Virtually all general psychology textbooks recount the story of Phineas Gage, one of the most famous case studies in neuroscience. Gage was a railroad construction foreman. On September 13, 1848, he and his crew were clearing boulders along a route, a process that involved drilling a shaft deep into the rock, tamping gunpowder down into the shaft, and then blowing the boulder apart. Gage was using an iron rod to press a charge into a shaft when the gunpowder ignited. The explosion shot the rod up through Gage’s left cheek and out the top of his head, taking out a large chunk of his prefrontal cortex. Remarkably, Gage remained conscious, and ultimately, he survived. After the accident, however, his personality changed. He became highly temperamental and impulsive, which is consistent with what we now know about the role of the prefrontal cortex in emotion regulation and behavioral inhibition. When I teach about Gage, I show digital images of his skull and the route of the tamping rod, which are fairly innocuous. To illustrate that these kinds of injuries are not that uncommon, I show images of similar but more recent cases. One of them is of a Brazilian construction worker who, in 2012, fell from a building onto a piece of rebar that penetrated completely through his head from front to back and lodged there. Like Gage, he survived. Surgeons were able to successfully remove the rebar, and the worker made a full recovery. Unlike with Gage, I show photos of the worker before surgery, with the rod stuck in his head. Before I show that slide, however, I warn students that if they are squeamish, they should look away. In other words, I give a trigger warning.
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