Undoubtedly, Virchow’s triad was at work.
Could this account for the death of Jesus?
With his arms and feet fixated to the cross, Jesus was unable to move for approximately six hours (Mark 15:25-37). The weight of his body over that time in his weakened state probably put severe stress on his shoulder joints, conceivably dislocating the joints further inhibiting his ability to move his extremities. Certainly, this would contribute to intravascular stasis such that it would increase the risk of DVT. In fact, a long car ride, a plane trip, or even lying sick in the hospital are usually enough to cause DVT. Preventative maneuvers are recommended by merely occasionally standing up to walk or strecing the legs and alternately relaxing and constricting the muscles in the legs to keep the blood moving.
Jesus did not have that simple luxury on the cross.Having been flogged by the Roman soldiers, the flesh on our Lord’s back was most likely severely lacerated. Pieces of metal, bone and rock in the whipcords sliced the skin open and likely penetrated the deep fascia in some areas so that the paraspinal muscles were exposed. The marks would extend from the shoulders to the legs. Arterial bleeding from the muscles layers was common. Furthermore the stretching of the arms and legs and the piercing of the arms and feet would account for the endothelial injury. When injured, the endothelium (inner lining of blood vessels) releases a cascade of chemical signals that increases the risk of intravascular coagulation.
Undoubtedly, Virchow’s triad was at work in the case of Jesus on the cross. Could this account for the death of Jesus? Could he have died because of deep venous thrombosis resulting in pulmonary embolism? Well, there are certainly other explanations of cardiopulmonary arrest that are just as probable during crucifixion.
|Crucifixion as trauma
Although conceivable, pulmonary embolism nor any other pathophysiology describes the death of our Lord. The gospels indicate otherwise. Matthew and John are clear as to how Jesus ultimately died.
And Jesus cried out again with a loud voice and yielded up his spirit. —Matthew 27:50
When Jesus had received the sour wine, he said, “It is finished,” and he bowed his head and gave up his spirit. —John 19:30
He gave up his spirit!? What does that mean? What pathophysiology can describe this? What would I write down as the cause of death on Jesus’ death certificate? “He gave up his spirit” would not satisfy my attending physicians, nor would it be admissible as a cause of death on a legal document such as a death certificate.
It may appear that I am interpreting “he gave up his spirit” too literally. Perhaps, this is just a descriptive way of saying he died. After all, he did stop breathing and his heart did cease contracting. So in a sense he did suffer cardiopulmonary arrest. Consider the following passage.
For this reason the Father loves me, because I lay down my life that I may take it up again. No one takes it from me, but I lay it down of my own accord. I have authority to lay it down, and I have authority to take it up again. This charge I have received from my Father. —John 10:17-18
This passage clarifies that it was not some faulty physiologic process that resulted in the death of our Lord. Nor was it one final straw that broke the proverbial camel’s back. This was a deliberate sacrifice. Not an accident. Not a pulmonary embolism. Make no mistake, it was a physical death like so many who have gone on before us (Phil 2:6-8, Heb 2:9-15). I cannot explain it more than to say, “He gave up his spirit.”
It was on his time. In essence it was in his way. So why did he choose this way? He didn’t deserve the cross; I did. He didn’t deserve those accusations, the mocking, the flogging, or the crown of thorns; I did. He took my place. Nothing but love can explain this (Jn 3:16, Rom 5:8, 2 Cor 5:19-21, 1 Jn 4).
As to the manner of death, I shouldn’t hesitate in checking the box next to “homicide.” It was my fault. I am the one. I may not know the exact cause of death, but the underlying conditions leading to the terminal event are clear; it was my sin and God’s love.
Dr. Aaron Greeley