Trauma 2010; 12: 171–174 Phineas P Gage – ‘The man with the Iron bar’

Phineas P Gage was a railway construction workman who, in 1848, received a devastating penetrating head injury. A 4 ft long tamping iron was fired by accident through his skull destroying both frontal lobes. He survived the accident through luck, the care he received from colleagues at the scene and through medical care received from doctors. This article examines closely the injury pattern, prehospital care, trauma care and medical and psychiatric sequelae Gage received. Key words: penetrating head injury; prehospital; ballistic; head injury Who was Gage? Phineas P Gage 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 both of his brain’s frontal lobes. He was born in Lebanon, Ne