How Did Jesus Die – The Medicine Behind Jesus’ Death

1. Adam B. Johnson, MD April 2, 2014 How Did Jesus Die – The Medicine Behind Jesus’ Death

2. Outline • Review Christ’s dual natures • Discuss the events preceding Christ’s death • Explain the major hypothesized mechanisms of Christ’s death • Pulmonary Embolism • “Broken Heart” • Suspension trauma • Suffocation • Fatal stab wound • Shock • Coagulopathy • Review Christ’s dual natures

3. Disclaimers • Learning about the physiologic mechanisms of death can be troubling to some. This is arguably even more distressing when talked about in the context of Jesus Christ. • I will include medical terms but strive to explain the medical jargon used. • Please stop me at any point during the presentation with questions you may have.

4. Christ’s Dual Natures • Fully Man • Gal. 4:4 “But when the fullness of time had come, God sent forth his son, born of a woman, born under the law.” • John 1:14 “The Word became flesh and made his dwelling among us…” • John 4:6 “…so Jesus, wearied as he was from his journey…” • Fully God • Titus 2:13 “waiting for our blessed hope, the appearing of the glory of our great God and Savior, Jesus Christ.” • John 1:14 “…We have seen his glory, the glory of the one and only Son, who came from the Father, full of grace and truth.”

5. Fully Man and Fully God • As man, He was able to die a human death • Mark 15:37 “And Jesus uttered a loud cry and breathed his last.” • As God, only Jesus himself could actually take his life • John 10:17-18 ”For this reason the Father loves me, because I lay down my life so that I may take it again. No one has taken it away from me, but I lay it down on my own initiative. I have authority to lay it down, and I have authority to take it up again.”

6. Events preceding his death • Emotional, Spiritual, and Physical Stress leading up to the Crucifixion: • Hematidrosis – phenomenon seen during times of immense stress, when sweat gland capillaries break, leading to the sweating of blood. • Luke 22:44 “And being in agony, He was praying very fervently; and his sweat became like drops of blood…”

7. Events preceding his death • Scourging – beatings at the hands of Roman soldiers consisted of the victim being tied to an upright post, stripped of his clothes, and repeatedly hit with strands of leather embedded with pieces of metal and bone. • Crown of thorns • Both events likely produced marked blood loss. • The blood loss coupled with lack of food, water, and sleep left Jesus in a critically weakened, pre-shock, hypovolemic state.

8. Christ’s Death • Seven major proposed hypotheses: • Pulmonary Embolism • “Broken Heart” • Suspension Trauma • Suffocation • Fatal Stab Wound • Shock • Trauma-Induced Coagulopathy

9. Pulmonary Embolism (PE) • PE refers to a blockage within an artery supplying blood to the lungs. • Symptoms include: chest pain, difficulty breathing, poor oxygenation, and possibly death. • Three factors predispose someone to blood clots and possible PE (Virchow’s Triad): • Injury to the blood vessels • Increased blood clotting • Poor blood flow

10. Pulmonary Embolism (PE) • Proponents of this hypothesis note that there are some genetic conditions within the Jewish population that predispose to increased blood clotting. • In addition, impaired blood flow while hanging on a cross and vascular injury from the events preceding the crucifixion, may have predisposed Jesus for a PE. • If Jesus’ body was in a state of DIC (Disseminated Intravascular Coagulation), he may have been bleeding in some parts of the body, but forming blood clots in others.

11. Pulmonary Embolism (PE) • An argument against the Pulmonary Embolism hypothesis is Jesus was not truly immobilized on the cross. • In addition, because of genetic drift over the past 2000 years, the current disorders may have been quite different in Jesus’ day. • Others note that Jesus may have been more likely to bleed, given the state of shock, as opposed to forming blood clots.

12. “Broken Heart” • Term refers to Cardiac Rupture. • Usually happens after a large myocardial infarction (heart attack), weakening the heart wall. • Death usually occurs quickly. • An argument against the Cardiac Rupture hypothesis is that the beatings leading up to the crucifixion, rather than the crucifixion itself, would have been most likely to produce a cardiac rupture.

13. Suspension Trauma • With prolonged suspension, blood tends to pool in the legs. • In someone who is already dehydrated, suspension can cause blood return to the heart to decrease. • If blood return decreases, by rule, the blood outflow to the vital organs will decrease. What goes in must come out. • This phenomenon is an extreme form of the feeling of dizziness and near passing out in a person who suddenly stands up after a period of lying down.

14. Suspension Trauma • An argument against the Suspension Trauma hypothesis is that Jesus had his feet nailed to the cross, and therefore, was not truly suspended by the upper half of his body. • In addition, volunteer re-enactments of people suspended to a cross did not produce a phenomenon of suspension trauma.

15. Suffocation • Literally the inability to breathe. • When suspended by the arms/hands, breathing becomes more and more difficult due to the muscle strength it takes to expand the chest. • In addition, there was excruciating pain with each breath because the body would have to be lifted up by either the hands or pushed up by the feet. The nails, piercing the nerves of the hands and feet would cause waves of pain with each and every movement of the body.

16. Suffocation • Suffocation was seen in Nazi concentration camp victims, who during torture of being suspended only by their hands, usually died in approximately 3 hours. • An argument against the Suffocation hypothesis is that many victims of crucifixion would stay alive for days on the cross without suffocating.

17. Suffocation • The practice of Crurifracture, or breaking of both legs, would hasten suffocation because the body would then be supported only by the arms. We do not have any indication that Jesus had his legs broken. • John 19:33-34 “ But coming to Jesus, when they saw that He was already dead, they did not break his legs.” • If suffocation was the primary means by which Christ died, he should have died sooner than the approximate 6 hours he was on the cross.

18. Fatal Stab Wound • John 19:33-34 “But when they came to Jesus and found that He was already dead, they did not break his legs. Instead, one of the soldiers pierced Jesus’ side with a spear, bringing a sudden flow of blood and water.”

19. Fatal Stab Wound • The flow of water is likely related the spear’s piercing of the lung, and the presence of a pleural effusion, an accumulation of fluid between the lining of the lung. • The presence of a pleural effusion was likely given the beatings and blunt trauma leading up to the crucifixion. • The flow of blood is likely related to the spear’s piercing of the heart.

20. Fatal Stab Wound • An arguments against this hypothesis is that the Roman centurions were well-trained, and would not make the mistake of thinking someone was still alive when thrusting the spear into the victim’s side. • The Biblical text infers that Christ was already dead when this event happened, and was therefore not the inciting event.

21. Shock • Defined as inadequate delivery of oxygen to the body’s tissues and organs, usually from a relative inadequacy of blood flow. • Several different types of Shock: • Hypovolemic • Cardiogenic • Distributive • With inadequate delivery of blood and oxygen, the body cannot perform normal metabolism, and death occurs first on a cellular level. This produces acid and toxic break-down products. Complete organ damage, and death, will ensue if shock goes untreated.

22. Shock • In states of shock, the body can attempt to compensate for the excess acid levels through hyperventilation. However, with crucifixion, Jesus’ respirations and hence, compensatory mechanism, would have been impaired. • With the events leading up to the crucifixion, there is little doubt that Jesus’ body was likely in hypovolemic shock.

23. Trauma-Induced Coagulopathy • Coagulopathy refers to a state in which the body’s ability to form blood clots is impaired. • Trauma-induced Coagulopathy is also referred to as Acute Trauma Coagulopathy (ATC). • The mechanism of ATC is related to increased activation of Protein-C, an anti-thrombotic protein after extensive trauma. • When several factors are present: shock, internal injury, hypothermia, and acid build-up in the blood, ATC is more likely to occur.

24. Trauma-Induced Coagulopathy • Even with modern medicine, when Trauma-induced coagulopathy is present, the mortality rates can be 60% or greater. • Proponents of the coagulopathyargument note that as Jesus’ side was pierced, he bled, even though he had already died.

25. Christ’s Death • Seven proposed hypotheses: • Pulmonary Embolism • “Broken Heart” • Suspension Trauma • Suffocation • Fatal Stab Wound • Shock • Trauma-Induced Coagulopathy

26. Christ’s Dual Natures - Fully God • Raised from the dead • Rom. 6:4 “…just as Christ was raised from the dead through the glory of the Father…” • Rom. 8:34 “Christ Jesus who died—more than that, who was raised to life—is at the right hand of God and is also interceding for us.”

27. Fully God • Will return again • Heb. 9:28 “so Christ was sacrificed once to take away the sins of many; and he will appear a second time, not to bear sin, but to bring salvation to those who are waiting for him.”

28. References • Bergeron, J.W. The crucifixion of Jesus: review of hypothesized mechanisms of death and implications of shock and trauma-induced coagulopathy. Journal of Forensic and Legal Medicine. 2012. Vol 19, Issue 3, P 113-116 • www.causeofjesusdeath.com • Edwards, W.D., Gabel W.J., Hosmer F.E. On the Physical Death of Jesus Christ. JAMA. 1986. Vol 255, No. 11, P1455-1463 • Terasaka D. Medical Aspects of the Crucifixion of Jesus Christ. www.blueletterbible.org • Davis C. T. A Physician’s View of the Crucifixion of Jesus Christ. www.cbn.com (The Christian Broadcast Network) • Cohen, M and Kutcher M. Coagulopathy associated with Trauma. 2010. www.uptodate.com