The prophet Isaiah foretold that Jesus’ visage and body would be marred more than that of any man in history (Isaiah 52:14). As an Emergency Medicine medical provider who is Advanced Trauma Life Support certified and who frequently cares for critically injured trauma patients, my mind goes to these words when caring for patients whose faces and bodies have been bruised and battered by trauma. What did Jesus endure from a medical perspective in His Passion for you and me?
The physical suffering and torment of Jesus began in the Garden of Gethsemane. It was in the Garden that Jesus in an agony (Luke 22:44) entered into prayer in preparation for what was to come. It is significant that this is the only place in the Bible that the word “agony” is used (Strong, 2001). The first evidence of Jesus’ physical torment is demonstrated by none other than the physician Luke when he mentioned that Jesus’ sweat was as it were great drops of blood falling to the ground (Luke 22:44). The medical term for this occurrence is hematidrosis, which occurs only in persons who have undergone extreme emotional stress (Edwards, 1986). In this occurrence, the tiny blood capillaries around the base of the sweat glands burst and leak blood into the sweat glands, causing the sweat to be tinged with blood.
The next aspect of Jesus’ suffering occurred with His arrest. Mark tells us that the soldiers laid their hands on him and took him (Mark 14:46). John gives more information when he states that the soldiers took Jesus and bound him (John 18:12). Both accounts likely minimized this occurrence. Roman soldiers were taught a very specific method of arrest that was intended to intimidate and cause pain. The method involved grabbing the wrist, twisting the arms behind the back so that the knuckles touched between the shoulder blades and then binding the hands into this painful position (Bishop, 1977).
Jesus was then marched to the palace (Matt 26:3) of the High Priest Caiaphas (Matt 26:57). Jesus was surrounded by sadistic Roman guards as well as sadistic temple guards for this journey. Very likely, the swords and staves (Matt 26:47) were used to prod and mock the bound prisoner on this journey. By the time Jesus arrived at Caiaphas’ palace, He had likely fallen numerous times due to the rough treatment from those whom He had Himself created. The blood tinged-rivulets of sweat on His face were likely caked with dust due to falling without being able to catch Himself with his hands, and his clothes were likely soiled from falling. We can be sure that the knees of Jesus’ robe were marked with sacred soil-prints from Gethsemane. Matthew 29:46 states, And he went a little further, and fell on his face, and prayed, saying... No doubt, Jesus’ entire robe was soiled from the blood-tinged sweat.
Jesus was marched directly to the palace of the High Priest Caiaphas. Annas, the previous High Priest who was also the father-in-law of Caiaphas, lived in the same palace. Jesus underwent examination by Annas first (John 18:13) in which Annas attempted to force Jesus to bear testimony against Himself (John 18:19). Annas knew it was a violation of the law to seek testimony from the accused himself, a judge or juror could only seek testimony from witnesses. Jesus responds, Why askest thou me? Ask them which heard me, what I have said unto them: behold, they know what I said (John 18:21), appropriately reminded Annas of the requirements of the law. In response, one of the Roman soldiers struck Jesus with the palm of his hand (John 18:22). Jesus then underwent questioning by Caiaphas (John 18:24). After this questioning Jesus suffered mockery and mistreatment from the palace guards who spit on Him… and [buffeted] Him… and did strike Him with the palms of their hands (Mark 14:65). The palace guards were strong, muscular men and the blows were intended to injure. Jesus’ hands were still bound behind His back, and the blows likely caused Him to fall, inflicting more than facial trauma. The promise of Zechariah, [I will] smite the shepherd (Zech 13:7), was more than figurative.
By this time, Jesus was battered and bruised, dehydrated, and exhausted from a sleepless night. His body was weak due to blood loss. His face was streaked with rivulets of blood, His hairs matted with bloody sweat from Gethsemane. Likely there was bruising beneath His eyes from the beating, and His face was haggard and pale. The torture of the night had just begun. From the palace of Caiaphas, Jesus was then led before Pilate for His first of two trials before Pilate. The Gospels do not indicate any abuse in this first trial before Pilate. Pilate could find no fault in Jesus and sent Jesus for His third trial before Herod (Luke 23:7). When Jesus would perform no miracle for or even answer the wicked Herod (Luke 23: 8-9), Herod then allowed his guards to mock Jesus, arraying Him in a “gorgeous” (Luke 23:11) robe and then sent Jesus back to Pilate.
In this second trial before Pilate, the forces of evil move actively and quickly. Jesus admits that He truly is the King of the Jews (Matt 27:11), the crowd demands crucifixion, Pilate’s superstitious wife attempts to intervene, Barabbas is released, and Pilate finally caves to the will of the multitude. Pilate then delivers Jesus to be scourged. It is significant that each of the Gospel writers mention the scourging, but none of the Gospel writers give details of the scourging. Scourging was a brutality too terrible to write about and to write about the Son of Man being mistreated so cruelly almost reaches sacrilege. History does tell us, however, how the Romans performed scourging. The guards strip Jesus of the clothing on His upper body and bend His body over a pillar about three feet high. His hands are then rudely pulled down on the opposite side of the pillar and secured to iron rings embedded into the pillar. The flagellum, a short piece of wood with leather straps with small pieces of metal and bone embedded in it, is brought. A sturdy soldier takes the flagellum, and standing several feet behind Jesus brings the cruel instrument down upon Jesus’s exposed back with all the strength he could muster (Bishop, 1977). This is done time and time again, first tearing and shredding the skin on the shoulders, upper arms, sides, and back. As the skin is torn, subsequent blows tear deep into the strong, sinewy muscles on Jesus’ back. The bleeding is mere oozing at first, but as the blows go deeper, small arteries are ruptured, causing blood to flow freely. The prophecy of the Psalmist, The plowers plowed upon my back: they made long their furrows (Psalm 129:3) was certainly an apt description. It was through no act of force that Jesus gave [His] back to the smiters (Isa. 50:6). We cannot imagine this level of abuse and mistreatment in our penal system today, yet it was with His stripes we are healed (Isaiah 53:5).
The cruel scourging is over. However, the sadistic Roman soldiers are not finished with Jesus. The soldier then stripped him (Matt 27: 28), exposing Jesus to the shame of nakedness that came only through the sin of man (Gen 3:7); Jesus again bears the shame of sin to satisfy the price for sin. The soldiers then put on Him a scarlet robe (Matt 27:28), mocking Him for His legitimate claim that He was the King of the Jews (Matt 27:11). The soldiers place the scarlet robe for mockery not knowing that in that scarlet robe was the emblem of the crimson sins Jesus is bearing to the cross so that our robes might be made white in the blood of the Lamb (Rev 7:9-17). The soldiers then take sharp thorns, plat the thorns into a crown, and put them upon Jesus’ head (Matt 27:29). Again, the soldiers perform this in mockery, never knowing that they are again allowing Jesus to bear the pain and shame of the consequences of the sin of man (Gen 3:17-18) in being made a curse for us. The soldiers place a reed in His hand as a mock-scepter (Matt 27:29) and then use the reed to beat upon the crown of thorns. With this beating, the sharp thorns are lodged deeply into Jesus’ scalp. The scalp is one of the most highly innervated and vascularized parts of the body. Very likely, Jesus bleeds heavily from these wounds, the rivulets of blood mingling with the spit and sweat upon His face. The prophet Isaiah suggests that Jesus was mistreated to the extent that His beard was plucked from His face (Isaiah 50:6), thus His face was more disfigured than that of any man in history (Isaiah 52:14).
The soldiers then remove the scarlet robe. By this time, the blood on Jesus’ back has dried on the robe, and as the robe is torn from His back, the clots break loose and fresh blood flows again, but more slowly this time. The hair under the thorns is damp, matted, and discolored. The face is so disfigured that individual features are almost indistinguishable. Jesus’ robe is bloodstained. Jesus is almost certainly in hypovolemic shock due to blood loss. His heart rate is increased in an attempt to pump His reduced blood volume to His vital organs. His body has undergone restriction of the blood vessels to his muscles and skin in a natural effort to sustain blood flow to the brain, heart, lungs, and kidneys. His body is flooded with stress catecholamines that leave Him weak and trembling. His body cells are deprived of essential oxygen and substrates necessary for function. His body is in metabolic acidosis; He is trembling, weak, and can barely stand. The soldiers around Him press closer to help him stand.
Jesus must carry His own cross to the site of crucifixion (John 19:17), a common sport for the condemned, yet a worthy lesson for the follower that the Crucified bore His own cross without complaint. According to the practice of the day, the upright beam itself is already planted on that Hill called Golgotha. The “cross” that Jesus carries is the crossbeam known as the patibulum. The patibulum is rough-hewn and weighs about thirty pounds (Bishop, 1977). Jesus very likely carries this upon His back. The back of the Divine is raw with the stripes from the scourging. The rough patibulum rubs cruelly on the wounds, breaking them open again. Possibly the patibulum is long enough that it hits against the crown of thorns still matting Jesus’ head, adding again to His pain. Nothing other than Divine Love can lift the feet and move Jesus’ body forward toward His final sacrifice of love. However, Jesus is too weak to bear the patibulum, and as a result, Simon of Cyrene is forced to bear this honor for Jesus (Matt 27: 32).
The somber procession comes to the little hill outside Jerusalem. It is not a scriptural oversight that the Gospel writers give no details regarding the crucifixion itself. Crucifixion was such a horrible death that no man wished to write of the details. And yet it was the death that Christ died for you and me. The executioner lays the patibulum on the ground. Jesus, clothing removed, is thrust backward onto the ground, the patibulum fitted under his neck. His wrists are grasped and thrust onto the rough-hewn wood (Bishop, 1977). The executioner takes the rough nail and feels quickly for the hollow of the wrist, then with a few quick strokes hammers the nail through the wrist, considered in ancient times to be part of the hand (Davis, 1965). He moves to the other side and performs the same action with the other wrist. The hands will remain stretched out for the rest of Jesus’ earthly life, the arms open to invite and embrace all mankind into the Love of the Divine. Two soldiers then grab the crossbeam and lift, dragging Jesus by the wrists. The crossbeam is hoisted on to the top of the upright post, which stands about six to seven feet high (Edwards, 1986), forming a cross-like an uppercase “T.” The executioner then kneels down and drives the nails through the feet into the cross with the right foot likely nailed over the left foot (Bishop, 1977).
Jesus’ body hangs, His arms in a “V” position, His full body weight hanging on His wrists. Three major nerves run through the wrist, and it is almost certain that the nails impinge directly on at least one of those three nerves, causing constant searing pain. The pain in the wrists is unbearable, and as Jesus hangs down, His shoulders and ribs are forced inward in an inspiratory condition, the muscles of the chest paralyzed and unable to breathe. Jesus experiences the unmistakable desperation that comes with asphyxiation. The Breath of Life must push himself up on His nail-pierced feet to intake the very air that He himself created. Three major nerves also course through the ankles into the foot, and again, as Jesus pushes Himself up on His feet, the nerves are almost assuredly impinged, causing searing pain. Jesus alternates between pulling Himself up to breathe a few quick breaths and then slumping down to relieve the pain in His feet (DePasquale and Burch, 1963). Jesus can only take shallow breaths; the reason why the statements on the cross contain few words.
Jesus can only draw small amounts of air into His lungs. Due to this, His lungs begin to collapse. His lungs retain carbon dioxide, and His body begins to go into respiratory acidosis. His heart beats faster to compensate, His lungs fill with fluid. In the stress on His heart, fluid begins to build up in the pericardium that surrounds the heart. The fluid around the heart decreases the ability of the heart to expand and contract to pump blood.
Three hours pass by. In this time, Jesus utters six statements on the cross, one of which is a request for pardon for your and my sins. A storm is brewing on the horizon. The pain mounts. Jesus recognizes His mother, who is standing at the cross, a fulfillment of the travail of birth that came through the consequence of sin (Gen 3:16). What woman could see her son in this travail and not relive her own travail of giving him birth? Jesus is dying. Asphyxiation is the cause of death. Jesus pulls Himself up for one last breath, glimpses Jerusalem, the anguish of His friends, the jeering crowd for one last time, and with the words It is finished, (John 19:30) His body sags, His head bows. The Creator of Life is dead.
The soldier comes forward and thrusts his spear into the side of Jesus. John tells us that water and blood pour forth in direct fulfillment of the prophecy, They shall look upon me whom they have pierced (Zech 12:10). This water and blood most likely came directly from the heart of Jesus Himself. The water was most likely fluid from the pericardium around His heart, cleansing water that had accumulated directly from the strain of love upon the Heart of the Divine. The blood is likely liquid blood from the heart that had only recently ceased beating. It is noteworthy that John does not state that water mixed with blood came forth but that rather blood and water (John 19:34) came forth. These two come forth separately, a clear demonstration of the separate doctrines of justification and sanctification that are present in the death of Jesus. Blood for the remission of sin as well as for atonement; water for regeneration as well as for purification.
The Sacrifice is over, and the Passion is finished. The body has been given, and the blood has been shed for you and me (Luke 22:19-20). Pain, humiliation, nakedness, thorns, travail, death, and even the wiliness of a supposedly victorious but defeated serpent have all been fulfilled; the curse of sin is vanquished. The Son has truly glorified the Father in rising triumphantly from the grave on the third day and finishing the work that God has given Him to do (John 17:4). All things [are] now accomplished, that the scripture might be fulfilled (John 19:28).

References
Bishop, J. “The Day Christ Died.” Harper Collins Publishers, New York, N.Y. 1977.
Davis, C.T. “The Crucifixion of Jesus: The Passion of Christ from a Medical Point of View.” Ariz Med 22: 183-187, 1965.
DePasquale, N.P., and Burch, G.E. “Death by Crucifixion.” Am Heart J 66(3): 434-435, 1963.
Edwards, W.D., Gabel, W.J., and Hosmer, F.E. “On the Physical Death of Jesus Christ.” JAMA. 255 (11), pp. 1455-1463, 1986.
Strong, J. “The New Strong’s Expanded Exhaustive Concordance of the Bible.” Thomas Nelson Publishers, Nashville, TN. 2001.