Love Wins and Hell

I recently read Rob Bell's book Love Wins; what a fantastic read!  I highly recommend it to anyone willing to ask themselves hard questions about what they believe hell is and who they think God is.  I've also recently watched a discussion with Francis Chan on youtube.com entitled "Erasing Hell" which is basically a direct response to Rob Bell's book.  Both pastor's do a great job coming from a place of love and peace, never asserting that the others belief is foolish or unfounded but rather, just wrong.  Francis even mentions in the recording that he called Rob Bell after he had read the book to discuss it, I wish very much I could have been there for that!

It is worth noting that Rob Bell is nonspecific in his responses to direct questions such as "Do you believe in an eternal hell?" (as would seem to be his current preferred methodology) and expresses statements like "I simply believe that allowing the possibility of God's grace to surprise us yet again."  I think this statement is a bit dishonest as the entirety of his book points specifically, I think, to the fact that he believes an eternal hell is not only not possible, but not biblical.  Though I don't agree with Rob Bell's assertion that an eternal hell is improbable, I do very much appreciate the book and his willingness to ask questions with courage and zeal.

Though I'm no scholar I always try to read the Bible thinking "What does this plainly say to me?".  I did some research today in an attempt to figure out what I believe.  Here is my study in finding out what hell is and what the Bible has to say about it.  

In response to Bell's questioning the possibility that perhaps our view of God's grace may surprise us:

What is hell?

Hell is punishment for those who do not know God and do not obey the gospel of Jesus.  It is a state of everlasting destruction and being shut out from the presence of the Lord and the glory of his might.

2 Thessalonians 1:8-10

⁸ He will punish those who do not know God and do not obey the gospel of our Lord Jesus. ⁹ They will be punished with everlasting destruction and shut out from the presence of the Lord and from the glory of his might ¹⁰ on the day he comes to be glorified in his holy people and to be marveled at among all those who have believed.

Who goes to hell?

People who do not believe in God and do not obey the gospel of Jesus will go to hell.  Men who defile the flesh, reject authority, revile angelic majesties (things they do not understand); who are unreasoning like animals will be destroyed.  People who are grumblers, always finding fault, people who follow after their own lusts, speak arrogantly, and those who flatter for the sake of gaining advantage.

2 Thessalonians 1:8-10

⁸ He will punish those who do not know God and do not obey the gospel of our Lord Jesus.

Jude 5-6

⁵ ...after saving a people out of the land of Egypt,[God] subsequently destroyed those who did not believe. ⁶ And angels who did not keep their own domain, but abandoned their proper abode, He has kept in eternal bonds under darkness for the judgment of the great day…

Jude 8-10

⁸ Yet in the same way these men, also by dreaming, defile the flesh, and reject authority, and revile angelic majesties. ⁹ But Michael the archangel, when he disputed with the devil and argued about the body of Moses, did not dare pronounce against him a railing judgment, but said, “The Lord rebuke you!” ¹⁰ But these men revile the things which they do not understand; and the things which they know by instinct, like unreasoning animals, by these things they are destroyed.

Jude 16

¹⁶ These are grumblers, finding fault, following after their own lusts; they speak arrogantly, flattering people for the sake of gaining an advantage.

Is hell forever?

There are men who die a second time for whom the black darkness has been reserved forever.  Men who suffer eternal destruction, away from the presence of the Lord.

Jude 12-13

¹² These are the men who are hidden reefs in your love feasts when they feast with you without fear, caring for themselves; clouds without water, carried along by winds; autumn trees without fruit, doubly dead, uprooted; ¹³ wild waves of the sea, casting up their own shame like foam; wandering stars, for whom the black darkness has been reserved forever.

2 Thessalonians 8-9

⁸ …those who do not know God and to those who do not obey the gospel of our Lord Jesus. ⁹ These will pay the penalty of eternal destruction, away from the presence of the Lord and from the glory of His power

QT Interval

QT intervals can be tricky, representing one of the greatest challenges in electrocardiography,  but it's important to identify lengthening QT intervals as they could lead to potentially lethal ventricular arrhythmias.

The American Heart Association defines the QT interval as "the time for electrical activation and inactivation of the ventricles" and is measured from the onset of the QRS complex, ventricular depolarization, to the end of the T wave, ventricular repolarization.

When measuring the QT interval we want to use the longest QT on the 12 lead.  It is best to select complexes not exhibiting U waves (repolarization of the Purkinje fibers) but if you must, there are ways to measure that too.  It's worth noting that bradycardia increases the amplitude of U waves, making them appear in 90% of cases with heart rates less than 65! 

QT interval pathology is determined at a heart rate of 60 beats per minute.  Obviously not all heart rates are found at that pace and we must therefore calculate what's called the "corrected QT interval" (QTc).  There are several formulas for finding the QTc, most of which involve symbols that look like more Egyptian hieroglyphs to me than math, online calculators, and even apps for your phone if you're not mathematically inclined.  Thankfully for me, our company uses Lifepack15s and it's clearly displayed near the PR interval.  

QTc is defined as "prolonged" if it is >440ms in men and >460ms in women and is associated with risk of torsades de pointes when greater than 500ms.

There are many causes of long Qtc such as hypokalemia, hypomagnesemia, hypocalcemia, hypothermia, myocardial ischemia, post-cardiac arrest, congenital long QT syndrome, and even medications like Digoxin.


TL;DR

• The QT interval is the depolarizing and repolarizing of the ventricles.
• A long QT interval leads to potentially lethal ventricular arrhythmias.
• Pathology is determined by the "corrected QT interval" (QTc) and is listed just under the PR interval on our Lifepacks. 
• QTc >500ms is associated with risk of torsades de pointes.
• U waves appear in 90% of cases of heart rates less than 65. 
• Many causes such as hypokalemia, hypomagnesemia, hypocalcemia, hypothermia, myocardial ischemia, post-cardiac arrest, congenital long QT syndrome, and even medications like Digoxin.

References:
Lifeinthefastlane.com
American Heart Association
Journal of American College of Cardiology