Phineas Gage (1823-1860) was a railroad worker living in the mid-nineteenth century who suffered a terrible accident while at work. An iron rod crashed through his head, tearing a large hole through his brain. Surprisingly, he survived this incident and in fact was relatively unharmed physically. His cognition and motor control were reasonably intact. However, there were marked personality changes that were very disturbing to those who had known him prior to the accident. While he had once been a sober and well-behaved citizen, after the accident he became rude, impulsive, and socially inappropriate. We now understand that he suffered from orbital frontal damage, with severe damage to the areas of the brain centrally involved with impulse control and social judgment.