Awards/Selection Lists: Non-fiction titles from ALSC Notable Books lists 2002-2013, Richie's Picks
Author's Website: http://www.scholastic.com/teachers/contributor/john-Fleischman
Brief Summary: Phineas Gage was a railroad foreman in the year 1848, when an accident with blasting caused a 13.5 foot iron rod to enter his check and exit cleanly through his skull. Amazingly he made a full recovery, but at what cost?
Personal Reaction: I have always found the story of Phineas Gage to be unsettling, mostly because of the graphic nature of the injury. However, the effects of the accident on the brain are fascinating, and something I have studied for some time with my psychology classes. Fleischman does a good job of laying down the general story of Phineas Gage, with interesting personal details and no elaborated personal opinion, however, I think he could have gone farther with his analysis, perhaps even looking into whether mental illness was a factor in his family tree, or if there was the possibility of genetic illnesses that could have led to Gage's deterioration (though he does state no family history of seizure...but from where does this information come from?), instead of guessing that the jostling of his brain in his skull, while driving a stage coach, may have lead to eventual seizure disorder and death.
Also the medical information is extremely distracting. It's interjected in the middle of the story and, while I'm sure it is meant to be informative and keep the reader interested, by its placement, it tends to disconnect the engaged mind, with a lot of advanced medical jargon that I do not see many children keeping up with, not for lack of trying. The illustrations and photographs, however, really helped move the information along.
Regardless, the book is written in a good tone, the story interesting, and even I learned a new fact or two, but there are holes in the research and I believe it almost feels at the end as if the author had given up, and chose to simply guess at the cause of death.
Content: With limited scientific knowledge, in an era where knowledge of the effects of bacteria on the human body, and the development of antibiotics, cellular biology, microscopes and proper surgical sanitization techniques was in its infancy, Phineas Gage, a hard working, well respected railroad man, of 26 years, is involved in an accident which sends a metal tamping rod through his skull, damaging his brain. Miraculously, after the incident he can still walk and talk, relaying his experiences to those who would listen, and eventually, even with rudimentary and antiquated medical practices, makes a full recovery. Or did he?
Not only were small pieces of Phineas' brain removed with the exiting of the tamping rod, but there was tissue damage in the brain, specifically the left frontal cortex. This damage, changed Phineas' demeanor and his ability to process emotion and function socially. The hardworking man that everyone respected and liked became vulgar, explosive, unpredictable and difficult to interact with. However, the doctors of the day, particularly those at Harvard, could only speculate on the reason for his survival, until subsequent decades of inquiry, after his death 11 years later, from a physical affliction that caused severe and increasingly frequent seizures (the author speculates it may have been hypothermia) would reveal that the areas damaged by the tamping rod were most likely those localized for social interaction. He still liked working with animals and horses, and drove a stage coach, though he couldn't find proper ways to interact with adults.
This case is studied by neuroscientists and psychology students across the globe, for insight into the connection between behavior and physiology, and its importance in neuroplasticity.
Content Evaluation: The largest conjecture I see the author make, during the course of this book, is that the probably cause of death for Phineas Gage, was hypothermia, due to his body being unable to regulate its own temperature. While it does make sense that someone who cannot control their body temperature may experience severe enough seizures, and subsequent tissue damage from lifestyle and the previous traumatic experience, that death may be imminent, he does not provide sources to back this information up. This point sticks out to me greatly, given that there is no proof that the part of the brain regulating temperature was damaged, and we will never know with any absolute certainty, due to the decomposition of Gage's body, prior to specimen collection, and his remains having been moved.
Overall, there is a phenomenal amount of information presented, which is staggering. However, as important as knowing how the brain works is to the story, it can, at times, become overwhelming and disorienting for the reader, who constantly has to shift between anecdotal story telling and facts present in textbook format. There are ways to present information on neurons and neurotransmitters with less information and technical terms that might confuse the intended audience. As an adult, who has study psychology and brain function, even I found my mind wandering, wishing the author would get back to the story.
Regardless, his information is well presented, and facts well documented, with many first hand accounts from the treating physician, family and town residents. However, I have to admit a shocking lack of bibliographic materials, listed only in a small "resource" section and no bibliography. Otherwise, the details, though slightly disjointed with medical jargon, were well told, and kept the reader interested.
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