Is there more to the ending? Maybe so.
I just watched the film, made a few comments on the board, and then read some more comments. I'm convinced there was more to the ending of this film than just Henry being loaded into the ambulance, fade to black.
I read that there was a final shot (that was cut from the film) of Gosling's character on top of the Brooklyn Bridge (a la out-of-body) watching himself die and the surrounding drama after the crash. I think it was this ghost Henry that was reliving a dream fantasy, not the suffering one on the ground.
The first shot of the film, after the crash, shows Henry leaving the scene by foot (physically) and undeniably entering into a dreamlike world. That makes me think he's having a near death out-of-body experience.
The film in other language is entitled El umbral, which is literally translated to "the threshold," but a Spanish-speaking friend told me means "place between two worlds" in his language. So what we might conveniently term "near death experience" or "out-of-body experience" or "shock induced hallucination" might actually be something else--a dreamlike separate reality superimposed on our own that perhaps only our superconscious can connect with.
I once felt as though there were other scenes cut out that would have more conveniently placed an earthy explanation to the story; perhaps Henry was still alive and recovering in a psych ward, traumatized so badly that he continually relives that night in fevered imagination. That's how he knows about psychiatrists, medication (Xanax) and not mixing Klonopin with alcohol, "Lila's" (a survivor's guilt Henry) suicide attempts, and other inexplicably non-crash related plot points.
But that would be too neat. I think the director should have left in the final shot with Henry's ghost atop the bridge. It would have turned the movie into more of a supernatural thriller than a "it was only a dream" movie. And it would have made it much more satisfying, for me.
A final shot might also explain Henry's final decision to leave this earth, a "spiritual suicide," after making peace with his loved ones and saying good-bye to all of his between-world characters. The phrase, "there is too much beauty in the world" might apply to his observing a budding romance between Sam and Lila at the end, but for him, his dream was over.