Just In Case

I love case studies, particularly when it comes to brains. They are such fascinating things. We all like to think that we are in control, that we know who we are and why we are the way we are. But then someone comes along an survives some crazy accident and we get a whole new view of what it means to be a human being. Take the case of Phineas  Gage.

In 1848, Gage, 25, was the foreman of a crew cutting a railroad bed in Cavendish, Vermont. On September 13, as he was using a tamping iron to pack explosive powder into a hole, the powder detonated. The tamping iron—43 inches long, 1.25 inches in diameter and weighing 13.25 pounds—shot skyward, penetrated Gage’s left cheek, ripped into his brain and exited through his skull, landing several dozen feet away. Though blinded in his left eye, he might not even have lost consciousness, and he remained savvy enough to tell a doctor that day, “Here is business enough for you.”


Gage’s initial survival would have ensured him a measure of celebrity, but his name was etched into history by observations made by John Martyn Harlow, the doctor who treated him for a few months afterward. Gage’s friends found him“no longer Gage,” Harlow wrote. The balance between his “intellectual faculties and animal propensities” seemed gone. He could not stick to plans, uttered “the grossest profanity” and showed “little deference for his fellows.” The railroad-construction company that employed him, which had thought him a model foreman, refused to take him back. So Gage went to work at a stable in New Hampshire, drove coaches in Chile and eventually joined relatives in San Francisco, where he died in May 1860, at age 36, after a series of seizures. – smithsonian.com

Damage to the prefrontal cortex does not disrupt the basic function of sensory, memory or emotional systems; it disrupts a person’s ability to synthesize these systems and produce organized social behavior. There is some debate as to whether it was just the injury that changed Gage’s personality, or if the change was in conjunction with the way he was treated after his injury. He was stared at, pointed at, and talked about by his friends and coworkers when he returned to work. After loosing his job he joined a ‘freak’ show for a while and spent the last bit of his life suffering from sever epileptic seizures, which Victorian era society often judged to be a ‘personality’ disorder.

Whether it was biological or sociological damage, Gage’s case shows us an example of a dynamic pattern such as we find in Chaos theory. Chaos theory studies the behavior of dynamical systems that are highly sensitive to initial conditions – such as your brain functions changing due to having a spike driven through it.


The microbes in the gut of a premature infant change radically from day 10 and days 16-21, as indicated by the colored bars keyed to different microbial groups. Even day to day, the relative proportions of microbes shifts, and probably continues to change as the baby encounters new environments, people and pets.

We confront these same types of  issues when it comes to many things – is it biology or is it sociology? If we think about the standard American diet, or any diet in fact, we can see this too. To some extent we are conditioned by our environment and create our own dynamic system with it and within it. When we think of the obesity epidemic here it is easy to say people should have more will power.  However, what we eat can change our brain chemistry and changes in our brain chemistry can alter the way we think about food.

Like the case of Gage, changes in his physical abilities changed the way his society and immediate social circle perceived and treated him. We don’t have case studied such as Gage’s where someone has, say, lost part of their gut microbes through a freak accident. But we do know this happens because we have case studies with medications and ones like the study above that looked at these types of changes in infants. What we don’t often study is the effects of an inundation of cheap, processed food on your internal communities – she said, as she ate her whole milk yogurt.

Homemade Yogurt (Curd)

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This is a basic recipe for homemade yogurt using commercial full fat milk. The yogurt is delicious as is, but can be made into the thick yogurt that is such a favorite in Greek cooking by straining. It goes great with spicy foods or just drizzled with local honey.


  • 1 quart (32 ounces) of full fat sheep or cow’s milk (pasteurized)
  • 2 tablespoons of previously homemade yogurt or plain unflavored yogurt with active live cultures
  • 2 tablespoons of full fat milk (same type)


Start with all ingredients at room temperature.

  1. Heat the milk just to the boiling point and pour into a non-metal container.
  2. Let cool to lukewarm (100-105F). A skin will form on top.
  3. Mix the 2 tablespoons of yogurt (homemade or commercial) with 2 tablespoons of milk.
  4. Add to the lukewarm mixture, carefully pouring down the side so that any skin that may have formed on top is not disturbed.
  5. Cover with a clean dishtowel and place on another towel in a warm, dry place for at least 8 hours (or overnight) until it thickens. Note: 8 to 12 hours is best. The longer the yogurt coagulates beyond that time, the more sour the taste becomes.
  6. Carefully drain any excess liquid.
  7. Refrigerate for 4 hours before using.

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