The story line including the wooden stake draws from one of the most famous neurological cases. In 1848, Phineas Gage was the foreman of a work-gang preparing the roadway for the Rutland & Burlington Railroad as it was being constructed through Vermont. Railways went where they wanted in those days: if the land was flat ahead of you, great. If there is a valley ahead on the specified route, then build a viaduct over it, and if there is a mountain or a hill ahead, then make a tunnel or a cut. The financiers were not worried about details. It was while constructing a cutting south of the village of Cavendish that Phineas Gage entered the (medical) history books. He and his team were blasting a path through rock to make a cutting. Once a deep hole had been bored in unwanted rock, the process was very much like that of military artillery of the period. Pack the hole with explosive, add a fuse (separate detonators came later!). Then seal the hole with clay or some other suitable material, pressing each layer down with appropriate gentleness using a tamping iron. As he was engaged in one of these operations, Gage was apparently distracted by questions from his team and turned to reply. It seems likely that he had not reached the sealing operation so the hole was unsecured, and that the tamping rod sparked off the wall of the hole, with the result that the charge exploded while Phineas Gage was in direct line of fire and of sight of the blasting hole. The tamping rod (1¼" or over 3cm diameter, and a metre long) flew from its hole, piercing poor Phineas. It flew through his jaw and skull, missing his eyes and optic nerves but destroying a large part of his left brain. The rod was eventually found to have flown about 25m beyond the site of the blast. Gage recovered much function, although his character was different. He developed symptoms of epilepsy, dying in 1860.
