How This Man Survived Having A Metal Bar Shot Through His Skull... And Changed Medicine Forever

A 3-D reconstruction of the path the iron took through Gage’s skull. Wikimedia Commons.

By 6:00 PM that night, Gage was starting to show the effects of his injury. He had, after all, lost a lot of blood and a significant amount of brain tissue. Williams turned the case over to a local surgeon, John Martyn Harlow, who noted that the bed sheet Gage lay on was now completely covered in gore. Gage was still awake and said that he expected to be back at work in a few days. But he was growing weaker. And his legs seemed to move by themselves, a clear sign that something was wrong with his brain.

Harlow began cutting away bone fragments and clearing the congealed blood out of the wound. He also had to remove another ounce of Gage’s brain that was sticking out of the skull. Finally, Harlow bandaged the wound, allowing a space for it to drain. Ultimately, there was little else he could do, and Gage’s condition began to rapidly grow worse. By the next morning, he was completely delirious. Within two weeks, he was close to falling into a coma. The tissue around his brain began to grow infected, and visible fungus collected on the open wound.

Gage’s family began making preparations for his funeral, even purchasing his coffin. But Harlow wasn’t ready to give up. Instead, applied medication to fungus to stop it from growing back. Then, he made a large incision in Gage’s forehead. It left a scar that Gage would have for the rest of his life, but the cut worked. Immediately, a large amount of extremely foul-smelling pus drained out of the wound. Gage had been suffering from what doctors now call a cerebral abscess. By draining it, Harlow had saved his life.

Almost a month after the accident, Gage was able to get out of bed and take a few shaky steps. Eventually, Gage was able to return to New Hampshire to stay with his family. And by the time summer rolled around, he was strong enough to help out around the farm. In April of 1849, Gage returned to Cavendish to meet with Dr. Harlow. Harlow noted that Gage seemed to have made a full recovery. The only lasting signs of the accident was a drooping of his left eyelid and a depression in the skin over the injury. Harlow was even able to feel the brain pulsing through it.

Dr. Harlow. Wikimedia Commons.

Gage reported that the injury no longer hurt but still gave him a “queer feeling which he is not able to describe.” But while Gage seemed like he had recovered physically, there were signs that something strange was happening in his mind. His family first noticed that he had trouble remembering things. More disturbingly, his personality had changed as well. Gage was no longer the man he used to be. Something strange had happened to Gage. And his unique case was beginning to change everything doctors knew about the brain.