“Phineas Gage Had a Hole in His Head” – Story Behind the Song


Banjo Dan Lindner wrote the lyrics used in this article. He did some compelling research but admits to a couple of deviations from truth. There is no record of Dr. Williams telling Phineas to pray because he was probably about to die, and Phineas didn’t subsequently go on the road as a sideshow attraction. He did, however, go to a few cities and show himself off after joining the New York Barnum show in 1850.

Phineas Gage is famous in the medical world for his contribution to neuroscience. The use of the song in this article demonstrates the making of a ballad from a historic event, and is a celebration of the fragility and strength of the human body.

Phineas Gage had a Hole in his Head

Phineas Gage had a hole in his head
And everyone knew that he ought to be dead
Was it fate or blind luck, tho it never came clear
He kept keepin’ on year after year

Phineas Gage was born in 1823, in Grafton County, New Hampshire. He was strong, intelligent, and by the time he was 25 was a foreman and blaster for the Rutland and Burlington railroad.

Now Phineas Gage was a prince of a man
A hard-working foreman, the best in the land
Resourceful, respectful, responsible too
The pride of the railroading crew.

Gage well understood the technique and the dangers of rock blasting, and had a blacksmith fashion a tamping rod that was 3 feet 7 inches long, an inch and ¼ in diameter and gently tapered at one end, coming to a point.

September 13 was a fine autumn day and
The crew was in Cavendish, working away
Drilling and blasting and laying the track
Across the Green Mountains and back.

Cavendish is in Vermont and the men were working on a cut through a rocky outcrop, blasting rock away and laying the line, which is still in use today. Gage decided where the holes would be drilled, and judged the right amount of blasting powder to use. After placing the powder into the hole, the fuse would be gently pushed in and sand added. This would be tamped down, the workmen would back away and the fuse would be lit.

But something incredible happened that day
When Gage was distracted and turning away
And his tamping rod slipped down the hole he had drilled
It’s a miracle he wasn’t killed

The young man stood over the hole after the blasting powder was added and either forgot to add sand or accidentally dropped the tamping iron into the hole.

For it struck on the granite and threw off a spark
And the gunpowder down in that hole
Went off with a roar and that big iron rod
Was blasted right up through his skull

The 3 feet 7 inch tamping iron entered Gage’s head through his cheek, just missing the cheekbone, shot up behind his eye, and exited through the top of his skull. The tamping rod, which weighed 14 lbs, continued flying through the air, landing some 25 yards away.

Poor Phineas lay in a heap on the ground
And they knew he was gone as they gathered around
But he sat up and started to talking instead
With a big bleeding hole in his head

Gage fell and lay unconscious for some minutes, while his crew members stared at him, horrified. Then he regained consciousness and got up. He climbed into the oxcart and sat up, talking and apparently in little pain, during the three quarter mile journey.

And he rode in an oxcart with nary a groan
And arriving in town he got out on his own
Stepped up on the porch, took a chair and sat down
As the townspeople gathered around.

The first doctor arrived to find Gage sitting upright on the porch and telling a growing crowd what had happened, with the blood still flowing. Gage called to the doctor that he had some business for him.

And the doc came a-running and took off his specs
And he said, Mr. Gage, better cash in your checks
Well it’s time you quit talking and learned how to pray
You’ll be meeting your maker today.

Dr. E. H. Williams examined the wound, noting the pulsations of the brain visible through the hole in the skull. Williams could not believe, despite the extent of the injury, that Gage’s tale of the rod passing through his head was true. Phineas insisted that his story was accurate, then, overcome with nausea, stood up and vomited. Dr. Williams noted that the pressure of vomiting caused a small amount of brain to exit the skull wound and fall to the floor. Dr. J. M. Harlow arrived about an hour later to find Gage lying on a bed surrounded by blood.

Well those medical fellers did all they could do
And not one of ‘em reckoned he’d ever pull through
But a couple months later, well glory to God
Ol’ Phineas was back on the job.

Harlow closely examined the wound, removing the fragments of skull that were visible and then gently pushed the forefinger of one hand through the hole in the skull and the forefinger of other hand through the wound in the cheek, until his fingertips touched. The two physicians worked to stop the bleeding, then Dr. Harlow replaced larger fragments of skull and used adhesive straps to close the wound. He covered both wounds with wet compress and left them partially open to drain.

A few days later it became apparent that the wound was infected. Gage lay, semi conscious, for ten days, hardly speaking. Harlow released half a pint of pus from the abscess on Gage’s skull, and his recovery began. Six weeks later he returned to his parents’ home in New Hampshire, not returning to Cavendish until April 1849.

But something had changed, and he didn’t last long
He was loud and profane, just could not get along
And his friends turned away, saying one thing’s for sure
Ol’ Gage isn’t Gage any more.

Phineas Gage never returned to his old position, although he did work for the contractors, for a short time. His personality had changed and he used bad language, was rude and obnoxious, and could not make a decision and stick to it. He was, “No longer Gage.”

So he worked a few odd jobs on farms and in town
Caught on with a sideshow and traveled around
But that big iron rod was his only true friend
Goin’ with him wherever he went.

In 1850 Phineas Gage joined the circus, more correctly he became a part of Barnum’s American Museum in New York and visited cities in New England to ‘show and tell.’ He then worked for a stagecoach company in Hanover, New Hampshire for 18 months. He took the tamping rod with him.

A medical miracle, Phineas Gage
Ended up down in Chile, driving a stage
Lived eleven more years missin’ part of his brain
Til the day of his reckoning came.

Gage did indeed drive a stagecoach in Chile, from Valparaiso to Santiago until an illness weakened him in 1859, when he went to live with his mother, who had moved to San Francisco. He began having epileptic seizures in February of 1860, and was dead and buried by May 23rd.

There’s a strange-looking skull and a big iron rod
Down at Harvard, they’re still on display
And the students and brain people all the world round
Still study the case to this day.

The body was exhumed in 1867 and the skull and iron rod were taken to Dr Harlow, who donated them to Harvard University School of Medicine. Phineas Gage, for all his sad history, has found fame as the man behind some of the initial and critical information about the function of the frontal lobes, personality and survival from head injury.