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GUY RAZ, host:

Now, this next story is also about a photograph, a much older one, actually a daguerreotype from the mid-19th century.

Mr. JACK WILGUS: We've had that daguerreotype. It's always been one of our favorites for close to 40 years.

RAZ: It's one of the first daguerreotypes Jack Wilgus and his wife Beverly got their hands on when they started a collection of old photos back in the 1960s. Now, this particular photo is of a well-dressed, handsome man with a closed eye, and he's holding a metal rod. And for 40 years, Beverly and Jack Wilgus thought the man was a whaler. But then, last year, they started scanning their old photos and posting them to the online photo sharing site Flickr, and someone noticed that whaler.

Ms. BEVERLY WILGUS: It was actually a comment on the photograph.

RAZ: That photo, the person wrote, is probably Phineas Gage. And who, you might ask, was Phineas Gage?

Mr. DOMINIC HALL (Curator, Warren Anatomical Museum, Harvard Medical School): One of the most famous medical cases that you know by name.

RAZ: That's Dominic Hall. He is the curator of the Warren Anatomical Museum at Harvard Medical School.

Mr. HALL: I talk about Phineas Gage every single day in some context or another.

RAZ: On September 13, 1848, 25-year-old Phineas Gage was blasting rocks to make way for what would become the Rutland and Burlington Railroad in Vermont.

Mr. HALL: That day, well, he was doing this process called tamping, which is essentially they're drilling holes in large rock, packing in some sort of explosive powder, packing sand on top of that explosive powder. They're laying a fuse and then, you know, they're detonating the fuse.

RAZ: And he was using a handmade tamping iron to pack those explosives, a three and a half foot long iron rod about an inch in diameter.

Mr. HALL: You get a couple of different accounts of what happens, but something clearly goes wrong, and a spark sets off the charge, and the rod is actually fired through Gage's head. It goes all the way through, comes out the top of his skull and lands about 30 yards away.

RAZ: The other workers quickly gathered around Phineas Gage as he lay on the ground.

Mr. HALL: Yeah. They certainly think he's - most likely going to die. He - but he is actually able to, with the help of other people, make it over to an oxcart. He sits up in the oxcart and travels to a local inn where he was staying, and that's where he's attended by these physicians, but he actually never loses consciousness at this point.

RAZ: He's awake the whole time.

Mr. HALL: He's awake the whole time. He's able to describe his injury.

RAZ: For three months, a local doctor named John Harlow worked on Gage. It was a crude form of what we might now call neurosurgery. And over the next year or so, Harlow started to notice changes in Gage's personality.

Mr. HALL: Before, he gets described as businesslike, friendly, maybe efficient, responsible. He's good at managing his team on the railroad. After the accident, he's occasionally referred to as childlike, vulgar. He has definitely has some social problems.

RAZ: Harlow eventually brought Gage to Harvard Medical School to be studied. The students even made a plaster cast of his head which, along with the iron rod and his actual skull, are still on display at the medical school's museum.

Anyway, Gage is examined, and a paper gets published about his condition.

Mr. HALL: Then he becomes this literal textbook case. He becomes the textbook example.

RAZ: The textbook example of a posttraumatic personality change. And over the next decade or so, Gage drifted. He spent some of that time as a curiosity act. He worked as a coach driver in Chile, and then he wound up in San Francisco, living with his mother. And in 1860, at the age of 36, Phineas Gage died, the result of seizures, most likely related to the accident more than a decade earlier.

And up until last year, no one alive really knew what Phineas Gage actually looked like because there were no known photographs or paintings of him, that is until Beverly Wilgus emailed that scan of her daguerreotype to Dominic Hall at Harvard with a simple question.

Ms. WILGUS: Could this be Phineas Gage? And that started the dialogue.

RAZ: They compared the scars in the image with Gage's skull, and they looked at the iron rod in the photograph and the tamping iron at Harvard's museum, both of which seemed to be engraved with the same inscription.

Mr. HALL: This is the bar that was shot through the head of Mr. Phineas P. Gage at Cavendish, Vermont, September 14, 1848.

RAZ: Dominic Hall was stunned.

Mr. HALL: It's sort of funny, but I have this sort of close relationship with Phineas Gage because of how often I look at his case and think about his case and talk about his case with other people. And so, before, when you're really thinking of Gage, you think of a skull, or you think of a life case, but now there's this image.

RAZ: And you can see that image at our Web site. That's npr.org.

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