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Chapter One: Unpleasantness in Vermont
Phineas P. Gage
It is the summer of 1848. We are in New England. Phineas P Gage, twenty-five years old, construction foreman, is about to go from riches to rags. A century and a half later his downfall will still be quite meaningful.
Gage works for the Rutland&Burlington Railroad and is in charge of a large group of men, a "gang" as it is called, whose job it is to lay down the new tracks for the railroad's expansion across Vermont. Over the past two weeks the men have worked their way slowly toward the town of Cavendish; they are now at a bank of the Black River. The assignment is anything but easy because of the outcrops of hard rock. Rather than twist and turn the tracks around every escarpment, the strategy is to blast the stone and make way for a straighter and more level path. Gage oversees these tasks and is equal to them in every way. He is five-foot-six and athletic, and his movements are swift and precise. He looks like a young Jimmy Cagney, a Yankee Doodle dandy dancing his tap shoes over ties and tracks, moving with vigor and grace.
In the eyes of his bosses, however, Gage is more than just another able body. They say he is "the most efficient and capable" man in their employ.- This is a good thing, because the job takes as much physical prowess as keen concentration, especially when it comes to preparing the detonations. Several steps have to be followed, in orderly fashion. First, a hole must be drilled in the rock. After it is filled about halfway with explosive powder, a fuse must be inserted, and the powder covered with sand. Then the sand must be "tampedin," or pounded with a careful sequence of strokes from an iron rod. Finally, the fuse must be lit. If all goes well, the powder will explode into the rock; the sand is essential, for without its protection the explosion would be directed away from the rock. The shape of the iron and the way it is played are also important. Gage, who has had an iron manufactured to his specifications, is a virtuoso of this thing.
Now for what is going to happen. It is four-thirty on this hot afternoon. Gage has just put powder and fuse in a hole and told the man who is helping him to cover it with sand. Someone calls from behind, and Gage looks away, over his right shoulder, for only an instant. Distracted, and before his man has poured the sand in, Gage begins tamping the powder directly with the iron bar. In no time he strikes fire in the rock, and the charge blows upward in his face.
The explosion is so brutal that the entire gang freezes on their feet. It takes a few seconds to piece together what is going on. The bang is unusual, and the rock is intact. Also unusual is the whistling sound, as of a rocket hurled at the sky. But this is more than fireworks. It is assault and battery. The iron enters Gage's left cheek, pierces the base of the skull, traverses the front of his brain, and exits at high speed through the top of the head. The rod has landed more than a hundred feet away, covered in blood and brains. Phineas Gage has been thrown to the ground. He is stunned, in the afternoon glow, silent but awake. So are we all, helpless spectators.
"Horrible Accident" will be the predictable headline in the Boston Daily Courier and Daily Journal of September 20, a week later. "Wonderful Accident" will be the strange headline in the Vermont Mercury of September 22. "Passage of an Iron Rod Through the Head" will be the accurate headline in the Boston Medical and Surgical Journal. From the matter-of-factness with which they tell the story, one would think the writers were familiar with Edgar Allan Poe's accounts of the bizarre and the horrific. And perhaps they were, although this is not likely; Poe's gothic tales are not yet popular, and Poe himself will die the next year, unknown and impecunious. Perhaps the horrible is just in the air.
Noting how surprised people were that Gage was not killed instantly, the Boston medical article documents that "immediately after the explosion the patient was thrown upon his back"; that shortly thereafter he exhibited "a few convulsive motions of the extremities," and "spoke in a few minutes"; that "his men (with whom he was a great favourite) took him in their arms and carried him to the road, only a few rods distant (a rod is equivalent to 5 1/2 yards, or 16 1/2 feet), and sat him into an ox cart, in which he rode, sitting erect, a full three quarters of a mile, to the hotel of Mr. Joseph Adams"; and that Gage "got out of the cart himself, with a little assistance from his men."
Let me introduce Mr. Adams. He is the justice of the peace for Cavendish and the owner of the town's hotel and tavern. He is taller than Gage, twice as round, and as solicitous as his Falstaff shape suggests. He approaches Gage, and immediately has someone call for Dr. John Harlow, one of the town physicians. While they wait, I imagine, he says, "Come, come, Mr. Gage, what have we got here?" and, why not, "My, my, what troubles we've seen." He shakes his head in disbelief and leads Gage to the shady part of the hotel porch, which has been described as a "piazza." That makes it sound grand and spacious and open, and perhaps it is grand and spacious, but it is not open; it is just a porch. And there perhaps Mr. Adams is now giving Phineas Gage lemonade, or maybe cold cider.
An hour has passed since the explosion. The sun is declining and the heat is more bearable.
Table of ContentsIntroduction xi
Unpleasantness in Vermont 3
Gage's Brain Revealed 20
A Modern Phineas Gage 34
In Colder Blood 52
Assembling an Explanation 83
Biological Regulation and Survival 114
Emotions and Feelings 127
The Somatic-Marker Hypothesis 165
Testing the Somatic-Marker Hypothesis 205
The Body-Minded Brain 223
A Passion for Reasoning 245
Notes and References 269
Further Reading 293
Most Helpful Customer Reviews
The French philosopher René Descartes could not have been more wrong, according to Antonio Damasio, a neurologist at the University of Iowa College of Medicine. Descartes thought the mind was completely separate from the body - an immaterial 'thinking thing,' the essence of which was cool conscious reasoning untainted by base physical influence. Through his research on patients with prefrontal cortex damage, Damasio discovered that reason, like almost all mental processes, is 'embodied,' that is, based in the human being¿s physical self. Emotions and other states that are rooted in physicality profoundly influence not only what people reason about, but how they reason. Without them, people either can¿t make decisions or they make self-defeating ones. This book tells how Damasio created, developed and tested his theory of embodied cognition, which is now widely influential in psychology, neuroscience and behavioral economics. We recommend this refreshingly nuanced, conversationally told (though sometimes desultory) narrative of scientific invention and discovery to readers who want to learn about this profound, influential set of ideas from the source. You will never think about your mind the same way again.
If you have a basic understanding of science and human physiology, then you will find this book fascinating. Damasio uses all the correct terminology, which can be a bit thick at times for the non-scientist. However, the reward of reading this book comes at the end. Damasio makes a very thoughtful and well-built explanation of how and why we think and do what we do. The charts are very helpful. This book will change your way of thinking and perhaps even change your life.
30 November 1999I know Tony Damasio slightly from the NINDS Advisory Council; he is always well-dressed and coiffured. His argument in this popular work is that the ability of the brain to judge emotional states and motivations of other individuals is the work of the prefrontal cortex. The lack of this ability contributes to the problems that frontal lobe injured patients have in making decisions. He argues that the mechanisms of reasoning must include a reference to, or integration of, information in the brain on the body states that represent the emotional and physiological responses to various decisions. In this way the brain can establish a hierarchy of significance of actions before taking appropriate decisions. Damasio proposes that this integration of emotional body states and logical decision trees is done in the prefrontal cortex. The argument seems, often, self-evident, and his data are largely anecdotal, but this is a very interesting book.
1 - Somatic-marker hypothesis posits that emotions/feelings are integral to reasoning, not an obstacle or impedence to it.2 - Hints that the self, broadly understood, is predicated upon emotions/feelings as defined by Damasio3 - Emotions defined as body-states (somatic states, e.g. heart rate, skin temperature) that broadly indicate danger or health to the organism4 - Feelings are conscious monitoring of emotions; draw correlations between emotions and external circumstancesDoes not cite Julian Jaynes but would be curious of such a comparison.
Antonio Damasio presents a very central thesis in modern philosophy of mind: the interdependence of mind and body, with an extremely solid argumentation from neurology. Along the way he gives a brilliant introduction to neurology (especially the parts relevant for his argumentation and especially his own work).I can recommend this book both to people interested in neurology ("and please not to much philosophical waffling") and philosophy of mind, as well as the general reader, as it is a very well-written book that will make anybody a little wiser on what it is to be human.
This book poses a wonderful hypothesis, in opposition to the views espoused by purists of reason in ages past (Plato and Descartes among them): that not only are emotion and feelings quite inextricably interlaced with reason and rationality, they are also essential to reason's proper functioning.Damasio introduces the reader to the issue at hand by providing case histories like that of Phineas Gage, the famous 19th century railroad worker whose personality underwent profound change on account of a horrific accident in which an iron rod was driven through his skull, resulting in the destruction of a portion of his brain somehow responsible for making sense of critical events arising in the social and personal spheres of his life. Damasio compares Gage with a modern counterpart, a man named "Elliot" who is able "to know but not to feel" (p. 45). Elliot, like Gage, made disastrous decisions, and his life, like that of his 19th century counterpart, spiraled out of control.What is it that causes such subjects to lose control of their lives? How is it that one can retain one's knowledge, memory, intellect, and power to reason, yet find one's decision-making ability in ruins? How is it that the destruction of neural substance more concerned with "emotional" matters can so profoundly affect "intellectual" ones?Damasio's central thesis deals with "somatic markers": as neural images of scenarios resulting from potential decisions on our part arise in our minds, unconscious feelings ("background feelings") accompany those images, disposing us to positively or negatively consider the images and the scenarios they represent (see p. 173). The resulting marking narrows our list of potential scenarios by allowing us to discount various options outright, or by strongly encouraging us to pursue various others.Much of Damasio's book comprises the development of the neural machinery to support this hypothesis, the testing of the hypothesis through experiments performed on Elliot and others with brain damage like his, and the erecting of defenses against possible attacks on the hypothesis.I've not found this book as engaging as the one that led me to it (Stanislas Dehaene's "The number sense"), but it's been an interesting read nonetheless.On a personal note, I'm saddened that I most likely won't make it through many more books before Spring Break is over!
Damasio revisits the still widely held Cartesian beliefs about the relationship between mind, brain, and body with the help of modern neuroscience.
It's a brilliant book based on interesting research, and as I understand it, quite revolutionary in its scope and theories. Damasio says that there is no dualism between the mind and the body. Our mind and consciousness stem from the brain and the body likewise since there are millions signals, both conscious and unconscious sent from the body to the mind and vice versa every second. Even such critical `mind' operations as rational decision making can be tied to the cooperation of the mind, body and feelings. In fact, feelings and emotions are critical to decision making, and have a special job providing a bridge between the rational and non-rational processes. They also help us learn, and we supposedly learn more through suffering than through avoiding pain and seeking pleasure.