Crucifixion was a method of execution inherited by the Romans from others. Until Alexander borrowed it from the Persians, the Greeks didn't practice it because of their horror of it. But the Romans, excellent students of efficiency, embraced this method because of its capacity to allow volume (many were simultaneously executed) and best of all, certainty of death. The Romans made clean sweeps of criminals, undesirables, rabble-rousers, and the politically incorrect. And crucifixion allowed for an orderly mass execution. Men hung on crosses, powerless to run and hide as Roman guards made rounds to make sure all died. It wasn't like pillaging a town, where every person had to be hunted, every piece of furniture hiding a silently panting victim. The victims of crucifixion were just hanging, ripe for death like apples on a tree ripe for picking. They were a captive audience, and the job would certainly get done. Efficiently, totally, and without question.

Because of our over-familiarity with the cross in churches, over thresholds, and at ceremonies, as early as childhood we have become desensitized to the true horribleness of this method of bureaucratic massacre. Those crucified were often the strongest of men, so this underscores how potent a method crucifixion was to kill someone. We now glance at the crucifix only as it is associated with Christ, and we forget-or have never known-just how gruesome death by crucifixion was. There are no horror movies that can come up with a more ghastly way to be killed.

For example, let's take one certain 33-year old retired carpenter and talk about the particulars. He fell into the category of being politically incorrect in a district of a man who was fairly incompetent. In fact, Pontius Pilate had made so many mistakes in governing the people of what he thought was a God-forsaken wasteland, that he was particularly sensitive about doing the right thing and not raising any more red flags for Rome to notice. When Jesus's own people implored Pilate to do the right thing, even though he knew no real wrong had been done, it was, after all, just a Jew. He would certainly get into more political trouble had he not crucified a trouble-maker and was wrong, than had he crucified Him and was wrong. Right? Not that he didn't try, though, to mitigate the poor guy's punishment.

Flogging was not pretty. And it was the law, a prerequisite scourging always preceeded a capital punishment. 39 lashes were the law, because exceeding the number of 40 was strictly prohibited by Hebrew law. The particular item used to administer the lashes was efficiently designed to cut the flesh. In fact, flogging was so severe an insult to the body, that many died from the blood loss, inflammation, and infection of the wounds before this preliminary led to the next step, crucifixion.

In Pierre Barbet's book, "A Doctor at Calvary," he investigates the archaeology of the scourging and describes the very instrument:

"...a distinctively Roman instrument was used; the flagrum. It had a short handle, to which were attached several long, thick thongs, usually two of them. At a little distance from the end balls of lead or the small bones of sheep were inserted...The thongs would cut the skin and the balls and the little bones would dig deep contused wounds into it. There would be a good deal of hemorrhage and considerable lowering of vital resistance."

But Pilate was goaded into assigning Christ the next step. Nothing personal-just politics. The crown of thorns was certainly a cruel unessential to the passion of Christ, but that was the lark of individuals and not Roman decree. The carrying of one's own cross, though, was an official way to get to Calvary. It was not meant to be a parade, although human beings are rubber-necking creatures, and a line of those condemned on their way to the final solution were a cause to drop everything in one's not-so-busy little day to gawk at the exciting life-and-death pageantry. Most people have images of Christ carrying the whole cross, but in fact He carried only the top part, that part that would be affixed to the vertical piece awaiting its crown. The whole cross would have been much too heavy, and the Roman's, a people of efficiency, would not have men tumbling onto the ground under such a load. Additionally, the vertical pieces of wood, planted firmly in the ground, designated the place, spacing, and height for the crucifixion, which saved several steps in this traditionally busy punishment. This top part was called the "pantibulum."

I have to wonder about some of those who claim to have Christ's stigmata, because they have them in the wrong place. Christ's wounds, the actual nail holes, were not placed in the hands, but through the ring of bones that are the wrist, at one time referred to anatomically as "Destot's space. Through it runs the median nerve. If the nails had been driven through the hands, merely hanging from them would cause them to eventually rip through the fleshy spaces between the bones leading to the fingers. The wrist, however, would provide a ring of bones to anchor the nail, so that solid, unyielding support would prevent this from happening. You can't have a good crucifixion with men slipping off of their crosses. Damage to the median nerve was an unfortunate side-effect, resulting in a torture all its own.

The nail through the foot posed no such annoyance to the executors, because the force of the hanging body pushed against the nail. In Christ's case, only one nail was used to embed both feet. The nails themselves were over four inches long, and thanks to the efficiency of the Romans, using only three nails per cross meant a savings of 25% in supplies and labor.

So now, Christ and the other unfortunates are hanging on their crosses. The punishment has begun. The Romans will just wait until they are dead, then tidy up for the next batch. It was the responsibility of the family of each victim to take the body and make burial preparations. Those without family would be carted off unceremoniously to an unbefitting disposal.

But those condemned didn't just die. Here once again is where our detachment blunts any grotesque awe of the nature of the way they died. Suffocation is what is mentioned...in passing. But it is so much more than suffocation. If you have a weak stomach, I advise you to stop reading now. And for those religious readers who feel I may be doing Christ indignity by describing His failings of the flesh, I disagree: If our religious teaching finds it important that He chose to die for us, then as a doctor I feel it important that we know just how bad a death He chose. He went out of this life, just like he came into it, as no one special, dying like a whole group of others did.

First of all, let's address the flogging again. He didn't carry His cross immediately after this. He had time to develop the pain of his wounds. So the Man who carried His cross had this weight to bear with many wounds peaking in their infectious inflamation. Added to that the debilitating dehydration from the blood loss of His wounds made Him marginally capable of carrying His load.

We have to remember that Christ probably had an impressive physique for His time. This is the man who turned over tables and sent profiteers running from the house of worship. No wimp could have gotten away with that. This is the man who held His own with fisherman. So to bring a man such as this down to the point where He is a stumbling participant in the procession to Calvary would require injuries severe indeed. The way to Calvary, additionally, was a forced march, the only respite being inability to proceed. And the Romans didn't have much patience for that. The top of the cross was good, solid wood, and it wasn't light. So add to all of the other factors a strenuous exertion.

Certainly having nails driven through your wrists and feet is painful enough. But the true cruelty of crucifixion goes beyond just being impaled against a cross. And the physiologic processes involved in crucifixion go beyond mere suffocation. Sure there was suffocation, but it wasn't just a lack-of-air-and-then-you-die phenomenon. Hanging on the cross severely limits the ability to mobilize the diaphragm, the main muscle that is the floor of the chest which moves the air into and out of the lungs. Eventually, not enough air is exchanged. Carbon dioxide builds up, oxygen falls, and if this would continue to death, it would be far more merciful than what actually happens. What actually happens is that the insidious hypoxia causes muscle cramps-everywhere.

We've all woken up in the middle of the night with a muscle cramp-the proverbial "charlie-horse." The wrath of a muscle completely contracting is enough to have us hopping ridiculously around the dark room to work it out. Crucifixion and its resultant hypoxia (low oxygen) causes this cramping in almost every muscle in the body. One just can't slip off into unconsciousness as the suffocation continues. In medicine, we call this condition tetany, and it is regarded as one of the most horrible ways to die. The only relief from tetanus is to better oxygenate one's body. The crucified would therefore have to lift up against the nail through the foot so as to straighten the abdomen, allowing better function of the diaphragm. When better breathing diminished the hypoxia, the cramping would subside, the victim would become exhausted by the painful effort against the nail through his feet, and slump again. Hypoxia would again develop, along with the tortuous cycle of tetanus, summoning up enough brave effort to straighten against the nail again, re-oxygenate, become exhausted, re-slump, and repeat the cycle. Again and again until one died of hypoxia and tetanus at the same time.

It gets worse.The strongest of men could repeat this dance with death for days. Since crucifixion was "just business" to the Romans, they had no interest in prolonging the torture. So, as an ironic gesture of mercy, they would use a metal bar to break the legs of the suffering so that they wouldn't be able to straighten up on the cross to effect proper breathing.

Christ Himself was spared this "gesture of mercy," because he was dead in three hours. Most researchers think he died so quickly because of the dehydration, blood loss, and inflammation he endured before being put on the cross. The crown of thorns didn't help either. (The scalp bleeds most profusely, having an excellent blood supply.)

The spearing of his side is usually thought of as an additional cruel battery, unnecessary and mean-spirited. Actually, this was part of the crucifixion process. The spear, in Christ's case, entered his right side but was driven deep enough to reach his heart. This was precisely the purpose, to make sure the victim of crucifixion was in fact dead. The reference to blood and then water issuing forth from this wound implies something called a "hemopericardium," or blood collecting in the sac around the heart. This was a severe impediment to normal contractility of the heart and probably hastened Christ's death. The "water" was nothing more than the plasma that had separated out from the clot in the puddle of whole blood in the sac.

Imagine Christ being rolled into an emergency room:

First of all, he would need a lot of intravenous fluids and blood transfusions. Severe hypotension due to acute blood loss would be a particularly difficult challenge in re-establishing normal cardiac function, the difficulty especially increased by the hemopericardium. His electrolytes would be lethally out of range, and the proper selection of fluids to re-balance them would be necessary before expecting any resemblance of normal cardiac function. Even shocking the heart would be useless for a while. Double, probably triple antibiotics would need to be started, and powerful drips to establish and maintain blood pressure.

Of course, this is all pretty ridiculous. You can't bring someone back from the dead. You would need a miracle.