Descartes' Error

Chapter One: Unpleasantness in Vermont

Phineas P. Gage

It is the summer of 1848. We are in New England. Phineas P Gage, twenty-five years old, construction foreman, is about to go from riches to rags. A century and a half later his downfall will still be quite meaningful.

Gage works for the Rutland & Burlington Railroad and is in charge of a large group of men, a "gang" as it is called, whose job it is to lay down the new tracks for the railroad's expansion across Vermont. Over the past two weeks the men have worked their way slowly toward the town of Cavendish; they are now at a bank of the Black River. The assignment is anything but easy because of the outcrops of hard rock. Rather than twist and turn the tracks around every escarpment, the strategy is to blast the stone and make way for a straighter and more level path. Gage oversees these tasks and is equal to them in every way. He is five-foot-six and athletic, and his movements are swift and precise. He looks like a young Jimmy Cagney, a Yankee Doodle dandy dancing his tap shoes over ties and tracks, moving with vigor and grace.

In the eyes of his bosses, however, Gage is more than just another able body. They say he is "the most efficient and capable" man in their employ.- This is a good thing, because the job takes as much physical prowess as keen concentration, especially when it comes to preparing the detonations. Several steps have to be followed, in orderly fashion. First, a hole must be drilled in the rock. After it is filled about halfway with explosive powder, a fuse must be inserted, and the powder covered with sand. Then the sand must be "tampedin," or pounded with a careful sequence of strokes from an iron rod. Finally, the fuse must be lit. If all goes well, the powder will explode into the rock; the sand is essential, for without its protection the explosion would be directed away from the rock. The shape of the iron and the way it is played are also

Introduction xi

PART I

Unpleasantness in Vermont 3

Gage's Brain Revealed 20

A Modern Phineas Gage 34

In Colder Blood 52

PART II

Assembling an Explanation 83

Biological Regulation and Survival 114

Emotions and Feelings 127

The Somatic-Marker Hypothesis 165

PART III

Testing the Somatic-Marker Hypothesis 205

The Body-Minded Brain 223

A Passion for Reasoning 245

Postscriptum 253

Notes and References 269

Further Reading 293

Acknowledgments 299

Index 301

Antonio Damasio, a neurologist and neuroscientist, is at the University of Southern California, where he directs a new brain research institute dedicated to the study of emotion and creativity. He is also an adjunct professor at the Salk Institute. The recipient of numerous awards (several shared with his wife Hanna Damasio, also a neurologist and neuroscientist), he is a member of the Institute of Medicine of the National Academy of Sciences and a fellow of the American Academy of Arts and Sciences. He is the author of two other widely acclaimed books, The Feeling of What Happens and Looking for Spinoza.

"An ambitious and meticulous foray into the nature of being." -- The Boston Globe

"We may well be about to discover that the heart is after all in the head." -- Financial Times

"Damasio's arguments are ingenious and wide ranging...His thoughtful and modest exposition should be taken seriously...It is no mean feat to say something original and intelligible about emotion." -- Nature