Phineas Gage may be neuroscience’s most famous patient. In 1848, when Gage was 25, an explosion caused a tamping iron rod to hit his cheek, penetrate his brain, and exit through his skull. He may not even have lost consciousness, yet he was left blind in one eye and with a permanent change in personality. He was ‘no longer Gage’, and not in a good way. Can we hold him accountable for anything he did once his brain had been damaged?