Name: The incredible way the brain can heal itself | BBC Ideas
Uploaded: 2025-12-11T21:01:20.000Z
Duration: 5 min 12 s
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On a fateful day in 1848, Phineas Gage, a 25-year-old American construction worker,

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was supervising a controlled explosion on a railroad track when an iron rod shot up, going right through his skull.

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Although he was unconscious for a minute or so, he woke up and was soon sitting upright and talking.

How did he survive this traumatic brain injury?

How did it change his life and his personality?

And what did Gage teach us about the brain's remarkable ability to adapt and recover?

Billions of neurons form trillions of connections carrying our thoughts as tiny electrical signals.

And when those connections get disrupted as a result of an injury, the brain can sometimes, to an extent, rewire itself in a process called neuroplasticity.

Well, once he'd woken up, he was taken to the nearest town, and

there he was treated by a Dr. John Harlow.

We know from Dr. Harlow's notes that the rod removed a chunk of Gage's brain,

the right frontal lobe, responsible for behavior, emotion and attention.

Gage's health soon deteriorated so much that his family altered a coffin, fearing the worst.

But he pulled through and soon enough he was back to normal.

So much so, his friends and family said that Gage was no longer Gage.

This once reportedly organized, reliable and courteous man became rude, capricious, and as Dr. Harlow put it, a child in his intellectual capacity.

While our personality is determined by many factors, including our genes and the environment we grew up in,

the area of the brain most associated with it is the frontal lobe.

The part destroyed by the rod in Gage's case.

You could think then that this change was irreversible and that Gage, as everyone had known him, was gone forever.

In fact, Gage recovered at least some, if not most, aspects of his personality.

After the accident, he moved to Chile and retrained as a stagecoach driver.

Driving a six horse carriage required a lot of cognitive effort.

He had to memorize a mountainous route with its dangerous twists and turns, and

While navigating crowded roads with a coach full of passengers, he followed the same routine each day.

Caring for the horses, driving, collecting fares.

This regular, repetitive activity was, in a way, a version of modern day neuro rehabilitation.

Every part of our body is connected to a specific part of our brain's outer layer called the cortex.

And when the brain experiences traumatic injury, it can sometimes adapt by reallocating functions to a different area.

Gage is often referred to as the man who started neuroscience, because his case was the first to point us towards this knowledge.

We once thought that after childhood, the brain remains fixed for the rest of our lives.

But now we know that our brains are in fact, amazingly flexible.

And the activity in the brain never stops.

Brain injury is currently the leading cause of disability worldwide.

But neuroplasticity offers some hope for recovery.

The fact that our neural connections remain flexible can also contribute to our understanding of how we treat mental health problems

such as anxiety or obsessive-compulsive disorder.

Neuroplasticity relies on regular practice and repetition, sometimes over a very long period of time.

Nowadays, neurorehabilitation encompasses a range of therapists,

helping people to reconnect with lost skills and to restore their emotional balance.

Many rehabilitation centers also incorporate music therapy.

Music engages various regions of the brain simultaneously,

including those responsible for movement, language, memory, and emotion.

And all this helps the brain to create new neural pathways.

But while the brain can form new connections, neuroplasticity does not restore it to its original state or functionality.

Illness or injury has the potential to alter the brain, so sometimes for a while, other times forever.

After the accident, Phineas Gage lived another 12 years.

He died from multiple seizures, undoubtedly linked to his brain damage.

He could never have imagined the legacy he left behind, that his terrible accident would not only alter the course of his life, but

would forever change our understanding of the brain.

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