5 Things That Happen After a Car Accident Breaks Your Skull

That insane sequence out of a Final Destination movie happened to a college student named Augusto Coaracy. He was driving over to a friend's house, seconds away from crossing under an overpass. Above him, a city bus was chugging along. Out of nowhere, one of the wheels on the bus decided it didn't want to go 'round and 'round anymore. It careened off the vehicle, tumbled over the edge of the overpass, fell to the street below, bounced twice in Augusto's direction, and crash landed on his car. If you're thinking this is just a hunk of inflatable rubber that probably boinked harmlessly off his windshield, you've obviously never picked up a bus tire before -- here's what it did to Augusto's car (top: The bus, with its back wheel missing; bottom: Augusto's car):

When the bus wheel came down on his head, it shattered his C1 vertebra in three parts -- that is, it smashed the neck bone that's in charge of supporting the skull and shielding the spinal cord. "The X-ray of my neck that night -- it's the most shocking thing from my accident," Augusto says, "It shows my vertebra in pieces."

How shocking? Well, the first person on the scene happened to work for the Brazilian health department. He later told Augusto that the accident was so horrific, he literally decided to quit his job the next day. That's right -- the injury was so gruesome that it inflicted traumatic splash damage on bystanders.

The paramedics got Augusto to the hospital, and he was relatively stable until a blood clot in his brain began to grow. And grow. And grow. His left eye looked ready to pop. The only thing doctors at the severely under-resourced hospital could do was take an honest-to-God jackhammer to his head and remove a chunk of skull for his brain to decompress. The intensive care unit at the public hospital didn't have room for him, so he was transferred to one that did ... and they forgot to fit him with a neck brace for the ambulance ride over.

They forgot to put a brace on the guy whose neck bones were in shards, and whose spinal cord was completely unprotected. A speed bump could have killed him. But it didn't, and Augusto's strange journey began ...

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Augusto was either unconscious or completely uncontrollable for the rest of the night. "My neck was broken and my skull had cracked. In my jumbled mind, though, there was no way I'd stay in a hospital. I was gonna muscle my way out of there." He was so uncooperative during the first night, as well as his week-long stay in the ICU, that doctors kept him strapped to the bed by his wrists and ankles. Whenever they tried to insert a catheter into him, he would rip it right out.

Next came an inability to hold a memory in his head for more than a few minutes. His family had to explain the accident to him over and over again, everything continually resetting like in Memento:

"Right when I'd say something like, 'Holy shit! You're telling me a bus wheel fell on my head?!' then bam! I'd be asleep again. The whole thing -- waking up, asking what happened, not believing it, finally starting to believe it, falling asleep -- would start over in two-and-a-half minutes. Really -- my brother timed it."

And then came the loss of inhibition. When awake, Augusto displayed all the recklessness and impaired judgment of a drunk. At one point a friend came over. Augusto's mother was in the room with them, fretting over whether all these visits would be bad for his recovery. His reaction was to pick up his cellphone from the bedside table and text his buddy, "Dude, my mom needs to smoke a joint and chill." Unfortunately for him, in his discombobulated state, he didn't send the text to his friend. He sent it to his mom.

And that was far from the most embarrassing thing he did ...

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Incredibly, this is a common symptom -- a lot of patients become sexually uninhibited following such an injury. Becoming a dick-flasher falls on the more extreme end of the scale, so Augusto has that going for him. But he's also far from the most extreme case -- there are rare head trauma cases where heterosexual patients have woken up after a brain injury identifying as gay, and vice versa. And while you'd presumably adjust to that, it pales in comparison to the truly horrifying situations where survivors of brain trauma come out at the other end as pedophiles.

But for Augusto, it was just a matter of seeing his inhibitions drop temporarily. He describes his attitude after the accident as "freestyle mode: I could say whatever I wanted, do whatever I wanted, and never get reprimanded for it. Everyone would still love me."

And that's the thing -- part of it was due to the injury, but part of it was knowing that this was the one time he could get away with it -- like that friend who's pantsless at the party after half a wine cooler. "My thought process went something like, 'I know I shouldn't, but still ...'" This was Augusto's golden opportunity to test the boundaries of conventional behavior, and he made full use of it.

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The bus wheel did a number on the muscular framework around Augusto's eye when it fell on his head. The surgeon who had opened his skull told him that his pupil looked ghastly that first night. It was one of the clues that his condition had taken a turn for the worse. "The craziest thing was that I saw the world as if through a kaleidoscope. If I looked at someone, I would see five of them." This made the recovery period really frustrating. Augusto was confined to his bed a lot of the time and couldn't relieve his boredom by reading a book, for example. The words would tangle up, floating in and out of the page.

Although his eyes are now fine, "that side of my face still goes through some trippy shit. I can't feel half of my nose and one-third of my mouth. I get pins and needles when I touch my cheek. If someone else touches my face while I'm not paying attention, it will start to tickle."

The more excruciating physical therapy came courtesy of Augusto's neck. It's the part of his body that harbors the most after effects from the trauma. "If I try to stretch these days," he says, "my neck will suddenly lock in place. When I crack it, I can hear the sound of the cracking coming from inside of one of my brain hemispheres. It's weird."

But the physical stuff was just one part of it, because ...

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Augusto admits that part of it was that he didn't want to get back to normal. After all, being pampered like a baby was awesome. "I could easily have stayed that way forever, relishing all the attention I was getting." There was serious temptation to do so, especially since his accident and one-in-a-million survival odds were a big story in his hometown. "I became the 'wheel boy.' I'd sometimes get recognized by complete strangers, who would congratulate me on making it. I started getting phone calls from people who would have never called me before in my life. These same people were sending me gifts! All of that gave me a really big ego trip."

This put Augusto in a precarious position. The adulation fed his vanity. On top of it, he was a young college student when the accident happened. He was meeting new people, he was no longer the nerdy boy in school, he felt great! When he went back to classes six months later, everyone on campus was incredibly kind and accommodating.

"At some point, I made a conscious decision not to let all this attention get to my head," he says. "After all, what had I actually accomplished to receive a bunch of praise? I'd simply been lucky to survive. Indeed, physical recovery took a lot of work on my part. I can safely say, though, that tending to my emotional well-being was just as important, and as challenging, as the physical therapy for my neck and eyes. That, to me, was the real recovery process that allowed me to grow from this experience. And I'm so grateful for that."

It's a long, bizarre trip, all thanks to a few defective lug nuts.

Augusto Coaracy's mind and sense of humor have made a full recovery since the accident. He now treats other people's minds as a public health psychologist in Sao Paulo, Brazil.

Related Reading: If you ever find yourself hospitalized, make sure you're up to date on your doctor's lingo. Or check out another subject's experience with almost dying. Have a story to share with Cracked? Email us here.

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