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Thomas Aquinas, Moral Behavior and Phineas Gage

For Aquinas, the rational appetitive function was the ground of moral behavior. In his fascinating book, Descartes' Error, Antonio Damasio reports a famous case of brain damage caused by a metal rod driven through the skull of a railway employee, named Phineas Gage.Neil Gillman, The Death of Death: Resurrection and Immortality in Jewish Thought (Woodstock, VT: Jewish Lights Publishing, 1997), 75-76. Gage recovered almost entirely from his physical disabilities, except for loss of sight in one eye. It is surprising, of course, that Gage survived such a traumatic event at all, but more surprising is the fact that his personality was completely changed as a result of the accident. Gage's doctor describes how "the equilibrium or balance, so to speak, between his intellectual faculty and animal propensities" had been destroyed. The changes became apparent as soon as the acute phase of brain injury subsided. He was now "fitful, irreverent, indulging at times in the grossest profanity which was not previously his custom, manifesting but little deference for his fellows, impatient of restraint or advice when it conflicts with his desires, at times perniciously obstinate, yet capricious and vacillating, devising many plans of future operation, which are no sooner arranged than they are abandoned. . . ." .

These new personality traits contrasted sharply with the "temperate habits" and "considerable energy of character" Phineas Gage was known to have possessed before the accident. Previously, he had "a well balanced mind and was looked upon by those who knew him as a shrewd, small businessman, very energetic and persistent in executing all his plans of action." So radical was the change in him that friends and acquaintances could hardly recognize the man. They noted sadly that "Gage was no longer Gage." So different a man was he that his employers had to let him go shortly after he returned to work. The problem was not lack of physical ability or skill; it was his new character.

Damasio uses this story to introduce his research on brain localization. That is, by a careful analysis of Gage's skull, Damasio has been able to determine exactly which parts of the brain were destroyed by the iron rod. He infers from this and other similar cases that specific regions are essential to the sort of practical reasoning Gage became incapable of performing. To return to Aquinas's language, Gage lost his ability to be attracted to the Good.

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