Phineas P. Gage (1823 – May 21, 1860) was an American railroad construction foreman remembered for his improbable[C] survival of a rock-blasting accident in which a large iron rod was driven completely through his head, destroying much of his brain's left frontal lobe, and for that injury's reported effects on his personality and behavior over the remaining twelve years of his life—effects so profound that (for a time at least) friends saw him as "no longer Gage." Long known as "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"[3]—Phineas Gage influenced nineteenth-century discussion about the mind and brain, particularly debate on cerebral localization,[1]:ch7–9[4] and was perhaps the first case to suggest that damage to specific parts of the brain might induce specific personality changes.[1]:1[5]:C So says Wikipedia about the Famous Phineas Gage case. Now, I have a character who has an injury similar to Mr. Gage's, but there has been little literature about what exact emotional and personality changes happened. I know the frontal lobe controls impulse control, but what other changes would occur with someone with a frontal-lobe injury?
Just a random page from a google of 'Frontal lobe damage' I got: The frontal lobes are involved in motor function, problem solving, spontaneity, memory, language, initiation, judgement, impulse control, and social and sexual behavior. Seems to me you could have a completely random grab-bag of symptoms/changes. You could probably exactly replicate the damage (survivable) 50 times and get 50 different changes. While I'm not a brain surgeon, I have stayed at a Holiday Inn Express...
You need to distinguish between Gage's injuries that were specific to him but opened up a new era of understanding of the biology of personality (nature previously thought to be all nurture), and whatever brain damage you want your character to have.
His forehead was crushed by a falling rock. He's had surgery to remove skull fragments and whatnot, but nothing could be done to save his brain.
Did you see these links and look at the citations: http://www.neuroskills.com/brain-injury/frontal-lobes.php http://www.nia.nih.gov/alzheimers/publication/frontotemporal-disorders/basics-frontotemporal-disorders
@stormcat you might also want to look at information on strokes http://en.wikipedia.org/wiki/Stroke one of the interesting things about brains is how plastic they are; it's well-documented that if a part of the brain is injured, say a part that regulates speech or spatial recognition, then often (with the assistance of therapy) the brain will eventually rewire itself to regain most of the lost function. in the same way, most mental functions don't map precisely to certain areas of the brain every time--it's not like "area 7" is always for listening to music, and "area 33" is always for remembering the names of flowers. some areas map consistently to certain functions, but a lot of stuff doesn't. the most likely immediate result of a traumatic brain injury is aphasia and memory loss, regardless of where on the head the injury occurred. long-term effects, you can pretty much make up what you like.
What Phineas Gage had as a result of his brain damage was specifically dysexecutive syndrome. http://en.wikipedia.org/wiki/Dysexecutive_syndrome#Symptoms I did read an essay that shared a specific story of a young woman with the disorder...but I'm having trouble finding it now. If I happen upon it (was on the internet) then I'll post it for you. ...Found it not a moment later! http://www.hcnet.usp.br/ipq/revista/vol37/n6/eng/301.htm Case 1 – Acquired EFs deficits after traumatic brain injury (TBI=traumatic brain injury)
Christ, that one didn't go into the specifics of it all. Trying to find one that gives you a good picture of the personality changes. There was a story that involved her stealing her grandmother's money on a whim. Having trouble finding it.
I was going to go into a dissertation on this very topic but elynne beat me to it and did an excellent job of it. Thanks, elynne. Nicely done. Also, despite the erroneous belief that each one side of the brain controls theoretical and the other real concepts, that has been determined (a little late to the fray in my opinion) to be totally false. And, both sides of the brain are irrefutably dependent upon each other. Studies have been done of people whose brains have been divided, either through disease, accident, or surgery. The corpus callosum, the collection of nerves and neurons that make up the bridge between the two hemispheres of the brain allow the two sides to communicate with one another. When this communication is disrupted, the two sides of one brain might as well be on two opposite sides of the world. Cutting a steak, pouring a glass of milk, putting on make up, driving a car, anything that requires coordinating bilateral function becomes nearly impossible. The left hand, quite literally, doesn't know what the right hand is doing. There is a great deal about the brain that has not been discovered yet. But modern science, in its ego coat, always seems to believe it has THE right answer, right now. Later, sometime down the line, some other scientist in his own ego coat will declare the past was wrong but NOW they have the right answer. So, don't wait too long for scientific research to give you all the answers. The best it can really do is hint at what we think we know.
I never did find the full monty on that case study. Not that I looked much more after admitting I was having troubles finding it. That part must have been in some book. I suppose I can offer the scraps of my memory. Dysexecutive syndrome in a young south american woman caused from traumatic brain injury. The best way to understand her change in personality is to understand that she was no longer processing things the same. She was always in the immediate and failed to give any importance to things out of the immediate. For instance, one day she was at home and suddenly got the urge to go to the beach. She needed money to get there and so she took it out of her grandmother's purse and went. This was something that she would have never done before, stealing from granny (who was upset and shocked). She stopped going to school and work and operated fully on her immediate interests. She was incapable of a mind frame beyond that. She was capable of logically understanding consequences of her actions if asked, however this knowledge was a removed concept for her. Also, she was apathetic to the consequences of her actions when they came about. She was not intentionally cruel, just incapable of the effect.
Some excellent responses all around. Indeed, Phineas Gage is only one of several documented cases of surviving severe head trauma, and ending up with a variety of what we know now as Acquired Brain Injury syndrome. A good article from British Medical Journal on this case: I bolded the part that I think is important. While the brain is 'plastic' and can re-route many connections in order to bypass the damaged area and regain function again, not all brain lesions are created equal. Some areas are fairly easily re-routed, some aren't. Brocca's area is one example, where a person never fully regains the ability to pronounce words, even though they understand them, as opposed to Wernicke's area stroke, where person retains ability to speak without impediment, but their comprehension for words suffers. Frontal lobe damage is very well described in the above article. These days we call it 'disinhibition', it is often seen in Acquired Brain Injury (ABI) as well as certain types of dementia. People can become profane, sexually disinhibited, aggressive when opposed, but also they can suffer extreme lack of motivation, so much so that many a young motorist with ABI needs nurses to prompt him to move, walk, eat, otherwise, it doesn't occur to them. They may have issues with forward planning and judgement. They can suffer with seizures, and if they aren't controlled, the brain is running the risk of more injury. The severity of symptoms and their exact type obviously depends on the place and extent of the lesion, but I'd google 'disinhibition' 'frontal lobe damage' and acquired brain injury' to get a better idea of the types of challenges these people face in daily life. ps. Here's a little diagram that can illustrate how specific and predictable damage from brain injury can be.
If you might be interested in a different but similar brain damage disorder, then you could look into Witzelsucht. Right frontal lobe damage resulting in the telling of jokes (puns being the most common), failure to be socially appropriate, and inability to feel sad. Might allow you some more freedom with the character after the injury than dysexecutive/gage-style. Plus, I think it's more straight forward than dysexecutive. http://en.wikipedia.org/wiki/Witzelsucht
I was involved in a motorcycle accident about 2 years ago and even though I was wearing a full face helmet I ended up some brain damage from the impact. Since I was unconscious immediately after impact and can't remember anything happening 10 minutes or so before the wreck, I have no idea how I hit the pavement. However, my helmet clearly has damage to the front front from the top down to the chin so it easy to estimate I have some damage to the front lobe. I can't say what issues are related directly to the front lobe and what issues are because of damage to another part of the brain, but I have noticed several things since my wreck. A change in my emotional range meaning I will get angrier at things more than I ever did before the wreck. Also, I cry a lot now. I cry over movies which never happened before my wreck, hell I have cried over some television commercials. I also find it easier to empathize with people. I have memory issues now too. They seem really minor and most people would say, "I just lost my train of thought" or "I forget stuff all the time". Unfortunately, these little things do happen to me all the time. I would guess on an average day, I completely forget what I was thinking about from one second to the next at least 3 dozen times. This of course doesn't include any memory lapses that happen that I don't remember. I forget doing activities, having conversations, and asking questions. My girlfriend always points out that I just asked that question the day before or when I suggest we do something she reminds me we just did it last week. This happens at least 2 or 3 times a day. Names are the worst for me. I will forget your name by the time it finishes coming out of your mouth. My attention span can drop to the size of a 5 year with ADD on a sugar high. I will lost interest in something in a matter of minutes and move away from it then forget I even started it or what I was doing. I find I have an urge to keep myself busy to some degree constantly. I try to sit down and relax and not think about anything during the day this lasts maybe 5 or 10 minutes before I have to engage myself in something. On the flip side, occasionally I will get so focused on something everything else disappears. I have gone 10 or 12 hours working on something without getting the least bit hungry and stopping just long enough to use the bathroom once or twice. The next day though I may not care about it at all even though it was my whole word the day before. These are the big things I notice on a day to day basis. There are some other problems I have with riding in a car, being touched while asleep, and nightmares. I didn't read every post in this thread, but thought I would offer some personal information about traumatic brain injury.
Maybe you need to look at how your character behaves in the first place as it looks like the main side effect is a reversal of the injured persons personality, as Gage's friends remarked, he was no longer, Gage.
