Kun Hwang; Chan Yong Park

doi:10.20408/jti.2025.0113

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Editorial The Last Temptation of Christ as terminal hallucination: a trauma surgeon’s interpretation of hypovolemic shock in literature and film: Kun Hwang, MD^1,2, Chan Yong Park, MD³; Journal of Trauma and Injury 2025;38(3):165-167.
DOI: https://doi.org/10.20408/jti.2025.0113
Published online: September 29, 2025

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¹Department of Plastic Surgery, Armed Forces Capital Hospital, Seongnam, Korea

²Department of Anatomy, Ewha Womans University College of Medicine, Seoul, Korea

³Division of Trauma and Acute Care Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul, Korea

Correspondence to Kun Hwang, MD Department of Plastic Surgery, Armed Forces Capital Hospital, 81 Saemaeul-ro 177 beon-gil, Bundang-gu, Seongnam 13574, Korea Tel: +82-31-725-6406 Email: jokerhg@naver.com

Chan Yong Park, MD Division of Trauma and Acute Care Surgery, Department of Surgery, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080, Korea Tel: +82-2-2072-2817 Email: trauma-park@naver.com

• Received: May 21, 2025 • Revised: June 25, 2025 • Accepted: July 18, 2025

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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ARTICLE INFORMATION
REFERENCES

In both trauma surgery and literature, moments near death frequently trigger powerful perceptions and inner conflicts. One of the most controversial and resonant depictions of such a moment appears in The Last Temptation of Christ, a novel by Nikos Kazantzakis that examines Jesus’s psychological and spiritual struggle during crucifixion [1]. The work emphasizes Christ’s human nature and his internal resistance to accepting his divine mission.

Martin Scorsese’s 1988 film adaptation intensifies this narrative by rendering the “last temptation” not as a fleeting thought but as a vivid, immersive vision in which Jesus imagines an alternate life—marriage, children, and old age—only to reject it with his final breath [2]. Although widely criticized for supposed heresy, this sequence is better understood not as blasphemy but as a dramatized portrayal of a terminal cognitive rupture under extreme physiological and psychological duress.

As trauma surgeons, we often witness similar transitional states. Patients with massive hemorrhage or cerebral hypoxia can display perceptual distortions, dissociation, or near‑death experiences (NDEs), which are increasingly studied within clinical neuroscience and psychology [3–5].

We seek to examine The Last Temptation of Christ, focusing on its climactic vision sequence, through the lens of hypovolemic shock and NDE phenomenology. By correlating the literary and cinematic narrative with current knowledge of terminal cerebral physiology, we suggest that Kazantzakis’s and Scorsese’s portrayals may capture the internal phenomenology of a dying trauma patient with surprising accuracy [6,7].

We employed a qualitative, interdisciplinary method combining narrative analysis with clinical experience and biomedical literature. The source materials are Nikos Kazantzakis’s novel The Last Temptation of Christ [1], Martin Scorsese’s film adaptation of the novel [2], peer-reviewed trauma and neuroscience literature on hypovolemic shock, NDEs, and ischemic hallucinations [3–5], and firsthand clinical experience managing severely hypotensive and perimortem patients. We interpreted the “vision sequence” during the crucifixion as a simulated NDE, identifying correlations between the literary/film imagery and known physiological phenomena such as cerebral hypoxia, hypotension‑induced confusion, and dissociative states. Case analogies are drawn from de‑identified trauma encounters involving patients in hemorrhagic shock with transient loss of consciousness, followed by reports of altered perception.

A striking parallel emerges between Kazantzakis's and Scorsese’s depictions of the crucifixion vision and the clinical features of NDEs in patients undergoing hypovolemic shock. The crucifixion scene in both the novel and the film presents a clear, progressive sequence of symptoms and sensations that align with clinical patterns seen in patients experiencing stage III–IV hypovolemic shock (Fig. 1, Table 1) [8].

(1) Progressive weakening and altered perception: Jesus is depicted as physically debilitated, with labored breathing, blurred vision, and fluctuating consciousness—signs consistent with systemic hypoperfusion and cerebral hypoxia [6].

(2) Sudden dissociative state: At the moment of maximal suffering, Jesus “escapes” into a vivid alternate reality, stepping off the cross with the aid of an angelic figure (later revealed as demonic). This abrupt transition corresponds to near‑death hallucinations reported in trauma patients, particularly under hypoxic conditions [3,4].

(3) Time distortion and euphoria: Within the vision, time accelerates; years pass in moments. Jesus marries, fathers children, and ages in a dreamlike arc, mirroring the subjective time expansion and emotionally saturated content documented in NDEs [5,9].

(4) Return to reality and rejection of the illusion: Jesus ultimately recognizes the unreality of the imagined life and returns to the cross, Jerusalem burning in the distance. He cries, “It is accomplished,” and dies. This cognitive “return” resembles the brief reorientation some trauma survivors describe before death or resuscitation, when the brain regains transient clarity amid systemic failure [7].

(5) Clinical analogs: Such patterns echo presentations in trauma‑induced shock, where patients have described dreamlike visions, life reviews, or peaceful scenes, phenomena consistent with the literature on NDEs [3,10].

(6) A clinical case resembling the crucifixion vision: A 32‑year‑old man sustained a penetrating chest injury in an industrial accident. On arrival, he was hypotensive (blood pressure, 70/40 mmHg), tachycardic (heart rate, 142 beats per minute), and had a Glasgow Coma Scale score of 13. During resuscitation, he repeatedly murmured about seeing his deceased brother “by the water,” a detail noted by staff. Despite aggressive intervention, the patient died within 12 minutes. These reported perceptions closely align with literature on NDEs and terminal dissociation, supporting the inference that similar neurophysiological mechanisms could underlie Kazantzakis’s fictional vision of Christ on the cross [3,5].

The theological and clinical implications bridge hypovolemic physiology with existential narrative. Kazantzakis's The Last Temptation of Christ has long been interpreted as a spiritual and psychological exploration of Jesus’s final moments—not as a denial of divinity, but as an affirmation of his humanity [1]. From a trauma‑surgery standpoint, that humanity is literal and embodied: Jesus suffers as real trauma victims do, through blood loss, hypoxia, and the fragmentation of coherent selfhood.

By aligning Jesus’s "last temptation" with a terminal hallucination—a final flicker of meaning produced by a dying brain—we highlight the clinical plausibility of Kazantzakis’s vision and its existential weight. In effect, the novel operates as a metaphysical trauma case study in which the protagonist’s final act is the conscious rejection of a comforting delusion.

Jesus chooses truth over fantasy and sacrifice over sedation. Medically, the vision could be interpreted as a protective dissociative phenomenon, akin to what is sometimes observed in mortally injured patients as the mind withdraws from unbearable sensory input and crafts a more tolerable reality [5].

Yet unlike most trauma cases, Jesus refuses to stay in that safer place. He returns to agony, accepts it, and completes his mission. This choice resonates with ethical dilemmas in trauma care—when to preserve consciousness, when to let go, and when to intervene—and reflects the internal struggle of clinicians who confront death daily, not as abstraction but as blood, breath, and will.

Ultimately, Kazantzakis’s crucifixion scene connects literary imagination with physiological truth. In doing so, it offers trauma surgeons a mirror: a fictional yet familiar portrait of the instant when body and soul part company. The Last Temptation of Christ thus provides a distinctive opportunity to examine how spiritual imagination and physiological experience converge at the boundary between life and death.

As trauma surgeons, we are intimate witnesses to this boundary. We see firsthand how cerebral hypoxia, hemorrhagic shock, and dissociative phenomena can produce vivid, sometimes peaceful, altered states that mirror what Kazantzakis and Scorsese depicted [2,4].

Far from diminishing the theological or literary gravity of the crucifixion vision, this interpretation deepens it. Kazantzakis’s Christ does not escape death; he meets it consciously, rejecting the brain’s final mercy, a beautiful lie. In doing so, he affirms his humanity and reflects the stark choice many trauma patients face, whether consciously or not: to surrender or to resist.

For trauma professionals, this literary portrayal functions as a symbolic case report of the terminal experience. It reminds us that beneath every clinical sign lies a subjective world—fleeting, largely unknowable, and nevertheless real.

ARTICLE INFORMATION

Conflicts of interest

Kun Hwang and Chan Yong Park are editorial board members of this journal, but were not involved in the peer reviewer selection, evaluation, or decision process of this article. The authors have no other conflicts of interest to declare.

Funding

This study was supported by the Korean Military Medical Research Project (No. ROK-MND-2024-KMMRP-006), funded by the Korean Ministry of National Defense.

Data availability

Data sharing is not applicable as no new data were created or analyzed in this study.

Fig. 1.

Jesus's guardian angel stops his suffering. Screenshot reprinted from Movieclips [8], available under the standard YouTube license.

Table 1.

Physiological correlates of the vision sequence in The Last Temptation of Christ

Clinical phenomenon	Physiological basis	Portrayal in the vision sequence
Dissociation	Hypoxia-induced disruption of cortical integration	Jesus mentally detaches from his suffering on the cross
Time distortion	Disrupted temporoparietal processing	The vision spans decades in mere seconds
Hyper-real imagery	Catecholamine surge; REM intrusion into wakeful state	Vivid scenes of marriage, children, and aging
Euphoria or peace during dying	Endogenous opioid and serotonergic activity	Emotional warmth and comfort in domestic life scenes
Return to reality before death	Transient cerebral perfusion or final synaptic activity	Jesus awakens back on the cross, cries out “It is accomplished”
Final mental clarity	Terminal brain wave surge (gamma oscillations)	Jesus experiences resolution and spiritual clarity before dying

REM, rapid eye movement.

REFERENCES

1. Kazantzakis N. The last temptation of Christ. Bien PA . Simon & Schuster; 1960.
2. Scorsese M, director. The last temptation of Christ. Cineplex Odeon Films; 1988.
3. Greyson B. The near-death experience scale: construction, reliability, and validity. J Nerv Ment Dis 1983;171:369–75.Article PubMed
4. Parnia S. Understanding the cognitive experience of death and the near-death experience. QJM 2017;110:67–9.Article PubMed
5. Bertão M, Dalcolmo Ú, Rego F. Deathbed phenomena, other end-of-life experiences and their effects in palliative care teams: a systematic review. Omega (Westport) 2025 Feb 17 [Epub]. https://doi.org/10.1177/00302228251321203Article
6. Steinback CD, Poulin MJ. Influence of hypoxia on cerebral blood flow regulation in humans. Adv Exp Med Biol 2016;903:131–44.Article PubMed
7. Stollings JL, Kotfis K, Chanques G, et al. Delirium in critical illness: clinical manifestations, outcomes, and management. Intensive Care Med 2021;47:1089–103.Article PubMed PMC PDF
8. Movieclips. The last temptation of Christ (1988): guardian angel at Golgotha scene (8/10) [Internet]. YouTube; 2019 [cited 2025 Jun 25]. Available from: https://www.youtube.com/watch?v=JyTf7wR8vWI
9. Kelly EW. Near-death experiences with reports of meeting deceased people. Death Stud 2001;25:229–49.Article PubMed
10. Von Rueden KT, Wallizer B, Thurman P, et al. Delirium in trauma patients: prevalence and predictors. Crit Care Nurse 2017;37:40–8.Article PubMed PDF

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The Last Temptation of Christ as terminal hallucination: a trauma surgeon’s interpretation of hypovolemic shock in literature and film

Fig. 1. Jesus's guardian angel stops his suffering. Screenshot reprinted from Movieclips [8], available under the standard YouTube license.

Fig. 1.

The Last Temptation of Christ as terminal hallucination: a trauma surgeon’s interpretation of hypovolemic shock in literature and film

Clinical phenomenon	Physiological basis	Portrayal in the vision sequence
Dissociation	Hypoxia-induced disruption of cortical integration	Jesus mentally detaches from his suffering on the cross
Time distortion	Disrupted temporoparietal processing	The vision spans decades in mere seconds
Hyper-real imagery	Catecholamine surge; REM intrusion into wakeful state	Vivid scenes of marriage, children, and aging
Euphoria or peace during dying	Endogenous opioid and serotonergic activity	Emotional warmth and comfort in domestic life scenes
Return to reality before death	Transient cerebral perfusion or final synaptic activity	Jesus awakens back on the cross, cries out “It is accomplished”
Final mental clarity	Terminal brain wave surge (gamma oscillations)	Jesus experiences resolution and spiritual clarity before dying

Table 1. Physiological correlates of the vision sequence in The Last Temptation of Christ

REM, rapid eye movement.