In 1936, the French surgeon Pierre Barbet published his medical book A Doctor at Calvary in which he describes taking a recently amputated arm and driving a nail into it in order to understand the mechanics of the crucifixion. Barbet performed the experiment on amputated limbs several times although one hand, he had to confess, belonged to a woman. His ad hoc and off-the-books experimentation is hardly unique. He is one of a cluster of famous doctors and artists who have tried to understand what the crucifixion was actually like and, in Barbet’s case, how it kills someone.

Barbet, who was at one point the chief surgeon at St. Joseph’s hospital in Paris, is not the only one to experiment on bodies (dead or living) in his efforts to ascertain the medical truth. In 1801 sculptor Thomas Banks and artists Benjamin West and Richard Cosway flayed the skin off the body of a recently executed man, hung it on a cross, and made a cast of the body. The cast is still on display at the Royal Academy of Arts. Banks’s intent was to produce an accurate image of the world’s most famous execution: the crucifixion of Jesus. An apocryphal story about Michelangelo states that the famous artist once tied a model to a cross and stabbed him in the side in order to get a realistic sense of what the crucifixion was like. Apparently, for the depiction of history’s most-painted cadaver, Michelangelo felt that it was necessary to have the real deal.

Interestingly, when doctors conduct their autopsies they start with the specifics of the passion narrative rather the generalities of crucifixion. Prior to his death, Jesus was scourged by Roman soldiers. We have no idea how many lashes Jesus received; when Barbet and others try to estimate the number they piously look to the Shroud of Turin, which is a pretty historically problematic object. But we have to assume that the scourging was a violent experience that left him weak and with blood loss. Then, like many other condemned prisoners, he was required to carry a heavy beam of wood to the place of execution. Even before Jesus arrived at Golgotha, therefore, he had been injured in ways that contributed to his relatively rapid death. That said, even without these tortuous preambles, people—ordinarily slaves and those guilty of treason—were regularly executed by the Romans in this fashion. We do not need to appeal to the scourging or crown of thorns to explain why he died.

As with so many academic questions there are differences of opinion about the manner in which crucifixion kills you but there’s some agreement that the nails were not the problem. The nails driven through his feet and hands would have been, in the words of Dr. Thomas McGovern, MD, “wretchedly painful… but relatively bloodless.” Even though binding people to crosses was more common than nailing, the 1968 discovery of the remains of a man whose heel bones had been penetrated with a heavy iron nail demonstrates that people were nailed to crosses in the ancient world. 

In his book, Barbet argued that the primary means of death was suffocation. A person suspended on a cross had their arms stretched tightly along the crossbeam. The positioning of the body made it difficult to breathe and in order to do so the convicted criminal had to lift themselves up by straightening their legs and fighting for every inhalation (Hold your arms tautly out in a T-shape and then elevate them slightly above your torso and you’ll notice that breathing is slightly more laborious than it ordinarily is). The victims were alive, argued Barbet, so long as they had the energy to struggle for oxygen. In short, Jesus died of suffocation.

Barbet’s theories were grounded in a form of torture known as aufbinden in which the subject was hung from a post with their hands tied above their head and their toes barely dragging on the ground. While this form of torture is familiar to modern viewers of action movies and Homeland, it was known to Barbet and his contemporaries from their experiences during World War I. Some of the stories of this form of torture by the Germans (in particular the story of the crucifixion of a Canadian soldier) may have been the result of anti-German propaganda, said Dr. Shannon Monaghan, a World War I historian who teaches at Harvard, but these stories had “staying power at the time” and left a deep impression  on people at the time. Aufbinden was reported to kill a man in 30-90 minutes, but many ancient victims of crucifixion­, who were able to "rest" their feet slightly on the cross, lived for days.

Dr. Thomas McGovern, by contrast, has argued that Jesus died from the shock induced from the blood loss he had sustained during his final day. If Jesus died from suffocation, McGovern argues, how could he have cried out in his last breath as he is reported to have done in the Gospels? Writing several years ago McGovern said “His heart probably started beating in a rapid rhythm called ventricular tachycardia. About 30 seconds before death, the heart rhythm slows down radically and noticeably, such that Jesus likely noticed and sensed his end was near.”

Frederick T. Zugibe, a forensics expert and former chief medical examiner of the Rockland County, New York, performed crucifixion experiments on healthy volunteers in the course of researching his book The Crucifixion of Jesus: A Forensic Inquiry. Zugibe agrees that asphyxia was not the cause of Jesus’s death. He argues that the cause of death was “hypovolemic shock [blood loss], developed in consequence of circumstances of execution: castigation with massive damage of soft tissues of the back, blood loss and dehydration.”

These theories can help explain why Jesus died so quickly. According to the Gospel of Mark, the crucifixion began around 9 in the morning and it took Jesus six hours to die. By comparison, the men who were crucified with him had to be finished off by the Roman soldiers who broke their legs. But McGovern’s theory doesn’t account for how it was that people in general died from crucifixion. For the Romans this was a painful, humiliating, and effective form of articulating their power and on some occasions thousands of people were executed at once. It’s impossible that every condemned criminal was scourged to within an inch of their life in advance of their execution. For these victims, who in some cases lived for days hanging from their crosses, the cause of death was more complicated. As an article “On the Physical Death of Jesus,” published in the Journal of the American Medical Association describes it “The actual cause of Jesus’ death, like that of other crucified victims, may have been multifactorial and related primarily to hypovolemic shock, exhaustion asphyxia, and perhaps acute heart failure.”

The death of Jesus, in other words, is complicated. What’s fascinating is the persistent interest in the mechanics and specifics of Jesus’s death. One of the problems for medical doctors scrutinizing the accounts of the crucifixion is that they treat the Gospels accounts—which diverge from one another in their specifics—and, more strangely, the Turin Shroud as if they were medical charts. Bible scholars, by contrast, would view the passion narratives as literary representations of historical events that have particular theological importance to those who wrote and read them. This is not to say, as Gregory House would say, that “everybody lies,” but rather that the evangelists aren’t interested in documenting symptoms, they are trying to communicate the cosmic importance of the event. Without an accurate report that meets the standards of modern medicine, the specifics of the description of his death are diagnostically unimportant.  In all probability Jesus died, like every other crucifixion victim, from a combination of asphyxia, heart failure, and, in his case, blood loss.