Michael Paul was returning from church Jan. 5 when he decided to crack his neck, just as he'd done dozens of times whenever he got a kink in it. But this time was different.
"He said, `I think I hurt myself,' " Paul's half-brother, Ronald Cook, said Thursday. "His hands started sweating, and he turned a pale color. By the time they got him to the hospital, he was already comatose."
Paul, 42, a muscular ironworker from Westminster, Calif., died at 1:07 a.m. Wednesday after being on life support at UCI Medical Center in Orange for 12 days. An autopsy showed that Paul gave himself a stroke.
The snap damaged Paul's vertebral artery, one of the main arteries to the brain, said Orange County Deputy Coroner Jackie Berndt. That led to swelling that restricted blood flow and killed off a portion of his cerebellum.
Cook said the damage also spread to the brain stem, which controls all involuntary life-support functions, like breathing.
"The doctor described (the brain stem) like a highway out of the city," Cook said. "With that blocked, everything died."
The official cause of death is "cerebellar infarction" due to "traumatic torsion of neck."
Local doctors called Paul's death a freak accident, something they'd only read about in medical journals.
"I've never heard of a person who's inflicted an (arterial) tear by himself," said Dr. David Abrahamson, a cardiologist at the Orange County Heart Institute and Research Center. "It's rare happening even in a chiropractor's office. This would be even more rare."
"Cracking your own neck shouldn't be done. That's why you should go to a chiropractor to do it, so you don't get a stroke," said Dr. Martin Geoffreys, a former board member of the Orange County Chiropractic Society. "We use minimal rotation, and we adjust from back to front. . . . That way, the vertebral artery won't be affected."
Abrahamson and Geoffreys said the risks are higher in people in poor cardiovascular health or with underlying connective-tissue weaknesses.
But Cook, 47, of Massachusetts, said his brother was in excellent health, apart from permanent discomfort caused by a 1980 construction accident in which he landed on his head.
"He was a stocky, strapping guy," Cook said. "That's one of the things that adds to the shock of the whole thing."
Cook said Paul, a born-again Christian with a 17-year-old daughter, began seeing a chiropractor after the 1980 fall and got in the habit of cracking his own neck whenever he got a kink in it.
"He'd whip it back and forth," Cook said.
The death stunned family members, and the repercussions still are being felt. Ten days ago, Paul's 68-year-old mother, Rosemary, was hospitalized with a heart attack.
"It's been horrible," Cook said. "It really has."