The dehydration of Jesus

This is part 3 of a series I'm writing on the crucifixion from a medical perspective. Check out parts 1 and 2 first if you haven't seen them! Part 1, Part 2

For the purposes of this post, let's assume Jesus survived the crucifixion and the spear wound and was laid in the tomb unconscious. Would dehydration ensure death?

A common popular belief is that people can survive no more than three days without water. This belief is far too simplistic. The actual length of time a person can survive without water depends heavily on the ambient temperature and the activity level of the person. For example, someone would absolutely die if they tried to exercise in the desert for three days straight without water. On the other hand, a person lying in bed sleeping in a cool room would almost certainly survive (unless they had some sort of underlying condition, injury, or blood loss).

Jesus is an interesting case because he is a combination of both of the two examples listed above, and was something of an Olympic-level faster (Luke 4:1-13). Uninjured, Jesus definitely would have survived three days without food or water lying down in a cool tomb.

But Jesus was injured--he was close enough to death that Roman soldiers thought he was dead, and after that they stabbed him.

Let's break down Jesus' hydration status throughout the entire ordeal. (Green for hydration events, red for dehydration events)

The last supper: Jesus was at a healthy hydration level after eating a meal.
Psychogenic hematidrosis (sweating blood): this would have dehydrated him some, but we don't know how much.
Two beatings: these would have involved intense physical exertion and possibly blood loss (but we don't know how much).
Crown of thorns: may have caused bleeding, but it wouldn't have been much.
Carrying the cross: Jesus collapsed en route to the crucifixion site, which indicates that Jesus was probably close to exhaustion at this point--or that he had sustained an injury that made carrying a beam of wood particularly difficult (for example, if he had sprained an ankle). It's also possible that Jesus wasn't physically exhausted, but mentally exhausted at this point (remember, he was distressed enough to sweat blood). At any rate, we don't know how exhausted he was, but he definitely would have been getting dehydrated.
Nails: blood loss from these wounds would not have been substantial, because the nails stayed in the wounds. This would have prevented much blood loss (medical side note--if you ever get, say, stabbed, leave the weapon where it is until you are in the care of a medical professional).
Hanging from the cross: this would have been physically exhausting. I won't go into detail here on why hanging from a cross is exhausting, but we could equate it to running 1 or 2 marathons in a row without a break (depending on how long he was on the cross). This would have severely dehydrated him. Not only was he constantly exerting himself to breath, he was completely exposed to the sun. He would have been sweating like crazy.
Hydration: Jesus received hydration while hanging on the cross (we have one documented instance of this happening). This could have been seen as a merciful gesture, easing his thirst, but it could be seen as equally cruel, as hydration would have prolonged the suffering. Jesus refused to drink wine mixed with myrrh just before his crucifixion (Mark 15:23). However, he accepted sour wine just before passing out:

"²⁸After this, Jesus, knowing that all things had already been accomplished, to fulfill the Scripture, *said, “I am thirsty.” ²⁹ A jar full of sour wine was standing there; so they put a sponge full of the sour wine upon a branch of hyssop and brought it up to His mouth. ³⁰ Therefore when Jesus had received the sour wine, He said, “It is finished!” And He bowed His head and gave up His spirit." (John 19:28-30)

I speculate that over the course of the crucifixion Jesus received multiple drinks of sour wine, but we don't know. The jar of sour wine was present, the sponge was present, the branch of hyssop was present, and it's purpose was specifically to hydrate the victims.

We only know what is included in the text, which is unfortunate. Jesus could have actually been very hydrated if he received many drinks. Keep in mind--just because Jesus refused the drink before his crucifixion doesn't mean that he kept refusing drinks. According to William Lane:

"According to an old tradition, respected women of Jerusalem provided a narcotic drink to those condemned to death in order to decrease their sensitivity to the excruciating pain . . . . When Jesus arrived at Golgotha he was offered . . . wine mixed with myrrh, but he refused it, choosing to endure with full consciousness the sufferings appointed for him (The Gospel of Mark, p. 564)"

(https://www.desiringgod.org/articles/the-wine-jesus-drank)

So Jesus didn't want to drink the wine mixed with myrrh, but he was happy to drink the sour wine.
We have one documented instance of him stating his thirst and receiving a drink. Based on that I think it is likely that he received drinks whenever he asked for them, which would have actually kept him fairly well hydrated.
Passing out: The fact that Jesus passed out just after receiving a drink means that, most probably, he was very dehydrated. He may have been in hypovolemic shock. We don't know how long he was on the cross after passing out, which would have been an immensely helpful metric for us. If he passed out, and 10 minutes later he was taken down, the drink he had just before passing out wouldn't have been absorbed yet (so it's more likely that he would recover after some time). If he passed out and remained on the cross for several more hours, he was probably flat out dead and we don't even need to have this conversation.
Spear wound: The spear wound could have caused so much blood loss that he died instantly, or avoided all major blood vessels and caused minimal bleeding. It at least bled some (of course it did, it was a spear wound) as documented in the New Testament. This would have caused further dehydration on top of whatever dehydration state Jesus was already in. I discuss the spear wound in depth in this post: http://honestsearchfortruth.blogspot.com/2018/08/jesus-could-have-survived-spear-wound.html

Conclusion
If Jesus was alive after being taken down from the cross and being stabbed, we don't know whether or not he could have survived dehydration in the tomb, because we don't know his baseline level of hydration when he was taken down from the cross.

At best, Jesus received a substantial amount of sour wine, drank just before passing out, was taken down (and stabbed) soon after passing out, and recovered consciousness at some point while lying down in the cool tomb.

At worst, Jesus died of hypovolemic shock before they took him down from the cross.

And that's the problem with this entire endeavor, the more I search down this path. There is simply too much that we don't know. We don't know how bad Jesus' injuries were. We don't know exactly how long he was on the cross. We don't know how hot it was that day. We don't know how many pushups the soldiers could do. We don't know the exact nature and severity of the beatings. We don't know exactly where Jesus was stabbed. There is just so much essential information that we don't have.

But is it possible that Jesus survived (and specific to this post, didn't die of dehydration)? Yes.

The spear wound infliced on Jesus: centimeters would have been the difference between life and death

For the purposes of this post, I will examine a hypothetical scenario in which Jesus was alive (but unconscious) at the time when he was stabbed and taken down from the cross. I will address the issue of whether or not Jesus was alive (and the extent of his injuries) in other posts, except to point out that the soldiers felt the need to stab Jesus to make sure he was dead. Regardless of what we think about Jesus' previous injuries, the soldiers weren't sure that Jesus was dead, and demonstrated that uncertainty by stabbing him.

So if Jesus was alive, would the spear wound have killed him?

Instead of analyzing every possible spear wound Jesus could have received, I will illustrate two possible scenarios and use them to demonstrate a broader point--the difference between a mortal and a non-mortal wound would have been a matter of centimeters, and a soldier (even an experienced one) attempting to inflict a killing blow certainly could have failed to do so.

Scenario 1: because Jesus was elevated on the cross, was stabbed in the side, and "water" came out of the wound in addition to blood, one likely scenario is that the spear (green arrow) traveled up through Jesus' diaphragm, peirced his lung (allowing a pleural effusion caused by previous injuries to drain), and then peirced either the apex or the diaphragmatic surface of his heart. Because Jesus was alive, his blood had not clotted, and therefore blood was mixed with the "water". This kind of wound would have been instantly fatal, and meets the description documented in the new Testament.

Scenario 1: A fatal wound

Scenario 2: everything is the same as scenario 1, except that the spear stopped short of peircing Jesus' heart (or the angle changed such that his heart was missed). Jesus still could have died from such a wound, but he definitely could have survived as well. Jesus being alive would have meant that his blood had not coagulated, and so blood would have mixed with "water" from the pleural effusion. This wound would have been survivable, meets the description documented in the New Testament, and would have looked the same as scenario 1 to the soldiers (except that there would have been less blood).

Scenario 2: A survivable wound

In conclusion, the two nearly identical wounds from scenarios 1 and 2 would have looked the same to the soldiers,  resulted in blood and "water" emanating from the wound, and are only different by a few centimeters. The first scenario would have been instantly fatal, while the second scenario would have been survivable.

Similar fatal/non-fatal scenarios exist for many other situations, and also could have met the description documented in the New Testament (for example, spear thrusts that either hit or narrowly missed the aorta).

But my point is this: we don't know the precise nature of Jesus' spear wound. We can't know, because the texts don't give nearly enough detail. What we do know is that there are some scenarios that would have caused death, and others that would have permitted survival.

In short, Jesus could have survived even though the soldiers thought he was dead and inflicted a spear wound on him.

Could Jesus have survived the crucifixion? Yes.

The question of whether or not Jesus actually died on the cross is central to the truth of Christianity. If Jesus died and rose again, his divine claims gain validity--if he did not, Christianity is a sham (1 Corinthians 15:19). But how much can we actually know about the medical emergency that took place ~2000 years ago when Jesus was beaten, tortured, crucified, stabbed, and buried?

For the purposes of this blog post, I will consider the documents of the New Testament to be historically accurate. I will use them to establish what physical injuries were inflicted on Jesus before, during, and after his crucifixion, and then evaluate whether or not it would have been possible for Jesus to survive. In later posts I will evaluate whether or not survival was likely.

The injuries that Jesus suffered
1. Psychogenic hematidrosis (sweating blood) (Luke 22:44)
2. Beating #1 (Matthew 27:1–2)
3. Beating #2 (John 19:1–5)
4. Scourging (John 19:1, Mark 15:15, Matthew 27:26)
5. Crown of thorns placed on his head (Matthew 27:31)
6. Carrying the crossbar of the cross, being unable to continue (Matthew 27:31-33)
7. Nails driven through both wrists (probably) (Luke 23:33)
8. Nails driven through both feet (probably) (Luke 23:33)
9. Hanging from the cross for about 6 hours (Bergeron 2012)
10. Passes out (John 19:30)
11. Spear wound to the side  (John 19:31-33)
12. Removing the nails from both wrists (No citation--I assume this happened)
13. Removing the nails from both feet (No citation--I assume this happened)

Aid that Jesus received
1. Simon of Cyrene carried the crossbar of the cross for Jesus (Matthew 27:32)
2. Jesus received hydration from bystanders at least once. Notably, just before saying "it is finished" and passing out. (it is especially relevant to note that he received hydration and had enough energy to yell at this point) (John 19:28-30) (Matthew 27:48-49)
3. Taken down from the cross
4. Bound in linen with spices (relevant in that it could have stopped any bleeding) (John 19:38-42)

Would #1-8 definitely cause death? --No
No, not immediately. While beatings and scourging can cause death, Jesus was still alive after #1-8 according to the narrative. So in this case, the answer is obviously no. What we're interested in here is either how these injuries progress with time or how they influence later injury (for example, if he sustained an epidural hematoma from head trauma, he could remain conscious for some time, but later die due to pressure on his brain).

Would #9-10 definitely cause death? --No
No, not in this case. Remember, we have two control subjects who underwent the same crucifixion, and did not die.

"³¹ Then the Jews, because it was the day of preparation, so that the bodies would not remain on the cross on the Sabbath (for that Sabbath was a high day), asked Pilate that their legs might be broken, and that they might be taken away. ³² So the soldiers came, and broke the legs of the first man and of the other who was crucified with Him; ³³ but coming to Jesus, when they saw that He was already dead, they did not break His legs." (John 19:31-33)

Crucifixion certainly can cause death, but it is an extremely slow death, and one that requires "finishing blows" to ensure that the victim dies--breaking of the legs in the case of the thieves, a spear wound in the case of Jesus. Crucifixion was designed to torture over a long period of time, not to kill. Another way of putting it--it was designed to keep victims alive for as long as possible.

Further, Jesus was only on the cross for ~6 hours (Bergeron 2012), considerably shorter than most victims of crucifixion (citation.....). But even if he were on the cross for longer, the other two men were still alive. So crucifixion for this amount of time is not definitely lethal in-and-of-itself. In fact, it's probably not lethal.

It is possible that #1-8 or any underlying illnesses that Jesus may have had made him more susceptible to death by #9. I will address this further later in the post.

Would #11 definitely cause death? --No
This point depends entirely on the nature of the spear wound.Were any major blood vessels damaged? Was Jesus' atrium punctured? What about the aorta? What about the liver? Exactly what does "side" mean, and at what angle did the spear enter? How deep did it penetrate? How large was the spear tip? What about it's shape? Did the spear enter the abdomen or the thorax?

I think a plausible scenario is that the spear entered Jesus' upper abdomen, traveled up through the diaphragm, and then entered the thorax. Lets say that Jesus had a pleural effusion due to previous beatings, which would account for the "blood mixed with water" coming out of the wound.

Contrary to what I have frequently heard from Christians, "blood mixed with water" is in no way an indicator that Jesus was in fact dead. It simply means that some sort of fluid had built up, and the spear-thrust punctured whatever cavity was holding the fluid. There are numerous possible explanations for this, but for now, I offer my suggestion that a pleural effusion was responsible for the "water" component.

Another interesting point that goes contrary to popular Christian belief about the "blood mixed with water" is that the presence of blood actually lends credence to the idea that Jesus was in fact alive. When a person dies, their blood stops moving and coagulates--which means there actually wouldn't have been blood mixed with the "water". However, there are multiple ways in which blood could have been mixed with the "water" and it be the case that Jesus was dead. All I'm saying is that in general, the fact that blood came out slightly weighs in favor of the proposition that Jesus could have been alive.

At any rate, Jesus definitely could have survived the spear wound.

Would #12-13 definitely cause death? --No
I included this point for completeness. By the time the nails were removed, sufficient clotting would take place to stop any bleeding (leaving the nails in place for that long actually would have helped).

Would #1-13 combined together definitely cause death? --No, not in 24 hours
This isn't to say that someone definitely wouldn't die from #1-13--a person could die from any of them under certain circumstances, and combining all of them together certainly makes death more likely. Timing is also key--and I will say that death from any of the injuries on their own (except for the spear wound--again this depends on how severe the spear wound was--and did a soldier who though he was already dead put his best effort into the spear thrust? We don't know) would probably not be fatal in the time-frame of, say, half a day.

However, I think anyone who suffered as many wounds as Jesus did, if they had survived, almost certainly would have died of an overwhelming infection in the following weeks or months. But even in that sense, the answer to "if Jesus had survived a week, would an infection definitely cause death?" is still no--which illustrates the major flaw of this blog post.

The limited reach of this blog post
The major flaw of this blog post is that I set the bar very low--I only asked whether or not is was possible for Jesus to survive. If Jesus had been shot in the head, he still could have possibly survived, and that's not what we care about. We want to know how likely it is that Jesus could have survived.

Therefore, I will work on a series of blog posts over the next few months where I try to answer a better question--how likely is it that Jesus could have survived?
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Thanks for reading! To discuss this blog post with me, hit me up on twitter! -@GoSearch4Truth

Citations:
1. Bergeron, Joseph 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 19.3 (2012): 113-116.
2. The New Testament, NASB version



Dear Mr. Strobel (or response team member),

My name is Joshua Willms. I am an MD/PhD student at Texas Tech University Health Sciences Center. I am writing you concerning the medical accuracy of your interview with Dr. Alexander Metherell, MD/PhD. I think that Dr. Metherell made critical errors in his interpretation of the text, implanting certainty into his statements that are not supported by the evidence.

First, there is not sufficient evidence to support his statement that Jesus was in hypovolemic shock after the flogging. In order to know that, we would need to determine Jesus' hydration status and know exactly how much blood he had lost. We don't know those details, so it is impossible to know whether or not Jesus was in hypovolemic shock. Jesus being unable to carry the cross could have been due to a multitude of reasons (examples include spraining an ankle, receiving severe lacerations on his shoulders, or being emotionally exhausted). The fact that Jesus said "I thirst" simply means he was thirsty--which he definitely would have been regardless of whether or not he was in hypovolemic shock.

Second, there is not sufficient evidence to support Dr. Metherell's statement that Jesus was experiencing heart failure. We would need detailed medical information about Jesus at the time to know that. Basically, Dr. Metherell is giving a hypothetical scenario of what could possibly happen if someone remained on a cross for long enough--but we have none of the diagnostic information we would need to confirm whether or not Jesus was actually experiencing heart failure. Dr. Metherell cannot have much certainty on this point with such limited information. This is also true with regards to his claim about respiratory acidosis--was Jesus experiencing some respiratory acidosis? Probably--but enough to cause an arrhythmia? We CANNOT know based on such limited medical information.

Third, there is not sufficient evidence to support Dr. Metherell's statement that Jesus was stabbed in the heart. The New Testament only says that Jesus was stabbed in the "side" and that water and blood flowed from the wound. Yes, one explanation for this is that the spear punctured a cardial and/or pleural effusion en route to the heart. Another, simpler explanation is that the soldier stabbed Jesus in the stomach (which also would have resulted in water and blood emanating from the wound, and does not require any additional hypotheses).

I do not mean to be rude, but it appears that Dr. Metherell simply took the guard's word for it that Jesus was dead and then cooked up a scenario that would fit with his preconceived conclusion. I assume you consulted with other medical experts to corroborate Dr. Metherell's statements? He has certainty about his scenario when other scholars do not--for example, see the work of Dr. Joseph W. Bergeron (citation below).

I sincerely hope that my comments in this letter are helpful, and if I am wrong, I certainly want it to be pointed out. Right now I think the evidence supports the notion that Jesus could have survived, and because of that, I do not consider myself to be a Christian. If I am wrong, I desperately want to know.

Sincerely,

Joshua Willms
MD/PhD student, 3rd year
TTUHSC School of Medicine
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