Authors never know what's going to lead to a novel. A dream. Something we see from the corner of our eye. A random question, or an overheard conversation in a coffee shop. Or... in the case of A Madness So Discreet, a story about someone's front lobe being punctured by a tamping iron.

I'm fascinated by the human brain. Deeply, deeply fascinated. Our understanding of the rest of our bodies is pretty thorough, but the organ that makes us US, that commands our speech and movement, our personalities and intelligence we're still drawing a pretty big blank on. Yes, we're learning. We're mapping our brains and using the technology at our fingertips to make strides, but one of the larger steps toward knowing more about our brains came in 1848.

Phineas Gage was a railroad worker whose job involved setting blasts to make way through rock for the new lines. He used a tamping iron - a metal rod three feet long - to tamp charges down before igniting them. On September 13, 1848 someone messed up. A hole had been bored into the rock, the powder had gone in, and (Gage thought) so had the sand that his tamping iron packs. But the sand wasn't there, and when Gage struck the gunpowder it ignited, sending his tamping iron through his skull. It entered below his left eye socket and exited through the top of his head.

Yep, that's gross.

Gage is famous not because he had a tamping iron blown through his head. He's famous because he lived even though part of his frontal lobe exited along with the tamping iron. Gage not only lived, but was walking and speaking right after the accident. His workmen carted him to the town doctor, to whom he supposedly said, "Here's work enough for you, doctor."

Yes, he even had a sense of humor about it all.

But, not for long. Though Gage lived through the accident, his personality showed damage long after the physical healing was finished. Gage had been a hard worker, an intelligent foreman and a pleasant person. Post-accident Gage was a shadow of his former self. The doctor who treated him initially, Dr. John Martin, followed Gage's progress with interest and documented the personality change:

The equilibrium or balance, so to speak, between his intellectual faculties and animal propensities, seems to have been destroyed. He is 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 pertinaciously obstinate, yet capricious and vacillating, devising many plans of future operations, which are no sooner arranged than they are abandoned in turn for others appearing more feasible. A child in his intellectual capacity and manifestations, he has the animal passions of a strong man. Previous to his injury, although untrained in the schools, he possessed a well-balanced mind, and was looked upon by those who knew him as a shrewd, smart businessman, very energetic and persistent in executing all his plans of operation. In this regard his mind was radically changed, so decidedly that his friends and acquaintances said he was 'no longer Gage.'

While Phineas' accident was life-changing in a bad way, it led to tremendous gains in the emerging science of neurology. Scientists were just beginning to understand that different areas of the brain served different purposes, and while they didn't quite grasp how this worked (enjoy this amusing early phrenology chart), Gage's trauma taught them that the frontal cortex was heavily involved in personality and social reasoning.

Gage died during an epileptic fit thirteen years after the tamping rod accident. His skull and tamping iron are in the Harvard University School of Medicine, if you want to go see them.

Gage's story is both sad and amazing, one that's always captured my attention. That a iron rod can pass through the human brain and that brain continue to function might sound like fiction, but it's not.

It's just science.

Reading about Phineas Gage got me interested in brain science, which led me to reading about lobotomies, which led me to reading about treatment of the insane, which led me to learning more about The Athens Lunatic Asylum, where A Madness So Discreet is set.

An amalgamation of different ideas and subjects came together to create A Madness So Discreet, but Phineas Gage ignited that spark.

Please tell me you get the joke (and forgive me, Phineas).

I like Phineas so much, I consider him my historical boyfriend. Watch the video to learn why.