A head injury hall of fame

As the story goes, the Greek tragedist Aeschylus spent the last day of his life outside, because an oracle had warned him that he would die on that date when a house fell on his head. He had reasoned that this was very unlikely if he did not go into a house, but still received a fatal head injury when an eagle dropped a tortoise on it.

It's a story that people have worried about being too good to be true, but Pliny the source of the story is normally treated as generally reliable. Birds like the lammergeier do drop marrow-filled bones and tortoises on rocks to get at the juicier bits inside, so that part is certainly possible. As to the oracle, that's harder to be sure about, but the double meaning of the prophecy playing its part in it coming true is what we'd expect.

More firmly documented is the case of Phineas Gage's head injury. Gage was a nineteenth-century railway foreman who figures heavily in the history of psychology and neurology. In 1823, he was charging a line of pre-drilled holes with gunpowder and fuses, then covering the charges with sand before packing the whole lot tight with an iron tamping rod.

In one hole, he had forgotten the sand, and when the iron rod sparked off the rocky sides of the hole, the gunpowder ignited and blew the rod directly through Gage's head. As work injuries go, this sounds incredibly serious, but Gage seemed to recover within minutes, despite the blood pouring from the two holes in his head. Imagine the compensation claim he could have made today!

What makes him special to the study of the brain is that although his injuries were severe, he survived them and an associated infection, only with a modified personality. The degree of the personality change attributed to his head injury has varied with time; current opinion suggests that it was exaggerated over time, but was real.

A bit of exaggeration is not surprising, given that Gage's next job was as an attraction in P.T. Barnum's travelling circus, with the very rod that had gone through his head.

In recent years, Keith Richards was in the news with concussion after falling out of a coconut palm. With what seems to be a talent for indestructibility, he was rapidly back on form and according to some reports hoping to recreate the head injury on camera for the Pirates of the Caribbean films.

Reports in more newsy sections of the paper, though, suggest that there are about a million cases of injuries to the head or brain reported to hospitals and GPs each year. While famous examples may raise the profile of head injury issues in general, it is perhaps more telling to think that a million cases a year translates into one in sixty people in the UK suffering a head injury.

It's not uncommon to have more than sixty friends, according to Facebook or MySpace. If accidents were randomly spaced through the population, it would be likely that you would know someone who suffered a head injury. While a celebrity head injury can make it seem like such an unusual thing that it doesn't impinge on real life, this application to people you know makes those chances more significant by far.

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