One of medicine’s great textbook cases concerns a 25-year-old railroad construction foreman named Phineas P. Gage. Gage’s company, the Rutland & Burlington Railroad, was laying new tracks across Vermont in the summer of 1848, and Gage was in charge of overseeing the controlled explosions used to blast through the layers of stratified rock covering the uneven terrain.
For this exacting job, he’d had a special iron bar made that was nearly four feet long, an inch-and-a-half in diameter and weighing more than 13 pounds. After a hole was drilled into the rock, and powder, a fuse and sand inserted, the job of the iron bar was to tamp down the sand, which contains the explosion within the rock.
One afternoon, a freak accident occurred, when a distracted Gage tamped in the powder, but without the sand in place. The striking of the iron bar on the stone caused a spark, which lit the fuse, and the entire explosion blew up in his face.
The force of the explosion sent the iron bar up like a rocket through Gage’s left cheek, the base of his skull and the front of his brain and out the top of his head. Gage was thrown to the ground but, to the shock of his fellow gang members, he not only survived the accident, but also was still able to walk and speak coherently. His terrible wounds were dressed by a young doctor named John Harlow and, two months later, he was completely healed, suffering only the loss of one eye.
Although Gage was, to all intents and purposes, his old physical self, his body appeared to be inhabited by a totally different person.
Harlow, who maintained a keen interest in Gage’s case, kept a careful record of the fact that Gage appeared to no longer have a connection between his intellectual capacities and his ‘animal’ propensities. He was invariably socially inappropriate and also appallingly profane, with little regard for his fellows. He also appeared to be utterly unable to plan any future operation without vacillating or changing his mind.
These new personality traits so differed from the thoughtful and well-balanced character he’d displayed before the accident that his employers were forced to let him go. Afterwards, he invariably chose work that did not suit him: on horse farms, as a stagecoach driver, even as a freak in a circus act. Unable to secure steady employment, he, like many misfits of the time, traveled to California, where he eventually died of an epileptic fit.
More than 150 years later, this case fascinated he Portuguese behavioral neuroscientist Antonio Damasio, who’d long suspected that cool-headed reasoning did not produce intelligent choices unless there was an emotional component. And Gage had not only been incapable of making good choices, but was also impelled to select situations for himself that were downright disadvantageous.
Living without feeling
As Damasio put it, Gage “worked hard at his downfall”. Although his mental skills for language, memory, perception and intelligence had remained intact, somehow all his value judgements were seriously impaired. He’d been unable to behave in an ethical manner, observe social conventions and, most important, make decisions that were advantageous to his survival.
Damasio went on to study a number of modern Gages. Like Gage, they’d suffered damage to the ‘ventromedial’ (or underbelly) region of the frontal lobe, the area of the brain relating to emotion. As Demasio discovered in his research, they were incapable of having any sort of emotional response to any aspect of their lives. As Damasio described it, they “could know but not feel”.
They had had, in short, lost their ability to act on a gut hunch.
The emotional hunch
From cases like these, Damasio began to suspect that reduced emotion has a central role in inhibiting the ability to make sound decisions about the future. In cases like Elliot or Gage, he believed that the loss of the emotional center of the frontal lobes robs someone of their gut hunches. When faced with logic alone, people invariably make the wrong decision.
To test this, Damasio gave a patient of his called Elliot a popular psychology test called the Gambling Test. In this test, which imitates ordinary gambling, a subject is given $2000 to gamble with and four decks of cards. Certain cards, which are ‘wins’, result in the gambler being paid money. Others, deemed ‘losses’, require the gambler to pay the experimenters a fine.
Two of the decks—decks A and B—had been stacked so that Elliot would get high wins, but also high losses. Similarly, decks C and D were laced with small wins and small losses.
Ordinarily, a normal person will begin to get a bad feeling about the first two decks, and his gut hunch will tell him to avoid it. But, with Elliot, he ended up losing, attracted to decks A and B for the high wins, but unable to intuit that he was losing all his money with them.
Ordinarily, intuition improves with experience. When normal subjects took the Gambling Test, they learned to predict from the situation. Their gut hunches helped them to anticipate the best moves.
Damasio does not understand how this predictive capability develops, attributing it to some a non-conscious estimate of success and failure that becomes more acute over time.
Many of the emotions that form our gut hunches could result from two types of information flow — what Joseph LeDoux of New York University refers to as ’low-road’ unconscious information to the amygdala, and conscious ‘high road’ cognitive information to the neocortex.
However, there is likely to be a third road, too. Parapsychologists suspect that intuition arises from information not contained within the boundaries of time and space. Dutch psychologist Dick Bierman, for instance, has been keenly interested in whether our bodies can actually predict bad news.
To test this hypothesis, he used the Gambling Test, but wired up his participants with skin-conductance devices that measure ‘fight-or-flight’ responses. He discovered that, as the game went on, his participants became more stressed a few moments before they selected a bad card. Although they didn’t show such predictive ability at first, this ability increased as they got further into the game. Their ability to receive a gut hunch improved with time.
This suggests that what we term the ‘gut’ hunch doesn’t reside in our bodies it all.
As with animals, so much of the information we receive about our lives may be filtering into us all the time, without our cognitive awareness. It may be that our unconscious intuition is constantly receiving sensory and intuitive data that our ‘sensible’ neocortex dismisses.
Unlike animals, which act on their own highly specific unconscious fears forever, unless desensitized, humans often ignore these subtle warning signals at their peril.