The Agony of
A physician's look at the crucifixion
Mark Eastman, MD
On the evening before His crucifixion Jesus was gathered with His disciples in the upper room sharing with them some of the most intimate truths of His entire ministry. As He discussed the love of the Father and His love for His disciples he declared:
"Greater love hath no man than this, that a man lay down his life for his friends" (John 15:13)
Though they did not realize it at the time the
disciples were only hours from the practical realization of this
One of the subtle evidences of the supernatural origin of the Biblical text is that astonishing events are often described in extremely brief narratives. This is perhaps best illustrated in the matter of fact way in which the crucifixion of Jesus Christ – the most pivotal event in the history of the universe - is described in the Gospel accounts. After Jesus was examined and declared to be without fault by the Roman Procurator Pontius Pilate, he delivered Him to be judged by the assembled crowd. When the opportunity arose to decide the destiny of Jesus the assembled crowd and the Jewish leadership cried out saying, "crucify Him, crucify Him." The horrifying events of the next six hours were preceded by the simple words: "Then delivered he Him therefore unto them to be crucified. And they took Jesus, and led him away." (John 19:16)
"Great Drops of Blood"
The physical suffering of Jesus began in the Garden of Gethsemane on the evening before His crucifixion. While the disciples slept the Gospel of Luke records that the LORD "being in an agony he prayed more earnestly: and his sweat was as it were great drops of blood falling down to the ground." The notion that someone could actually sweat blood seems contrived. However, there is a rare but recognized condition called hematohydrosis, in which capillary blood vessels that feed the sweat glands rupture causing them to express blood. This usually occurs under conditions of extreme physical or emotional stress. However, Jesus wasn’t sweating blood because he was afraid of the physical pain of the cross. Indeed, the book of Hebrews tells us that Jesus looked forward to the cross:
"Looking unto Jesus, the author and finisher of our faith, who for the joy that was set before Him endured the cross, despising the shame, and has sat down at the right hand of the throne of God" (Hebrews 12:2)
After His arrest they led Him away to the High Priest Caiaphas where the Scribes and elders were assembled. During this inquisition we are told that "some began to spit on Him, and to blindfold Him, and to beat Him, and to say to Him, ‘Prophesy!’ And the officers struck Him with the palms of their hands." Beatings about the face received by a blindfolded individual cause even worse trauma because the victim cannot "roll with the punches." In the hours that followed Jesus received two additional beatings at the hands of Roman soldiers. Severe disfigurement of the face would certainly have resulted from the brutal treatment. It is likely that the eyelids were swollen shut as a result of such beatings. This was done in fulfillment of Isaiah 52:13-14:
"Behold, my servant shall deal prudently, he shall be exalted and extolled, and be very high. As many were astonished at thee; his visage was so marred more than any man, and his form more than the sons of men"
After His trial before Pontius Pilate Jesus was scourged (flogged) by the Roman guards. This process typically involved a whip with numerous leather thongs, 18-24 inches long, with bits of metal, bone or glass embedded in the leather. At times they would use an iron rod to beat the prisoner. According to Jewish custom a prisoner was usually flogged 39 times (Forty minus one as a sign of Jewish mercy!) Scourging was an extreme form of punishment. The skin on the victim’s back was usually shredded thus exposing the underlying muscle and skeletal structures. Severe blood loss and dehydration were the rule. Many victims died from such scourging. After the scourging of Jesus the Roman soldiers beat Him a second time with their hands and with a reed. Then they put on him a "crown of thorns." Jesus had not drank since the night before, so the combination of the beatings, the crown of thorns and the scourging would have set into motion an irreversible process of severe dehydration and cardio-respiratory failure.
All of this was done so that the prophecy of Isaiah would be fulfilled: "I gave my back to the smiters, and my cheeks to them that plucked off the hair: I hid not my face from shame and spitting." (Isaiah 50:6). And, Isaiah 53:5, "But he was wounded for our transgressions, he was bruised for our iniquities: the chastisement of our peace was upon him; and with his stripes we are healed."
Crucifixion was invented by the Persians between 300-400 B.C. It was "perfected" by the Romans in the First Century B.C. It is arguably the most painful death ever invented by man and is where we get our term "excruciating." It was reserved primarily for the most vicious of criminals. The most common device used for crucifixion was a wooden cross which consisted of an upright pole permanently fixed in the ground with a removable crossbar, usually weighing between 75-100 lbs. Victims of crucifixion were typically stripped naked and their clothing divided by the Roman guards. In Jesus’ case this was done in fulfillment of Psalm 22:18, "They divide My garments among them, and for My clothing they cast lots." As a gesture of "Roman kindness" the prisoner was offered a mixture of vinegar (gall) and wine as a mild anesthetic. The victim was then placed on his back, arms stretched out and nailed to the cross bar. The nails, which were generally about 7-9 inches long, were placed between the bones of the forearm (the radius and ulna) and the small bones of the hands (the carpal bones).
The placement of the nail at this point had several
effects. First it ensured that the victim would indeed hang there
until dead. Secondly, a nail placed at this point would sever the
largest nerve in the hand called the median nerve. The severing of
this nerve is a medical catastrophe. In addition to severe burning
pain the destruction of this nerve causes permanent paralysis of the
hand. Furthermore, by nailing the victim at this point in the wrist,
there would be minimal bleeding and there would be no bones broken!
Thus scriptures were fulfilled: "I can count all my bones: they
look and stare upon me." (Psalm 22:17). And Psalm 34:20, "He
keepeth all his bones: not one of them is broken."
The positioning of the feet is probably the most critical part of the mechanics of crucifixion. First the knees were flexed about 90 degrees and the feet were flexed (bent downward) an additional 90 degrees until they were parallel the vertical pole. An iron spike about 7-9 inches long was driven through the feet between the 2nd and 3rd metatarsal bones. In this position the nail would sever the dorsal pedal artery of the foot but the resultant bleeding would be insufficient to cause death.
The Catastrophic Result
The resulting position on the cross sets up a horrific sequence of events which results in a slow painful death. Having been pinned to the cross the victim now has an impossible position to maintain. With the knees flexed at about 90 degrees the victim must bear his weight with the muscles of the thigh. However, this is an almost impossible task-try to stand with your knees flexed at 90 degrees for 5 minutes. As the strength of the legs give out the weight of the body must now be borne by the arms and shoulders. The result is that within a few minutes of being placed on the cross the shoulders will become dislocated. Minutes later the elbows and wrists become dislocated. The result of these dislocations is that the arms are as much as 6-9 inches longer than normal. With the arms dislocated considerable body weight is transferred to the chest causing the rib cage to be elevated in a state of perpetual inhalation. Consequently, in order to exhale the victim must push down on his feet to allow the rib muscles to relax and the chest wall to be lowered. The problem is that the victim cannot push very long because the legs are extremely fatigued. As time goes on the victim is less and less able to bear weight on the legs causing further dislocation of the arms and further raising of the chest wall, making breathing more and more difficult. The result of this process is a series of catastrophic physiological effects. Because the victim cannot maintain adequate ventilation of the lungs the blood oxygen level begins to diminish and the blood carbon dioxide (CO2) level begins to rise. This rising CO2 level stimulates the heart to beat faster in order to increase the delivery of oxygen and the removal of CO2. However, due to the pinning of the victim and the limitations of oxygen delivery, the victim cannot deliver more oxygen and the rising heart rate only increases oxygen demand. So this process sets up a vicious cycle of increasing oxygen demand – which cannot be met - followed by an ever-increasing heart rate. After several hours the heart begins to fail, the lungs collapse and fill up with fluid, which further decreases oxygen delivery to the tissues. The blood loss and hyperventilation combines to cause severe dehydration. That’s why Jesus said, "I thirst." Over a period of several hours the combination of collapsing lungs, a failing heart, dehydration, and the inability to get adequate oxygen supplies to the tissues cause the eventual death of the victim. The victim, in effect, cannot breath properly and slowly suffocates to death. In cases of severe cardiac stress, such as crucifixion, a victim’s heart can even burst. This process is called "Cardiac Rupture." Therefore it could be said that Jesus died of a "broken heart!" To slow the process of death the executioners put a small wooden seat on the cross which would allow the victim the privilege of bearing his weight on his buttocks. The effect of this was that it could take up to 9 days to die on a cross. When the Romans wanted to expedite death they would simply break the legs of the victim causing him to suffocate in a matter of minutes. At three o’clock in the afternoon Jesus said Tetelastai, meaning, "it is finished." Then He gave up the ghost. When the soldiers came to Jesus to break His legs He was already dead. Not a bone of Him was broken!
How Should We Then Live?
I realize that it is difficult to read of the details of Jesus’ physical sufferings. And yet, when we realize that He looked forward, on our behalf, to the cross, we are overwhelmed with His practical demonstration of love and, hopefully, a personal realization of our unworthiness. How should we then live? I believe that the Apostle Paul said it best:
"Let this mind be in you which was also in Christ Jesus, who, being in the form of God, did not consider it robbery to be equal with God, but made Himself of no reputation, taking the form of a bondservant, and coming in the likeness of men. And being found in appearance as a man, He humbled Himself and became obedient to the point of death, even the death of the cross. Therefore God also has highly exalted Him and given Him the name which is above every name, that at the name of Jesus every knee should bow, of those in heaven, and of those on earth, and of those under the earth, and that every tongue should confess that Jesus Christ is Lord, to the glory of God the Father." Philippians 2:5-11