GAGE / STANFORD: two famous brain injury survivors
- Ben
- Jun 23
- 7 min read
My new essay 'Injury and inhibition', published today on Aeon.co discusses the life and legacy of Phineas Gage, who survived a brain injury in 1848 and went on to become one of the most frequently-cited neuropsychology case studies of all time. Gage was injured while working on a rail-road construction site, when his iron tamping rod was blown through his head by an explosion. For over a century, brain scientists claimed his injury caused a profound change in his personality. From a mild-mannered and responsible foreman, he became a drunken vagrant, a sexually promiscuous gambler and brawler. The damage to his frontal lobes, the scientists said, had destroyed his capacity for self control, 'disinhibiting' the animal passions we might all exhibit if these civilising parts of our nervous systems were removed. Gage became a kind of avatar for the idea of behavioural disinhibition.
More than 150 years later, the idea is still used to explain surprising or inconvenient behaviour on the part of people with brain injuries, and Gage is still cited as a kind of patient zero. Yet, as detailed in the essay, the stories told about Gage are largely false. Of the handful of primary sources that exist about Gage, only one mentions any change in his personality and then only briefly. It says nothing about violence, sexual promiscuity, gambling or drunkenness. It also describes how, less than a year after his injury, Gage was back in stable employment.
It was the very slightness of reliable fact which allowed myths about Phineas Gage to flourish
In the Aeon essay, I draw a comparison between the stories told about Gage and those told about his contemporary, Eadweard Muybridge. Famous for his work as a photographer, Muybridge is less widely known as a brain injury survivor (he was comatose for several days after a stage coach accident when he was 30) or as a murderer (he shot his wife's lover with a revolver in 1874). Even though his contemporaries claimed it was the brain injury that drove Muybridge to commit the murder, both events are overshadowed by his artistic and technical legacies. He is remembered as a troubled genius.
Malcolm MacMillan, who did much of the work de-mythologising Gage, concluded that it was "the very slightness of reliable fact which allows myths about Phineas to flourish". In comparing him with Muybridge, the point of my essay is to reinforce this observation - there is too much written about Muybridge for us to reduce his personality to a neurological diagnosis. I also try to highlight the role of class and status in the way the two figures are remembered. Muybridge was connected to powerful people who protected him from criminalisation during his life and continued to protect his reputation even after his death. Gage, by contrast, had no-one to protect his reputation.
One of the powerful people Muybridge worked with was Leyland Stanford, the businessman and politician, who funded some of his early photographic experiments in animal locomotion.
While researching the essay I learned some interesting details about Stanford. He seems to have been forceful character, someone who'd had notable impacts on others and, through his work on the trans-continental railways, on whole communities. He was one of the 'big four' investors in the Central Pacific and Southern Pacific railroads that eventually spanned much of the United States. He later became the first Republican governor of California and founded Stanford University. Maybe he was the kind of person Ayn Rand was thinking of when she wrote about railroad executives in her enormous novel Atlas Shrugged - someone with immense self-regard and certainty, someone with the money and connections to push forward a vision of the world and make it reality. He was not dissimilar, it seemed, to today's technology moguls - amassing huge wealth not only through the machinery of capitalism but also by taking a hand in politics. Then I came across an 1893 obituary which attributed Stanford's death to 'locomotor ataxia', a term that suggested neurological implications. Sure enough, I learned that it refers to a movement disorder caused by neurosyphilis, that is, syphilis in the brain. Stanford too was a survivor of brain injury, in his case a progressive one.
Locomotor ataxia is just one consequence of neurosyphilis. It can also include a wide range of psychiatric and behavioural changes, so many that it has been described as 'The Great Imitator' for its tendency to mimic other conditions. An article from 2023 lists depression, mania, psychosis, hallucinations, delusions, elation, dementia, and 'schizophrenia-like illness' among the consequences. Personality changes associated with the condition include aggressiveness and paranoia.
Descriptions of Stanford in his youth mark him out as a lier, a drifter and something of a bully
Returning to Stanford's biography, it was easy to find accounts of his behaviour that could be read as indicative of neurological personality change. Descriptions of him in his youth mark him out as a lier, a drifter and something of a bully: "He spent most of his life altering himself, moving about, shifting,” writes the journalist and historian Roland De Wolk. "He failed at just about everything. As a student, he was a repeated dropout who never graduated from what today would be high school. He claimed to have passed the New York State bar, but the record indicates he did not... Later in life he liked to boast that he hired Harvard and Yale graduates to run his San Francisco street cars, his point being they had wasted their time at university." In later years, Stanford's business and personal conduct made him emblematic of the crony capitalism of the 19th century. In her biography of Eadweard Muybridge, the historian and cultural critic Rebecca Solnit describes him as a "thief on a grand scale", describing how his railway projects were funded by gigantic government loans that he never paid back, defrauding American tax payers of millions of dollars (hundreds of billions in today's currency). She also details how he exploited his own employees, including paying Chinese and Native American workers less than their white counterparts and refusing to pay large sums owed to whole communities. As well as these large-scale betrayals, he seemed an inconstant friend and business partner. After funding Muybridge to begin the motion studies, he alienated him by allowing a set of illustrations based on his work to be published uncredited, for which Muybridge later attempted to sue him.
It's striking how similar some of these characterisations are to those attributed to Gage by the neuroscientists who have used his life as evidence for theories of frontal lobe function. He was untrustworthy, changeable, a wanderer, a bad business man, a braggart, a bully.
As far as I'm aware, nobody has suggested that Stanford's questionable behaviour might be attributable to his neurosyphilis or to 'disinhibition' stemming from it. Both his itinerant and poorly disciplined youth and his fraudulent, deceptive and domineering adulthood are seen instead as typifying the 'wild west' culture of the period, honouring the complexity of his humanity, rather than erasing and replacing it with a monolithic diagnosis. Roland De Wolk even invites us to view him as somehow quintessential of the American attitude, combining "corporate chicanery, political fraud, coverups and crime" with "our fathomless capacity for ambition, invention, and philanthropy." Not only is Stanford not reduced here, he is ballooned into a being of encompassing historical relevance: "Leland Stanford led the rare life big enough to contain them all."
Rich people get to be eccentric and exciting. Poor people are policed and punished for being crazy.
I'm not claiming that Stanford's behaviour could or should be explained in terms of his neurological condition. Just like Muybridge, Stanford is long dead, so that there would be no earthly way of proving or disproving the claim. My point is to highlight the way that this speculative, scientifically unsound methodology is exactly the kind that has been applied in the case of Phineas Gage. Making retrospective claims about long-dead historical figures can be fun but it produces weak science. And it's a bad way to formulate theories about living people. As with my comparison between Gage and Muybridge in the Aeon essay, I'm also trying to draw attention here to the role of class and status in how stories are told about different people. Stanford's actions are never (as far as I can find) reduced to a neurological diagnosis. He is attributed with autonomy, conscious intention, deliberation, intent. And even his most unethical behaviours are often romanticised as those of a 'robber baron', a term that makes him sound more like a dashing highwayman than a systematic and self-serving crook. (In case you were wondering, the massive tax-payer fraud he committed was not some feat of imagination or technical wizardry as portrayed in stories like The Big Short. From the accounts I've read it was conducted largely by dint of administrative lassitude. He borrowed the money, made promises, and just never paid it back). He is not pathologised as 'insane', 'disordered' or 'disinhibited'. As with Muybridge, and unlike Gage, Stanford's cultural and economic status largely protect him from these descriptions.
To me, these stories are indicative of the way psychological theories tend to echo the normative values and economic structures of the culture that produces them. Rich people get to be eccentric and exciting. Poor people are policed and punished for being crazy.
I suppose the best psychological theorists would be the ones that are vigilant about these kinds of biases. I suppose they'd also take seriously the demands of other disciplines into which they might stray in their search for evidence. If we want to look at history for scientific purposes, then we need to take historical practice seriously. Otherwise we end up doing not just bad science but bad history as well.
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