It changes the 3 hurt sounds, and the death sound, to the scream. It doesn't always play, if you get hurt, then again, it just won't play. However on some occasions it will. And it's such a long sound, if you die and immediately exit to the main menu, it will continue to play until done.


Achievement:
Featured on THE WORST ISAAC MODS 9 - https://www.youtube.com/watch?v=XtHdjCqrxYU&lc=z23wgdcy5miiefqe2acdp43aeuxzpyryzo3kensawkdw03c010c.1518925969946115
haha yes