Phineas Gage Reading Guide
Directions: After you read each chapter answer the following questions. Some questions are asking
about facts, some ask you summarize, other questions ask you to make connections or state opinions.
Be sure to read each question carefully and answer appropriately in complete sentences. This will be
your first test grade. Be sure to get this turned in on time! Let's start the semester off right!
Chapter 1 "Horrible Accident in Vermont" (Pp. 1-22)
1. When did Phineas' lucky/unlucky accident happen? (include date, month and year, you get an extra
point for the time of day) September 13, 1848 at 4:30pm
2. Describe the accident which changed Phineas' life. Phineas and his assistant were loading dynamite
when his tamping iron slips and hits the granite, sparking the fuse. Then the rod shot straight up,
through his cheek bone and out the front of his forehead.
3. The author asks the reader to think about whether Phineas was lucky or unlucky. The fact that
Phineas' brain injury was an "open brain injury" was lucky in one way, but unlucky in another. Explain
how and why the open nature of the wound was both lucky and unlucky. Phineas was lucky in the fact
that he had an “open brain injury” because it allowed for more room for his brain to swell. This does
not immediately kill him, it helps in keeping him alive by not cutting off oxygen to his brain. Phineas is
also unlucky for this very same reason. Since his brain is outside of the skull, it is not protected from
germs and infection. Dangerous germs get inside Phineas and causes pus to build upon his forehead.
This causes his recovery time to take much longer than first expected.
4. Why did the railroad contractors decide not to hire Phineas back after his recovery? They decide to
let Phineas go because he is not his “normal” self. He is angry, very fickle in decisions, and curses
around women. They no longer trust his skill and judgment.
5. At this point in your reading, do you think Phineas was lucky or unlucky? Explain your reasons for
thinking so. I think that Phineas is unlucky. He used to be the most liked man on the work force, but
now, nobody trust him. Sure he might be physically healed, but emotionally and physiologically, he is a
totally different person. He is just not the same old Phineas that he used to be.
Chapter 2 "What we thought about how we thought" (Pp. 23-42)
1. What is "ether" and how has it changed surgery? Ether is the first type of anesthesia introduced to the
medical world. It changed the realm of surgery drastically. Before the “days of Ether”, people would
have to be held down or restrained during surgery and doctors would have to work very quickly. Then
when Ether came, the patient “went to sleep” and the doctors could take their time.
2. Make a T-chart or Venn diagram comparing the photo on p.25 with a modern operating room.
3. What do the following parts of the brain do?
The brain stem: keeps your automatic functions going,ex: breathing and heartbeat
The cerebellum: coordinates movement
The cerebral cortex:allows you to think, remember, learn imagine, read, speak, listen, and
dream; to make sense of what your senses are telling you
The limbic system: coordinates memory, sensation, and emotion
The corpus callosum: is the part under the brain but just above the brain stem
The frontal lobe: the front part of the brain cortex
4. Draw and label the (right hemisphere) half brain diagram on page 28.
5. Which lobe did the tamping rod pass through during Phineas' accident? The tamping rod when
through the frontal lobe of Phineas.
6. What is the fundamental unit or main building block of all living things? What is the fundamental
unit of the brain? The cell is the basis for all living things. Our brain is made up of nerve cells.
7. Approximately how many neurons do the human brain and spinal cord contain all together? In our
brain and spinal cord, we have 10 billion neurons.
8. Draw and label a neuron.
9. What is a synapse and what happens in the synapse? A synapse is the small gap between the axon
terminal and the dendrite of another. In the synapse, an electric impulse is converted into a chemical
neurotransmitter and floats across to the next neuron.
10. Approximately how many synapses does each neuron have? Approximately how many synapses
does a whole human brain have? Is that incredible, or what? A neuron can have between 1,000 to 6,000
synapses. A whole human brain has10 trillion synapses!!!!!
11. Explain what the "Whole Brainer" believed about the human brain. What do you think about their
beliefs? They believed that all thoughts and emotions were generated anywhere in the brain and go into
action anywhere. If one part of the brain was injured, then the thoughts would develop in another spot.
I do not believe their theory, but it is logical thinking for the time period.
12. Explain what the "Localizers/Phrenologists" believed about the human brain. What do you think
about their beliefs? Who do you agree with the most, Whole Brainers or Localizers? They believed that
the brain is divided into specific areas that control specific things. Their theories seem to make more
sense to me. I agree most with the Localizers/Phrenologists.
13. Explain who was right, the Whole Brainers or the Localizers. Why? (Warning: this is a "trick
question") Both groups were right. The Localizers were right about localization but the Whole Brainers
were right about the complex interconnections of the brain.
Chapter 3 "Following Phineas Gage (Pp. 43-64)
1. What is epilepsy? Describe what an epileptic seizure is. It is an electrical storm in your brain's nerve
cells. It begins in your brain and can cause muscle convulsions. An epileptic seizure can be caused by a
tumor, inherited genetics, or a blow to the head.
2. Back in 1860 how did the doctors try to treat Phineas' seizures? All the doctors have in the day are
theories, useless drugs, and nursing instructions. One family physician “bleeds” him. This doctor
believes that Phineas has too much blood in his body, but this does nothing for him.
3. How did Phineas die? He died from a sort of hypothermia, not that he was in cold water, but the
same effects. During a seizure, his brain shuts down circulation to his feet and hands, then skin, and
finally organ by organ until his heart stops.
4. How old was Phineas when he died? Phineas was 36, he died 27 days short of this 37 birthday.
5. Who was Paul Broca? What is Broca's area? Paul Broca is a French surgeon who announces how
damage to a certain spot in the brain causes certain damage. Broca's area is the spot where damage is
found on the brains of stroke patients.
6. Who was Carl Wernicke? What is Wernicke's area? Carl Wernicke is a German who finds another
similar spot on the left temporal lobe. This controls the ability to understand speech.
7. Would you say Broca and Wernicke are "whole-brainers" or "Localizers?" Explain your answer. I
think that Broca and Wernicke are “Localizers” They both find areas in the brain that are specific to
certain motor skill and mental tasks.
8. Why do you think Dr. Harlow wanted to do an autopsy of Phineas' brain after he died? I believe that
he wanted to really see what Phineas' skull looked like. This way, Harlow could be certain of the exact
placement of the damages to Phineas' brain.
9. What did Phineas' doctor mean when he wrote that, "Gage was no longer Gage," after the accident.
Explain how Phineas changed due to the accident. (P. 59) Phineas was not himself after the tragedy. He
used to be the best man on the railroad, trusted by everyone. After the accident, he was stubborn and
very fickle with his plans.
Chapter 4 "Putting Phineas Together Again" (Pp. 65-75)
1. Who are Antonio and Hanna Damasio? They are a husband and wife team of doctors who are
renowned brain researchers at the University of Iowa Hospitals & Clinics in Iowa City.
2. What types of injuries do their patients have? How do they get those injuries? Their patients have the
same kind of frontal lobe damage at Phineas. They get their injuries from surgery from removing a
tumor from deep inside the frontal cortex.
3. Why do the Damasios measure conductivity with a skin response machine? They do emotional test
by measuring the electrical conductivity on a persons skin.
4. How did Dr. Hanna Damasio "reconstruct" Phineas' brain to discover exactly what parts of his brain
were destroyed? She took photos, x-rays, and measurements of Phineas' skull and put them into a
computer. She then remade the entrance and exit holes and found the exact center line that the tamping
iron went through. With this all in the computer, Dr. Hanna could now “see” his brain, just as it was in
his head.
5. Write a brief review of the book. Describe the story and the style of the book. What did you think of
it? What did you find most interesting? Would you recommend it to a friend? This book was definitely
one of a kind. The way that the narrator “talks” to you and tells you what is about to happen and what
to expect. The book is very descriptive and explains all of the medical terms that one does not know.
There are also constructive photographs to help you understand exactly what is going on. I found the
entire life story of Phineas interesting. The fact that he suffered such a damaging injury but lived many
years after with “no effects.” I would recommend this book to a friend that was interested in
psychology or medical brain injuries.