If you haven't heard of this unlucky chap, let me briefly fill you in.
Phineas Gage was an American railroad construction foreman in the mid 19th century. No biggy. One day an explosion caused a large iron tamping rod to pass through his skull destroying his left frontal lobe. Incredibly, Phineas not only survived but remained conscious throughout the ordeal, sitting up right and able to talk throughout the 3/4 mile cart ride to town, where he was subsequently treated by Dr John Harlow.
Post accident, the story goes, Gage was a completely different person, despite returning to seemingly full physical health. He changed from a quiet and popular man to being fitfull, impatient, agressive and at times 'indulging in the greatest profanity'.
Dr Harlow himself states:
'In this regard his mind was radically changed, so decidedly that his friends and acquaintances said he was “no longer Gage" '
In Damasio's book 'Descartes Error', he describes Gage's decline in social functioning, his inability to hold down jobs or maintain social relationships and that...
'We would probably ﬁnd him drinking and brawling in a questionable district, not conversing with the captains of commerce, as astonished as anybody when the fault would slip and the earth would shake threateningly'
But a detailed look at the sources by Macmillan paints a rather different story. He emphasizes that the accounts describing Gage's dramatic change in behaviour refer largely to the first two months post his accident. Beyond those first two months, Gage holds down a variety of jobs successfully, is reported to recite fanciful stories to his nieces and nephews and in no way was an 'impatient, foul-mouthed, work-shy drunken wastrel'. Macmillan concludes that Gage made a good psychosocial recovery and despite not being the 'same Gage' as he was once before, he was much closer to his original self then is often depicted.
I think there are two important issues here. For Kotowicz, it shows how neuroscience often tries to deny the importance of introspection, subjective feeling and our relationship with the environment and psychological factors. He uses this example, to argue against the kind of eliminitivist materialism put forward by the likes of Paul Churchland. Instead he proposes that much of Gage's behaviour can be explained as a normal Psychological reaction to the trauma of the accident and the subsequent deformity that Gage had to live with.
I think he makes an important point, that to ignore the psychosocial factors affecting Gage after the accident is a gross error on the part of scholars such as Damasio and does provide a good example of the problems of studying the brain in isolation in order to explain behaviour. This is not of course, to deny that changes in brain can lead to changes behaviour, just go to the pub for a few hours, nor that neuroscience does not have in important part to play. The point here, is that the brain isn't the whole story and throughout Kotowicz's paper there is the undertone of a rejection of the biological direction Psychiatry seems to be heading in. By taking the brain out of context, not only do we miss other important e.g. psychological factors but the results we do achieve with regards to the brain risk being confounded.
Secondly, I think it raises an important issue within philosophy of science in general. Unless we are rigorous, critical and skeptical toward the paper or theory put in front of us, science becomes a matter of faith. Take, for example, the problem of secondary citing, whereby a theory, model or idea becomes generally accepted on the basis of continuous secondary reporting and citing without reference and analysis of the original source. And it gets worse, unless you are an expert in that particular field (and even then), it is completely impractical to endlessly check the citations in a paper and then the citations in that paper and so on.
I imagine if you're reading this blog you are probably the kind of person who would argue passionately for the theory of evolution against a creationist - and so would I. But I wonder how many of us have actually looked and studied the evidence, sources and papers in support of evolution in the kind of rigorous depth that the scientific method would warrant to support our arguments? I have not.
I suppose the important factor that distinguishes science is that there is (arguably) certainty in the methodology. As scientists we are confident that the falsifiability of empirical evidence provides us with the best means of gaining knowledge. The faith then, comes in the form of our trust in its correct implementation by those who specialise in that particular profession - on these grounds Damasio has failed his fellow scientists.
Macmillan, M., & Lena, M. (2010). Rehabilitating Phineas Gage Neuropsychological Rehabilitation, 20 (5), 641-658 DOI: 10.1080/09602011003760527
Kotowicz, Z. (2007). The strange case of Phineas Gage History of the Human Sciences, 20 (1), 115-131 DOI: 10.1177/0952695106075178