Please DO NOT READ if you are a bit squeamish.
On 13 September 1848, a young man called Phineas Gage was at work in Vermont. He was an ‘efficient and capable’ railroad construction foreman and on that day was making roadbeds. The process involved using explosive powder and compressing it with an iron rod. Unfortunately, for Phineas an explosive detonated, the 43 inch rod penetrated his left cheek and beyond.
After the initial impact, Phineas stood up, spoke and with help got onto a cart and was taken to Dr Williams. He was amazed. Then another doctor took over his care. Once physically recovered from the injury, Gage* reapplied for his job. However, due to the insult to his brain, his personality changed. He lacked inhibition, swore, made poor decisions, judgement and became disrespectful.
Phineas Gage’s case was how doctors initially realised that the front of the brain (left and right frontal cortex) is responsible for language, decision-making, intelligence and reasoning.
Apparently, when Phineas met Dr Williams, he angled his head saying ‘Here’s business for you.’
When Pernicious Anaemia/B12 deficiency finally affects the front of the brain a person may have disinhibition, have difficulty with thoughts and language. (The patient will have presented many times to doctors). It is highly likely that the patient will be misdiagnosed with a psychiatric illness.
*N.B. A gage is an instrument for measuring the amount or level of something. For example: -
A concentration (mg/L)
or
(a)
CAPACITY.
Often Doctors are on the wrong Track.
At my wits end
MrJustatip's diagnosis - FINALLY.
