Write Out

I'm not sure it's writer's block or if it's just insomnia or the head cold that developed from the extended allergy season (wish it would hurry up and snow) but I haven't been up to writing the last day or so.  Here's a rerun, from my archive.

The Strange History of Altusim 

Of the four fine essays given by Marilynne Robinson in this series, this one is my favorite.   One of the most enlightening passages was the one in which she talks about the famous case of Phineas Gage.  It is a demonstration of how the reductionist method practiced by those who demote the mind to chemicals and neural circuitry produces a facile, two-dimensional cartoon of real human beings, ignoring enormous parts of human life and personality, not on the basis of it being irrelevant but it being inconvenient to their purpose.  Whose imagined Phineas Gage is more convincing?  That of the alleged scientists or the novelist-essayist?

I am indebted to Daniel Dennett for the ant and the lancet fluke, a metaphor that comes to mind often as I read in his genre.  for example, consider poor Phineas Gage, the rail-road worker famous for the accident he suffered and survived more than 150 years ago, an explosion that sent a large iron rod through his skull.  Wilson, Pinker, Gazzaniga, and Antionio Damasio all tell this tale to illustrate the point that aspects of behavior we might think of as character of personality are localized in a specific region of the brain, a fact that, by their lights, somehow compromises the idea of individual character and undermines the notion that our amiable traits are intrinsic to our nature.

Very little is really known about Phineas Gage.  The lore that surrounds him in parascientific contexts is based on a few anecdotes of uncertain provenance, to the effect that he recovered without significant damage - except to his social skills.  Gazzaniga says,  "He was reported the next day by the local paper to be pain free."  Now, considering that his upper jaw was shattered and he had lost an eye, and that it was 1848, if he was indeed pain free, this should surely suggest damage to the brain.  But, together with his rational and coherent speech minutes after the accident, it is taken to suggest instead that somehow his brain escaped injury, except to those parts of the cerebral cortex that had, till then, kept him from being "'fitful, irreverent, and grossly profane.'"  He was twenty-five at the time of the accident.  Did he have dependents?  Did he have hopes?  these questions seem to me of more than novelistic interest in understanding the rage and confusion that emerged in him as he recovered.

How oddly stereotyped this anecdote is through any number of tellings.  It is as if there were a Mr. Hyde in us all that would emerge sputtering expletives if our frontal lobes weren't there to restrain him. If any kind of language is human and cultural, it is surely gross profanity, and, after that, irreverence, which must have reverence as a foil; to mean anything at all.  If to Victorians this behavior seemed like this emergence of the inner savage, this is understandable enough.  But from our vantage, the fact that Gage was suddenly disfigured and half blind, that he suffered a prolonged infection of the brain, and that "it took much longer to recover his stamina,"  according to Gazzaniga, might account for some of the profanity, which, after all, culture and language have prepared for such occasions.  But the part of Gage's brain where damage was assumed by modern writers to have been localized is believed to be the seat of the emotions.  Therefore  - the logic here is unclear to me - his swearing and reviling the heavens could not mean what it means when the rest of us do it.  Damasio gives extensive attention to Gage,  offering the standard interpretation of the reported change in his character.  He cites at some length the case of a "modern Phineas Gage,"  a patient who, while intellectually undamaged, lost "his ability to choose the most advantageous course of action."  Gage himself behaved "dismally" in his compromised ability "to plan for the future, to conduct himself according to the social rules he previously had learned, and to decide on the course of action that ultimately would be most advantageous to his survival."  The same could certainly be said as well of Captain Ahab.  So perhaps Melville meant to propose that the organ of veneration was located in the leg.  My point being that another proper context for the interpretation of Phineas Gage might be others who have suffered gross insult to the body, especially those who have been disfigured by it.  And in justice to Gage, the touching fact is that he was employed continually until his final illness.  No one considers what might have been the reaction of other people to him when his moving from job to job - his only sin besides cursing and irritability - attracts learned disapprobation.

I trouble the dust of poor Phineas Gage only to make the point that in these recountings of his afflictions there is no sense at all that he was a human being who thought and felt, a man with a singular and terrible fate.  In the absence of an acknowledgment of his subjectivity his reaction to this disaster is treated as indicating damage to the cerebral machinery, not to his prospects, or his faith, or his self-love.  It is as if in telling the tale the writers participate in the absence of compassionate imagination, of benevolence, that they posit for their kind And there is another point as well.  This anecdote is far too important to these statements about the mind, and about human nature.  It ought not to be the center of any argument about so important a question as the basis of human nature.  It is too remote in time, too phrenological in its initial descriptions, too likely to be contaminated by sensationalism  to have any weight as evidence.  Are we really to believe that Gage was not in pain during those thirteen years until his death"  How did that terrible exit wound in his skull resolve?  No conclusion can be draw, except that in 1848 a man reacted to severe physical trauma more or less as a man living in 2009 be expected to do.  The stereotyped appearance of this anecdote, the particulars it includes and those whose absence it passes over, and the conclusion that is drawn from it are a perfect demonstration of the difference between parascientific thinking and actual science. 

This is only one of the masterpieces of human observation and elucidation contained in Robinson's essays.   All of those reconstructions of Phineas Gage are acts of imagination,  Robinson's no more than Gazzaniga's or Damasio's,  I'll ask again, whose version of him is more credible, more mindful of what must have been left out and in consideration of the believably of  various features of the near-contemporary accounts in which the story comes down to us.  Who is more exacting in that?  What are the motives involved in the reconstructions of the real man.

And this:

I hadn't known that two verified photographs of Phineas Gage have recently been discovered.   Before now the only image I'd ever seen of him was his shattered skull.  As can be seen, he was a very handsome man even after his accident left him disfigured.  I had also not known that he wasn't merely a laborer on the railroad but a foreman.  He had every reason to believe himself to be a young man of stature, a man who had prospects above the ordinary.   I can only imagine what an adjustment his catastrophic accident must have forced to his self-image.  

The accounts of his change in personality apparently don't square with the facts.  As Marilynne Robinson pointed out, he was continually employed until shortly before his death.  Here's an account of his work history,  which hardly seems like the picture painted in most of the "scientific" uses of him which I've read. 

Fancy and truth 

Most of the accounts of the rest of Phineas’ life paint a picture of a permanently unstable if not an uncontrollable personality. The trouble is they are either gross exaggerations or complete fabrications. None is independently documented. Taken together, these descriptions are of a once-temperate, mild, friendly, and genial Gage who was a favourite with his peers and elders, and who was industrious and reliable. According to them, this Phineas was transformed into a boastful, unpredictable, moody, depraved, slovenly, quarrelsome, aggressive, and drunken bully who had fits of temper, and whose sexuality was impaired. This Phineas is a waster who does not settle down and is unwilling to work. For most of the rest of his life he exhibits himself as a human freak with circuses or on fairgrounds and dies and penniless in an institution.

But what does Harlow, until now almost the only source of information about him, actually tell us? It is that Phineas gave lectures and exhibited himself and his tamping iron throughout New England; worked as an ostler at Jonathan Currier’s Hanover Inn in Dartmouth, NH, for 18 months; and then went to Valparaiso to work as a stage-coach driver. After about another 5-6 years Phineas became ill and returned, probably in 1859, to his family, then resident in San Francisco. After again regaining his health, his mother said he “was anxious to work” and did so as a farm labourer in Santa Clara County. In February 1860 he began to have epileptic seizures and only after they had begun did he become restless, dissatisfied with his employers, moving often from one job to another. The seizures became more frequent and he died in May 1860 of repeated attacks (status epilepticus). Phineas had survived his accident for eleven and a half years.

... Consider the demands of coach-driving: its routine imposes a repetitive and fairly rigid daily structure and a description of the daily tasks of a driver on the very route Phineas may have driven (Valparaiso-Santiago-Valparaiso) clearly shows this. Phineas had little choice over his tasks: he had to rise early in the morning, prepare himself, and groom, feed, and harness the horses; he had to be at the departure point at a specified time, load the luggage, charge the fares and get the passengers settled; and then had to care for the passengers on the journey, unload their luggage at the destination, and look after the horses. The tasks formed a structure that required control of any impulsiveness he may have had.

Even before going to Chile, Phineas seems to have been able to look after himself while travelling and exhibiting himself; he earned enough to be independent, and to work for a long period for Jonathan Currier. The 1850s daguerreotype found by Jack and Beverly Wilgus certainly seems to show a confident Phineas, squarely facing the world. On his return to USA and after recovering, he was anxious to work. Phineas seems only to have become restless and dissatisfied with his employment after the seizures began late in his life. Although my argument is frankly speculative, it is supported by the results of modern rehabilitation programs like those in the BBC Radio 4 Case Study broadcast and discussion on Phineas.

John Fleischman has put this thesis pithily: Phineas “figured out how to live.” The thesis is extremely important for modern sufferers of injuries to the brain. If Phineas could make a social recovery by himself, what are the limits for those in formal rehabilitation programs?

It's hard to believe that someone as erratic as Gage was claimed to be, due to the injury to his brain, could have sustained that work history.  I would guess it would compare quite favorably to many men of his class, in that time who had suffered a far less catastrophic injury and disfigurement.  From what I know about my great-great - grandfathers, his rough contemporaries, it would seem to be fairly typical.   Considering the very strong possibilities that his move to Chile may have necessitated him learning to adapt to many new and puzzling conditions, and the length of his employment in the challenging work as a teamster, I'd expect he must have been quite patient.   It would seem that it was only near the end of his life, as he began to have seizures that he became more erratic.   I wonder if he might not have begun to suffer some form of dementia, the insult his brain had suffered was far more dramatic than those who begin to exhibit early onset dementia.  Fear, anxiety and rage as ones physical capability, memory and reason are failing are reported by those who have only suffered several concussions.  

Much has been made of his previous employers refusal to hire him back on, in face of his frightening accident and seriously altered appearance.  The extent to which the reports of his changed personality could have been self-serving on the part of those employers - it wasn't exactly an age when hiring the handicapped was seen as a moral requirement - should be considered.  Especially in light of his picking up and working at several different difficult jobs.  If he was less amiable to his fellow workers, he could easily have had any kind of expectations of comradeship or workers solidarity shattered by their reaction to someone who no longer had the approval of the bosses  I've known strong union members who were shunned by their fellow workers in the face of a new and unfriendly supervisor, lose a good part of their former confidence in those 

Contrary to the picture of him as a barely in control monster, apparently his family saw him quite differently.   According to Dr. John Martyn Harlow, who attended him after his injury: 

Phin­eas was accus­tom­ed to enter­tain his little neph­ews and niec­es with the most fab­u­lous rec­i­ta­tions of his won­der­ful feats and hair-breadth escapes, without any foun­da­tion ex­cept in his fancy. He con­ceived a great fond­ness for pets and sou­ve­nirs, es­pe­cial­ly for child­ren, hors­es, and dogs—only ex­ceed­ed by his at­tach­ment for his tamp­ing iron, which was his con­stant com­pan­ion for the re­main­der of his life. 

As with his changing jobs several times, his reportedly telling his nieces and nephews tall tales of his adventures is given as proof of some pathological condition, a physiologically explained disinhibition from lying.   If that's the case they would have to account for the myriad of uncles, perhaps including me, who are inclined to stretch the truth in order to retain the attention of our young relatives.  

A lot more could be written about the use of the Phineas Gage case by those who are ideologically motivated to convince us that our minds aren't all that much, anyway.   Going into the little known about Phineas Gage leads me to the opposite conclusion, the will power, the stable sense of self in what must have been as radical a forced alteration of that self-image strong enough to make him interesting to these attempts, leads me to see a real person, a real soul apart from his damaged brain.  But that's possibly due to my pre-existing point of view.  Only mine accounts for his continuing work at demanding jobs, the accounts of his affection for his nieces and nephews and animals, frequently a source of irritation in the best of them, of him squarely facing the camera, a demonstration of a presence of mind, a presence of personality that is rare for daguerreotype portraits of that period.  Of a real person instead of a complicated physical structure and chemical reaction.

My thanks to my cousin T.W. who told me about this recent research this weekend.  

Update:   I forgot to point out that the criticism of Phineas Gage's being "unable to settle", his going from job to job and place to place, traveling around New England, Chile and California, would, in another young man in that period, be seen as an admirable sense of adventure, grit and courage.  Perhaps his accident and the miraculous recovery he had told him to not put off such things because any day could end up with you dead.   How his accident turned that into evidence of pathology might reveal the most about how the predispositions people have, their expectations of what they will see and what we want to see can be as easily entered into "science" and academic scribbling as it can other aspects of thinking and writing.   Perhaps it is due to my father being a fully disabled veteran of the Second World War, of growing up with his blindness and disfigurement being just who my father was, that Gage's adventurousness doesn't look pathological to me.  If my father had the sight of one eye, I can easily imagine him doing the same.