Jesus Christ's death on the cross was a study in the agony of a man whose arms and legs--their major nerves possibly cut by spikes--shot searing jolts of pain through a body already ravaged by blood loss from a severe whipping.
Having suffered for at least three hours, Jesus finally died of an unusually severe variety of blood loss-induced shock and a type of suffocation that normally resulted from crucifixion.
In the end, he may have suffered a climactic heart seizure--perhaps brought on by a blood clot breaking loose inside his arteries and fatally damaging his heart muscle. More likely, perhaps, he suffered a final episode of acute heart failure possibly caused by a catastrophic disturbance in the rhythm of his heartbeat.
If he did sustain a lance wound after he lost consciousness for the last time, the spear tip probably pierced the chest cavity, releasing a combination of blood and fluid that accumulated because of the worsening asphyxiation. The end of the lance probably penetrated Jesus' heart, too, but its effect was academic for the man widely perceived as the son of God was already dead before the Roman soldier raised his weapon.
These conclusions, at least, are the findings of the most complete medical review of the agony of Christ's death ever published in a medical journal. The article containing the conclusions was published last week in the Journal of the American Medical Assn.
Surprisingly, perhaps, the new evaluation is apparently the first prominent medical evaluation of the Crucifixion published in this century. No major medical publication has addressed the issue at all in recent years. Dr. George Lundberg, the journal's editor and a pathologist himself, said he found "nothing surprising" in the post-mortem review of Jesus' death, adding that "I believe the descriptions are realistic, make good sense and are consistent with what expectations would be for a crucifixion death."
Leading pathologists across the country agree that the evaluation is interesting speculation but not a final judgment. Indeed, questions so deeply rooted in history, philosophy and theology cannot be resolved with certainty.
In fact, remarked Dr. Michael Baden, deputy chief medical examiner in New York City, not only is it impossible to draw truly reliable medical conclusions about Christ's death, but trying too hard to do so may hopelessly confuse faith and science. Baden has been involved in such prominent cases as the assassination of President John F. Kennedy and the drug death of comedian John Belushi. Jesus' death, noted Baden, was not just a representative crucifixion, but the best known of all time.
"There is something beautiful about faith, and (it) stands on its own feet," Baden said. "Conflict is created when one tries to give faith scientific underpinnings. They are two different kinds of belief.
"I think that it is hard to give scientific exactitude . . . to accounts that do not permit that kind of exactitude."
Some of Baden's position is similar to that of the Roman Catholic Church, noted Father Newman Eberhardt, professor of church history at St. John's Seminary in Camarillo. In any final analysis, said Eberhardt, if one assumes, as Christians do, that Jesus Christ was the son of God, 20th-Century pathology is irrelevant because the Crucifixion occurred under complete divine control. If the belief in the deity of Jesus is rejected, attempted science nearly 2,000 years after the fact can't be diagnostic anyway.
"These events," said Eberhardt, "are not naturally explicable. The church is set up to teach the way to heaven. She doesn't have any insights into biology."
And irrespective of the relevance of science to such an inherently religious matter, doctors who have reviewed the new crucifixion pathology findings note that at least some of its science may rely for its most definitive conclusions on medical evidence that is at least controversial and perhaps suspect. The main component of this chain of evidence is the Shroud of Turin, purported by many to be the actual burial cloth of Jesus but whose authenticity remains unconfirmed.
Controversial for decades, the shroud still awaits what may be a crucial evaluation--in the form of radiocarbon dating--that may help to resolve whether its fiber actually dates to the time of Jesus. The Roman Catholic Church controls the shroud and has made it clear a decision of how or if the shroud will be scientifically dated may not be made for another year. If the shroud is the burial cloth of Christ and contains an image of his body at the time of burial, it could confirm more scientifically than anything else the nature and type of injuries he sustained and tell something about his overall physical appearance.
But if the shroud proves not to be genuine, agreed three leading pathologists, most of the medical conclusions in the newly published review disintegrate scientifically.
Moreover, the Mayo Clinic pathologist who is the principal author of the new study is a "born-again" Christian who brought to his review an eagerness, he said, to confirm the tenet of faith that Christ died on the cross--making the Resurrection a true miracle. He said the research team, however, successfully managed to put aside its personal faith in order to conduct a valid scientific and historical inquiry.
At the same time, though, the pathologist, Dr. William D. Edwards, said he has experience only in hospital autopsies and has never, for instance, participated in a postmortem examination of the victim of a hanging or severe beating. Most contemporary pathologists and medical examiners have never seen a crucifixion victim, though one expert questioned by The Times said he once had himself tied to a cross to observe, firsthand, its effects on respiratory capacity.
The Mayo Clinic evaluation was written by Edwards but involved research contributions by Wesley Gabel, a Methodist minister in Rochester, Minn., where the clinic is located, and Floyd Hosmer, a Mayo Clinic medical illustrator who produced a series of detailed scientific drawings translating the meld of scripture, history and science into graphics tailored for a medical audience. Scripturally, the review relies heavily on sources that are standard references in conservative "born-again" Christianity, including books by bible scholar Josh McDowell.
The events of Good Friday, Edwards, Gabel and Hosmer concluded, involve these medical phenomena:
--The night before his death, Jesus is said in some scriptural accounts to have been in great emotional agony and that his sweat had the appearance of blood. If the description is accurate, the Mayo Clinic team speculated, Christ may have suffered from a rare medical condition called hematidrosis, in which blood is transferred to the sweat glands, emerging from the body mixed with perspiration.
--Before his brief religious trial on blasphemy charges and the ordeal of crucifixion, Jesus almost certainly was in robust physical condition, owing to the fact that his ministry required him to travel great distances on foot through what is now Israel. But by the morning of the Crucifixion itself, he was probably in a state of exhaustion and severe emotional upset--factors that would counteract his overall physical strength.
--Once Christ had been tried and condemned, the first step in the execution process was a severe scourging, inflicted with a type of whip that may have had pieces of sharp bone and metal tied into its thongs. The whipping was apparently severe, resulting in a large volume of blood loss that may have been as much as a quarter to a third of the body's total blood supply.
--The blood loss set the stage for the early onset of shock. The fact that Christ could not support the weight of his own cross when instructed to carry it to the execution site lends additional support to the deepening shock theory.
--Jesus was attached to the cross with spikes five to seven inches long that were driven one each through his wrists and one through both of his feet. There are no major arteries at the sites of the nailings, but the spikes may have hit any of a number of crucial major nerves. What would have resulted would be "excruciating fiery bolts of pain in both arms." Similar pain would have occurred because of wounds to the feet.
--Jesus would have been suspended with much of his weight borne by his arms, with his legs bent under him. In the classic symptoms of crucifixion, the position would have almost immediately started to reduce his respiratory capacity, initiating a gradual lessening of the oxygen being mixed into his bloodstream and setting the stage for eventual asphyxiation.
--Suffering would have been intense since severe muscle cramps, agonizing shooting pain from the nerve injuries and the struggle to maintain breathing by lifting the weight of his body with his arms could have been combined with such discomforts as insects burrowing into his ears, eyes and nose and birds of prey attacking the wounds.
--Because of the way Jesus' respiratory system was compromised, speaking--as the Scriptures say he did seven times from the cross--would have been excruciatingly painful. Exhalation, the component of breathing that permits speech, is the most agonizing to a crucifixion victim. Because the chest's role in respiration would have been severely curtailed, Jesus was probably controlling his intake of air and oxygen with the muscles of his abdomen.
--Eventually, the combination of blood loss before the crucifixion and the toll of the ordeal itself would have brought on something called hypovolemic shock, a state similar to what occurs in severe bleeding victims who are about to die. Meanwhile, the stress on Jesus' respiratory system would have precipitated symptoms like those of congestive heart failure and blood clots would have begun to form on the major arteries or valves of the heart. Eventually, in the last moments of Christ's agony, one of the clots may have broken loose, precipitating a catastrophic heart seizure that would account for biblical descriptions of an apparently climactic, final moment of agony.
--It is possible--perhaps likely--there was no such climactic heart attack, however, and that death was due more probably to shock, the eventual overwhelming effect of exhaustion-induced suffocation and some other sudden, acute heart failure episode. That terminal moment could have been influenced by the onset of a fatal cardiac arrhythmia. It is not clear from available evidence if Jesus' death may have been influenced by an actual cardiac rupture, a situation popularized in the traditional layman's perception of the Crucifixion in which Christ is said to have died of a broken heart.
--Whatever this sequence of events was, it was responsible for his death. Though there are contradictions in the biblical accounts, traditional Christian belief holds that a Roman soldier jabbed the moribund Christ with a lance tip. The wound apparently penetrated the chest cavity, causing release of a mixture of blood and clear fluid that had accumulated as a result of the suffocation effects. The lance tip probably also pierced the heart, but by then its effect was inconsequential. Christ had been on the cross for between three and six hours.
In all, concluded the Mayo Clinic article, "the weight of historical and medical evidence indicates that Jesus was dead before the wound to his side was inflicted.
"The important (conclusion) may be not how he died but whether he died. Interpretations based on the assumption that Jesus did not die on the cross appear to be at odds with modern medical knowledge."
"If I were to pick one conclusion as the most important, it would not be a medical one, but theological," Edwards said in a telephone interview. "I think our most important conclusion is that Christ died on the cross. Many people would consider that self-evident and the important implications are theological more than medical in regard to various explanations of the Resurrection," the belief that, three days after his death, Jesus rose from the dead.
Skeptics have suggested, Edwards noted, that Jesus may not have been dead when he was taken from the cross and that, if that were the case, the Resurrection could have been a hoax. "I think the authors would tend (to say) that there is nothing in our (medical findings) that counters the scriptural Crucifixion and that is not because we started out from that bias. It's just the way it unfolded. Our findings pretty strongly support the literal, biblical interpretation of a supernatural, miraculous physical resurrection."
When Edwards and the two other authors first submitted their article for publication in the AMA journal a year or so ago, the conclusions did not take any account of the clinical evidence that may be contained in the Shroud of Turin, recalled Dr. Robert Bucklin, a deputy San Diego County medical examiner who, as a committed Christian, has been studying the shroud since the 1940s.
He is today one of the most prominent experts on the shroud and he is convinced of its authenticity. Bucklin received a copy of the earlier draft of the new study when the Journal of the American Medical Assn. asked him to act as a review editor--common practice among major medical publications.
Bucklin said in a telephone interview he was gratified to see that the final version of the Edwards analysis relied significantly on the shroud. Without the shroud, Bucklin said, "you can only speculate" about the physiological causes of Jesus' death.
But even though Bucklin believes the shroud to be authentic, he cautioned against reliance on the new medical conclusions as being entirely factual simply because, even assuming the shroud is what it is said to be, "you have to be very careful" about drawing pathological conclusions nearly 2,000 years after an event.
"I've been to court too many times," Bucklin said. He said his own analysis of the pathology of the Crucifixion would give exhaustion less of a role in the cause of death than pure suffocation. Bucklin said he once had assistants tie him to a cross for a few minutes so he could better understand the physiology of what occurs in crucifixion.
"You are entitled to bring in other disciplines. You can put it all together and when you do, you have a very complete picture of what happened on that day in Jerusalem," Bucklin said. But still, placing too much faith in such medical analysis may miss the point. To do so ignores, Bucklin said, the fundamentally religious nature of the interpretation of the life of Jesus Christ.
"One thing to keep in mind is that it is very clear that Christ willed his death in the scriptures," Bucklin said. "That doesn't mean these other things (medical events) did not occur. I am not trying to say there were not anatomic reasons for his death. But the bottom line is that he willed his death at that particular moment."
Baden agreed, saying in a telephone interview that "the problem here is to interpret faith in the light of the scientific principles." Clearly, said Baden, the new Crucifixion review is more historical than medical and "would not be admissible in a court of law if we were looking at an individual found in similar circumstances today.
"There were other things going on here (in this case.) I think (if this was a modern day case) it would require a diagnosis including exposure and exhaustion with lacerations of the back, (head) and chest.
"But we're talking about a discussion of faith and mixing it again with the trappings of science and I am not persuaded that, with or without the Shroud of Turin, there is validity to this interpretation. I don't think this type of analysis would reach the degree of validity to be permitted in the courtroom, but I'm sure physicians realize that.
"It's certainly interesting to try to correlate biblical and other historical statements with modern knowledge."