What makes us special as humans?

Is it the personas we hold, the stories we cherish with one another, or something else all together?

7 min readApr 25, 2022

A photograph of Phineas Gage (1823–1860); Author unknown / Wikimedia Commons

The content that follows explores the story of Phineas Gage and his mind-blowing personality change, one of the most famous stories in all of neuroscience. Then, it discusses Elon Musk’s announcement of Neuralink’s* potential to cure similar neurological abnormalities, possibly at the expense of our identities as humans.
That begs the question: What defines our identities as humans? What, specifically, makes us uniquely special?

* Neuralink is a company advancing neurotechnology through the development of a microchip to be surgically implanted within human brains.

Prelude

The story of Phineas Gage is one that has notably popularized books of psychology and neuroscience. He is often referred to as one of the most famous patients in all of neuroscience and psychology, having experienced a brain injury that destroyed much of his left frontal lobe. Gage miraculously survived the traumatic incident but not without changes that took a tremendous toll on the rest of his life.

— Fast forward to a few years ago —

Elon Musk announced that Neuralink will be able to one day treat the Phineas Gages of our modern time. While patients with paralysis and brain disease — like Parkinson’s or Alzheimer’s — seem to be at the top of Neuralink’s priority list of illnesses to combat — the potential for impact keeps growing. For just a few weeks ago, Musk posited in a TED interview that “morbid obesity”, too, could potentially be aided by Neuralink’s brain chip. What’s more, many experts believe that these technologies will hit the consumer market within the next couple decades, helping to solve some of humanity’s largest biological cruxes.

Who was Phinease Gage?

In 1848, 25-year-old Phineas Gage was the foreman of a crew commissioned to cut a railroad bed for the Rutland and Burlington Railroad near Cavendish, Vermont, U.S.A. His job consisted of deciding where holes ought to be drilled in the rock, and how much explosive powder to charge them with. To concentrate the force of the explosion, a method known as tamping was often applied to the explosive sites, in which a metal tamping rod — a long, crowbar-shaped device — would be used to firmly pack the powder and fuse. Only upon adding more sand, and tamping the hole more firmly, would the fuse be ready for safe detonation.

On September 13, 1848, Gage was tamping away at one of the holes when suddenly — what was the result of a distraction that caused him to turn his head — his tamping iron hit a rock, causing a spark to ignite the powder [Source]. The resulting explosion thrust the six kilogram, 1.1 meter long and 3 centimeter thick tamping iron up through his head. The rod entered Gage’s left cheekbone, pierced through his skull and brain — damaging a significant portion of his left frontal lobe — and then shot out his head, landing some 25 meters away.

What was perhaps most remarkable about the incident was not the fact that Gage survived and went on to live another 11 and a half years, but that he was immediately conscious after the incident and able to speak [Source]. After making his way back to the inn and blinded in his left eye, he was even witty enough to greet Edward Higginson Williams, an American physician who was first to arrive to the scene, with, “Doctor, here is business enough for you” [Source].

American Physician, John M. Harlow, soon arrived at the scene, and with the help of Edward Higginson Williams, the two effectively drained the infection from Gage’s skull, a expeditious action that saved his life. In Ambroise Paré’s famous words, Harlow humbly remarked, “I dressed him, God healed him” (Harlow, 1868).

After just 3 months of rehabilitative care, Gage was able to return back to his parent’s farm, but not without observation. As Harlow recounted in his paper regarding the psychological aftermath of Phineas’ life “the balance between his intellectual faculties and animal propensities seems to have been destroyed.”

His close friends and acquaintances recalled the Phineas they knew to have been a “strong and active” man with “an iron will”; one who was a “great favorite” among his crowd. His contractors referred to him as “the most efficient and capable foreman” in all the people they knew. Phineas had been regarded as a man with none other than “a well–balanced mind” and an “energetic [temperament] in executing all his plans.”

But to their dismay, Phineas had returned home a “fitful,” “irreverent,” “grossly profane” individual that showed but “little deference for his fellows.” The Phineas they knew was no longer there. He would abandon all the aspirations and desires that he sought throughout his life no sooner than he’d commit to them. As Harlow noted, it was as if Gage was a “child intellectually,” but one holding “the animal passions of a strong man.” (Harlow, 1848, 1849, 1868).

So ‘radical’ was the change, his friends and acquaintances said he was ‘no longer Gage’ — John M. Harlow

Why was Phineas so special?

Phineas’ incident captivated the heart of much of the neuroscientific community over the last two centuries because of the tremendous impact that the incident had on his character, bringing to light one of the first pieces of evidence suggesting a relation between personality and the function of the frontal lobes of the brain. This was during a time when the functionality of the different parts of the brain was largely unknown, as there had been little research done to uncover such mysteries.

So drastic was the shift in Gage’s persona and behavior from this event that his friends and family believed him to be wholly unrecognizable, so much so to the point where he was “no longer Gage.” Despite the effects of his mind-blowing injury, however, Gage eventually went on to work at a stable in New Hampshire, then as a horse carriage driver in Chile, and finally came to reunite with his relatives back in San Francisco. There, Phineas died after experiencing a tragically fatal series of epileptic episodes at the age of 36.

This case was one of the greatest in all of neuroscience, and its significance largely stems from the fact that it had a great impact on the status quo surrounding anatomy and psychology at the time. This realization was largely due to Phineas miraculously surviving the traumatic incident, upon which further observations concluded that the post-incident Phineas was behaviorally different from pre-incident Phineas.

Helping the Gage’s of our modern time

In 2017, when he founded Neuralink, Elon Musk suggested that a chip could be used to help anyone with a neurological defect. Just a few weeks ago, Elon suggested that it could be used to modify behavioral patterns within the brain in order to combat the neurological associations with morbid obesity. As Sadaf Farooqi, a professor of metabolism and medicine at the University of Cambridge, notes, “in […] people with severe obesity, it’s the function of a particular brain region, the hypothalamus, that’s really driving […] an increase in appetite… If you could find a way to target that particular region and even those particular neurons that drive appetite, then in theory, a drug or a technology [like Neuralink’s] […] could improve the lives of patients.”

While many experts back the potential for impact with a technology akin to what Neuralink aspires to create, it doesn’t go without its shortcomings. For instance, there are many ethical implications that ought to be considered when evaluating the efficacy of brain technologies. For if something as powerful as a computer could completely rewire the fundamental structures of our minds, what consequences could come from that? As Sara Goering’s lab — which explores the effect of Deep Brain Stimulation (DBS) (a method of brain stimulation used to treat depression) on personality changes within individuals — brings to light, some people undergo completely radical changes in their belief systems to the point where they’re not even sure who they are anymore.

One patient who underwent DBS treatment recounted the following:

“I’ve begun to wonder what’s me and what’s the depression, and what’s the stimulator. I mean, for example, I can be fine, and then all of a sudden … and, and I might realize it later, I do something socially or interpersonally, just not right. I’ll say something that is insensitive or just misread a person entirely, say something that either make ME look like a fool, or, hurts them, or, something along that line. I can’t really tell the difference. There are three things — there’s me, as I was, or I think I was; and there’s the depression, and then there’s depression AND the device and, it, it blurs to the point where I’m not sure, frankly, who I am” (Goering et al. 2017)

If the future that neurotechnology holds brings about an uncertainty in the identities of those who will use such technologies, who’s to say that we really are “progressing.” After all, who are we if not ourselves. Of course, there are those who will pursue treatment anyway, and to know the impact that neurotechnology will bring, only time will tell. I, however, am among those hopeful, and look forward to Neuralink’s continued pursuit toward some of the greatest feats in neuroscience.