "mother", and "ela" is what a mother creates: "life".
"Päike" is "sun", and "päive" is what the sun creates: "day". Tammet hopes to launch
Mänti in academic circles later this year, his own personal exploration of the power of
words and their inter-relationship.

Professor Simon Baron-Cohen, director of the Autism Research Centre (ARC) at

Cambridge University, is interested in what Mänti might teach us about savant ability.
"I know of other savants who also speak a lot of languages," says Baron-Cohen. "But
it's rare for them to be able to reflect on how they do it - let alone create a language of
their own." The ARC team has started scanning Tammet's brain to find out if there are
modules (for number, for example, or for colour, or for texture) that are connected in a
way that is different from most of us. "It's too early to tell, but we hope it might throw
some light on why we don't all have savant abilities."

Last year Tammet broke the European record for recalling pi, the mathematical
constant, to the furthest decimal point. He found it easy, he says, because he didn't even
have to "think". To him, pi isn't an abstract set of digits; it's a visual story, a film
projected in front of his eyes. He learnt the number forwards and backwards and, last
year, spent five hours recalling it in front of an adjudicator. He wanted to prove a point.
"I memorised pi to 22,514 decimal places, and I am technically disabled. I just wanted
to show people that disability needn't get in the way."

Tammet is softly spoken, and shy about making eye contact, which makes him seem
younger than he is. He lives on the Kent coast, but never goes near the beach - there are
too many pebbles to count. The thought of a mathematical problem with no solution
makes him feel uncomfortable. Trips to the supermarket are always a chore. "There's
too much mental stimulus. I have to look at every shape and texture. Every price, and
every arrangement of fruit and vegetables. So instead of thinking,'What cheese do I
want this week?', I'm just really uncomfortable."

Tammet has never been able to work 9 to 5. It would be too difficult to fit around his
daily routine. For instance, he has to drink his cups of tea at exactly the same time every
day. Things have to happen in the same order: he always brushes his teeth before he has
his shower. "I have tried to be more flexible, but I always end up feeling more
uncomfortable. Retaining a sense of control is really important. I like to do things in my
own time, and in my own style, so an office with targets and bureaucracy just wouldn't
work."

Instead, he has set up a business on his own, at home, writing email courses in language
learning, numeracy and literacy for private clients. It has had the fringe benefit of
keeping human interaction to a minimum. It also gives him time to work on the verb
structures of Mänti.

Few people on the streets have recognised Tammet since his pi record attempt. But,
when a documentary about his life is broadcast on Channel 5 later this year, all that will
change. "The highlight of filming was to meet Kim Peek, the real-life character who
inspired the film Rain Man. Before I watched Rain Man, I was frightened. As a nine-
year-old schoolboy, you don't want people to point at the screen and say, 'That's you.'
But I watched it, and felt a real connection. Getting to meet the real-life Rain Man was
inspirational."

Peek was shy and introspective, but he sat and held Tammet's hand for hours. "We
shared so much - our love of key dates from history, for instance. And our love of
books. As a child, I regularly took over a room in the house and started my own lending
library. I would separate out fiction and non-fiction, and then alphabetise them all. I
even introduced a ticketing system. I love books so much. I've read more books than
anyone else I know. So I was delighted when Kim wanted to meet in a library." Peek
can read two pages simultaneously, one with each eye. He can also recall, in exact
detail, the 7,600 books he has read. When he is at home in Utah, he spends afternoons at
the Salt Lake City public library, memorising phone books and address directories."He
is such a lovely man," says Tammet. "Kim says, 'You don't have to be handicapped to
be different - everybody's different'. And he's right."

Like Peek, Tammet will read anything and everything, but his favourite book is a good
dictionary, or the works of GK Chesterton. "With all those aphorisms," he says,
"Chesterton was the Groucho Marx of his day." Tammet is also a Christian, and likes
the fact that Chesterton addressed some complex religious ideas. "The other thing I like
is that, judging by the descriptions of his home life, I reckon Chesterton was a savant.
He couldn't dress himself, and would always forget where he was going. His poor wife."

Autistic savants have displayed a wide range of talents, from reciting all nine volumes
of Grove's Dictionary Of Music to measuring exact distances with the naked eye. The
blind American savant Leslie Lemke played Tchaikovsky's Piano Concerto No1, after
he heard it for the first time, and he never had so much as a piano lesson. And the
British savant Stephen Wiltshire was able to draw a highly accurate map of the London
skyline from memory after a single helicopter trip over the city. Even so, Tammet could
still turn out to be the more significant.

He was born on January 31 1979. He smiles as he points out that 31, 19, 79 and 1979
are all prime numbers - it's a kind of sign. He was actually born with another surname,
which he prefers to keep private, but decided to change it by deed poll. It didn't fit with
the way he saw himself. "I first saw 'Tammet' online. It means oak tree in Estonian, and
I liked that association. Besides, I've always had a love of Estonian. Such a vowel rich
language."

As a baby, he banged his head against the wall and cried constantly. Nobody knew what
was wrong. His mother was anxious, and would swing him to sleep in a blanket. She
breastfed him for two years. The only thing the doctors could say was that perhaps he
was understimulated. Then, one afternoon when he was playing with his brother in the
living room, he had an epileptic fit.

"I was given medication - round blue tablets - to control my seizures, and told not to go
out in direct sunlight. I had to visit the hospital every month for regular blood tests. I
hated those tests, but I knew they were necessary. To make up for it, my father would
always buy me a cup of squash to drink while we sat in the waiting room. It was a
worrying time because my Dad's father had epilepsy, and actually died of it, in the end.
They were thinking, 'This is the end of Daniel's life'."

Tammet's mother was a secretarial assistant, and his father a steelplate worker. "They
both left school without qualifications, but they made us feel special - all nine of us. As
the oldest of nine, I suppose it's fair to say I've always felt special." Even if his younger
brothers and sisters could throw and catch better than him, swim better, kick a ball
better, Daniel was always the oldest. "They loved me because I was their big brother
and I could read them stories."

He remembers being given a Ladybird book called Counting when he was four. "When
I looked at the numbers I 'saw' images. It felt like a place I could go where I really
belonged. That was great. I went to this other country whenever I could. I would sit on
the floor in my bedroom and just count. I didn't notice that time was passing. It was only
when my Mum shouted up for dinner, or someone knocked at my door, that I would
snap out of it."

One day his brother asked him a sum. "He asked me to multiply something in my head -
like 'What is 82 x 82 x 82 x 82?' I just looked at the floor and closed my eyes. My back
went very straight and I made my hands into fists. But after five or 10 seconds, the
answer just flowed out of my mouth. He asked me several others, and I got every one
right. My parents didn't seem surprised. And they never put pressure on me to perform
for the neighbours. They knew I was different, but wanted me to have a normal life as
far as possible."

Tammet could see the car park of his infant school from his bedroom window, which
made him feel safe. "I loved assembly because we got to sing hymns. The notes formed
a pattern in my head, just like the numbers did." The other children didn't know what to
make of him, and would tease him. The minute the bell went for playtime he would rush
off. "I went to the playground, but not to play. The place was surrounded by trees.
While the other children were playing football, I would just stand and count the leaves."

As Tammet grew older, he developed an obsessive need to collect - everything from

conkers to newspapers. "I remember seeing a ladybird for the first time," he says. "I
loved it so much, I went round searching every hedge and every leaf for more. I
collected hundreds, and took them to show the teacher. He was amazed, and asked me
to get on with some assignment. While I was busy he instructed a classmate to take the
tub outside and let the ladybirds go. I was so upset that I cried when I found out. He
didn't understand my world."

Tammet may have been teased at school, but his teachers were always protective. "I
think my parents must have had a word with them, so I was pretty much left alone." He
found it hard to socialise with anyone outside the family, and, with the advent of
adolesence, his shyness got worse.

After leaving school with three A-levels (History, French and German, all grade Bs), he
decided he wanted to teach - only not the predictable, learn-by-rote type of teaching.
For a start, he went to teach in Lithuania, and he worked as a volunteer. "Because I was
there of my own free will, I was given a lot of leeway. The times of the classes weren't
set in stone, and the structures were all of my own making. It was also the first time I
was introduced as 'Daniel' rather than 'the guy who can do weird stuff in his head'. It
was such a pleasant relief." Later, he returned home to live with his parents, and found
work as a maths tutor.

He met the great love of his life, a software engineer called Neil, online. It began, as
these things do, with emailed pictures, but ended up with a face-to-face meeting.
"Because I can't drive, Neil offered to pick me up at my parents' house, and drive me
back to his house in Kent. He was silent all the way back. I thought, 'Oh dear, this isn't
going well'. Just before we got to his house, he stopped the car. He reached over and
pulled out a bouquet of flowers. I only found out later that he was quiet because he likes
to concentrate when he's driving."

Neil is shy, like Tammet. They live, happily, on a quiet cul-de-sac. The only aspect of
Tammet's autism that causes them problems is his lack of empathy. "There's a saying in
Judaism, if somebody has a relative who has hanged themselves, don't ask them where
you should hang your coat. I need to remember that. Like the time I kept quizzing a
friend of Neil's who had just lost her mother. I was asking her all these questions about
faith and death. But that's down to my condition - no taboos."

When he isn't working, Tammet likes to hang out with his friends on the church quiz
team. His knowledge of popular culture lets him down, but he's a shoo-in when it comes
to the maths questions. "I do love numbers," he says. "It isn't only an intellectual or
aloof thing that I do. I really feel that there is an emotional attachment, a caring for
numbers. I think this is a human thing - in the same way that a poet humanises a river or
a tree through metaphor, my world gives me a sense of numbers as personal. It sounds
silly, but numbers are my friends."

Phineas Gage
From Wikipedia, the free encyclopedia
Jump to: navigation, search
Phineas P. Gage[n 1]
 The second identified portrait of Gage,
seen here with his "constant companion during
the remainder of his life"—his tamping iron..[n 2]
July 9?, 1823[n 1]
Born
Grafton Co., New Hampshire
May 21, 1860 (aged 36)[n 3]
Died
In or near San Francisco, California[1]
Cypress Lawn Cemetery, California
Resting place
Warren Anatomical Museum, Boston
Residence New England, Chile, California
Railroad construction foreman, blaster,
Occupation
stagecoach driver
Home town Lebanon, New Hampshire[n 1]
Spouse(s) None
Children None
Jesse Eaton Gage
Parents
Hannah Trussell (Swetland) Gage[n 4]

Phineas P. Gage (July 9?, 1823 – May 21, 1860)[n 1] was a railroad construction
foreman now remembered for his incredible survival of an accident in which a large
iron rod was driven completely through his head, destroying one or both of his brain's
frontal lobes, and for that injury's reported effects on his personality and behavior—
effects so profound that friends saw him as "no longer Gage."

Long called "the American Crowbar Case"—once termed "the case which more than all
others is calculated to excite our wonder, impair the value of prognosis, and even to
subvert our physiological doctrines"[2]—Phineas Gage influenced 19th-century thinking
about the brain and the localization of its functions,[3] and was perhaps the first case
suggesting that damage to specific regions of the brain might affect personality and
behavior.

Gage is a fixture in the curricula of neurology, psychology and related disciplines, and
is frequently mentioned in books and academic papers; he also has a minor place in
popular culture.[n 5] Relative to this celebrity, the body of known fact about the case is
remarkably small, which has allowed it to be cited, over the years, in support of various
theories of the brain and mind wholly contradictory to one another.[n 6] A survey[4] of
published accounts has found that even modern scientific presentations of Gage are
usually greatly distorted—exaggerating and even directly contradicting the established
facts.

A daguerreotype portrait of Gage—"handsome...well dressed and confident, even

proud," and holding the tamping iron which injured him—was identified in 2009 (see
below). One researcher points to it as consistent with a social recovery hypothesis,
under which Gage's most serious mental changes may have existed for only a limited
time after the accident, so that in later life he was far more functional, and socially far
better adapted, than has been thought. A second portrait came to light in 2010 (see
right).

Contents
[hide]

• 1 Gage's accident
• 2 Subsequent life and travels
• 3 Death and subsequent travels
• 4 Brain damage and mental changes
• 5 Distortion and misuse of case
• 6 Current research
• 7 Notes
• 8 References
• 9 Further reading

• 10 External links

[edit] Gage's accident

On September 13, 1848, 25-year-old Gage was foreman of a work gang blasting rock
while preparing the roadbed for the Rutland & Burlington Railroad outside the town of
Cavendish, Vermont. After a hole was "drilled" into a body of rock (via a laborious
process which today might best be thought of as chiseling)[5] one of Gage's duties was to
add blasting powder, a fuse, and sand, then compact the charge into the hole using a
large iron rod. Possibly because the sand was omitted,[5] around 4:30 PM:

the powder exploded, carrying an instrument through his head an inch and a fourth in
[diameter], and three feet and [seven] inches in length, which he was using at the time. The iron
entered on the side of his face...passing back of the left eye, and out at the top of the head.[n 7]

Nineteenth-century references to Gage as "the American Crowbar Case" may mislead

some readers. For Americans of the time a crowbar did not have the bend or claw
sometimes associated with that term today. Gage's tamping iron was something like a
javelin, "round and rendered comparatively smooth by use":[6]

The end which entered first is pointed; the taper being [twelve] inches long...circumstances to
which the patient perhaps owes his life. The iron is unlike any other, and was made by a
neighbouring blacksmith to please the fancy of its owner.[n 8]

Weighing 13–1/4 lb (6 kg), this "abrupt and intrusive visitor"[n 9] was said to have landed
some 80 feet (25 m) away.

Amazingly, Gage spoke within a few minutes, walked with little or no assistance, and
sat upright in a cart for the 3/4-mile ride to his lodgings in town. The first physician to
arrive was Dr. Edward H. Williams:

I first noticed the wound upon the head before I alighted from my carriage, the pulsations of the
brain being very distinct. Mr. Gage, during the time I was examining this wound, was relating
the manner in which he was injured to the bystanders. I did not believe Mr. Gage's statement at
that time, but thought he was deceived. Mr. Gage persisted in saying that the bar went through
his head....Mr. G. got up and vomited; the effort of vomiting pressed out about half a teacupful
of the brain, which fell upon the floor.[7]

Dr. John Martyn Harlow took charge of the case about an hour later:

You will excuse me for remarking here, that the picture presented was, to one unaccustomed to
military surgery, truly terrific; but the patient bore his sufferings with the most heroic firmness.
He recognized me at once, and said he hoped he was not much hurt. He seemed to be perfectly
conscious, but was getting exhausted from the hemorrhage. Pulse 60, and regular. His person,
and the bed on which he was laid, were literally one gore of blood.[8]

Despite Harlow's skillful care,[n 10] Gage's recuperation was long and difficult. Pressure
on the brain[n 11] left him semi-comatose from September 23 to October 3, "seldom
speaking unless spoken to, and then answering only in monosyllables. The friends and
attendants are in hourly expectancy of his death, and have his coffin and clothes in
readiness. One of the attendants implored me not to do anything more for him, as it
would only prolong his suffering..."[9]

But on October 7 Gage "succeeded in raising himself up, and took one step to his chair."
One month later he was walking "up and down stairs, and about the house, into the
piazza," and while Harlow was absent for a week, Gage was "in the street every day
except Sunday," his desire to return to his family in New Hampshire being
"uncontrollable by his friends...got wet feet and a chill." He soon developed a fever, but
by mid-November he was "feeling better in every respect...walking about the house
again; says he feels no pain in the head." Harlow's prognosis at this point: Gage
"appears to be in a way of recovering, if he can be controlled."[10]

The Boston Post for September 21, 1848 (misstating the dimensions of Gage's tamping
iron and overstating damage to the jaw).[n 7]

[edit] Subsequent life and travels

By November 25 Gage was strong enough to return to his parents' home in Lebanon,
N.H., where by late December he was "riding out, improving both mentally and
physically." In April 1849 he returned to Cavendish and paid a visit to Harlow, who
noted at that time loss of vision (and ptosis) of the left eye, a large scar on the forehead,
and "upon the top of the head...a deep depression, two inches by one and one-half
inches wide, beneath which the pulsations of the brain can be perceived. Partial
paralysis of the left side of the face." Despite all this, "his physical health is good, and I
am inclined to say he has recovered. Has no pain in head, but says it has a queer feeling
which he is not able to describe."[11]

Unable to return to his railroad work, Harlow says, Gage appeared for a time at
Barnum's American Museum[12] in New York City (the curious paying to see,
presumably, both Gage and the instrument that injured him) although there is no
independent confirmation of this. Recently however, evidence has surfaced supporting
Harlow's statement that Gage made public appearances in "the larger New England
towns."[13] (On Gage's job-loss and public appearances, see more below.)

Gage later worked in a livery stable in Hanover, New Hampshire and then for some
years in Chile as a long-distance stagecoach driver on the Valparaiso–Santiago route.
After his health began to fail around 1859, he left Chile for San Francisco, where he
recovered under the care of his mother and sister (who had gone there from New
Hampshire around the time Gage went to Chile). For the next few months he did farm
work in Santa Clara.[14]
"Front and lateral view of the cranium, representing the direction in which the iron
traversed its cavity..."[15]

[edit] Death and subsequent travels

In February 1860, Gage had the first in a series of increasingly severe convulsions, and
he died in or near[1] San Francisco on May 21 — just under twelve years after his
accident. He was buried in San Francisco's Lone Mountain Cemetery.[n 3] In 1866,
Harlow somehow learned where Phineas had been and opened a correspondence with
his family, still in San Francisco. At his request they unearthed his patient long enough
to remove the skull, which was then delivered to Harlow back in New England. About a
year after the accident, Gage had allowed his tamping iron to be placed in Harvard
Medical School's Warren Anatomical Museum, but he later reclaimed it and (according
to Harlow) made what he called "my iron bar" his "constant companion during the
remainder of his life";[14] now it accompanied the skull on its journey to Harlow. After
studying them for his second (1868) paper, Harlow redeposited the iron, this time with
Gage's skull, in the Warren Museum, where they remain on display today. The iron
bears this inscription:[n 12]

This is the bar that was shot through the head of Mr Phinehas [sic] P. Gage at Cavendish,
Vermont, Sept. 14, [sic] 1848. He fully recovered from the injury & deposited this bar in the
Museum of the Medical College of Harvard University. Phinehas [sic] P. Gage Lebanon
Grafton Cy N-H Jan 6 1850.

Much later, Gage's headless remains were moved to Cypress Lawn Cemetery as part of
a systematic relocation of San Francisco's dead to new resting places outside city limits.
[16]
[edit] Brain damage and mental changes

North-facing view of "cut" through rock along what was once the track of the R&BRR,
3/4 mile south of Cavendish, Vt. Gage may have met with his accident while setting
explosives either here or at a similar cut nearby.[5]

Significant brain injury is often fatal, but Harlow called Gage "the man for the case. His
physique, will, and capacity of endurance could scarcely be excelled," and as noted
earlier the iron's 1/4-inch leading point may have reduced its destructiveness.[n 10]
Nonetheless, the brain tissue destroyed must have been substantial (considering not only
the initial trauma but the subsequent infection as well) though debate as to whether this
was in both frontal lobes, or primarily the left, began with the earliest papers by
physicians who had examined Gage.[17] A 1994 study by Damasio et. al[18] (modeling not
Gage's skull but a similar one)[19] concluded there was damage to the frontal lobes on
both sides, but a 2004 study by Ratiu et. al.[n 13] (based on CT scans of Gage's actual
skull, and presenting a video reconstruction of the tamping iron passing through it)
agrees with Harlow's view that the damage was most likely to the left hemisphere only.

Neurologist Antonio Damasio uses Gage to illustrate a hypothesized link between the
frontal lobes, emotion and practical decision-making.[20] But any theory that looks to
Gage for support faces the difficulty that the nature, extent, and duration of the injury's
effects on his mental state are very uncertain. In fact, little is known about what Phineas
was like either before or after his injury (almost none of it first-hand),[n 14] the mental
changes described after his death were much more dramatic than anything reported
while he was alive, and even those descriptions which seem credible do not specify the
period of his post-accident life to which they are meant to apply.

In his 1848 report, as Gage was just completing his physical recovery, Harlow had only
hinted at possible psychological symptoms: "The mental manifestations of the patient, I
leave to a future communication. I think the case...is exceedingly interesting to the
enlightened physiologist and intellectual philosopher."[21] And after observing Gage for
several weeks in late 1849, Henry Jacob Bigelow, Professor of Surgery at Harvard,
wrote that Gage was "quite recovered in faculties of body and mind."[n 8] (Noting dryly
that, "The leading feature of this case is its improbability," Bigelow emphasized that
though "at first wholly skeptical, I have been personally convinced," calling the case
"unparalled in the annals of surgery."[n 8] Bigelow's stature largely ended scoffing about
Gage among physicians in general — one of whom, Harlow later wrote, had dismissed
the matter as a "Yankee invention.")[22]

It was not until 1868 that Harlow gave particulars of the mental changes found today
(though usually in exaggerated or distorted form — see below) in most presentations of
the case. In memorable language, he now described the pre-accident Gage as having
been hard-working, responsible, and "a great favorite" with the men in his charge, his
employers having regarded him as "the most efficient and capable foreman in their
employ." But these same employers, after Gage's accident, "considered the change in
his mind so marked that they could not give him his place again":

The equilibrium or balance, so to speak, between his intellectual faculties and

“ animal propensities, seems to have been destroyed. He is fitful, irreverent,
indulging at times in the grossest profanity (which was not previously his
custom), manifesting but little deference for his fellows, impatient of restraint
or advice when it conflicts with his desires, at times pertinaciously obstinate,
yet capricious and vacillating, devising many plans of future operations,
which are no sooner arranged than they are abandoned in turn for others
appearing more feasible. A child in his intellectual capacity and
manifestations, he has the animal passions of a strong man. Previous to his
injury, although untrained in the schools, he possessed a well-balanced mind,
and was looked upon by those who knew him as a shrewd, smart
businessman, very energetic and persistent in executing all his plans of
operation. In this regard his mind was radically changed, so decidedly that
his friends and acquaintances said he was 'no longer Gage.' [14] ”
Of the handful of available primary sources,[n 14] Harlow's 1868 presentation of the case
is by far the most informative, and despite certain errors in dating (see below) there
seems no reason to doubt its general reliability.[23] The description above, although not
published until two decades after Harlow last saw Phineas, appears to draw on Harlow's
own notes made soon after the accident.[24] But other behaviors of Gage's which Harlow
describes[25] appear to draw on later communications from Gage's friends or family,[n 15]
and it is difficult to match these various behaviors (which range widely in their implied
level of functional impairment)[n 16] to the period of Gage's life during which each was
present.[26] This complicates reconstructon of what Gage was like during those several
periods, a problem which takes on renewed importance in light of recent research (see
below) indicating that Gage's behavior at the end of his life differed significantly from
that in the years immediately after the accident.

[edit] Distortion and misuse of case

The left frontal lobe (red), the area damaged by Gage's tamping iron, according to Ratiu
et. al.[n 13]

There is no question Gage displayed some kind of change in behavior after his accident,
but books and articles usually describe these changes in terms well beyond anything
given by Harlow. Psychologist Malcolm Macmillan, in his book An Odd Kind of Fame:
Stories of Phineas Gage, surveys scores of accounts of the case (both scientific and
popular), finding that they are varying and inconsistent, typically poorly supported by
the evidence, and often in direct contradiction to it. Accounts[4] commonly ascribe to
Gage drunkenness, braggadocio, "a vainglorious tendency to show off his wound," an
"utter lack of foresight," inability or refusal to hold a job, and much more — none of
these mentioned by Harlow nor by anyone else claiming actual knowledge of Gage's
life.[n 14]

Harlow himself, writing in 1868 while in contact with Gage's mother, somehow
mistakes the year of Gage's death as 1861, whereas Macmillan shows conclusively[n 3]
that Gage actually died in 1860 — a striking if relatively unimportant illustration of the
difficulty of establishing even basic fact about the case. In another example, several
sources[18][27][28] state that Gage's iron had been buried with him, but in fact Harlow's
account of how he obtained the iron does not say this.[14]

More substantively, Macmillan points out[29] that in a passage mistakenly interpreted[27]

as implying Gage could not hold a job after his accident—"'...continued to work in
various places;' could not do much, changing often, 'and always finding something that
did not suit him in every place he tried'"—Harlow[14] is referring not to Gage's post-
accident life in general, but only to the months between the onset of his convulsions and
his death.

Beyond the obvious importance of correcting the record of a much-cited case,

Macmillan writes, "Phineas' story is worth remembering because it illustrates how
easily a small stock of facts becomes transformed into popular and scientific myth," the
paucity of evidence having allowed "the fitting of almost any theory to the small
number of facts we have."[30] A similar concern was expressed as far back as 1877,
when British neurologist David Ferrier, writing to America in an attempt "to have this
case definitely settled," complained that "In investigating reports on diseases and
injuries of the brain, I am constantly amazed at the inexactitude and distortion to which
they are subject by men who have some pet theory to support. The facts suffer so
frightfully...."[31]

Thus in the 19th-century controversy over whether or not the various mental functions
are localized in specific regions of the brain, both sides found ways to cite Gage in
support of their theories.[n 6] Phrenologists made use of Gage as well, claiming that his
mental changes resulted from destruction of his "organ of Veneration" and/or the
adjacent "organ of Benevolence."[32]

It is often said[33] that what happened to Gage played a part in the later development of
various forms of psychosurgery, particularly frontal lobotomy. Aside from the question
of why the unpleasant changes usually attributed to Gage would inspire surgical
imitation,[n 17] careful inquiry turns up no such link, according to Macmillan:
[T]here is no evidence that Gage's case contributed directly to psychosurgery...As with surgery
for the brain generally, what his case did show came solely from his surviving his accident:
major operations could be performed on the brain without the outcome necessarily being fatal.
[34]

[edit] Current research

The first known photograph of Gage (identified in 2009).[n 18]

By late 2008 an advertisement for a previously unknown public appearance by Gage

had been discovered, as well as a report of his physical and mental condition during his
time in Chile, a description of what may well have been his daily work routine there as
a stagecoach driver, and more recently an ad for a second public appearance. This new
information suggests that the seriously maladapted Gage described by Harlow may have
existed for only a limited time after the accident—that Phineas eventually "figured out
how to live" despite his injury,[35] and was in later life far more functional, and socially
far better adapted, than has been thought.[36]

Macmillan hypothesizes that this change represents a social recovery undergone by

Gage over time, citing persons with similar injuries for whom "someone or something
gave enough structure to their lives for them to relearn lost social and personal skills"
(in Gage's case, his highly structured employment in Chile). If this is so then along with
theoretical implications, it "would add to current evidence that rehabilitation can be
effective even in difficult and long-standing cases," according to Macmillan,[36] who
asks, if Phineas could achieve such improvement without medical supervision, "what
are the limits for those in formal rehabilitation programs?"[37]

In 2009 a daguerreotype portrait of Gage (left) was identified—the first likeness of him
known other than a life mask taken around 1850. It shows "a disfigured yet still-
handsome" Gage[38] with one eye closed and scars clearly visible, "well dressed and
confident, even proud"[39] and holding his iron, on which portions of the inscription
(recited above) can be made out. (For decades the daguerreotype's owners had imagined
that it showed an injured whaler with his harpoon.)[40] Authenticity was confirmed in
several ways, including photo-overlaying the inscription visible in the portrait against
that on the actual tamping iron in Harvard's Warren Anatomical Museum; and similarly,
matching the injuries seen in the portrait against those preserved in the life mask.[39]

Macmillan cites the daguerreotype as consistent with the social recovery hypothesis
already described.[37] To better understand the question, he and collaborators are actively
seeking additional evidence on Gage's life and behavior, and describe certain kinds of
historical material (listed here) for which they hope readers will remain alert, such as
letters or diaries by physicians who their research indicates Gage may have met, or by
persons in certain places Gage seems to have been.[1] [36]

In 2010 a second image of Gage was identified (see head of article). This new image,
copies of which are in the possession of at least two different branches of the Gage
family, depicts the same subject as the daguerreotype identified in 2009, according to
Gage researchers consulted by the Smithsonian Institution.[n 2]