Phineas Gage, a railroad construction worker, was a guy with a real hole in his head. In 1848, a blasting accident near Cavendish, Vermont slammed a thirteen-pound iron rod through his brain.

He was alert and talking after the accident. A doctor cleaned and cared for the wound, and in a few weeks Phineas walked twenty miles to his home.

Cheerful and dependable before the accident, he became rude, unpredictable and antisocial. P-T Barnum’s freak show hired him as the man with a hole in his head. Eventually, after several unsuccessful jobs, he went to San Francisco, where he died from seizures in 1860… eleven years after the accident.

In 1994, Harvard Medical School neurologists x-rayed, photographed and re-measured Phineas’ skull, superimposing the images on a three-D computer brain model. They found the rod’s entrance below the cheekbone and exit out the top of the head missed key areas on the side and top of the brain. This enabled Phineas to function, move and talk. But because it slammed through the area where the brain halves meet, his personality changed.

In 1998, the one-hundred-fiftieth anniversary of his accident, Phineas made his last public appearance. Scientists came from everywhere to Cavendish to present papers on frontal cortex injuries.

Phineas’ skull has now retired to Harvard’s collection of medical oddities. But his case is widely credited with providing insight into the role of the frontal lobes in personality and social interaction, for the first time linking biology with behavior.