In 1848, railroad foreman Phineas Gage survived a catastrophic accident in which a tamping iron blasted through his left frontal lobe, a case first documented by physician John Martyn Harlow (1848; 1868) and now understood as a landmark natural experiment linking frontal brain lesions to personality and social behaviour: once “Gage was no longer Gage,” showing impulsivity, poor judgment, and altered moral conduct, patterns that modern lesion studies and reconstructions (notably by Antonio Damasio in 1994, and later anatomical analyses by Malcolm Macmillan and colleagues, with CT-based reconstructions by Ratiu et al., 2004) interpret as damage to ventromedial and orbitofrontal networks crucial for emotion-guided decision-making and social norm adherence. Today, this synthesis reframes Gage not as a caricature of total moral ruin but as evidence that character expression depends on integrated brain systems that can be selectively disrupted and partially compensated over time. From a Christian perspective, the case resonates with Scripture’s holistic anthropology, in which humans are viewed as embodied souls (Genesis 2:7), whose minds can be renewed yet are vulnerable to injury (Romans 12:2; 2 Corinthians 4:7), and also with theological ethics that locate moral responsibility within created finitude, emphasising compassion over blame (Psalm 103:14; Luke 10:33–35). Gage’s story thus invites a pastoral stance that honours the imago Dei even amid neurological impairment while affirming the call to wise care of the body (1 Corinthians 6:19–20). For personal wellbeing and societal health, this work grounds humane clinical practice, reduces stigma by explaining behaviour through brain–environment interactions, informs rehabilitation and public safety with mercy and realism, and encourages communities to pair accountability with grace, an integration of neuroscience and theology that promotes healing, justice, and hope.