Phineas and Friends: Three mysterious medical accidents that are still perplexing to this day

Vinny Vince examines the peculiar nature of a selection of bizarre medical cases, and the way in which their intrigue has captured and inspired the scientific community for decades.

A man buried in an avalanche while on holiday skiing was starved of oxygen for at least 15 minutes. Weeks later, while solving Sudoku puzzles, he began to develop seizures in his left arm – seizures that didn’t occur while doing calculations or writing. After a functional magnetic resonance exam during which doctors encouraged him to solve the puzzles, they found that the seizures (and the completion of the seemingly innocent little maths puzzles) were accompanied by high levels of activity in the right central parietal cortex. This rare case is a similar condition to the well-known photosensitive epilepsy, where seizures are triggered by flashing lights. Luckily, the issue had a simple fix for the 25-year-old student – once he stopped solving Sudoku puzzles, the seizures never returned. Time to take a crack at Wordle?

Alexis St Martin was shot in the stomach in 1822 after an accidental close-range discharge of a shotgun. Amazingly, he survived, although a hole was left in his stomach. This hole happened to heal in connection with a hole in his skin and muscle, so he ended up with a permanent gastric fistula. William Beaumont, the doctor who saved his life, realised the potential of this fascinating accident and he decided to use it to study the digestive system. He began by tying string to pieces of food, inserting them through the hole in St Martin’s stomach, and then removing them every few hours to watch the process of digestion. As disgusting as these perverse experiments may seem (St Martin even tried to run away from Beaumont at one point, but was caught!), they did provide a valuable discovery. They showed that digestion is primarily chemical rather than mechanical – stomach acid digests the food more than any mashing or squeezing processes. Although ethical considerations in science have come a long way since then, we can still thank Beaumont for these fascinating insights into digestion.

Finally, and most infamously, is the mysterious case of Phineas Gage, a construction worker who had a tamping rod penetrate his left cheek, go straight through his skull, and land several feet away, after an accidental explosion. Miraculously, he not only survived, but likely stayed conscious, despite being completely blinded in his left eye. As if this wasn’t fascinating enough, the real mystery came a few months later, when his friends described him to Gage’s doctor as “no longer Gage”. He became erratic, violent, couldn’t stick to plans, and used “the grossest profanity”. He was fired from his job and eventually died from seizures. This chilling case is one of the most famous in neuroscience – it gave clear evidence that certain functions are associated with specific areas of the brain. In fact, it is one of the first ever sources of evidence that the frontal lobe is involved in personality.

These are, of course, some of the most perplexing and gruesome cases, but accidents happen all the time that lead to vital scientific discoveries. Here’s to many more in the future, although preferably more resulting from happy surprises than traumatic injuries!

From SATNAV Issue 24, page 12.