A Paramedics View of Christianity

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A Paramedic’s view of Christianity

A Paramedic's View of Christianity The Electrocardiogram of a Christian

Chaplain Christopher A. Credle, EMT-Paramedic, CICP, BCBT, LBT, CRCC, PhD

Preface

© Copyright 2013 - SOULMEDIC Ministries

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Scripture quotations taken from the Amplified® Bible (AMP), Copyright © 1954, 1958, 1962, 1964, 1965, 1987 by The Lockman Foundation Used by permission. (www.Lockman.org) Scripture taken from The Message (MSG). Copyright © 1993, 1994, 1995, 1996, 2000, 2001, 2002. Used by permission of NavPress Publishing Group.

Scripture quotations marked (NLT) are taken from the Holy Bible, New Living Translation, copyright © 1996, 2004, 2007 by Tyndale House Foundation. Used by permission of Tyndale House Publishers, Inc., Carol Stream, Illinois 60188. All rights reserved.

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Scripture quotations are taken from the Complete Jewish Bible, (CJB) copyright 1998 by David H. Stern. Published by Jewish New Testament Publications, Inc. www.messianicjewish.net/jntp. Distributed by Messianic Jewish Resources Int'l. www.messianicjewish.net. All rights reserved. Used by permission.

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Dedication This work is dedicated first to GOD Himself, for the calling, that He placed on my life, to work in the field of Emergency Medical Services (EMS) as a Paramedic and as a Chaplain. It is truly a blessing to be able to minister to the men and women that work in this field of EMS. Next, I dedicate this work to the men in my life that mean the most to me: To my grandfather, Reverend Edgar D. Williams, we called him Gaga, The OLD Goat, as a man and as a minister of the Gospel he truly believed in and acted on the premise of first century Christianity. He was truly a friend and confidant to all that he came in contact with.

Many have stated that I am a chip off the old block when it comes to him. He would push, push harder and then push you more causing you to reach for higher and higher goals in life.

He and I would sit and discuss the Bible and what it truly means to be a Christian and a minister of the Gospel of Jesus Christ. I was truly blessed to have such a man to be my grandfather.

To the man who I can truly call ABBA Father, my dad, we called daddy, Evangelist Michael P. Credle. The man who God placed in my life to teach me so many things there is no way to mention them all. This man taught me to love God, my country, and my fellow man and he taught me to make the Golden Rule my daily rule. God has done a great work in the both of us. We read in Malachi 4:6 And he shall turn the heart of the fathers to the children, and the heart of the children to their fathers… and he did. I am truly blessed to have a father that is not afraid to ask the tough questions and does not mind being IN YOUR FACE; he has always been a face to face type of parent, friend and minister to my self or others.

To the Best brothers any boy could ever grow up with and now these men are truly my friends. To William (Bill) Credle, Randy Credle, Chief Adam Credle (USCG Retired), and Daniel (Dan) Credle I have been blessed to have you as my brothers. You each in your own ways have taught me much about this life, for that I am truly grateful.

To my boys, Jacob and Jesse I love you and wanted to share with you my daily prayer for my life. This prayer is the chorus from the song; I want to be just like you, from Phillips, Craig and Dean's 1995 album Lifeline.

"I Want to be Just Like You" "… Lord, I want to be just like You, 'Cause he wants to be just like me I want to be a holy example, For his innocent eyes to see Help me be a living Bible, Lord, That my little boy can read I want to be just like You, 'Cause he wants to be like me…"

May I always be the father to you that God is to me.

I LOVE YOU BOYS!

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A Paramedic's View of Christianity The Electrocardiogram of a Christian: A Study into the Heart of a Christian Table of Contents Dedication .................................................................................................................................. 4 Acknowledgments ...................................................................................................................... 6 Preface ....................................................................................................................................... 7 Introduction .............................................................................................................................. 18 Chapter 1 A Brief Anatomy and Physiology Lesson ................................................................. 24 Chapter 2 EKG Waveforms and Lead Placement .................................................................... 44 Chapter 3 Interpretation of the Lead II EKG ............................................................................. 56 Chapter 4 The Bible does not make SENSE to me! WHY? ...................................................... 84 Chapter 5 Origin and the Purpose of the Bible ......................................................................... 94 Chapter 6 Interpretation of Gods Word the Bible...................................................................... 99 Chapter 7 God's View of the Human Heart ............................................................................ 108 Chapter 8 Interpreting Rhythms Originating from the Sinus Node ......................................... 130 Chapter 9 Interpreting Rhythms Originating from the Atria ..................................................... 146 Chapter 10 Interpreting Rhythms Originating from the Atrial-Junction Node .......................... 196 Chapter 11 Interpreting Supraventricular Dysrhythmias ......................................................... 214 Chapter 12 Interpreting Heart Block Rhythms ........................................................................ 250 Chapter 13 Interpreting Rhythms Originating from the Ventricles .......................................... 272 Chapter 14 Interpreting the Other Rhythms Originating from the Ventricles .......................... 288 Chapter 15 Asystole EQUALS Apostasy ................................................................................ 330 Chapter 16 Now is the Time to Have Your HEART Examined ............................................... 340 Chapter 17 The CONCLUSION.............................................................................................. 350 Stars of Life ............................................................................................................................ 364 Appendix A: As a Christian in the field of EMS ....................................................................... 368 Appendix B: The Emergency Medical Services Chaplain ....................................................... 370 Appendix C: SOAP Method of Personal Bible Study .............................................................. 378 Getting to Know the Author .................................................................................................... 379 References ............................................................................................................................. 381

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Acknowledgments I would like to Thank God first for choosing me to work and minister in the field of Emergency Medical Services. Thank you for teaching me that the Bible can be and is to be used to teach all subjects all the time.

To first Love of my life, my wife Amy, thank you for listen to God and taking that giant leap of faith that led you to say YES and marry me. Thank you for being the Best friend a man could ever want or need. Thank you for being the most amazing mom to all our kids both young and old. Thanks for allowing me to stay in my room all these hour that have gotten me this far. I love you Lady Ames!

To the second Love of my life, my daughter Kelsey, thank you for being the best daughter a dad could ever want. You make me smile every time I think of you. I am very proud of you. I love you Kelsey!

To Dr. Shawn Tracy, Thank you for being a true (In your Face) friend that you are. Thank you for all the help that you have given me on this project, and, all the hours that you have spent proof reading. I am forever grateful!

To Grady Johnson, EMT-P, Dr. Susan Crisp EMT-P, thank you for poking and prodding me to finish what I started in the quest to obtain my PhD in Restorative Justice.

Preface

Preface What started as a word study on the word HEART back in 1988 while in my first year in college has turned into a life long passion to read, to understand and to then teach God's Word the Bible through that of a Paramedic's View of Christianity.

I would have to say that I started to gather information for this book in the fall of 1987, the day I started my Basic Emergency Medical Technician (EMT) course. It was not long after that, that I started looking for ways to study the Bible from a medical perspective. I started my life long personal relationship with Jesus Christ, by asking Him to personally come and take up residents with in my HEART (My mind, will, emotions and personality / character) to be my Savior over the Easter weekend in 1979 after my grandfather died because I wanted to see him again one day in heaven. It was during my Discipleship Training School (DTS), which is a course in Discipleship and Cross Cultural Missions, where I learned to Personally KNOW God and making Him the LORD of my daily life and learned to make Him known to others from my personal prospective. It has taken me since that day and will continue to take the rest of my life to make Him Lord of every aspect of my life.

Let's just take a quick look at some of the information that I found as I started to study the Bible from a medical perspective. Cardiology was one of the hardest subjects for me to learn in EMT and Paramedic school. So I started studying my Bible using medical terms and I started with the word heart. Here some twenty-five years later I am still studying the human heart.

In the King James Version (KJV) of the Bible, I have found that the English word, "heart", is mentioned 946 times in 823 different verses. There are 724 verses with the word "heart" in the Old Testament and 99 times in the New Testament. Frequently, the translators of the English bible would interpret "heart," for several different Hebrew and Greek words.

Sometimes, the translators would use the English word "heart" for the Greek and Hebrew words "mind", "will", "conscience", "emotions", "soul affections", "personality", "character" or, "human nature."

The word "heart" is also translated with the holistic view of a person's center, of all their physical, emotional, intellectual, and moral activities. "Heart" can also be translated in English, as the center of something. Exodus 15:8 says "And with the blast of thy nostrils the waters were gathered together, the floods stood upright as an heap, [and] the depths were congealed in the heart of the sea." We see in Exodus 15:8 that the translators used the word "heart of the sea," which also could be said "center of the sea." We also see another example in Matthew 12:40 which says, "For as Jonas was three days and three nights in the whale's belly; so shall the Son of man be three days and three nights in the heart of the earth." As a physical organ, the "heart" is the center of our physical life; the pump that moves our blood throughout our body. Take a moment and ponder the futility of the body, without a heart, in these two verses. 1 Samuel 25:37 says "But it came to pass in the morning, when the wine was gone out of Nabal, and his wife had told him these things, that his heart died within him, and he became [as] a stone." Proverbs 14:30 says "A sound heart [is] the life of the flesh: but envy the rottenness of the bones."

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It was during one of those days studying that God revealed to me that the path that your blood flows through your HEART depicts a picture of the way you become a Born-Again Christian? Let's take a few moments to look into this shall we?

The Blood Flow through the Heart From a medical perspective, de-oxygenated blood from the body enters the right side of the heart, into the right atrium through two veins: The Superior Vena Cava (SVC) and Inferior Vena Cava (IVC). The SVC collects blood from the upper half of the body. The IVC collects blood from the lower half of the body. Blood leaves the SVC and the IVC and enters the Right Atrium (RA). When the RA contracts, blood then flows through the tricuspid valve into the right ventricle (RV). Contraction of the ventricle (serves to pump blood to the lungs for the exchange of gases) then closes the tricuspid valve and forces open the pulmonary valve.

Blood flows into the pulmonary artery. This branches immediately, carrying blood to the right and left lungs. Here the blood gives up carbon dioxide and takes on a fresh supply of oxygen.

The capillary beds of the lungs are drained by venules that are the tributaries of the pulmonary veins. Four pulmonary veins, two draining each lung, carry oxygenated blood to the left atrium (LA) of the heart. When the LA contracts, blood travels "through the mitral valve to the thicker, walled, left ventricle (LV) that serves to forcefully pump blood through the aortic valve into the aorta" and, to the rest of the body. This happens every time that your heart beats.i Reference Figure 1.5 to see the normal blood flow through the heart and lungs.

The Bible tells us in Leviticus 17:11 "For the life of the flesh is in the blood: and I have given it to you upon the altar to make an atonement for your souls: for it is the blood that maketh an atonement for the soul".

This great verse contains a wealth of scientific and spiritual truth. It was not realized until the discovery of the circulation of the blood by the creationist scientist William Harvey, in about 1620, that biological "life" really is maintained by the blood, which both brings nourishment to all parts of the body and also carries away its wastes.

Its spiritual truth is even more significant. The blood, when shed on the altar, would serve as an "atonement" (literally, "covering") for the soul of the guilty sinner making the offering. In fact, the "life" of the flesh is actually its "soul," for "life" and "soul" both translate the same Hebrew word (nephesh) in this text. When the blood was offered, it was thus an offering of life itself in substitution for the life of the sinner who deserved to die.

The Bible is clear in its teaching that no human man could die for another man’s sins, for his blood would inevitably be contaminated by his own sin. Therefore, the blood of a "clean animal" was required. Animals do not possess the "image of God", including the ability to reason about right and wrong, and therefore cannot sin. Even such clean blood could only serve as a temporary covering, and it could not really "take away" sin. For a permanent solution to the sin problem, nothing less was required than that of the sinless "Lamb of God, which taketh away the sin of the world" John 1:29 known as Jesus Christ Himself. "Neither by the blood of goats and calves, but by His own blood He entered in once into the holy place, having obtained eternal redemption for us" Hebrews 9:12. Since His life was in His blood, He has "made peace through the blood of His cross" Colossians 1:20.ii

Preface William Harvey (1628) stated it this way, the circulation of the blood is further confirmed by probable reasons: It will not be foreign to the subject if I here show further, from certain familiar reasonings, that the circulation is matter both of convenience and necessity. In the first place, since death is a corruption which takes place through deficiency of heat, and since all living things are warm, all dying things cold, there must be a particular seat and fountain, a kind of home and hearth, where the cherisher of nature, the original of the native fire, is stored and preserved; from which heat and life are dispensed to all parts as from a fountain head; from which sustenance may be derived; and upon which concoction and nutrition, and all vegetative energy may depend. Now, that the heart is this place, that the heart is the principle of life, and that all passes in the manner just mentioned, I trust no one will deny.

The blood, therefore, required to have motion, and indeed such a motion that it should return again to the heart; for sent to the external parts of the body far from its fountain, as Aristotle says, and without motion it would become congealed. For we see motion generating and keeping up heat and spirits under ail circumstances, and rest allowing them to escape and be dissipated. The blood, therefore, becoming thick or congealed by the cold of the extreme and outward parts, and robbed of its spirits, just as it is in the dead, it was imperative that from its fount and origin, it should again receive heat and spirits, and all else requisite to its preservation — that, by returning, it should be renovated and restored.iii Blood flows from the body through the Superior and Inferior Vena Cava: (Symbolically the good and bad thoughts) In this world we have only two types of influence on our thought life as seen from Colossians 1:9-13 "For this cause we also, since the day we heard it, do not cease to pray for you, and to desire that ye might be filled with the knowledge of his will in all wisdom and spiritual understanding; That ye might walk worthy of the Lord unto all pleasing, being fruitful in every good work, and increasing in the knowledge of GOD; Strengthened with all might, according to his glorious power, unto all patience and longsuffering with joyfulness; Giving thanks unto the Father, which hath made us meet to be partakers of the inheritance of the saints in light: Who hath delivered us from the power of darkness, and hath translated us into the kingdom of his dear Son:".

The two types of influence on our thought life are good and bad thoughts. Using symbolism for the superior vena cava and inferior vena cava, the superior vena cava represents the good, Godly thoughts. The inferior vena cava represents the bad, demonic thoughts. These influences are both spiritual and physical ramifications and are bombarding us day-in and day-out. We have a choice to choose the superior or inferior thoughts in our life. The choice we make ultimately will determine the outcome of our decisions and actions. Notice Romans 6:16, "Know ye not, that to whom ye yield yourselves servants to obey, his servants ye are to whom ye obey; whether of sin unto death, or of obedience unto righteousness?"

Then to the Right Atrium (Symbolically the Mind): Romans 8:5-7 "For those who are according to the flesh and are controlled by its unholy desires set their minds on and pursue those things which gratify the flesh, but those who are according to the Spirit and are controlled by the desires of the Spirit set their minds on and

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seek those things which gratify the [Holy] Spirit. Now the mind of the flesh [which is sense and reason without the Holy Spirit] is death [death that comprises all the miseries arising from sin, both here and hereafter). But the mind of the [Holy] Spirit is life and [soul] peace [both now and forever]. ...because the mind of the flesh [with its carnal thoughts and purposes] is hostile to God, for it does not submit itself to God's Law; indeed it cannot." (AMP) Your mind is the place where we respond to the hearing of the WORD of GOD. The WORD of GOD is presented to us in many forms. We are presented the WORD of GOD by way of reading the Bible. We are presented the WORD of GOD by hearing the scriptures by the spoken voice, either through preaching/teaching or, reading the Bible out loud. Another powerful way, that the WORD of GOD is presented to us, is through a personal testimony of the goodness of GOD. Perhaps, the greatest impact, on our life or the lives of others, is when the WORD of GOD is presented to us by someone displaying GOD's nature, LOVE. All of the forms presented show us how GOD diligently longs to reveal himself to us. When we make Jesus Christ the Lord of our life, a dramatic, positive change will take place. By making Jesus Christ, the LORD of our life, is to make Jesus the BOSS of our life. Making Jesus the LORD of our life makes the stand that we are no longer the owner of our life. Let's look at this in a way that we all can understand.

To the Right Ventricle (Symbolically the Will): Symbolically, we will set the right ventricle, as the will of an individual. The will is power to make a conscience choice. The will is the power to make decisions. The subconscious has powerful influence in determining our will. The subconscious is aptly portrayed by the old cartoons, where we see the little red devil, with a pitch-fork in hand on one shoulder and, an angel with the halo on the other; both sides trying to get us to choose to do either good or bad. Life's choices are up to us; we have complete responsibility over the choice we execute.

We can choose/will to follow GOD or choose/will to follow our own ways. With our will, we express our desires and determinations to set goals and carry them out. While on duty, we have a duty to act. However, while off-duty, we are not obligated to act. We are not obligated to stop at the scene of an emergency while off-duty. So, why do we still do it? We still stop to help others, in their time of need, because that is who we are. Those, in the profession of Police, Fire, or EMS services, are the type of people who choose/will daily to help other people. Many times, we think of the other person's needs, before taking into account our own personal safety.

Taking into account the natural realm of the will, in the spiritual realm, the Holy Spirit allows us to see, hear, sense and feel His presence. The Holy Spirit is calling out to us to choose GOD's will. Then, somehow or somewhere we get the chance to see or hear the Gospel preached. At the moment we are presented the Gospel, the Holy Spirit brings conviction on us, to get us to repent from our sins. It is at that point, in our mind, that we become aware of Jesus Christ. The Holy Spirit reveals to us what Jesus did for us on the Cross of Calvary. The Holy Spirit then continues to pull and tug on our heart. He calls us to come until we choose/will to turn our life over to Jesus, to be our Lord, Savior and, the new boss of your life.

Joshua 24:15 "And if it seem evil unto you to serve the LORD, choose you this day whom ye will serve; whether the gods which your fathers served that were on the other side of the flood, or the gods of the Amorites, in whose land ye dwell: but as for me and my house, we will serve the LORD." It is at that point, that your spiritual blood goes to your lungs for a spiritual gas exchange.

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To the Lungs: (Symbolically the exchange that took place for us at the Cross) In the physical, our lungs are the place where different types of gases are exchanged in our body. In the lungs, the blood gives up carbon dioxide and takes on a fresh supply of oxygen.

Symbolically, in the spiritual realm, the Holy Spirit guides and leads us, to the revelation that we are a sinner. Romans 3:23 describes all humanity by saying "For all have sinned, and come short of the glory of GOD;" and that we have a personal need for salvation from the penalty of our sins. Romans 6:23 tells us what the penalty of sins brings, "For the wages of sin is death; but the gift of GOD is eternal life through Jesus Christ our Lord." and Matthew 9:13 "But go and learn what that means, I will have mercy, and not sacrifice: for I am not come to call the righteous, but sinners to repentance."

The only way, to get a pardon from our sins is to repent of our sins. We repent of our sins by asking GOD to forgive us and make us a new creature (Christian). Once we become a new creature, GOD gives us a new heart. Romans 5:6-9 describes His love towards us, "For when we were yet without strength, in due time Christ died for the ungodly. For scarcely for a righteous man will one die: yet peradventure for a good man some would even dare to die.

But GOD commends his love toward us, in that, while we were yet sinners, Christ died for us.

Much more then, being now justified by his blood, we shall be saved [Rescued] from wrath through him."

The same way our blood gives up carbon dioxide and, takes on a fresh supply of oxygen within our body, Jesus performs that great exchange in us. When we ask Jesus into our hearts, and we repent of our sins, Jesus forgives us our sins, because of His shed blood. Just as the carbon dioxide is exchanged in the lungs, with a fresh supply of oxygen, Jesus exchanges our sins, for Salvation. Romans 10:9-10, "That if you shall confess with your mouth the Lord Jesus, and shall believe in your heart that GOD has raised him from the dead, you shall be saved. For with the heart man believes to righteousness; and with the mouth confession is made to salvation."

The WORD of GOD in Romans 10:13 says, "For whosoever shall call upon the name of the Lord shall be saved." Let me describe the salvation process, with a review of the physical realm.

The human respiratory system is uniquely designed by God, to extract oxygen from ambient air and, to remove waste gases from the body. Humans need a continuous supply of oxygen for cellular respiration, and, they must get rid of excess carbon dioxide, the poisonous waste product of this process. Some 250 different volatile substances have been found in human breath. The oxygen, we need, is derived from the Earth's atmosphere, which is 21% oxygen.

Breathing consists of two phases, inspiration and expiration. When a breath is taken, air passes in through the nostrils, through the nasal passages, into the pharynx, through the larynx, down the trachea, into one of the main bronchi, then, into smaller bronchial tubules, through even smaller bronchioles, and, into a microscopic air sac, called an alveolus. Most of the lung tissue is composed of alveoli. There are an estimated 300 million alveoli in the lungs providing gas exchange.

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It is here that external respiration occurs. Simply put, it is the exchange of oxygen and carbon dioxide, between the air and the blood in the lungs. The blood picks up oxygen and disposes of carbon dioxide, in an extensive capillary network surrounding the alveoli and respiratory bronchioles. Oxygen-rich blood is returned to the left ventricle, via the pulmonary veins, for distribution to the rest of the body.

The body's tissues need the oxygen and, have to get rid of the carbon dioxide, so, that the blood carried throughout the body exchanges oxygen and carbon dioxide with the body's tissues. Internal respiration is basically the exchange of gasses between the blood in the capillaries and the body's cells. Cellular respiration occurs when cells use oxygen in metabolic reactions and generate carbon dioxide, water, and energy.

Now, for the spiritual side of salvation; up to now, we have had a thought in our mind, that we need to check out this Jesus. Then, in our will, we make a very personal decision and, act on it, by asking Jesus to RESCUE us from our sin and, then, to become the boss of all the areas of our life.

When we ask Jesus into our hearts, and repent of our sins, He, through His BLOOD, forgives us our sins, by taking away the (carbon dioxide) sin and giving us (oxygen) Salvation.

The lungs are the place, within your body, where different types of gases are exchanged, within your body's blood. We can also see the different types of spiritual gas exchanges that were made on our behalf, as Jesus hung on the cross and, shed His blood. Some of those exchanges are: We are FORGIVEN because He was PUNISHED We are HEALED because He was WOUNDED We are RIGHTEOUS in Him because He was made SIN We are made ALIVE because He tasted DEATH We become A NEW MAN because the OLD MAN was crucified We are BLESSED because He was CURSED We are ACCEPTED because He was REJECTED When we asked Jesus into our hearts, we not only received an exchange (carbon dioxide/sin for a fresh supply of oxygen/Salvation) but, at that precise moment, GOD, the great physician, performed heart surgery on us. GOD actually performed a heart transplant on us.

He gave us a new heart known as the New Birth. This new birth, or regenerated heart, is no longer owned by sin, as the old heart was, but, GOD owns our new heart. He allows us to still have free will in and for our lives and hearts. The WORD of GOD says in Ezekiel 18:31 "Cast away from you all your transgressions, whereby ye have transgressed; and make you a new heart and a new spirit:". GOD also said in Ezekiel 36:26 "A new heart also will I give you, and a new spirit will I put within you: and I will take away the stony heart out of your flesh, and I will give you an heart of flesh."

Let's look at what happens at the New Birth (being Born Again) 1. A moral and spiritual change, not a physical one.

2. A change of heart (new heart), will, motives, desires, life and conduct, and, not an organism.

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3. A change of masters, not of constitutional makeup of body, soul, or spirit 4. An adoption of one from the satanic family into the family of God 5. Not a coming into existence of the body, soul, or spirit, as in the natural birth, but, a consecration of them to serve God and holiness instead of Satan and sin.

6. Not a begetting by the Holy Spirit, in the sense that Jesus became and, is the only begotten Son of God: 7. A change of nature, but, not the coming into existence of that nature 8. A change of favor, a new standing before God 9. A change of character, state and service 10. There is no comparison between the natural and spiritual birth, as to choice in the matter, conception, embryo, process, and actual birth. The very moment, one is grown enough to recognize that he is a sinner and, when he repents and believes the gospel, a moral and spiritual change takes place: Since you have accepted Jesus Christ into your heart and, have had a spiritual gas exchange, by asking Jesus to be your personal Savior and Lord, it is time for that new regenerated Godly Heart and Blood to flow, into all the areas of your life, starting with your emotions.

To the Left Atrium (Emotions): Back in the human lungs, the capillary beds of the lungs are drained by venules that are the tributaries of the pulmonary veins. Four pulmonary veins, two draining each lung, carry oxygenated blood to the left atrium (LA) of the heart or, your emotions / feelings. Your emotions are seen as the affective aspect of consciousness and feeling or, being Heart-Felt, something that you feel. Acts 17:27 "That they should seek the Lord, if haply they might feel after him, and find him, though he be not far from every one of us:" We live in a society where the words "I feel" have become the catch phrase of communication.

Worse yet, what people feel has become the basis of much of their decision-making. The words "I feel" have become the do-all expression, used for anything and everything that people may experience, think, or want. But, what do people really mean when they say, "I feel this" or, "I feel that"? And, more importantly, what does the Bible teach about feelings?

What is the world's philosophy today? "If it feels good, do it!"

As believers, we are not to be led by our feelings, but, we are to be moved by them, to show compassion and understanding to those in need. That is the right purpose and use of feelings and emotion; so that, we may also be able to comfort, (console and encourage) those who are in any kind of trouble or distress, with the same kind of comfort that we are comforted by God (sounds like what we do on EMS calls, just add the medical part).

2 Corinthians 1:4 "who comforts us in all our troubles, so that we can comfort those in any trouble with the comfort we ourselves have received from God." (NIV)

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As EMS providers, I know that we see things that human eyes were never created to see.

This fallen world is full of pain, sickness, death and, other carnage that we have to see and deal with day-in and day-out, while on duty. Struggles, with life and death, do not place us at risk on every call, though certainly dangers often come our way. Now, on the other hand, our souls are in harm's way, with every call; and, that is a danger graver than any bullet, fire or being hit on the road, while working a motor vehicle accident, could ever be.

The emotions and feelings, that we all have before, during, and after our calls, are bottled up so that others will not think bad or less about us. We all find ways of dealing with these unbidden emotions and feelings that come from a career, devoted to responding to people in crisis. Some people even try to stop feeling; Thinking that it was better to be a brick, and, not to feel, than to experience emotions and, we know the outcome of that. It would tear you apart, piece-by-piece. In fact, it wasn't until the '80s and even into the '90s, before Critical Incident Stress Debriefing (CISD), and, Critical Incident Stress Management (CISM) were created; Then, Defusing, one on one, and now, psychological first-aid, all became an accepted part of emergency services; Police, Fire, and EMS workers, who showed their emotions, were considered weak and, possibly not right for the job. We were all encouraged to keep it inside. Professionals, after all, do not succumb to emotionalism. Others would turn to sex, drinking or drugs to alleviate the pain.

To the Left Ventricle (Personality and Character): The characteristics, (that distinguish an individual or a nation or a group, especially, the totality of an individual's behavioral and emotional characteristics) are his or her Character/Personality traits. Personality is that which constitutes and characterizes a person.

The word "person" (Latin, persona) is derived from the mask, through which an actor spoke his part (persona). For full personality, there must be self-consciousness; with the capability of free will, thought and action--self-determination--hence, we speak of personal character, personal action, etc. The personality is the unit of the entire rational being, perhaps most clearly represented by "the will"; it is that which is deepest in man; your true personality which is always being formed.

Another way to look at personality or character is that they are the qualities or conditions of being a person, or, the totality of qualities and traits, as of character or behavior, that are peculiar to a specific person; The pattern of collective character, behavioral, temperamental, emotional, and, mental traits of a person: Distinctive qualities of a person, especially those distinguishing, personal characteristics that make one socially appealing: the complex of all the attributes--behavioral, temperamental, emotional and mental--that characterize a unique individual; "their different reactions, reflecting their very different personalities"; "it is His nature to help others."

1 Timothy 4:12-16 "Let no one despise or think less of you because of your youth, but be an example (pattern) for the believers {Then the unbelievers} in speech, in conduct, in love, in faith, and in purity. Till I come, devote yourself to [public and private] reading, to exhortation (preaching and personal appeals), and to teaching and instilling doctrine. Do not neglect the gift which is in you, [that special inward endowment] which was directly imparted to you [by the Holy Spirit] by prophetic utterance when the elders laid their hands upon you [at your ordination]. Practice and cultivate and meditate upon these duties; throw yourself wholly into

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them [as your ministry], so that your progress may be evident to everybody. Look well to yourself [to your own personality] and to [your] teaching; persevere in these things [hold to them], for by so doing you will save both yourself and those who hear you." (AMP) Christ-Like Character and Personality!

God wants every one of us to have a Christ-like character and His personality. It is a responsibility we have as a Christian. It takes commitment and testing, to build His character and personality in us.

You can assess the character/personality of others by what they talk about and how they live their lives. Godly (Christ-like) character is what distinguishes those that serve Christ and those who don't.

Character takes commitment. Christ wants us to be committed to him completely. The following scriptures implore us to live a godly life, because a godly life solidifies our character.

2 Thessalonians 3:6-15; "In the name of the Lord Jesus Christ, we command you, brothers to keep away from every brother who is idle and does not live according to the teaching you received from us. For you yourselves know how you ought to follow our example. We were not idle when we were with you, nor did we eat anyone's food without paying for it. On the contrary, we worked night and day, laboring and toiling so that we would not be a burden to any of you. We did this, not because we do not have the right to such help, but in order to make ourselves a model for you to follow. For even when we were with you, we gave you this rule: "If a man will not work, he shall not eat." We hear that some among you are idle. They are not busy; they are busybodies. Such people we command and urge in the Lord Jesus Christ to settle down and earn the bread they eat. And as for you, brothers, never tire of doing what is right. If anyone does not obey our instruction in this letter, take special note of him. Do not associate with him, in order that he may feel ashamed. Yet do not regard him as an enemy, but warn him as a brother." (NIV) Proverbs 20:27 "The spirit of man [that factor in human personality which proceeds immediately from GOD] is the lamp of the Lord, searching all his innermost parts." (AMP) 1 Timothy 4:16 "Look well to yourself [to your own personality and to [your] teaching; persevere in these things [hold to them], for by so doing you will save both yourself and those who hear you." (AMP) Traits, or characteristic patterns of behavior, are basic in the development of every individual's unique personality. The most serious problem that plagues Christians of all ages and, of all times, is that of the "old" and "new" natures. The two are diametrically opposed to each other, and, every Christian has the two within himself. Paul certainly set forth the conflict quite clearly in Romans 7:11-25 wherein he noted "the good which I would I do not, but the evil which I would not, that I do." It then calls for a constant and consistent application to daily living, of the integration of the traits of life to the center, which is Christ. Only when this takes place can the latent power of the personality be combined with the power of God, to produce a productive usefulness in the Christian life.

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To the body: (To your personal body for a time of spiritual growth, then, the Church, and then, to the rest of the world) The left ventricle pumps oxygen rich blood from the lung, through the arteries to all the organs of the body. In order that every single cell is supplied with the vital oxygen and, all nutrients, the major arteries ramify into increasingly smaller arteries. These branch again into even smaller, called arterioles, and, finally into capillaries, a dense network of tiny vessels.

From these capillaries, oxygen exchange takes place with the cells. The capillaries then transit into the venules, which are the smallest veins. The venules transport the now oxygenpoor, carbon dioxide-rich blood away from the cells, until ultimately the "used" blood reaches the right ventricle, through the vena cava. The blood is now pumped back to the lungs.

Let's look at the spiritual side of this: the blood is leaving the left ventricle to go to the aorta and into the systemic circulation, where the oxygen rich blood is pumped out to all organs of the body, under high pressure/POWER! Acts 1:8 "But ye shall receive power, after that the Holy Ghost is come upon you: and ye shall be witnesses unto me both in Jerusalem, and in all Judaea, and in Samaria, and unto the uttermost part of the earth". (NIV) Matthew 28:18-19 "And Jesus came and spake unto them, saying, All power is given unto me in heaven and in earth. Go ye therefore, and teach all nations, baptizing them in the name of the Father, and of the Son, and of the Holy Ghost:" (NIV) The Bible teaches us that we are one body with many parts. Every body part, down to the single cells within the body, needs the vital oxygen and, all nutrients that can be obtained through the blood of Jesus Christ. Romans 12:4-5 "For as in one physical body we have many parts (organs, members) and all of these parts do not have the same function or use, So we, numerous as we are, are one body in Christ (the Messiah) and individually we are parts one of another [mutually dependent on one another]." (AMP) In the same way, as the new God-given blood flows through us, (through our mind, will, emotions, and our personality/character) then, it wants to flow to every area of our lives. Until the love and God-like-character, which are inside of us, starts to exude from our pores and overflow on to all those around us. Then, systemic circulation, within the Christian heart, would be you and I answering the God given mandate or commission: Matthew 28:18-20 "Jesus approached and, breaking the silence, said to them, All authority (all power of rule) in heaven and on earth has been given to Me. Go then and make disciples of all the nations, baptizing them into the name of the Father and of the Son and of the Holy Spirit, Teaching them to observe everything that I have commanded you, and behold, I am with you all the days (perpetually, uniformly, and on every occasion), to the [very] close and consummation of the age. Amen (so let it be)." (AMP) With this commission, we, as Christians, are to make changes in our lives as God leads us, to do so. Then, start walking out our salvation, in front of others. We have an example to live by from what Apostle Paul wrote to the church in Philippi in Philippians 2:12. "Therefore, my dear ones, as you have always obeyed [my suggestions], so now, not only [with the enthusiasm you would show] in my presence but much more because I am absent, work out (cultivate, carry out to the goal, and fully complete) your own salvation with reverence and awe and trembling (self-distrust, with serious caution, tenderness of conscience,

Preface watchfulness against temptation, timidly shrinking from whatever might offend God and discredit the name of Christ)." (AMP)iv

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Introduction The point of this book is to teach Christian men and women in the field of Emergency Medical Services (EMS) to grow from being a baby in Christ (Carnal Christians) to becoming (Spiritual Christians) the complete and perfect, man or woman of God that He (God Himself) has wanted you and I to become from the beginning of time. Thus becoming the whole person God created them to be (over-comers) through the enabling power of His Holy Spirit.

I want you all to see this Paramedic's view of Christianity, in a way that you and I in EMS can really relate. To do this, I am going to take the stand that we all have just returned to the class room to start taking the hardest Paramedic level review class and exam there is. The thing is this review class will take you and me the rest of our life's to complete.

When I pick up my Bible and read 1 Corinthians 9:24 it states this: Know ye not that they which run in a race run all, but one receiveth the prize? So run, that ye may obtain. But in my paramedic's mind it reads like this: Do you not remember those of us that have earned the right to hold the title as a Paramedic, did we not all start off in a Paramedic class. Did we not all finish that course of study to obtain the cards we have in our pockets, certificates on the wall and patches we wear on our sleeves. But we are to truly study to receive the true certificate of completion which we are to receive at the time when we stand before God and see Jesus face to face.

I became involved with EMS in 1985 in a Rescue/EMS Explorer Post. An Explorers Post is a worksite-based program operated by the Boy Scouts of America that offers young people, boys and girls alike, the opportunity to observe careers in action and prepares them to become caring and responsible adults.

In the fall of 1987, I took my Basic EMT class at night, while completing my senior year in high school. I went to take my state written and practical exam the Saturday morning of my senior prom. After I graduated from high school, I attended a Discipleship Training School (DTS), at Pacific and Asia Christian University (PACU). PACU is now known as the University of the Nations. U of N is the University for Youth With A Mission (YWAM). I returned home after my DTS, and I returned to the classroom for my Emergency Medical Technician Intermediate in 1989. Then, in the fall of 1990, I went back to school again for my Emergency Medical Technician - Paramedic. I completed my Paramedic in the spring of 1992.

I am not only a Paramedic but I am also an ordained minister, with the Jameson Evangelistic Association. I have been in ministry for over twenty years now since 1991, all the while maintaining a full-time job in EMS. My love for helping others to become whole (Spirit, Soul and Body) did not stop with just being a minister. I went on to become a Christian counselor or some call us Christian therapist s. I am a Licensed Belief Therapist (LBT), a Board Certified Belief Therapist (BCBT), a Certified Reentry Crisis Counselor (CRCC) and a Certified Youth Behavioral Advisor (CYBA) through the Therapon Institute.

The Therapon Institute offers Biblical Counselor Certifications and Licenses based upon the exclusive faith-based therapeutic treatment model, Belief Therapy, not solely as an

Introduction

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alternative to traditional treatment and recovery programs, but to help identify life-controlling problems and to process the deep spiritual recovery issues of hurting and healing people.

With that said, I want you the reader to know from the beginning that this is not a book for the unregenerate person (non-Christian). The Bible says in Acts 17:28, "For in Him (in Christ) we live, and move, and have our being." The verse expresses the Biblical position that Dr. Paul Carlin, the founder of Belief Therapy速 calls Positional Truth. A person is either "in Adam" (by nature) or "in Christ" (by faith) (see Romans Chapters 5 and 6). Christ is the source of our life ("we live"), our direction ("we move"), and our identity ("have our being").

Not "our doing," but "our being." Being is more important than doing. We see in 1 John 5:12, "He that has the Son has life; he that has not the Son of God has not life." Understanding your identity in Christ is absolutely essential for your success at living the victorious Christian life.

Then there is, 1 Corinthians 2:4-3:4 4And my language and my message were not set forth in persuasive (enticing and plausible) words of wisdom, but they were in demonstration of the [Holy] Spirit and power [a proof by the Spirit and power of God, operating on me and stirring in the minds of my hearers the most holy emotions and thus persuading them], 5So that your faith might not rest in the wisdom of men (human philosophy), but in the power of God. 6Yet when we are among the full-grown (spiritually mature Christians who are ripe in understanding), we do impart a [higher] wisdom (the knowledge of the divine plan previously hidden); but it is indeed not a wisdom of this present age or of this world nor of the leaders and rulers of this age, who are being brought to nothing and are doomed to pass away. 7But rather what we are setting forth is a wisdom of God once hidden [from the human understanding] and now revealed to us by God--[that wisdom] which God devised and decreed before the ages for our glorification [to lift us into the glory of His presence]. 8None of the rulers of this age or world perceived and recognized and understood this, for if they had, they would never have crucified the Lord of glory. 9But, on the contrary, as the Scripture says, What eye has not seen and ear has not heard and has not entered into the heart of man, [all that] God has prepared (made and keeps ready) for those who love Him [who hold Him in affectionate reverence, promptly obeying Him and gratefully recognizing the benefits He has bestowed]. 10Yet to us God has unveiled and revealed them by and through His Spirit, for the [Holy] Spirit searches diligently, exploring and examining everything, even sounding the profound and bottomless things of God [the divine counsels and things hidden and beyond man's scrutiny]. 11For what person perceives (knows and understands) what passes through a man's thoughts except the man's own spirit within him? Just so no one discerns (comes to know and comprehend) the thoughts of God except the Spirit of God. 12Now we have not received the spirit [that belongs to] the world, but the [Holy] Spirit Who is from God, [given to us] that we might realize and comprehend and appreciate the gifts [of divine favor and blessing so freely and lavishly] bestowed on us by God. 13And we are setting these truths forth in words not taught by human wisdom but taught by the [Holy] Spirit, combining and interpreting spiritual truths with spiritual language [to those who possess the Holy Spirit].

14 But the natural, nonspiritual man does not accept or welcome or admit into his heart the gifts and teachings and revelations of the Spirit of God, for they are folly (meaningless nonsense) to him; and he is incapable of knowing them [of progressively recognizing, understanding, and becoming better acquainted with them] because they are spiritually discerned and estimated and appreciated. 15But the spiritual man tries all things [he examines, investigates, inquires into, questions, and discerns all things], yet is himself to be

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put on trial and judged by no one [he can read the meaning of everything, but no one can properly discern or appraise or get an insight into him]. 16For who has known or understood the mind (the counsels and purposes) of the Lord so as to guide and instruct Him and give Him knowledge? But we have the mind of Christ (the Messiah) and do hold the thoughts (feelings and purposes) of His heart. 1HOWEVER, BRETHREN, I could not talk to you as to spiritual [men], but as to nonspiritual [men of the flesh, in whom the carnal nature predominates], as to mere infants [in the new life] in Christ [unable to talk yet!] 2I fed you with milk, not solid food, for you were not yet strong enough [to be ready for it]; but even yet you are not strong enough [to be ready for it], 3For you are still [unspiritual, having the nature] of the flesh [under the control of ordinary impulses]. For as long as [there are] envying and jealousy and wrangling and factions among you, are you not unspiritual and of the flesh, behaving yourselves after a human standard and like mere (unchanged) men? 4For when one says, I belong to Paul, and another, I belong to Apollos, are you not [proving yourselves] ordinary (unchanged) men? (AMP) I would love for a non-Christian to pick up this book and be able to understand it and come to the point in his or her life and ask Jesus to Rescue them, but let's get real. You will see for yourself as we read what Dr. Jay Adams, states regarding 1 Corinthians 2 - 3:4. "It is just this difference between the regenerate and the unregenerate person that makes all the difference... you must distinguish between those who can understand and effectively apply the Word of God to their lives in order to make those changes that please God and those who cannot...

All counseling that purports to be Christian must bring about change that is pleasing to God. But if unregenerate persons can neither understand nor do things that God requires, it is impossible to counsel them. The important truth for counselors, therefore, is that they should not attempt to counsel non-believers. Since counseling is the instruction and application of truth that enables one to love God and his neighbor (as Jesus summed up the content of Scripture), counselors must reckon with the fact that the love of God (love He gives and accepts) is not "poured into our hearts" until the Spirit of God is (Romans 5:5).

"There is no way the 'natural' person (who is 'in the flesh', not in the Spirit) can make changes that please God. Such changes are part of the sanctifying work of God's Spirit that takes place only in regenerate persons‌ no one can be sanctified until and unless he has first been regenerated and justified. Changes made by unbelievers are displeasing to God, even when formally in accordance with His word, because they are but skin deep.

They do not stem from a heart of love for Jesus Christ. They are hypocritical: outward only. God did not command His church to make hypocrites (those whose outer state does not conform to their inner one). There are enough whitewashed sepulchers, full of death and corruption within. We do not need to manufacture more.

"What then should we do? We should certainly not attempt to do the impossible counsel unbelievers. Instead, we should do what God commanded in the first place: evangelize them! ‌ Because some have misunderstood this important distinction, they have confused two very important matters.

"It is not only a waste of time to attempt to change unbelievers since any change they make is other than the change that God requires, but it is positively harmful to try.

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Because unbelievers who follow your advice and make outward changes receive a small amount of relief, they may think they have the real thing. That is a twofold tragedy. First, they settle for something other than God's way while thinking they have actually pleased Him. This makes it harder for them to realize their need for a Savior. Those who think they are well do not call for the doctor. And secondly, since the change they make is superficial and does not go to the heart of the matter, in six weeks or six months it will fall apart. Then thinking that they have tried God's counsel (even though they didn't), they conclude, 'God's way doesn't work either.' Either way, you have harmed the potential counselee."v When I was studying to become a Belief Therapist, I was taught to always begin at the beginning - so have YOU the reader of this book been born again? Do you have a personal Relationship with Jesus Christ? If not please STOP reading this book now, open and read the bible in the book of John! Then find a local Christian church and ask how you can be saved.

If you are a Christian then YOU just heard your stations tones go off and you are the next unit up for the call. You stop what you are doing; write down the type of call, then write down the address. You then run out to your unit, climb into the driver's seat, start the engine, fasten your seat belt and off you go. The same is true for this call I call the real Christian life.

When I write down the type of call that I am about to respond to, I think about when God told the prophet Habakkuk to write something down. Habakkuk 2:1-4 1[OH, I know, I have been rash to talk out plainly this way to God!] I will [in my thinking] stand upon my post of observation and station myself on the tower or fortress, and will watch to see what He will say within me and what answer I will make [as His mouthpiece] to the perplexities of my complaint against Him.2And the Lord answered me and said, Write the vision and engrave it so plainly upon tablets that everyone who passes may [be able to] read [it easily and quickly] as he hastens by. 3For the vision is yet for an appointed time and it hastens to the end [fulfillment]; it will not deceive or disappoint. Though it tarry, wait [earnestly] for it, because it will surely come; it will not be behindhand on its appointed day. 4Look at the proud; his soul is not straight or right within him, but the [rigidly] just and the [uncompromisingly] righteous man shall live by his faith and in his faithfulness. (AMP) When I write down the address of the call that I am about to respond to, it starts me thinking about the differences in Religion vs. Relationship. Over the years, I have often been called a religious man but you see I can not stand religion. I am a man of relationships. Let us think about and reason together (Isaiah 1:18 "Come now, and let us reason together, saith the LORD: though your sins be as scarlet, they shall be as white as snow; though they be red like crimson, they shall be as wool.") how religion and relationship are defined by Wikipedia.

Religion: is a collection of cultural systems, belief systems and worldviews that establishes symbols that relate humanity to spirituality and moral values. Many religions have narratives, symbols, traditions and sacred histories that are intended to give meaning to life or to explain the origin of life or the universe. They tend to derive morality, ethics, religious laws or a preferred lifestyle from their ideas about the cosmos and human nature.

The word religion is sometimes used interchangeably with faith or belief system, but religion differs from private belief (is the psychological state in which an individual holds a proposition

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or premise to be true) in that it has a public aspect. Most religions have organized behaviors, including clerical hierarchies, a definition of what constitutes adherence or membership, congregations of laity, regular meetings or services for the purposes of veneration of a deity or for prayer, holy places (either natural or architectural), and/or scriptures. The practice of a religion may also include sermons, commemoration of the activities of a god or gods, sacrifices, festivals, feasts, trance, initiations, funerary services, matrimonial services, meditation, music, art, dance, public service, or other aspects of human culture.vi Intimate and Personal Relationship: Intimacy generally refers to the feeling of being in a close personal association and belonging together. It is a familiar and very close affective connection with another as a result of a bond that is formed through knowledge and experience of the other. Genuine intimacy in human relationships requires dialogue, transparency, vulnerability and reciprocity. To sustain intimacy for any length of time requires well-developed emotional and interpersonal awareness. Intimacy requires an ability to be both separate and together participants in an intimate relationship. Lacking the ability to differentiate oneself from the other is a form of symbiosis, a state that is different from intimacy, even if feelings of closeness are similar‌From a center of self knowledge and self differentiation intimate behavior joins family, close friends as well as those with whom one is in love. It evolves through reciprocal self-disclosure and candor.vii Religion vs. Relationship: Religion to me is similar to when I write down the address for a call in a specified subdivision and I drive the ambulance to that subdivision but stop only at the entrance. Am I at the call? NO!! Religion for too long has keep the laity away from the true intimacy available with God. Christianity to me is a real relationship where I can build intimacy with the Great Physician. I like how Jack Frost a Christian Counselor defines intimacy; he says intimacy is, "in-to-me see!" Jesus asks me to see into Him and I am to ask Him to see into me. This is not achieved until I have turned into the subdivision and have driven the ambulance to the actual physical address of the call; call out on scene (10-23). I am then to get out of my ambulance grab the needed medical or trauma equipment, airway kit and cardiac monitor and walk into the residents and take over patient care.

Who would you rather answer the call to help you or your family member in a time of need, those that have religion and only come to the subdivision or those that have an intimate and personal relationship and will come all the way into the house? Christianity is not about religion at all but is all about right relationships and being rightly related to others. God's relationship with Jesus and the Holy Spirit, God's relationship with Man. True Christianity then turns to look at a man's (woman's) relationship with others and to see if they are rightly or wrongly related. The following is a short list of the major areas that we as maturing Christians are to actively work on and maintain Rightly Related Relationships (RRR).

Rightly related to God Rightly related to Self Rightly related to Family Rightly related to Worship Rightly related to the World

Introduction Rightly related to Prayer Rightly related to the Work Place Rightly related to our Patients Rightly related to the Community It is my prayer; that you may receive a fresh revelation of God through what God has given me as a fellow pre-hospital provider. Let's take this ambulance ride together, viewing Christianity and God's Love Letter to this world through from a Paramedic's prospective. . I am excited to reveal what God has reveled to me.

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Chapter 1 A Brief Anatomy and Physiology Lesson The Human Heart as We Know It While you are reading this book, your body is unconsciously performing tasks to keep you alive. Right now while you sit quietly, a myriad of wonderful events are taking place necessary for your survival. Right now your heart is beating. If you're in average physical condition, it beats between 60 and 70 times per minute, 93,000 times per day, 655,000 times per week, 34 million times per year, and 2.4 billion beats in the average lifetime. What's so amazing is that, most of the time, it fuels itself, paces itself, repairs itself, and alters itself in response to lifestyle changes, with no conscious effort on your part.

From a functional viewpoint the heart of man, is a miracle of performance. Through a complex nervous and hormonal feedback regulation system, the heart and circulatory system maintain the exactly correct rate and output to supply the correct blood flow for both the marathoner and the couch potato. The parts of you that are functioning at any particular time receive a share of blood in proportion to their need, and those that are resting quietly receive their carefully metered due.

In addition to your heart, your liver is detoxifying your blood, your brain is storing away information, cells are being formed and cells destroyed, energy is being used and produced, and many other tasks vital to life and function all carry on in a wonderful harmonious way.

Your nervous system too is marvelously complex. It has the ability to communicate the feeling of pain resulting from intense pressure, yet adapts appropriately to the pressure of sitting or standing without distracting neural traffic.

A nervous system just like yours precisely controls the muscles of the concert pianist playing Chopin, the baseball slugger making contact with 98 mph fastball, and the gymnast performing a triple somersault to a precise landing. Thomas Jefferson may have had similar thoughts in mind when he observed, "No knowledge can be more satisfactory to man than that of his own frame, its parts, their functions, and actions." In an earlier era, St. Augustine noted, " Men go abroad to wonder at the height of mountains, at the huge waves of the sea, at the long courses of the rivers, at the vast compass of the oceans, at the circular motion of the stars, and pass by themselves without wondering." viii Did you know that the human heart begins showing rhythmic contractile activity very early in embryological life (between 15 and 21 days after fertilization) and continues this activity until death?

It is a very efficient pump. But at this early age the heart is not yet an effective pumping organ. Within several days after vascular tissue formation, the fluid precursor to blood flow is occurring. This is the beginning of blood flow, the vascular system, and the cardiac pump. In order for the heart to be an effective pumping organ, it must be able to maintain this cyclic fashion and be able to maintain this for as many as 80 to 100 years.ix In the modern medical field there is a name for every area of the body studied and we know that the study of the heart is cardiology. Cardiology (from Greek καρδίᾱ, kardiā, "heart"; and

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from Hebrew ( ) Lebab / ( ) Leb "Inner man, mind, will, heart") is a medical specialty dealing with disorders of the heart. The field includes diagnosis and treatment of congenital heart defects, coronary artery disease, heart failure, valvular heart disease and electrophysiology. Physicians specializing in this field of medicine are called cardiologists.

As the center focus of cardiology, the heart has numerous anatomical features (atria, ventricles, heart valves) and numerous physiological features (systole, heart sounds, afterload) that are of concern. Disorders of the heart lead to heart disease and cardiovascular disease and they lead to a significant number of deaths.

The primary responsibility of the heart is to pump blood around the body. It pumps blood from the body called the systemic circulation through the lungs called the pulmonary circulation and then back out to the body. This means that the heart is connected and affects the entirety of the body. While plenty is known about the healthy heart, the bulk of the study in cardiology is in the disorders of the heart and restoration, where possible, of function.

The heart is a muscle that squeezes blood and functions like a pump. Each part of the heart is susceptible to failure or dysfunction and the heart could be divided into the mechanical and the electrical.

The electrical part of the heart is centered on the periodic contraction (squeezing) of the muscle cells that are caused by the cardiac pacemaker located in the sinoatrial node. The study of the electrical aspects is a subfield of electrophysiology called cardiac electrophysiology and can be seen on the electrocardiogram (EKG). The action potentials generated in the pacemaker continues throughout the heart in a specific pattern and is the system that carries this potential is called the electrical conduction system. Dysfunction of the electrical system manifests in many ways and includes Wolff-Parkinson-White syndrome, ventricular fibrillation, and heart block.

The mechanical part of the heart is centered on the fluidic movement of blood and the functionality of the heart as a pump. The mechanical part is ultimately the purpose of the heart and many of the disorders of the heart disrupt the ability to move blood. Failure to move sufficient blood can result in failure in other organs and may result in death if severe. Heart failure is one condition in which the mechanical properties of the heart have failed or are failing, which means insufficient blood is being circulated.

There exist other disorders of the heart that disrupt both the electrical and the mechanical properties of the heart. A more poignant disorder is that of a myocardial infarction (MI) or heart attack. An MI causes cellular death of the heart which reduces both the electrical and mechanical capabilities of the heart and can lead to death if severe. x As stated above each part of the heart is susceptible to failure or dysfunction and the heart could be divided into the mechanical, electrical and as we will see throughout this book the spiritual.

In 1 Samuel 25 verse 36-38, we read what I believe to be the first ever recorded heart attack.

When Abigail got home she found Nabal presiding over a huge banquet. He was in high spirits—and very, very drunk. So she didn't tell him anything of what she'd done until

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morning. But in the morning, after Nabal had sobered up, she told him the whole story. Right then and there he had a heart attack and fell into a coma. About ten days later GOD finished him off and he died. (MSG) Physiology is the study of life, specifically, how cells, tissues, and organisms function. So, physiology of the human heart is to look at how it works, from the normal blood flow through the heart, to the electrical impulses, that the heart generates itself and, uses to cause the heart muscles to contract. Now, let us take a quick look at how God made our hearts to work physically.xi The heart is a wondrous organ about the size of your fist, weighing in at less than a pound (about 400 grams). Each day, the adult heart beats over 100,000 times, delivering 7500 liters of blood to the tissues of the body. The heart is dynamic, ever sensitive and responsive to mechanical, chemical and electrical stimuli. It continuously fluctuates in rate and force in response to our physiologic and environmental needs.

The heart is not positioned straight up. Rather, it sits on its right border (the base of the septum is pulled to the left) with the right chamber rotated anteriorly. Visualize the patient's right lateral border of the heart being pulled forward. In turn, this would bring the left border of the heart more posterior. Nevertheless, the larger left ventricle occupies the majority of the anterior, lateral and inferior surfaces of the heart.xii

Figure 1.1 Location and Viewsxiii

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The Mechanical Structures of the Heart The mechanical structures of the heart include the heart's layers, chambers, septum, valves, and the major vessels (including the coronary arteries). Each of these structures contributes to the effective ejection of blood - the primary purpose of the heart.

The heart is made up of two types of cells: those that generate or conduct electrical impulses, and those that contract and relax.

Electrical cells have THREE unique characteristics: Automaticity: the cell can generate an electrical impulse without being stimulated Excitability: the cell can change its internal electrical balance to reach threshold Conductivity: the cell can move an electrical impulse to the next cell Throughout this book we will be dealing with a lot of different subject matters from patterns in human behavior to patterns in numbers that we see and use daily. We saw our first number pattern above when we were talking about Automaticity, Excitability and Conductivity which we know as the THREE unique characteristics to the hearts electrical cells.

So what is so special about the number 3? In the physical I see it as the three types of patients we have and they are the STABLE, the UNSTABLE and the DEAD. We have 3 types of treatments available to treat our 3 types of patients, MEDICINE, ELECTRICAL and MECHANICAL (CPR). Then we have 3 types of electrical treatments, synchronized cardioversion, defibrillation, and pacing (TCP). Notice a pattern developing here, everything so far appears to be in three's (3's).

As in the physical, in studying the number three in the Bible we find that the Bible also shows us patterns of the number three. The study of numbers from the Bible is known as Biblical Numerology. It is quite obvious that the Bible uses numbers in patterns. Who can deny that 40 is significant? Jesus was in the desert for 40 days, and the Israelites wandered in the desert for 40 years. I believe the following analysis is accurate and I know of others that would disagree.

E. W. Bullinger states in his book Number in Scripture - Its Supernatural Design and Spiritual Significance, "We can have neither words nor works without "number." The question which we have to answer is - Is number used with design or by chance? Surely if God uses it, it must be with infinite wisdom and with glorious perfection. And so it is. Each number has its own significance; and its meaning is found to be in moral harmony and relation to the subject matter in connection with which it stands. This harmony is always perfect. Every word of God's Book is in its right place."

I also wanted to list a few things that E. W. Bullinger states about the Spiritual Significance of the number 3: The number 3 (Three) is the NUMBER OF DIVINE PERFECTION. The Trinity consists of Father, Son, and Holy Spirit. (Please see Figure 1.3 The Shield of the Trinity and Figure 1.4 The EMS Shield of the Trinity) There are three qualities of the universe: Time, Space, and Matter. To exist (except for God), all three are required. Each quality consists of three

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elements. Therefore, we live in a trinity of trinities. You may ask what a Trinity is. It is a group of three; triad or the state of being threefold or triple.

The three qualities of the universe are each three: Time is one yet three: Past, Present and the Future Space is one yet three: Height, Width and Depth and then Matter is one yet three: Solid, Liquid and Gas 1 Corinthians teaches us that, all of us in this world can be divided into three categories: The natural (who are unregenerate) The spiritual (who are regenerate, and are spiritually mature) The carnal (who are regenerate, but spiritually immature, i.e., "babes in Christ.")

My Human abilities are three: Thought, Word and Deed and God Himself has three attributes: Omniscient, Omnipresent and Omnipotent The three-fold nature of temptation: (1 John 2:16 For all that is in the world--the lust of the flesh [craving for sensual gratification] and the lust of the eyes [greedy longings of the mind] and the pride of life [assurance in one's own resources or in the stability of earthly things]-these do not come from the Father but are from the world [itself]. (AMP)) Man's three great enemies are: The World, the Flesh, and the Devilxiv I know as we progress through this study into the Heart of a Christian, we will revisit this number 3 from time to time. You will see.

Layers Our hearts are made up of three different layers known as the epicardium, myocardium, and endocardium.

The epicardium forms the outer layer of the heart. The myocardium forms the middle layer and the endocardium the innermost layer of the heart. The coronary arteries provide blood to the heart tissues, carrying blood first across the epicardium, then the myocardium and finally terminating in the endocardium.

Here we find that three again, so our hearts are a Trinity. We are most definitely created in the image of the ONE true God who is made up of God the Father, God the Son and God the Holy Spirit. As humans we are a trinity of trinities in our selves, we have a three-fold nature: BODY: Flesh, Bones and Blood SOUL: Emotion, Reason and Volition SPIRIT: Conscience, Intuition and Devotion, with each quality consists of three elements in themselves.

The muscular myocardium is the thickest layer and the workhorse of the heart. It is composed of specialized muscle and electrical cells that are able to conduct an electrical impulse quickly and contract forcefully. The endocardium has a smooth inner surface to allow blood to flow easily through the heart's chambers. The heart's valves are part of the endocardium.

I like to think of it this way; the epicardium forms the outer layer of the heart is God the Father, He is the all encompassing One. The muscular myocardium is JESUS; He is the thickest layer and the workhorse of the God Head. He is the one that became the God man, lived on this earth sinless, suffered under Pontius Pilate, was crucified, dead, and buried; he

Chapter 1 A Brief Anatomy and Physiology Lesson descended into hell; the third day he rose again from the dead; he ascended into heaven, and he sits on the right hand of God the Father; who also prays for us and he is coming to judge the quick and the dead. The endocardium is the Holy Spirit, He has a smooth (gentleman) inner surface that allows the blood shed by Jesus to flow easily through our heart's chambers (Mind, Will, Emotions and Personality). The heart's valves are part of the endocardium and as The Holy Spirit is a perfect gentleman He will stand at those valves knocking and ask for our permission to work on us in a certain area of our heart (Mind, Will, Emotions and Personality) but He will not push past the valves (doors) in our heart that we close off to Him. This is seen in Revelation 3:20 Behold, I stand at the door and knock; if anyone hears and listens to and heeds My voice and opens the door, I will come in to him and will eat with him, and he [will eat] with Me. (AMP)

The Shield of the Trinity or Scutum Fidei (a Latin phrase meaning "Shield of the Faith", taken from the Vulgate of Ephesians verse 6:16) is a traditional Christian visual symbol which expresses many aspects of the doctrine of the Trinity, summarizing the first part of the Athanasian Creed in a compact diagram. The Earliest attested version of the diagram, from a manuscript of Peter of Poitiers' writings, Compendium Historiae in Genealogia Christi 1210.

Figure 1.2 The Shield of the Trinityxv This diagram consists of four nodes (generally circular in shape) interconnected by six links.

The three nodes at the edge of the diagram are labelled with the names of the three persons of the Trinity (traditionally the Latin-language names, or scribal abbreviations thereof): The Father ("PATER"), The Son ("FILIUS"), and The Holy Spirit ("SPIRITUS SANCTUS"). The node in the center of the diagram (within the triangle formed by the other three nodes) is labelled God (Latin "DEUS"), while the three links connecting the center node with the outer nodes are labelled "is" (Latin "EST"), and the three links connecting the outer nodes to each other are labelled "is not" (Latin "NON EST").

The links are non-directional - So the following twelve propositions can be read off the diagram: The Father is God The Son is God The Holy Spirit is God God is the Father God is the Son God is the Holy Spirit

The Father is not the Son The Son is not the Father The Father is not the Holy Spirit The Holy Spirit is not the Father The Son is not the Holy Spirit The Holy Spirit is not the Son

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As seen within The Shield of the Trinity; God is a trinity of persons: the Father, the Son, and the Holy Spirit. The Father is not the same person as the Son; the Son is not the same person as the Holy Spirit; and the Holy Spirit is not the same person as Father. They are not three gods and not three beings. They are three distinct persons; yet, they are all the one God. Each has a will, can speak, can love, etc., and these are demonstrations of personhood. They are in absolute perfect harmony consisting of one substance. They are coeternal, coequal, and copowerful. If any one of the three were removed, there would be no God.xvi I like to explain the Trinity to my fellow EMS personal by using the following diagram. I call it the EMS Shield of Trinity. As you look and study the following you will see that the Trinity is possible.

The heart has three distinct layers; yet, they are all the heart. They each work and are in absolute perfect harmony consisting of one substance. They are coeternal, coequal, and copowerful. If any one of the three were removed, there would be no HEART.

On the EMS Shield of the Trinity, the links are also non-directional - So the following twelve propositions can be read off the diagram: The Epicardium is the Heart The Myocardium is the Heart The Endocardium is the Heart The Heart is the Epicardium The Heart is the Myocardium The Heart is the Endocardium The Epicardium is not the Myocardium The Myocardium is not the Epicardium The Epicardium is not the Endocardium The Endocardium is not the Epicardium The Myocardium is not the Endocardium The Endocardium is not the Myocardium Figure 1.3 The EMS Shield of the Trinityxvii Chambers The chambers of the heart are the main drivers within an intricate pathway, delivering blood to the lungs for gas exchange and enriching the body's cells with oxygen. The contracting and relaxing chambers facilitate varying pressure gradients that drive a resting cardiac output of five litres of blood per minute.

As the ventricles contract, the pressure in the ventricles overcomes the pressure of the aorta or pulmonary arteries, resulting in the valves opening and blood ejection. Similarly, as the ventricles relax and open, the resulting falling pressure created within the ventricles draws blood from the atria. Essentially, blood is sucked into the ventricle. In a healthy heart,

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approximately 65-85% of ventricular blood volume is provided during early diastole. Atrial diastole tops off the remaining 15-35% (atrial kick).

Figure 1.4: Normal blood flow of heart and lungsxviii The heart consists of 4 chambers - 2 atria and 2 ventricles. The smaller atria are about 1/3 the size and volume of the ventricles. The left ventricle is the largest chamber of the heart, with about 3 times more muscle mass than the right ventricle. Both ventricles share a similar volume capacity. Due to the predominant size of the left ventricle, it is not surprising that 70% of all myocardial infarctions occur within the left ventricle.

Let's take a quick look into the hearts 4 chambers as they pertain to the Christian Heart: The Right Atrium (Mind) Recollection, Memory, reasoning, conscious mental events, capabilities, Stores information, organized conscious and unconscious adaptive mental activity, Ego. The Right Ventricle (Will) Choice, Subconscious, Express desire, choice, willingness, consent, decisions made, express determination, insistence, persistence, goals are set. We then have the Left Atrium (Emotions) the affective aspect of consciousness & FEELING Heart Felt. The Left Ventricle (Personality) The complex of characteristics that distinguishes an individual or a nation or group; especially: the totality of an individual's behavioral and emotional characteristics. For more information on this please read the Preface of this book.

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Figure 1.5 The Christian Heart/PVCxix Discussions of the heart often refer to two hearts - a right and a left heart. Structurally, this is due to a thick layer of connective tissue called the septum that separates the left and right heart. Functionally, the right heart pumps deoxygenated blood to the lungs while the left heart pumps oxygenated blood to the body. When either the left or right side of the heart is unable to pump an adequate volume of blood, heart failure ensues that causes both decreased output and a backward volume buildup.

From the Christian perspective there is also two hearts - a right and a left heart. Spiritually, this is due to the fact that the Right Heart (Mind and Will) are dealing with the part of the human heart that only God himself can see. Jeremiah 17:9 - 10 The heart is hopelessly dark and deceitful, a puzzle that no one can figure out. But I, God, search the heart examine the mind {and motives behind the human Will (added by this author)}. I get to the heart of the human. I get to the root of things. I treat them as they really are, not as they pretend to be."

(MSG) As we move on to the Left Heart (Emotions and the Personality) this to me is seeing the individuals patterns of human behavior. Here we are dealing with the outward part of the human heart that is open for all to see. I Timothy 3:15 That thou ought to know how to behave thyself.

The Bible identifies behavioral problems as being rooted in a heart problem. I believe that all Behavioral problems, unless there is a diagnosed physical disorder, are always a

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spiritual problem. The Bible also makes a strong connection between what we believe and what we think.

Your heart is the home of your belief system. Belief (From within your Mind) <produces> Thought (Requesting that you act on these leads us to your Will) <produces> Feelings (Which trigger our Emotions) <produce> Behavior (Personality in action for the Good or Bad) Matthew 15:16-20 states it this way: Jesus replied, "You, too? Are you being willfully stupid?

Don't you know that anything that is swallowed works its way through the intestines and is finally defecated? But what comes out of the mouth gets its start in the heart. It's from the heart that we vomit up evil arguments, murders, adulteries, fornications, thefts, lies, and cussing. That's what pollutes. Eating or not eating certain foods, washing or not washing your hands that's neither here nor there." (MSG) Notice they begin in the heart (our belief system), move to the mind (the cognitive part of man where we think), which triggers the emotions (our feelings) and finally are manifested in our behavior (actions).

Valves Valves act as gates ensuring unidirectional blood flow. They are located between the atria and ventricles as well as between the ventricles and the major arteries. The atrioventricular (AV) valves lie between the atria and the ventricles of the right and left heart. The ventricles eject blood through semilunar valves composed of 3 cusps.

The atria and ventricles are separated by the tricuspid valve (3 leaf ) [Me, Myself and the great I Am] in the right heart and the bicuspid or mitral valve (2 leaf ) [Carnal vs. Spiritual man] in the left heart. Blood ejected from the ventricles pass through the semilunar valves, the pulmonic valve into the pulmonary arteries and the aortic valve into the aorta. Pressure within a ventricle or artery catches the cusps of a valve - like a parachute - closing the valve and preventing back flow.

Coronary Arteries In order to beat over 100,000 times daily, the heart muscle requires a substantial blood and oxygen supply. The coronary arteries distribute the oxygen and nutrients necessary to provide energy to meet the workload demands of the heart. Even at rest, the cardiac cells extract 75% of the oxygen from the coronary arteries to meet energy demands. Essentially, the heart is entirely dependant on increased coronary artery blood flow to meet any increases in cardiac workload.

About 4-5% of the body's blood volume is contained by the heart's arteries and veins. This is a large volume considering that the heart comprises less than 1% of an adult's body mass.

The heart's blood supply is provided mostly as the heart relaxes and dilates during diastole.

This is unique - most organs receive pulsations of new oxygen-rich blood during cardiac systole (contractile phase of the heart).

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The right coronary artery (RCA) sprouts off of the aorta superior to the aortic valve, so the RCA primarily serving the right ventricle and the right atria. In about 50% of the population, the RCA branches early on to form the conus artery to further serve the right side of the heart. The RCA serves the right ventricle, the right atrium, the SA node (50-60% of people) and the AV node (90% of people). Note that the AV node and the Bundle of His are often served by both the RCA and the circumflex artery.

The left main begins at the left border of the aorta opposite the entrance to the RCA. The left main soon splits into 2 arteries: 1) the circumflex wraps around the surface of the left heart; and 2) the left anterior descending artery travels down the anterior surface of the left ventricle. The circumflex also serves the SA node (40-50% of people) and the AV node (10% of people). The coronary veins exit into the right atrium via the coronary sinus. A one-way valve covers the coronary sinus, called the Thebesian valve.

Major Vessels Several major vessels enter and exit the heart. The arteries carry blood away from the heart while the veins bring blood to the heart. While memorizing the major vessels is unnecessary, having a basic picture of the major vessels is clinically important.

The main vessel feeding the right heart is the vena cava. The right atrium also receives venous blood from the coronary sinus, the main venous return of the heart's blood supply.

Approximately 65% of blood volume is normally contained in the venous system. With increased energy demands, blood flow must increase. Sympathetic nervous system stimulation is responsible for the majority of the fluctuations in blood flow during exercise, with vasodilation and vasoconstriction occurring simultaneously to increase blood flow to the vital organs (i.e. brain, muscle).

The right ventricle ejects blood through the main branches of the left and right pulmonary arteries to the lungs. The left atrium receives its oxygen-rich blood supply via four main pulmonary veins. The left ventricle ejects blood into the aortic arch to the body. Within the arch, the coronary arteries branch off first followed by three main arteries that branch to the brain (carotids) and the upper thorax (subclavian artery).xx

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Figure 1.6 Schematic drawing of the Coronary Arteriesxxi

The Cardiac Cycle Late in the 1700s, physiologists realized that an electric stimulus causes muscles to contract.

In the past 200 years, electrophysiologists have continued to uncover many secrets of cardiac electrophysiology. With these discoveries, an in depth understanding of cardiac electrophysiological events has led to insights into dysrhythmia interpretation and treatment.

The heart's electrical system is composed of five significant components: the SA node, the AV node, the Bundle of His, the Bundle Branches, and the Purkinje network. These electrical structures work as a cohesive interdependent team, conducting electrical impulses rapidly throughout the heart. Their location within the heart is depicted in the Figure 1.8 below.

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Figure 1.7 xxii The cardiac cycle is the sequence of events that occurs between the end of one heart contraction and the end of the next.

Mechanical cardiac cycle: Ventricular systole + Ventricular diastole Electrical cardiac cycle: Depolarization + Repolarization Relationship of electrical to mechanical events: Ventricular depolarization triggers systole (Stages of systole 0.23 seconds) and Ventricular repolarization corresponds to diastole (Stages of diastole 0.52 seconds)xxiii The electrical conduction system of the heart is a system of interconnected structures that allow the passage of electrical impulses through the heart muscle. I like to think of the hearts electrical system as that still small voice of the Holy Spirit as He speaks to us in our day to day lives. These electrical impulses are generated in a specific sequence, and are the impulses that generate the wave tracing that comprise the cardiac rhythm strip. This specific sequence gives us the basic foundation by which rhythm strip analysis in conducted.

The sinoatrial node (SA) is the primary pacemaker of the heart. The SA node is located in the upper right atrium and beats at a rate of 60-100 beats per minute. The impulses are then directed through the internodal pathways. These cells direct the impulses from the SA node to the AV node and then conduct them across the muscles of the atrium.

The AV node (or atrioventricular node) comprises a portion of the tissues of the AV junction;

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which includes some surrounding tissue and the bundle of His. The AV node slows down the conduction process, which results in a slight delay before the electrical impulse reaches the ventricles. The AV node has an intrinsic rate of 40-60 beats per minute.

The bundle of His is located at the top of the cardiac wall that separates the ventricles creating the electrical bridge between the atria and the ventricles. Since there are two ventricles, the electrical impulses that cause the contraction must be conveyed to both ventricles. This is where the bundle branches come into play. The bundle of His splits into two separate conduction systems, one for each ventricle called the right and left bundle branches. This allows the electrical impulses to be carried to the ventricles at the same time.

The bundle branches end with the Purkinje system. This system has an intrinsic rate of 2040 beats per minute. This network of fibers transmits electrical impulses through the muscles of the ventricles.

Depolarization The spread of electrical impulses and their conduction across the heart occurs through a process called depolarization. All ions in the body carry an electrical charge. The process of depolarization involves the buildup of ions inside the cell until enough energy is built up to cause the cells to fire a stimulus to the muscle fibers of the heart, which causes the contraction.

As confusing as the terminology may be, a cell in the resting state is polarized, and depolarization occurs at the precise moment of muscle contraction. After depolarization, the muscle cells return to their baseline electrical state and begin the process of recharging all over again. This pattern of depolarization and repolarization is what is seen as wave forms on the EKG but we will get to that in a later chapter.xxiv The SA Node has a rate of intrensic depolarization of 70 to 80 times per minute.

The AV Nodal fibers have an intrinsec rate of about 40 to 60 times per minute And the Purkingie fibers discharge at a rate of 15 to 40 times per minute The SA Node is located in the right atrial wall near the opening for the Superior Vena Cava.

From this position in the heart it releases cyclic depolarizations. Moving through the Atria via cell to cell conduction. This depolarization spreads from near the point of stimulation to adjacent areas. Following this spread of the depolarization through time, it appears similar to a wave on a still pond that is the result of a single small pebble. The wave moves from the point of impact and spreads in all directions equally. This depolarization moves through the atria in a similar fashion. Because the atrial muscle mass is made up of cells of a variety of types and organizational patterns the depolarization wave will move through the atria a little faster in some areas than others. The further the distance traveled by the action potential the longer the time period required to reach the destination.

Due to the large build up of connective tissue that supports the valve structures at the junction of the atria and ventricals this wave of depolarization is effectively prevented from entering the ventricular musculature by conduction through the adjoining muscle mass. This prevents the spread of the SA Node generated action potential from stimulating the superior

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portion of the ventricaular mass. In this manner the ventricles are prevented from contracting from the top down and instead are stimulated to contract from the appex (bottom) up. After the AV node is stimulated and sends the impulse down through the Bundle of His. The AV Node is located at the base of the right atrium near the junction of the four heart chambers.

Connecting the SA and AV nodes are internodal pathways. These "pathways" are a series of purkinjie fibers that take a more direct route between these nodes than the rest of the cardiac cells in the Atrium. It appears that, although these fibers are not a distinct anatomical structure, they do not exist isolated from each other. They do perform an important physiological function. They conduct the depolarization of the SA Node to the AV Node faster than the wave of depolarization as it progresses between these structures through the atrial muscle mass. In this manner the AV Node is assured of receiving the depolarization at a constant time in the cycle rather than relying upon waiting for the depolarization wave to move through the atrial muscle mass.

If the signal is channeled back through the Nodal Pathway by an abnormality (extra fibers) or due to other physiological events, the heart rate is increased and most likely doubled or trippled. This is called an SVT or Supra Ventricular Tackycardia.

As the signal leaves the AV Node it is sent to the Common Bundle, which is also named the Atrioventricular Bundle or the Bundle of His. This bundle of purkinjie fibers leaves the AV Node and progresses down the interventricular septum towards the apex (bottom) of the heart. After a short distance, the bundle splits into right and left branches that eventually spreads to the left and right ventricular cardiac musculature of the heart and to the apex of the heart. Once the bundle branches reach the apex of the heart the individual purkinjie fibers branch out to the ventricular myocardium. There are a great number of fibers in the left bundle branch and this branch is factually slightly faster and stronger than the right branch.

This combined with a larger muscle mass, the left ventricle produces a more powerful contraction.

God Himself intended man and women to always be in right relationships within them selves and with others around them. God created us to be in right relationship with Him, in right relationship with our selves, in right relationship with our families and in right relationship to His Word Jesus and His word the Bible. Then God created within you and me a model to show you and I how important it is to always be in Rightly Related Relationships.

Let me show you what I mean, in the past couple of paragraphs God created structures within our own being that is our heart, which has to maintain a proper Rightly Related Relationship between that of the electrical and that of the mechanical aspects within our hearts at all costs. If any area of this relationship is lost then our hearts will go into heart failure both in the physical and in the spiritual realms. As long as our physical hearts stay in right relationship we will live but the precise moment that this relationship fails then we will start to experience cardiac problems that if left untreated will lead to our deaths.

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Timing of a "heart beat" at 72 beats per minute Each cardiac cycle starts with the depolarization released from the SA Node. Once this depolarization is released it is picked up by the internodal pathways and travels rapidly to the AV Node. The atrial muscle mass begins to contract. This wave of depolarization spreads through the atrial musculature causing them to contract beginning closest to the original point of stimulation. Just as there is a wave of depolarization moving through the Atria, there is also a wave of contraction. Immediately behind the wave of contraction is repolarization and then relaxation. Those myocardial cells which receive the depolarization early will conduct early and will also relax early.

In this way, four types of waves move through the Atria and the Ventricles.

They are:  Depolarization  Contraction  Repolarization  Relaxation It takes about 0.1 seconds for the wave of contraction to move throughout the Atria. It also takes about 0.1 seconds for a wave of relaxation to move through the Atria. From the clock below, it is clear that the Atria contracts for 0.1 seconds and relaxes for 0.1 seconds. The Atria rests for 0.6 seconds. Consider that both relaxation and rest are both passive events, it is easy to see that the Atria works for 0.1 second and rests for 0.7 seconds in an 0.8 second clock.

Now, consider the timing function of these structures. This discussion will be based upon a normal heat beating at a resting rate of 72 per minute with each cycle requiring about 0.8 seconds to complete.

Perform the mathematical conversion: 72 beats per minute = 0.8 seconds per heart beat.

You will now understand where the 0.8 seconds came from.xxv 72 heart beats _____________ 60 seconds

1 heart beat =

_____________ 0.8 seconds

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The Cardiac Clock The 0.8 second clock will have only eight divisions with 0 at the top. 0.2 at the right, 0.4 at the bottom, 0.6 at the left, and also implied, as well as shown is 0.8 at the top. The "cardiac clock" meets the same exact criteria set down for typical clocks but is based upon a different time cycle. Rather than 60 seconds or one minute per cycle, this clock is based upon 0.8 seconds which represents the time for one cardiac contraction cycle at 72 beats per minute.

Figure 1.8 The Cardiac Clockxxvi

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Figure 1.9 One Complete Cardiac Cycle as shown on an EKG (0.8 sec)

Cardiac Output Simply put, cardiac output is the amount of blood ejected by the left ventricle in one minute.

The left ventricle seems to get all the attention perhaps because the body's blood flow and pulse are provided by the left ventricle.

For an adult, an average cardiac output is about 5-8 liters of ejected blood per minute. With strenuous activity, an adult's cardiac output can increase to an amazing 25 liters per minute to satisfy the body's demands for oxygen and nutrients.

Cardiac output is a product of heart rate (beats per minute) and stroke volume. Stroke volume is the amount of blood ejected by the left ventricle with each contraction.

For the heart, low cardiac output may in turn cause ischemia. Cardiac ischemia weakens contractility, further impacting cardiac output. When caring for patients with cardiac ischemia, assess for signs and symptoms of poor cardiac output (shock). Sufficient cardiac output is necessary to sustain life both in the physical and in the spiritual.

Heart Rate Here again God shows you and I that we have to always maintain right relationships.

Generally speaking, your heart rate and cardiac output have a direct relationship with on another. As your heart rate increases, so does your cardiac output. This means a heart rate

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of 100 a minute will almost always result in more blood ejected per minute than a heart rate of 80 a minute.

We all know that when one of our patients has a heart rates of 260 a minute they will be usually showing signs and symptoms of shock, with a corresponding poor cardiac output. In fact, heart rates of more than 150 a minute are often associated with a reduced cardiac output.

What if your patient's heart rate is too slow - say below 50 a minute? We will notice a fall in the patient's cardiac output due to the bradycardiac rhythm. Does the heart have adequate filling time? By all means YES, the ventricles have all the time they need to fill to the brim.

Stroke volume should be good. So the problem is that there isn't a sufficient heart rate, right?

As a general rule, we should always closely monitor patients with rates more than 150 a minute or less than 50 a minute for signs and symptoms of poor cardiac output. Always remembering to treat the patient and not the monitor, and as always exceptions do exist. For example, peak performance athletes have very efficient, larger hearts with higher resting stroke volumes than the average population.

Heart rate is an important factor in any physical assessment, as is collecting a cardiac history. The seriousness of a cardiac rhythm is intimately connected with each.xxvii Stroke Volume While heart rate is an undisputed contributor to cardiac output, stroke volume is the other major player. As heart rates vary to changes in cardiac output demand, so does stroke volume. Stroke volume is the amount of blood ejected with each beat fluctuates with changes in preload, afterload, and catecholamine release.

Preload The blood supply to the ventricle is often referred to as preload. Technically, the definition of preload is the volume or pressure in the ventricle at the end of diastole. Note that atrial kick offers much to preload, especially for those getting older in years (contributing up to 35% of cardiac output). Preload is connected to stroke volume and cardiac output via the FrankStarling law. More preload causes more cardiac fiber stretch and increased contractility. xxviii Afterload The resistance to the ejection of blood by the ventricle is called afterload. The left ventricle, for example, must create sufficient pressures during systole to overcome diastolic arterial pressure and systemic vascular resistance before any blood is ejected. While preload enhances contractility and stroke volume, high pressures in the arterial vessels during ventricular end diastole is inversely related to stroke volume.

And the higher the afterload, the more difficult a job it is for the left ventricle to eject sufficient stroke volumes. Similar to preload, increased afterload causes increased myocardial

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workload, a factor to consider for those with advanced cardiac disease and/or cardiac ischemia.

Afterload is also tied to cardiac hypertrophy. As the resistance to chamber contraction increases, the chamber adapts to this increased workload with the accumulation of increased fibre within the myocardial cells. This makes the cells stronger but also bulks up the cells, ultimately resulting in chamber hypertrophy. Unfortunately, these thicker chamber walls can be associated with additional complications such as decreased contractility, reduced stroke volume, and cardiac dysrhythmias.xxix

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Chapter 2 EKG Waveforms and Lead Placement The EKG is an important tool used for the diagnosis and treatment of various cardiac and other related diseases. The recorded tracing of the EKG waveforms produced by the heart can tell you basic information about a patient's condition.

In order to evaluate a rhythm, you must first understand each component and its normal appearance. When these components differ from the expected norm, a dysrhythmia (or arrhythmia) is indicated. Remember, an abnormal EKG tracing may only be the result of artifact. The tracing must be evaluated for artifact prior to the evaluation of the heart rhythm.xxx EKG Leads In order to record electrical activity, EKGs use leads which measure the difference in electrical potential between either two points on the body (bipolar leads), or a point on the body and a virtual reference point with zero electrical potential located in the center of the heart (unipolar leads).

Standard Limb Leads The most basic EKG leads are the 3 standard limb leads (four lead system), which are bipolar leads which measure the potential difference between the right arm, left arm, and left leg. They are positioned as follows: Lead I - Difference between the left arm and right arm Lead II - Difference between the left leg and right arm Lead III - Difference between the left leg and left arm With a fourth electrode is placed on the right leg to use as ground.xxxi For monitoring purposes with the four lead system, the white electrode is placed just below the clavicle (collarbone) on the right shoulder. When utilized - in leads I and lead II - the white electrode has a negative polarity. In accordance with the American Heart Association (AHA), the end of the electrode cable is labelled "RA" for right arm.

The red electrode, an electrode with positive polarity in lead in leads II and III, is connected below the left pectoral muscle near the apex of the heart. The end of the red electrode cable is usually labelled "LL" for left leg.

The black electrode is connected below the left clavicle near the shoulder. Often labelled "LA" for left arm, the black electrode switches polarity dependent on the lead chosen. With lead I, the black electrode becomes positive (white is always negative). The black electrode assumes a negative polarity in lead III. A fourth electrode usually green is placed on the right leg to use as ground. The end of the green electrode cable is usually labeled "RL" for right leg.

Chapter 2 EKG Waveforms and Lead Placement

Various mnemonics might help ensure correct lead placement. Three examples are:

Salt (white), Pepper (black) Red (red) Right (white), Smoke (black) over fire (red) Whoops (white) Better (black) Run (red) an EKG

Figure 2.1xxxii

Figure 2.2xxxiii

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As can be seen from the diagram above, from the standpoint of electrical vectors, the three standard limb leads form an approximate equilateral triangle (known as Einthoven's triangle).

In Figure 2.3 below depicts the regions viewed by each of the 3 Leads.

Figure 2.3 xxxiv Lead I provides a left lateral view of the heart. Perhaps the lead most often chosen for cardiac monitoring, lead II - an inferior lead - views the apex of the heart. Lead III also provides an inferior view.xxxv

Lead Lead I Lead II Lead III

Views Heart Chambers Lateral Left ventricle and left atrium Inferior Left and right ventricle Inferior Right and left ventricles Table 2.1 xxxvi

Components of an EKG Tracing The EKG is a representation of the electrical events of the cardiac cycle, graphed as a function of time. Each event is marked by a distinctive waveform, the recognition and interpretation of which can lead to a greater understanding of a patient's cardiac physiology and pathology. Pathology that can be identified and studied using EKGs include rhythm disturbances, ischemia and infarction, chamber enlargements, electrolyte abnormalities, and drug toxicities.xxxvii

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As it beats, the heart generates small electrical currents. A recording of this electrical activity is called an "EKG" (electrocardiograph). The terms EKG and EKG mean the same thing. EKG comes from the German language while EKG comes from English. A standard EKG is obtained by placing electrodes on the patient's body in a specific pattern and monitoring the flow of the electrical activity. The test is entirely painless.

By analyzing the exact pattern of the EKG, healthcare professionals can learn a great deal about how the heart is working.xxxviii The electrocardiogram is composed of waves and complexes. Waves and complexes in the normal sinus rhythm are the P wave, PR Interval, PR Segment, QRS Complex, ST Segment, QT Interval and T wave I intend to show that the EKG of the Christian heart will show us a physical tracing of how the Holy Spirit, whom I see as the hearts Electrical Current, speaks to us as the still small voice.

This physical tracing will in turn show us how we the Christian responded to His promptings and leadings as He speaks to us individually to work on designated areas of the hearts.

As in normal sinus rhythm the P wave starts in the right atrium, as well the tracing of the Christian EKG will start in the right atrium too. In the Christian heart as seen in Figure 1.6 The Christian Heart/PVC the right atrium is the Mind, which is where we have our own belief system. Your Belief starts from within your Mind (P Wave), and your beliefs either founded on TRUTH or a Lie produces Thought. That thought will always request that you act on these thoughts which in turn lead us to your Will (PR Segment). Acting on or not acting on your will produces Feelings. This triggers our Emotions (QRS Complex), this emotional response; produces inward and outward Behaviors. I like to think that our Personality (ST Segment), is acting outwardly with our behaviors and our Character (ST Segment), is us acting inwardly with our behaviors.

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Flow of Electrical Current

Table 2.2 xxxix Now starts the "nitty gritty". We are going to follow the heart through it's entire electrical cardiac cycle. Below is the entire cardiac cycle. Nothing is labeled as of yet, just look at it for few moments. Then we will start, step by step. Please refer to Figure 2.4 below.

Figure 2.4 The first phase of the electrical cycle we will examine is the resting phase. The resting phase for all practical purposes can be defined as, "the period of time where electrical activity is absent, the heart and the heart's electrical activity is at rest. See Figure 2.5 below.

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Figure 2.5

Figure 2.5 P Wave The second phase of the electrical cycle is the "firing" (deplorization) of the Sinus Node (SA Node). Think about this for a moment before looking at Figure 2.7 there are "specialized" nerve cells in the heart, the SA Node is one of such specialized cells. The SA Node is commonly referred to as the "Pacemaker" of the heart! When electrical impulses travel through the heart, they do in by two methods, through specialized cells, and through the cardiac cells (muscle tissue). Electrical discharges "travel" much faster through the specialized nerve tissue, as opposed to muscle tissue. The "specialized cells" also very importantly, have the ability to "slow down" an electrical transmission. This next Figure 2.7 demonstrates the electrical by the EKG line and the mechanical by the heart picture.

In normal sinus rhythm, the SA node acts as the pacemaker. The electrical impulse from the SA node spreads over the right and left atria to cause atrial depolarization. The P wave contour is usually smooth, entirely positive and of uniform size. The P wave duration is normally less than 0.12 sec and the amplitude is normally less than 0.25 mV. A negative Pwave can indicate depolarization arising from the AV node.

I believe that the P Wave of the Christian heart shows us our Minds reaction to our own personal belief system. As I stated above your beliefs either founded on TRUTH or a Lie produces Thought. Your thought life will always request that you act on these thoughts which in turn lead us to your Will which I intend to show on the Christian EKG as the PR Interval/Segment.

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A Paramedicâ&#x20AC;&#x2122;s view of Christianity Figure 2.6

Figure 2.6 Look at the EKG line in Figure 2.6. The beginning upslope of the line represents the SA Node discharging. The wavy lines represent Atrial Electrical Discharge and contraction. Although these wavy lines don't go into a 360 degree direction from the SA Node, in reality they do.

Once the SA Node discharges, the electrical impulse travels in a 360 degree pattern. Look at the EKG line again. When you start looking at EKG strips, examine the "P" waves, all "P" waves for that particular patient should resemble each other. If some of them look different, chances are the cardiac cycle is not beginning with the SA Node, but somewhere else in the Atrium!

The PR Interval and or Segment The PR interval is an isoelectric segment seen on the EKG, that is, no wave or deflection is recorded. During the PR segment, the impulse travels from the AV node through the conducting tissue (bundle branches, and Purkinje fibers) towards the ventricles. (Note a wave will be recorded only after the impulses exit the conducting systems and activates the ventricular muscle to give the QRS complex). Most of the delay in the PR segment occurs in the AV node.

The PR interval is the time (in seconds) from the beginning of the P wave (onset of atrial depolarization) to the beginning of the QRS complex (onset of ventricular depolarization). The normal PR interval duration range is from 0.12 sec - 0.20 sec, measured from the initial deflection of the P-wave to the initial deflection of the QRS complex. The PR interval is longer with high vagal tone. A prolonged PR interval can correspond to impaired AV node conduction.

Looking at the Figure 2.7 below, you will see an EKG line and the heart. We will now discuss the next phase, termed...the "PR" interval or segment. Carefully look at the EKG line, after the "P" wave, you will see a very short Isoelectric period. There appears to be no electrical

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activity here. This is the function of the AV Node (Atrial/Ventricular Node). Remember I said "specialized" nerve cells can slow down an electrical transmission, well this is the AV Nodes function. The AV Node normally cause a slight delay, this permits the atrium to pump blood into the ventricles, giving the ventricles time to fill before they contract. The AV Node has a backup function as well, it is termed the "backup Pacemaker" of the heart. If the AV node does not receive enough impulses, generally between 50 and 60 a minute, it will take over the job of the SA Node. This causes the EKG line not to have a "P" wave, this is called a junctional rhythm, because it originates at the av JUNCTION! But let's not get ahead of ourselves here. The AV Node also can block impulse from the atrium and SA Node. This is very important, especially if too many impulses are coming down as seen in atrial fibrillation.

If all the impulses (around 300-600) passed through the AV Node, our ventricular rate would be (around 300-600), how long could our patients tolerate that?

I believe that the PR Segment of the Christian heart shows us a physical tracing of the spiritual journey that our thought life goes through while waiting for a response from the request that was placed in to our wills from our minds. This response will show up in the form of an emotional response as seen in the QRS Complex of the Christian EKG.

Figure 2.7

Figure 2.7

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The QRS Complex In normal sinus rhythm, each P wave is followed by a QRS complex as seen in Figure 2.7 above. The QRS complex represents the time it takes for depolarization of the ventricles.

Activation of the anterioseptal region of the ventricular myocardium corresponds to the negative Q wave. The Q wave is not always present. Activation of the rest of the ventricular muscle from the endocardial surface corresponds to the rest of the QRS wave. The R wave is the point when half of the ventricular myocardium has been depolarized. Activation of the posteriobasal portion of the ventricles give the RS line. The normal QRS duration range is from 0.04 sec to 0.12 sec measured from the initial deflection of the QRS from the isoelectric line to the end of the QRS complex.

Normal ventricular depolarization requires normal function of the right and left bundle branches. A block in either the right or left bundle branch delays depolarization of the ventricles, resulting in a prolonged QRS duration.

I believe that the QRS complex of the Christian heart shows us a physical tracing of the emotional response that has occurred as a direct result of our thoughts wanting our wills to act. This emotional response will occur no matter what we are thinking on, or wanting to do or not do, it is how God created us. Having the right or wrong emotional response will be determined by our actions that will occur after the meeting held in our minds along with our wills. The different emotional response that we have will either produce an inward or an outward Behavior or both as seen in the Christian EKG as the ST segment.

Let's review. The SA Node initiates the cardiac cycle. When the atrium is depolarizing, it transmits the "P" wave to EKG strip. Next the AV Node causes a transmission delay of electrical energy, this permits the ventricles time to fill. The electrical energy then travels down through the Bundle of His and bifurcates into the Right and Left Bundle Branches.

Since the left ventricle does most of the work and is larger, it has an anterior branch, called the anterior fasicle, and a posterior branch, called the posterior fasicle. Remember electrical current travels faster in specialized cells in the Nodes and the Bundle Branches. Remember the SA Node is the Pacemaker of the heart. The AV Node generally slows down the transmission of the signals from the SA Node, however, it has the ability to speed up or generate it's own transmissions. The AV Node is also referred as the backup pacemaker.

Every cell within the heart has the ability to initiate a cardiac cycle by firing. If the cell is in the atrium, the "P" wave will look different from those that are generated by SA Node. If the AV Node initiates the cardiac cycle by firing, the QRS will still be skinny (QRS equal to 0.12 or less, more on this latter), and the "P" wave will be missing or an extremely short "PR" Interval will be present. There is generally "retrograde" conduction, in other words if the AV Node imitates the response the signal will travel back up to the atrium, but the "P" wave will be buried (unable to see it) in the QRS complex. If the SA Node Fails to fire, and the AV Node fails to fire, then a response may be initiated by the ventricle(s) itself. Hint, these type of ventricular initiations will be wide (QRS greater than 0.12), because the path for the signal is

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slower since it is not traveling in the "specialized" cells, but in the cardiac cells. This translates into a wide QRS, because remember the EKG paper moving across is time; well it takes longer to depolarize the ventricles in this manner, so the QRS becomes WIDE. We are going to continue to examine the EKG tracing, focusing for several minutes on the QRS cycle. Remember now, the QRS reflects ventricular contraction, or depolarization.

The "Q" wave is the first downward (negative, more on this latter) deflection in the depolarization of the ventricle. Many times Q waves may be absent. When we discuss latter Myocardial Infarctions, Q waves play a significant role. The first upward deflection of the QRS is called the "R" wave. It may follow the Q wave, if a Q wave is present, or it may be the first wave by it' self. The "S" wave is the first downward deflection that follows an "R" wave.

The terminal portion of the QRS is the "ST" segment. This represents the delay time after depolarization, and waiting for repolarization (charging up). This segment is extremely important when diagnosing Myocardial Infarction! (Sorry that you will not be able to see the color.)

The ST Segment The ST segment represents the period from the end of ventricular depolarization to the beginning of ventricular repolarization. The ST segment lies between the end of the QRS complex and the initial deflection of the T-wave and is normally isoelectric. It is clinically important if elevated or depressed as it can be a sign of ischemia and hyperkalemia.

Although the ST segment is isoelectric, the ventricules are actually contracting. Pumping of blood does begin when ventricular pressure exceeds aortic pressure, causing the semi lunar valves to open. This is normally at the end of the QRS complex and start of ST segment.

I believe that the ST segment of the Christian heart shows us a physical tracing of the inward or of the outward Behaviors or both. These behaviors follow the emotional response that we have had from the meeting held in our heads with our wills. I like to think that our Personality, is acting outwardly with our behaviors and our Character, is us acting inwardly where only God Himself can see.

The QT Interval The QT interval begins at the onset of the QRS complex and to the end of the T wave. It represents the time between the start of ventricular depolarization and the end of ventricular repolarization. It is useful as a measure of the duration of repolarization. The QT interval will vary depending on the heart rate, age and gender. It increases with bradycardia and decreases with tachycardia. Men have shorter QT intervals (0.39 sec) than women (0.41 sec). The QT interval is influenced by electrolyte balance, drugs, and ischemia.

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The T Wave The T wave corresponds to the rapid ventricular repolarization. The wave is normally rounded and positive. The T wave can become inverted, peaked or flattened due to electrolyte imbalance, hyperventilation, CNS disease, ischemia or myocardial infarction.xl The last 1/3 of the "T" wave is a vulnerable area of time. If a ventricular response is initiated here, such as a premature ventricular contraction (PVC), ventricular tachycardia can occur!

The "T" wave is also useful in diagnosing ischemia or myocardial infarction (more on this latter). "U" waves are seldom seen, so we won't spend a lot of time on them. Anything above the isoelectric line is considered POSITIVE, and anything below is considered NEGATIVE. So the "Q" wave is a negative deflection. The "R" wave is a positive deflection. The "S" wave is more positive than negative, but going towards the negative. xli I believe that the T wave of the Christian heart seen or not on the EKG represents the Christian finishing one complete thought process from conception in our Beliefs to the execution of our wills seen through our inward or outward Behaviors or both; to staying stuck on the previous thought or starting the next thought a coming back to the baseline of our thought process.

Always remembering what the Bible has to say in 2 Corinthians 10:3-5, let's look at these verses from the following three translations. I love the different wordings and hope you are blessed as I am every time that I read them.

The Message: 2 Corinthians 10:3-5 The world is unprincipled. It's dog-eat-dog out there! The world doesn't fight fair. But we don't live or fight our battles that wayâ&#x20AC;&#x201D;never have and never will. The tools of our trade aren't for marketing or manipulation, but they are for demolishing that entire massively corrupt culture. We use our powerful God-tools for smashing warped philosophies, tearing down barriers erected against the truth of God, fitting every loose thought and emotion and impulse into the structure of life shaped by Christ. Our tools are ready at hand for clearing the ground of every obstruction and building lives of obedience into maturity. (MSG) New Living Translation: 2 Corinthians 10:3-5 3 We are human, but we don't wage war as humans do. 4We use God's mighty weapons, not worldly weapons, to knock down the strongholds of human reasoning and to destroy false arguments. 5 We destroy every proud obstacle that keeps people from knowing God. We capture their rebellious thoughts and teach them to obey Christ. (NLT) The Amplified Bible: 2 Corinthians 10:3-5 3 For though we walk (live) in the flesh, we are not carrying on our warfare according to the flesh and using mere human weapons. 4 For the weapons of our warfare are not physical [weapons of flesh and blood], but they are mighty before God for the overthrow and destruction of strongholds, 5 [Inasmuch as we] refute arguments and theories and reasonings and every proud and lofty thing that sets itself up against the [true] knowledge of God; and we lead every thought and purpose away captive into the obedience of Christ (the Messiah, the Anointed One), (AMP)

Chapter 2 EKG Waveforms and Lead Placement Table 2.3 below shows the electrical activity i.e. the leading of The Holy Spirits as He prompts the Christian to listen to His still small voice and respond appropriately to His leadings. As I will show, in the following chapters this too can be traced in the form of an EKG.

Table 2.3 xlii I believe that the Christian HEART (Thought Process: Mind, Will, Emotional response and seen in our Personality) can be traced as an EKG. This EKG represents the Christian's thought process from conception in our Beliefs to the execution of our wills seen through our inward or outward Behaviors or both; to staying stuck on the previous thought or starting the next thought, then to a coming back to the baseline of our thought process to start it all over again.

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Chapter 3 Interpretation of the Lead II EKG Steps in Interpreting the Lead II EKG After you obtain an EKG on your patient, what do you do then? There is a sequence of steps that is helpful to follow known as a systematic approach to reading an EKG.

We are going to use the five step method to Interpreting the lead II EKG 1. Rhythm (regularity) 2. Rate 3. P wave configuration 4. PR interval 5. QRS duration and configuration

Step 1: Determining the EKG Rhythm or Regularity Is The QRS Pattern Regular or Irregular?

Determining the rhythm involves evaluating the pattern of how the atria and ventricles contract. The rhythm can occur in regular or irregular intervals. Each chamber of the heart is assessed for its type of pattern. There are many mechanisms that cause an irregular rhythm, but for now, we will focus on just a few.

1. Pauses 2. Missed beats 3. Extra beats First let's look at a nice regular rhythm. Look below at Figure 3.1.

Figure 3.1

Figure 3.1 See how nice and regular this rhythm is? Each spike (QRS, more on this latter) is nice and even. Each spike is right on time, if you have the time and patience, measure each one out, or just take my word for it, that it's regular. Note: the illustration here is regularity, I don't expect you to know this is normal sinus rhythm, just recognize that it is nice and regular! Now look at Figure 3.2.

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Figure 3.2 Now for the most part this rhythm is regular, except for the distance between the number 4 spike (QRS), and number 5 spike (QRS). This makes this rhythm IRREGULAR!xliii The P-P wave interval should be evaluated first. The caliper interval is established when the first point of the caliper is placed on the beginning of one P wave and the second point on the beginning of the next P wave. Measuring several of these intervals determines if the P waves are occurring in a regular sequence. At least 10 seconds of the EKG tracing of P waves are measured to determine if the P waves occur in a regular or irregular rhythm throughout the rhythm strip.

Next, determine the rhythm of the QRS complex. Since the QRS complex is a configuration of three possible waveforms, it is important to analyze this interval from the same waveform in each of the QRS complexes. For example, it is often easier to see the R wave of the QRS complex. Measuring the R-R wave interval is easy due to its upward deflection, see Figure 3.3 below. Occasionally, the QRS complex does not exhibit an R wave, in which case you can use the point of the Q and S wave junction as an easy point of evaluation. Most importantly, you must measure the same part of the waveform for each QRS complex to determine the regularity of the ventricular depolarization. The first point of the caliper should be placed on the first QRS complex and the other point placed on the next QRS complex.

The interval should be evaluated throughout at least a 6-second strip to determine the rhythm of the QRS complexes.

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Figure 3.3xliv Regular rhythms can almost always be quickly identified with just 2 steps. #1 (Is the QRS narrow or wide?) and #2 (Check the P waves). Simple, basic and fast. These rhythms would include sinus rhythms, atrial rhythms, junctional rhythms and ventricular rhythms of varying rates. The irregular rhythms - those with pauses, extra beats or have a chaotic pattern - often demand closer inspection.

Checking for a regular rhythm pattern simply involves determining whether the R-R interval is consistent. This often can be accomplished with a quick visual snapshot of the rhythm. Are the QRS complexes evenly spaced?

Irregular rhythms should be printed on a rhythm strip of six seconds or longer. First, try to identify any periods of regularity. While the rhythm as a whole may be irregular, segments may be regular. These regular periods are often referred to as the underlying rhythm. Apply the five-step method to the underlying rhythm first. When naming a rhythm, the underlying rhythm is identified before any irregular rhythm components.

Next study the segments of the rhythm that stand out as different. This may be early beats, periods where QRS complexes are absent or other inconsistencies. Apply the 5-step method to these segments.

An example may help clarify this process. In Figure 3.4, the rhythm as a whole is not regular.

The underlying rhythm begins and ends this rhythm. First apply the 5-step to the underlying rhythm. The rate is somewhere around 75-100 a minute. The QRS complex is narrow. The

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impulse originates above the ventricles. Where? The P waves are upright, a sign of a sinus focus. The underlying rhythm is a sinus rhythm.

Figure 3.4 A Rhythm Strip with an Irregular Pattern The faster segment in the middle of this six second strip requires a second pass of the five step method. The rate is fast at about 240 a minute. The QRS complexes are wide with no visible P waves. This is most likely a run of ventricular tachycardia.

An interpretation of this rhythm begins with the underlying rhythm followed by a description of any remaining rhythm features. You would call this rhythm seen in Figure 3.4 a sinus rhythm with a run of ventricular tachycardia.

Occasionally, the entire rhythm is chaotic, devoid of any pattern. This chaotic nature is typical of atrial fibrillation and ventricular fibrillation. Use the four step method to determine where the impulse initiates. At this point, a differential of possible rhythms is useful. An even closer inspection of the rhythm is often required. xlv

Step 2: Determining the Atrial and Ventricular Rate Heart Rate and Pulse Rate As we start to assess our patient's heart rates we have to first think about heart rate verses pulse rate. Heart rate is the number of QRS complexes - the number of ventricular depolarizations - present in a minute. Heart rate is not always the same as pulse. Heart rate is a measurement of electrical activity while pulse ensures the perfusion of the blood to the target tissues.

Many have been caught depending on the cardiac monitor for vital information such as heart rate. For example, patients with electronic pacemakers may display heart rates twice the pulse rate. This occurs because the QRS complex produced after the pacer spike also may count as a separate QRS complex, thus doubling the heart rate.

Another example of a serious disparity between heart rate and pulse occurs with premature ventricular complexes (called PVCs). The PVCs come early and cause short filling times. It follows then that the ventricles stretch minimally and subsequently contract ineffectively. The outcome: many PVCs fail to produce a perfusing pulse and the peripheral pulse is less than the heart rate displayed by the cardiac monitor (which includes both normal QRS complexes and PVC complexes).

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Heart rate is virtually always provided on the screen of a cardiac monitor. This number may offer some value but taking a patient's pulse is always good practice. Don't get burned. Never forget we are treating patients, not just EKG rhythms.

TREAT THE PATIENT - not the monitor - This is the gold standard.

This cannot be said enough. Most of us have been caught at one time or another relying on the cardiac monitor to the exclusion and great risk of the patient.xlvi As a general rule, a patient with a heart rate that is too fast (>150 a minute - not enough filling time) or too slow (< 50 a minute - not enough rate) requires urgent assessment for signs and symptoms of low / poor cardiac output (shock).

Of course, assessing for poor cardiac output only after heart rates are less than 50 a minute or over 150/minute is overly rigid. Exceptions exist. If the patient has a history of cardiac illness i.e. coronary artery disease, myocardial infarction(s) or heart failure, expect lower stroke volumes that might require faster heart rates (60 a minute or more) to produce an acceptable cardiac output.

Poor cardiac output can also occur with tachycardia at rates less than 150/minute. A diseased heart is often less compliant (more rigid), making it more dependent on sufficient preload and filling time to produce an effective stroke volume. As a result, fast rates of even 130/minute may be associated with inadequate filling times and poor cardiac output. The more significant the cardiac history, the narrower the optimal heart rate range.xlvii Low cardiac output is associated with signs and symptoms of shock: hypotension, shortness of breath, deteriorating level of consciousness, pale color, cool extremities, and possibly cardiac ischemia. Signs and symptoms of shock require a rapid response that may include slowing rapid heart rates or speeding up heart rates that are too slow.

We are about to see that number three again. When it comes to cardiac emergencies we all treat 3 types of patients on a daily basis. They are the DEAD patient, the UNSTABLE patient and the STABLE patient. Then as we turn to see what the Bible has to say about mankind we find that Paul in the book of 1 Corinthians teaches us that, all of us in this world can be divided into 3 categories. They are the NATURAL man, the CARNAL man, and the SPIRITUAL man.

Now, let us look at each of these, I want to start with the spiritual man seen as our stable patient, then on to the carnal man as our unstable patient, and then the natural man who is our dead patient.

The Stable Patient: These patients generally may or may not have an EKG rhythm that may or may no be desirable. However, their vitals signs are stable; they have no complaints such as, shortness of breath, chest pain or confusion. The major problem here is...if we leave the underlining problem causing us to see our patient today, the patient's heart rhythm just might become

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unstable! We generally use the conservative approach in stable patients first. MEDICINE! Examples: If our patients had an EKG rhythm of Supraventricular Tachycardia (SVT) and they were stable, we would try the medicine Adenosine I.V. first.

The Spiritual Man: "But he that is spiritual judgeth all things, yet he himself is judged of no man. For who hath known the mind of the Lord, that he may instruct him? But we have the mind of Christ" 1 Corinthians 2:15-16.

The spiritual man is a person who is regenerated, is spiritually mature, one who has and is continuing to crucify the lusts of their flesh, the lusts of their eyes, and the pride of their life the Self-life. Self (carnality) will never take one step after Jesus. But when self is denied, if we take up the cross, the old, sinful, Adamic nature will be slain out of us by the Word, by the Spirit, by the blood of Jesus, and we shall come to the mind of Christ. Again, this is a process. There are three dominant characteristics of the spiritual man which are: 1) he has the mind of Christ, 2) he has the fruits of the Spirit, and 3) he is led by the Spirit.xlviii We will discuss this in more detail in a later chapter.

The Unstable Patient: These patients also have an EKG rhythm that is undesirable. Their vital signs are unstable!

They may have a low blood pressure or complain of shortness of breath, chest pain or be confused. The major problem here is...if we leave the rhythm untreated the patient may become dead. We generally use a more aggressive approach in unstable patients first!

ELECTRICAL! The form of electrical treatment an unstable patient receives depends on one thing! Our goal, "do we want to slow down and convert this rhythm, or do we want to speed it up?" If the rhythm is too fast, our goal is to slow it down and convert it, we would use synchronized cardioversion. If our rhythm is too slow our goal is to speed it up, we would use external transcutaneous pacing or TCP. Examples: If our patient had an EKG rhythm of Supraventricular Tachycardia and they were unstable, we would do a synchronized cardioversion to slow it down. If our patient has a second or third degree heart block with a slow rhythm and were unstable, we would use TCP. After we try electrical first, our second treatment option is medicine in unstable patients. Think electrical first in unstable, then medications next. "Does this mean that if the code bag is still in the cabinet on the truck, I should wait to give electrical first if I have medication closer?" NO! It means your very first thought is electrical, having someone get it, and set it up. It most instances you can try medication, AS LONG AS IT DOES NOT INTERFERE WITH YOUR FIRST ACTION WHICH IS ELECTRICAL! What's the rational? Remember your patient is unstable; they have a high likelihood to become DEAD. Electrical is the method of treatment first in unstable!

The Carnal Man: The carnal man is a person that is regenerate, but spiritually immature, i.e., babes in their Christian faith and in their Christian life. "And I, brethren, could not speak unto you as unto spiritual, but as unto carnal, even as unto babes in Christ" 1 Corinthians 3:1.

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We notice immediately that there are two distinct kinds of Christians: the carnal Christian and the spiritual Christian. This is taught throughout the New Testament in the Gospels, such as the parable of the ten virgins (Matt. 25:1-13) and in many passages of the Epistles. Both the carnal Christian and the spiritual Christian have been born of the Spirit, yet they are worlds apart. The expression, "carnal Christian," may justly be coined out of 1 Corinthians 3:1 because here Paul addresses the Corinthian Christians as "carnal." He speaks to these Christians, saying, "And I, brethren, could not speak unto you as unto spiritual, but as unto carnal, even as unto babes in Christ."

A carnal Christian is as a babe in Christ, however, one who is not a fresh babe that brings joy, but a babe that has been a babe too long. And so, a state of babe-hood has turned into a tragedy, into disgrace, into a burden of the church.

They are the one who does not grow, mature, or develop. They have no accomplishments but that they are born. They cannot walk, cannot talk, cannot understand nor follow instructions, they cannot help, cannot serve, cannot lift the burdens of others, they cannot fight their own battles; they cannot even clean or feed themselves nor pull themselves up.xlix The DEAD Patient: These patients also have an EKG rhythm that is undesirable. Their vital signs are absent!

They have no pulse! Your first thought for intervention is ELECTRICAL! Next since these patients have no pulse and are not breathing, is CPR MECHANICAL. The last intervention in order is MEDICINE. Remember here, "all dead people get epinephrine, the deader they are, the more epinephrine they get!" Again let's back up for a moment. Notice I said your first thought is ELECTRICAL. Why thought, instead of action? Well the code bag may not be readily available to your patient. You should always do CPR MECHANICAL / action until electrical is available in dead patients. But, burn this in your brain, your best intervention for saving this patient's life if they are dead, is electrical. If electrical intervention is at your hands length, don't waste time, use electrical first! American Heart studies show that the sooner electrical intervention is introduced into your dead patient's treatment regime, the better the outcome for survival! The longer electrical is withheld, or not available to your patient, the less likely the outcome will be favorable. Your second intervention is CPR. Think of CPR as your bridge and time-buyer. Good CPR keeps the vital organs perfused until you're electrical and drugs can do their job. Always make good CPR a priority, always check pulses with CPR and always assess ventilation!

The Natural Man is known as a DEAD man walking: "But the natural man receiveth not the things of the Spirit of God: for they are foolishness unto him: neither can he know them, because they are spiritually discerned." 1 Corinthians 2:14.

The natural man is dead to the spiritual world; he is a man who lives according to the human sin nature. He is governed by his intellect and by his natural affections. The natural man has never experienced the being rescued through Jesus Christ. They have not experienced the rebirth - they are unconverted and they are unregenerate. The natural man is asleep to

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spiritual things. He cannot understand spiritual things, and spiritual things are foolishness to them because they cannot process them in a rational manner.l Your first thought for intervention in the dead patient is ELECTRICAL I see this as the Holy Spirit wanting to lead us to repentance!

The second form of intervention for these patients that have no pulse and are not breathing is MECHANICAL known as CPR. I see this as you and I having to personally respond to the Holy Spirits drawings and Repent and Turn to God asking Jesus to become our Savior and Lord. Repentance means that you make a choice to turn 180 degrees and follow Christ and walk out your salvation.

The last intervention in order is MEDICINE, I see this as you and I after we become Christians starting to read and study the Bible. The Bible is God's Gos-pill for you and I to take daily into our lives. We will discuss this in detail in the next chapter.

The new 2010 AHA guidelines NO longer the use A-B-C first but now it is C-A-B. October 2010, Chest compressions should be the first step in addressing cardiac arrest. Therefore, the American Heart Association (AHA) now recommends that the A-B-Cs (Airway-BreathingCompressions) of cardiopulmonary resuscitation (CPR) be changed to C-A-B (Compressions-Airway-Breathing) with the rate of chest compressions at least 100 per minute. The changes were documented in the 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.li What type of electrical do we use in dead patients? Well of course that depends on the rhythms. Too fast, like ventricular tachycardia, or ventricular fibrillation we defibrillate. Absent, as in asystole we pace with a TCP. Also another condition is Pulseless Electrical Activity, or PEA. For those of us that are dinosaurs in EMS we know this as EMD (Electromechanical Dissociation) for years before it became PEA. This is a condition where you have some electrical activity but not mechanical activity. In other words, the heart is not contracting, giving you a pulse. PEA is really not a rhythm, but a condition. You can have a normal sinus rhythm, but if there is no pulse, the condition is PEA. If you have a patient with the condition of PEA, and the rhythm is a slow wide ventricular rhythm, you may want to try TCP. Remember, try it early on and don't wait if you are going to try it, do it right away! Then look for and treat your H's and T's.

H's and T's The H's and T's is a mnemonic used to help recall the major contributing factors and potentially reversible causes to pusleless arrest including PEA, Asystole, Ventricular Fibrillation, and Ventricular Tachycardia. These H's and T's will most commonly be associated with PEA, but they will help direct your search for underlying causes to any arrhythmias.

To the Christian, the H's and T's is a mnemonic used to remind each of us to look for any and all of the HINDRANCES and TEMPTATIONS we have allowed in our lives to go unchecked.

Leaving these H's and T's to go unchecked leads to spiritual arrhythmias which I see as a

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breakdown in our daily prayer life, spiritual growth and our personal relationships with God the Father, Jesus or the Holy Spirit.

The H's include: Hypovolemia, Hypoxia, Hydrogenion (acidosis), Hyper-/hypokalemia, Hypoglycemia, Hypothermia.

The Christian H's include: (There are many more Hindrances to our personal Spiritual growth then I have listed here, we will talk about these listed and more in a later chapter in detail.)

From WITHIN yourself: Spiritual Fatigue, Forgetfulness, Neglect, Dullness of Hearing, Lack of Endurance, Pride, Selfishness, Self-reliance, Sinfulness, Frustration, Shame, Lies (from Satan) that we believe, Distorted View of God and Distorted View of Self and NOT taking personal responsibility for your action.

From things OUTSIDE yourself: Prevalence of Lawlessness, Commands & Doctrines of Men, Stumbling blocks Laid by Others, Cultural Pressure, Materialism/Consumerism, Abuse (physical, sexual, spiritual, verbal) Satanic hindrances and Childhood wounds.

Personal DISTRACTIONS: Busyness, Laziness and Addictions.

The T's include: Tablets / Toxins (Overdose), Tamponade (cardiac),Tension pneumothorax, Thrombosis (coronary and pulmonary), and Trauma.

The Christian T's include: (Temptations you and I all face) We all have our own temptations we must face. The only people that don't have temptations are the ones that are physically dead. We all have personal desires, which mean that we can all be tempted. Let me share some examples: Sexual Desire not kept within the bonds of a Godly marriage. Then there is cheating others out of something to get ahead in this life. Lying to others to make yourself seem better than what you really are. Stealing something that is not you're own and the list goes on and onâ&#x20AC;Ś Temptations will always be a part of this life and they will always start first as a desire in your heart. We all remember that your heart is the home of your belief system. So the Temptation starts off as a Belief within your Mind. This produces a Thought that requests that you act on this Temptation which leads us to your Will. At this point you have not sinned but this produces you're Feelings. Now that your feelings are involved they will trigger our Emotions to response. At this point you still have not sinned with this temptation. Your emotions will produce a Behavior and this behavior will either be pleasing to God or you and I will chose to Willfully SIN against God with this temptation. This action of turning to or from God starts to produce our personalities for or against God.

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You might ask what SIN is? I like what John Wesley's mother once wrote to him. She said: "Take this rule: whatever weakens your reason, impairs the tenderness of your conscience, obscures your sense of God, or takes off your relish of spiritual things; in short, whatever increases the strength and authority of your body over your mind, that thing is sin to you, however innocent it may be in itself." Susanna Wesley (Letter, June 8, 1725)lii Easton's Illustrated Dictionary states that the moral character of a man's actions is determined by the moral state of his heart. The disposition to sin or the habit of the soul that leads to the sinful act is itself also sin.

Rev. R. A. Torrey says: "There are many things which are not sinful in the ordinary understanding of the word sin, but which HINDER spiritualityâ&#x20AC;Ś The gratification of the flesh and the fullness of the Spirit do not go hand in hand. "The flesh lusteth against the Spirit, and the Spirit against the flesh: and these two are contrary the one to the other." Galatians 5:17.

We live in a day when the TEMPTATION of the indulgence of the flesh is very great."liii The effect of the different Hindrances and Temptations that we face daily will be seen in your HEART (Mind, Will, Emotions and Personality). If we give into the Hindrances and Temptations they will lead us to sin. Once you or I give into the hindrances or temptations we will have allowed ourselves to sin and this always lead to a spiritual Heart condition that will lead to a spiritual Heart attack if not changed.

The good news is found in 1 Corinthians 10:13 13For no temptation (no trial regarded as enticing to sin), [no matter how it comes or where it leads] has overtaken you and laid hold on you that is not common to man [that is, no temptation or trial has come to you that is beyond human resistance and that is not adjusted and adapted and belonging to human experience, and such as man can bear]. But God is faithful [to His Word and to His compassionate nature], and He [can be trusted] not to let you be tempted and tried and assayed beyond your ability and strength of resistance and power to endure, but with the temptation He will [always] also provide the way out (the means of escape to a landing place), that you may be capable and strong and powerful to bear up under it patiently. (AMP) THREE BASIC RHYTHMS Of course you need to know more than three basic rhythms, but I will teach rhythms in 3 categories. This sets the correct course for one of your three types of patients, stable, unstable, and dead mentioned in the pages prior. By recognizing what type of patient you have, this will decide your treatment choices, medicine, electrical, and mechanical.

Quickly recognizing an excessively fast or slow heart rate is vital. These extreme rates can lead to an inadequate cardiac output that requires urgent treatment. While rhythm interpretation is important, treatment for extreme unstable rates generally does not require knowledge of where the impulse originated. You remember what you were thought: Cardiac Output = Heart Rate x Stroke Volume

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But first before we get to the three basic rhythms, let us take a quick look at the rhythm that sets the standard against which all other rhythms are compared. That rhythm is known as Normal Sinus rhythm.

NORMAL SINUS RHYTHM

Figure 3.5liv Normal sinus rhythm is the rhythm of a healthy normal heart, where the sinus node triggers the cardiac activation. The sinus rhythm is normal if its frequency is between 60 and 100/min.

Known as Sinus rhythm, this rhythm is reflective of a normally functioning conduction system.

The electrical current is following the normal conduction pathway without interference from other bodily systems or disease processes.lv Sinus rhythm is the desired rhythm. Patients with this rhythm should have normal cardiac output. Normal cardiac output means that the heart is beating adequately, pumping blood to the body's organs to maintain normal function. Signs and symptoms of adequate cardiac output include an alert and oriented patient with no difficulty breathing, no chest pain or pressure, and a stable blood pressure. Because this is a normal rhythm, no intervention is necessary.lvi This now brings us to the standard that God requires in and for our lives as we grow from the Carnal (babies in Christ) into the Spiritual (mature) Christians that Gods wants us to become In Him, For Him and Through Him. Just as Normal Sinus Rhythm is the standard that we use to look at all other cardiac rhythms', the instrument that God uses to measure if we are meeting His standards is the Plumb Line.

We see in the book of Amos 7:7-8 7 Then he showed me another vision. I saw the Lord standing beside a wall that had been built using a plumb line. He was using a plumb line to see if it was still straight. 8 And the LORD said to me, "Amos, what do you see?" I answered, "A plumb line." And the Lord replied, "I will test my people with this plumb line. I will no longer ignore all their sins. (NLT) God here is speaking to His followers, to His children, to the Christian "I will test my people."

With what is God personally going to test our lives with? He stated that he was going to test each of us "with this plumb line" A plumb line is a simple tool used to determine whether or not something is perfectly vertical and upright. The Bible is a Christian's "Plumb Line" to which we align our lives. This plumb line that we are to align our lives to is the WHOLE (unadulterated) BIBLE from the front cover to the back cover.

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God goes on to say that "I will no longer ignore all their sins." You see when I asked Jesus to become my Savior the Bible teaches that God gives me a new heart. This is seen in Ezekiel 11:19 And I will give them one heart [a new heart] and I will put a new spirit within them; and I will take the stony [unnaturally hardened] heart out of their flesh, and will give them a heart of flesh [sensitive and responsive to the touch of their God] (AMP) My new heart us made to be sensitive and responsive to the touch of God and the leading by the indwelling Holy Spirit. I am now to respond to the still small voice and leading of the Holy Spirit. I am to walk out my salvation with the Fear of the Lord which is to hate sin as much as He does and do all as if I am doing the task for Jesus Himself.

I then turn over to 2 Corinthians 3:3 You show and make obvious that you are a letter from Christ delivered by us, not written with ink but with [the] Spirit of [the] living God, not on tablets of stone but on tablets of human hearts. (AMP) Chris' version of this verse is, You oh God show yourself to me and want me to show YOU to others and make it obvious and plain as day, that you have made me to be Your LOVE letter to be shared with everyone and delivered by me through the way I live my live, not written in ink on paper but to be walked out in my daily life in the way I Think, the choices I make with my Will, the Emotions that I display to others and with the actions that I do as shown in my Personality and Character.

This idea of a Christian suffering from spiritual angina or spiritual Ischemia, injury or even Infarction (heart attack) comes from a thought to action process known as, The Continuum of Sin. Thoughts, it always starts out as a thought (you think about doing it). My thoughts will lead me to a Choice, I then choose to do it (a little won't hurt right, if it feels good do it). I do it and it now becomes a habit; it feels good so I'm going to do it all the time. At this point I have allowed this habit to start controlling my life, I have now lost control. It's not really feeling so great anymore but for some reason I am still choosing to do it and that brings me into bondage. It no longer feels good at all anymore but it feels impossible for me to stop doing it now. This all started with one single thought, that I personally choose to act on it became a sin that I did again and again, which became a habit where I lost control in this area of my life and now that sin has total control over me. The act of willfully sinning if left unrepeated will lead to that sin having total control of you. We all sin, and we all make bad choices, none of us will ever be perfect in this world of the flesh.

God also states in Galatians 6:6-9 7 Don't be misledâ&#x20AC;&#x201D;you cannot mock the justice of God. You will always harvest what you plant. 8 Those who live only to satisfy their own sinful nature will harvest decay and death from that sinful nature. But those who live to please the Spirit will harvest everlasting life from the Spirit. 9 So let's not get tired of doing what is good. At just the right time we will reap a harvest of blessing if we don't give up. (NLT) Here in verse 8 "Those who live only to satisfy their own sinful nature will harvest decay and death from that sinful nature;" I see this, as the idea that a Christian who lives to satisfy their Carnality will eventually lead them to suffering from spiritual angina, Ischemia, Injury or even Infarction but more on this later. Let's get back to those three rhythms shall we.

TOO FAST First rhythm is TOO FAST! Heart rates over 150/minute are often associated with an inadequate filling time for older patients and for those with a significant cardiac history. As a

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result, stroke volumes tend to be poor. Even though the rate is high, when combined with a low stroke volume, the product (cardiac output) is low. lvii Our goal is to slow it down. We have two methods to slow down a rhythm, electrical and medicine. Which treatment of the two do we use first? Depends on our patient! If the patient is stable, we would try I.V. medication first. If our patient was unstable, we would try cardioversion first, then I.V. medication.lviii From the Christian perspective, a heart rhythm that is going to fast that it causes an inadequate filling of the patients ventricles (Will and Personality / Character) as a result, we will see poor cardiac output. This poor output is seen as "getting ahead of God" which is very poor personal judgments on our parts.

In using the expression "getting ahead of God" I am by no means suggesting that we can out run God or that God is too slow and behind the times. What I am saying when I use this expression is that the human nature of man whether a Christian or not is to hate waiting about anything. We just don't like waiting, not a one minute. We want what we want right now, thank you very much! But God's timing is not our own!

So what is so bad when it come to getting ahead of God's timing and setting out to do something in our own time. Let's look at a story from the Bible that I think will show us some of the true consequences that come from getting ahead of God. Let's take Abram for example. God promises Abram (later called Abraham) that he will be the father of many nations. Genesis 12:1-3, The LORD had said to Abram, "Leave your native country, your relatives, and your father's family, and go to the land that I will show you. 2 I will make you into a great nation. I will bless you and make you famous, and you will be a blessing to others. 3 I will bless those who bless you and curse those who treat you with contempt. All the families on earth will be blessed through you." (NLT) As we will see time passes on and Abram is still without child. So his wife Sarai (later named Sarah) comes up with this idea. Because Sarai does not think that she will ever get pregnant she tells Abram to take their maidservant Hagar for a wife and to have a child with her. For once Abram listens to his wife's advice. Genesis 16:2 So Sarai said to Abram, "The LORD has prevented me from having children. Go and sleep with my servant {Hagar}. Perhaps I can have children through her." And Abram agreed with Sarai's proposal. Any of you men out there see any problems with this idea. MEN! We all know this just was not a good thing to do and we also know that this is not going to end well for Abram is it?

Hagar gets pregnant. What does Sarah do next, she gets angry and jealous. I told you this was not going to end well for Abram. Abram, as any good husband would, tells her to do as she wants. Sarah tells Hagar that she and the baby had to get OUT of her house. The Angel of the Lord finds Hagar in the wilderness and instructs her to name her son Ishmael and says of him, Genesis 16:12 This son of yours will be a wild man, as untamed as a wild donkey! He will raise his fist against everyone, and everyone will be against him. Yes, he will live in open hostility against all his relatives. (NLT)

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Then in God's time, Sarah some fourteen years later finally gives birth to Isaac, the son God had promised Abraham. When Isaac is finally weaned from his mother, Abraham throws a party and Sarah notices Ishmael mocking Isaac. Again the sparks of jealous and envy begin to fly between Sarah and Hagar. Genesis 21:8-13 8 When Isaac grew up and was about to be weaned, Abraham prepared a huge feast to celebrate the occasion. 9 But Sarah saw Ishmaelâ&#x20AC;&#x201D;the son of Abraham and her Egyptian servant Hagarâ&#x20AC;&#x201D;making fun of her son, Isaac. 10 So she turned to Abraham and demanded, "Get rid of that slave woman and her son. He is not going to share the inheritance with my son, Isaac. I won't have it!" 11 This upset Abraham very much because Ishmael was his son. 12 But God told Abraham, "Do not be upset over the boy and your servant. Do whatever Sarah tells you, for Isaac is the son through whom your descendants will be counted. 13 But I will also make a nation of the descendants of Hagar's son because he is your son, too." (NLT) It doesn't take a genius or Bible scholar to understand that Sarah and Abraham in the above story made bad decisions because they became impatient and felt they could wait no longer.

As we know now, Ishmael's linage can be traced to the Arab (Muslim) people of our day and Isaac to the Jews. Now thousands of years later, the Arab-Israeli conflict still exists! Talk about some serious consequences!

As stated above, our goal in treating these patients (Christians) is to slow the heart rate down. Which treatment we use, depends on our patient! If the patient is stable, we would try I.V. medication first. This would be that Christian themselves praying, asking for forgiveness, then asking for the Holy Spirits guidance in searching the Bible for scriptures to stand on.

They then must choose to walk away from the hindrances and the temptations that have lead them to sin. As the Bible teaches us in James 4:4-10 You're cheating on God. If all you want is your own way, flirting with the world every chance you get, you end up enemies of God and his way. And do you suppose God doesn't care? The proverb has it that "he's a fiercely jealous lover." And what he gives in love is far better than anything else you'll find. It's common knowledge that "God goes against the willful proud; God gives grace to the willing humble." 7-10So let God work his will in you. Yell a loud no to the Devil and watch him scamper. Say a quiet yes to God and he'll be there in no time. Quit dabbling in sin. Purify your inner life. Quit playing the field. Hit bottom, and cry your eyes out. The fun and games are over. Get serious, really serious. Get down on your knees before the Master; it's the only way you'll get on your feet. (MSG) If our patient was unstable, we would try cardioversion first; this would be the Christian seeking out Christian counseling to get to the heart and root of this spiritual issue. A more challenging question for each of us to answer is, "Am I making a rush decision that will cost me significantly down the road?" For now let's move on to the person's heart rhythm that is just not pumping fast enough, you will see what I mean.

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TOO SLOW Second rhythm is TOO SLOW! Heart rates of less than 50/minute provide a lengthy filling time, thus maximizing stroke volume but very slow rates also, can compromise cardiac output. Even a good stroke volume of 80 ml when combined with a heart rate of only 30/minute yields a cardiac output of only 2400 ml, less than half an adult's average resting cardiac output of 5000 ml. The outcome for a patient with cardiac disease and a poor stroke volume is much more ominous (i.e. 40 ml x 40/min. =1600 ml).

Our goal is to speed it up. We have two methods to speed up a rhythm, electrical and medicine. Which treatment of the two do we use first? Depends on our patient! If the patient is stable, we would try I.V. medication first if there wasn't a present of heart block greater than 2nd degree type II. If our patient was unstable, we would try Transcutaneous Pacing (TCP) first, then I.V. medication. The drug of choice is Atropine. If the drug and pacing is unsuccessful we may have to do CPR if the pulse rate and blood pressure is not enough to provide perfusion to our patient's vital organs.

Remember that air goes in and out and blood goes round and round. So then a heart rhythm that is going to slow, which now has adequate filling time but the problem now is just not enough pumping of the blood. That means not enough blood going round and round through the body resulting again in poor cardiac output.

As for the Christian perspective, if the ventricles cannot contract strongly enough to pump blood adequately, the valves within your heart are impaired. If we have gotten to this point in the diseased heart process then the ventricles are too stiff to fill properly causing inadequate cardiac output, which is a result of pump (Heart) failure on the levels of both the physical and that of the spiritual (Failure in your Mind, Will, and Emotions). If the valves are impaired then we have both a physical and spiritual problem. Spiritually we have a failure and backing up from your Personality/Character to your Emotions causing issues of what went on at the time of your salvation and the exchange that took place for us at the Cross (within your lungs).

This in turn causes more back up to move into your Will and then move into your Mind.

Heart failure is not a primary disease but is result from numerous other disorders both physically and spiritually. Spiritually, I see this as you and I not acting on something when we know that we should and not acting when Gods asks to or responding to His request to slowly.

Let's review an example in Scripture to support this idea found in Luke 10:25-38. I like to call this story the first ever recorded EMS system. This story takes us from seeing an assault happen, to bystanders standing around and not doing anything to the Medical Responder arriving on scene, treating and packaging the patient for transport, transporting the patient to the closest appropriate facility of his day, and then doing his paper work and even paying for the billing. You and I know this story as the Good Samaritan and it is the foundation of most states Good Samaritan Law.

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Luke 10:25-37 let's read it together. 25Just then a religion scholar stood up with a question to test Jesus. "Teacher, what do I need to do to get eternal life?" 26He answered, "What's written in God's Law? How do you interpret it?" 27He said, "That you love the Lord your God with all your passion and prayer and muscle and intelligenceâ&#x20AC;&#x201D;and that you love your neighbor as well as you do yourself." 28"Good answer!" said Jesus. "Do it and you'll live." 29Looking for a loophole, he asked, "And just how would you define 'neighbor'?" 30-32Jesus answered by telling a story. "There was once a man traveling from Jerusalem to Jericho. On the way he was attacked by robbers. They took his clothes, beat him up, and went off leaving him halfdead. Luckily, a priest was on his way down the same road, but when he saw him he angled across to the other side. Then a Levite religious man showed up; he also avoided the injured man. 33-35"A Samaritan traveling the road came on him. When he saw the man's condition, his heart went out to him. He gave him first aid, disinfecting and bandaging his wounds. Then he lifted him onto his donkey, led him to an inn, and made him comfortable. In the morning he took out two silver coins and gave them to the innkeeper, saying, 'Take good care of him. If it costs any more, put it on my bill I'll pay you on my way back.' 36"What do you think? Which of the three became a neighbor to the man attacked by robbers?" 37"The one who treated him kindly," the religion scholar responded. Jesus said, "Go and do the same." (MSG) In fact, to me, getting behind God may be just as prevalent and equally if not more fatal as getting ahead of Him. So what does it mean to get behind God? Getting behind God means missing opportunities that God provides for us in the now moment. Proverbs 3:27-29 27-29 Never walk away from someone who deserves help; your hand is God's hand for that person.

Don't tell your neighbor "Maybe some other time" or "Try me tomorrow" when the money's right there in your pocket. Don't figure ways of taking advantage of your neighbor when he's sitting there trusting and unsuspecting. (MSG) "I'll get to it later" is a common excuse. Here are some others that my rational mind regularly comes up with to put off the good work God prompts me to do. "If I give all my stuff away, I'll have nothing for myself." "This is too inconvenient; it can't be God's will." "It's not my job."

"Someone else will take care of it." "I'm too busy."

The reasons for not moving forward with God are numerous, but underneath each excuse lie some deeper heart issues like fear, procrastination, stubbornness, misguided belief systems, selfishness, unbiblical prioritization, laziness, slowness of heart, stinginess and worldliness, to name a few.lix As stated above, our goal in treating these patients (Christians) is to speed the heart rate up.

Which treatment we use, depends on our patient! If the patient is stable, we would try I.V. medication first. This would be that Christian themselves praying, asking for forgiveness,, then asking for the Holy Spirits guidance in searching the Bible for scriptures to stand on.

They then must choose to walk away from the hindrances and the temptations that have lead them to sin.

If our patient was unstable, we would try TCP first; this would be the Christian seeking out Christian counseling to get to the heart and root of this spiritual issue. We must then be willing to allow the Holy Spirit to perform heart surgery on us to fix any and all areas of failure

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or disorder within our lives. God will do this if we ask and allow Him to because He wants us to be whole.

Now we have come to the patient that has no traceable rhythm at all on the EKG. What about them?

TOO NONE: (Those rhythms leading to death) Asystole, the most deadly rhythm, is commonly the end-stage rhythm that follows prolonged Ventricular Tachycardia (VT), Ventricular Fibrillation (VF) or Pulseless Electrical Activity (PEA), and for this reason the prognosis for a patient found to be in asystole is generally not good. The reason this rhythm is the most deadly, is that it is the most difficult to change or achieve a Return Of Spontaneous Circulation known as (ROSC). You see, asystole is not really a rhythm at all. It's actually an absence of any rhythm; it's also a cardinal sign of death!

You know, TV DEATH! __________________ Flat line.

I know that at the minute that I die I will be with God. I know this because I am told this in 2 Corinthians 5:8 We are confident, I say, and willing rather to be absent from the body, and to be present with the Lord. (KJV) BUT really come on now! I do not want to die physically until it is my time to go see God face to face.

As stated above asystole, is commonly the end-stage rhythm that follows prolonged VT, VF or PEA, and all of these rhythms, if not reversed will lead to your patient's death. We will discuss your treatment for VT, VF in a later chapter.

For now let's look at the treatment for PEA and asystole, the new 2010 AHA guide lines state: When a rhythm check using a manual defibrillator or cardiac monitor reveals an organized rhythm, a pulse check is performed. If a pulse is detected, post-cardiac arrest care should be initiated immediately. If the rhythm is asystole or the pulse is absent (PEA), CPR should be resumed immediately, beginning with chest compressions, and should continue for 2 minutes before the rhythm check is repeated. The provider performing chest compressions should switch every 2 minutes. CPR quality should be monitored on the basis of mechanical or physiologic parameters.

The drug therapy for PEA and asystole is as follows: A vasopressor can be given as soon as feasible with the primary goal of increasing myocardial and cerebral blood flow during CPR and achieving ROSC. Available evidence suggests that the routine use of atropine during PEA or asystole is unlikely to have a therapeutic benefit. For this reason atropine has been removed from the cardiac arrest algorithm.

PEA is often caused by reversible conditions and can be treated successfully if those conditions are identified and corrected. During each 2-minute period of CPR the provider should recall the H's and T's to identify factors that may have caused the arrest or may be complicating the resuscitative effort. Given the potential association of PEA with hypoxemia, placement of an advanced airway is theoretically more important than during VF or pulseless VT and might be necessary to achieve adequate oxygenation or ventilation. PEA caused by severe volume loss or sepsis will potentially benefit from administration of empirical IV/IO

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crystalloid. A patient with PEA caused by severe blood loss will potentially benefit from a blood transfusion. When pulmonary embolism is presumed or known to be the cause of cardiac arrest, empirical fibrinolytic therapy can be considered. Finally, if tension pneumothorax is clinically suspected as the cause of PEA, initial management includes needle decompression. If available, echocardiography can be used to guide management of PEA because it provides useful information about intravascular volume status (assessing ventricular volume), cardiac tamponade, mass lesions (tumor, clot), left ventricular contractility, and regional wall motion.

The goal in treating the potentially reversible causes (your H's and T's) of PEA and asystole is to have your patient have ROSC. If the patient has ROSC, post-cardiac arrest care should be initiated. Of particular importance is treatment of hypoxemia and hypotension and early diagnosis and treatment of the underlying cause of cardiac arrest. Therapeutic hypothermia may be considered when the patient is comatose.lx From my perspective as a Christian, spiritual asystole like that of physical asystole, is the end-stage rhythm that follows prolonged VT, VF or PEA, (Spiritual H's and T's / Sins / the Backslidden Christian) and all of these rhythms, if not reversed will lead to spiritual death which could also lead to physical death.

We will cover spiritual VT, VF and PEA in a later chapter. Spiritual asystole, I see as being spiritually dead, for the backslidden Christian if treated through confession and repentances (Turning 180 degrees and going in the opposite direction) of personal sin, prayer and Christian faith-based counseling, will lead to your spiritual patient having a spiritual ROSC. If this Christian does not repent and is still choosing to walk away from God, then they have almost come to the point of apostasy and are to be seen as being again spiritually dead as they were before they became a Christian.

This treatment plan is seen in Galatians 6:1-5 Brethren, if any person {Believer (NLT)} is overtaken in misconduct or sin of any sort, you who are spiritual < Medical Responders > [who are responsive to and controlled by the Spirit] should set him right and restore and reinstate him, without any sense of superiority and with all gentleness, keeping an attentive eye on yourself, lest you should be tempted also. 2 Bear (endure, carry) one another's burdens and troublesome moral faults, and in this way fulfill and observe perfectly the law of Christ (the Messiah) and complete what is lacking [in your obedience to it].3 For if any person thinks himself to be somebody [too important to condescend to shoulder another's load] when he is nobody [of superiority except in his own estimation], he deceives and deludes and cheats himself. 4 But let every person carefully scrutinize and examine and test his own conduct and his own work. He can then have the personal satisfaction and joy of doing something commendable [in itself alone] without [resorting to] boastful comparison with his neighbor. 5 For every person will have to bear (be equal to understanding and calmly receive) his own [little] load [of oppressive faults]. (AMP) < Added by this author > I see all non-Christians as being in Spiritual asystole at all times until the time that they have there own personal relationship and conversion to Christ. That spiritual ROSC in the nonChristian happens at the very second that the non-Christian acknowledges and confess' with their mouths that Jesus is Lord and believes in their HEARTs (Mind, Will, Emotions and Personality) that God raised Jesus from the death that he died on the cross for our sins. God

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says this to you and I in Romans 10:9 Because if you acknowledge and confess with your lips that Jesus is Lord and in your heart believe (adhere to, trust in, and rely on the truth) that God raised Him from the dead, you will be saved. (AMP) I am going to try to stay in the physical side for the remainder of this chapter, and get through the 5 steps of Interpreting the Lead II EKG. I have only covered one and a half {Rhythm (regularity) and half of Rate} thus far, of the five steps and have three and a half left to cover before I end this chapter. We still finish covering the rhythms' Rate, and then cover the rhythms' the P wave configuration, the PR interval and the rhythms' QRS duration and configuration.

Let's get started so that I can get back to the spiritual side of this study on EKG's.

EKG RATES The method used to calculate the heart rate is based on whether the rhythm is regular or irregular. The heart rate must be determined for both atria and ventricles. The atrial rate is determined by the P-P wave interval measurements, and the ventricular rate is determined by the R-R wave measurement. Most frequently, the atrial and ventricular rates will be the same; sometimes, however, the rates may be different due to conditions occurring in the myocardium. It is important to note if the atrial rate is different from the ventricular rate since this will help narrow the selection of dysrhythmias. The methods used to differentiate the rates are described in the following sections.

Regular Rhythm Once you have determined that the rhythm is regular, you can use this method to calculate the atrial and ventricular rate. The caliper interval of the P-P or R-R measurement is placed on the EKG paper to determine the number of small boxes or duration of time. Move the caliper interval to the top or the bottom of the page so that the number of boxes can be determined without individe the number into 1500 to calculate the heart rate. The ventricular rate is determined in the same manner except you will need to count the number of boxes between the QRS complexes. This method of calculation provides an accurate heart rate similar to measuring a person's pulse. The actual rate is extremely important when the heart rate is either tachycardia or bradycardia.

Irregular Rhythm When the rhythm is irregular, as determined in Step 1, the interval between the P waves or the QRS complexes is not constant. To determine the heart rate for an irregular rhythm, use the 6-second strip method. Simply multiply the number of P waves and QRS complexes in a 6-second strip by 10. This method is often used in emergencies to determine an estimated heart rate (pulse rate) for the patient. So now look at Figure 3.7.

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Figure 3.6 The first item to look at is the "Time Markings". You will see 3 of them (I only circled one).

Notice the period of time between each one of them is 3 seconds. And two, 3 second intervals represent 6 seconds. There are 10 six second periods in a minute. 10 times 6 equals 60 seconds! This is important! Make sure you "see this" and understand this. Once you able able to identify a six second time period, rate determination is a snap! Now look at the item QRS Complex. There are 8 of them on this six second strip. Therefore, if we multiply 8 times 10 (because there are 10 six second intervals in a minute), it equals 80! Let's do another! Look at Figure 3.8.

Figure 3.7 There are 5 QRS complexes in the 6 second strip. Take 5 times 10 (there are 10 six second strips in a minute), and that equals 50. Therefore the heart rate is 50!

There are other ways to determine EKG rates, such as the 300, 150, 100... method, but I prefer you learn rate determination this way. This method helps you learn that as the strip is traveling, it is actually recording time, in a precise manner. Each one of those little boxes, and bigger boxes precisely represents time. See Figure 3.9.

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Figure 3.8 The boxes whether they are big or little going across represent TIME! The boxes whether they are big or little going up and down represent AMPLITUDE! At this time don't concern yourself with amplitude, only time. Seconds can be broken down into smaller units, called milliseconds. There are 1,000 milliseconds in one second! There are 60 seconds in a minute!

To find out how many milliseconds in a minute, we have to multiply 60 seconds times 1,000 milliseconds. That equals 60,000 milliseconds. Now please stay with me. Look at Figure 3.9, I have "boxed" in black, one BIG BOX. You will see I have magnified one big box. One Big Box equals 200 milliseconds. Five Big Boxes equal 1,000 milliseconds or one second! Do it by math...5 boxes times 200 milliseconds equals 1,000 milliseconds, or one second! Look at Figure 3.9, Using the time marks, start from the left and count the number of big boxes (hint: use your mouse pointer, I also numbered the first 15 boxes at the bottom of Figure 3.9). You will find there are 15 big boxes between each time mark. Take 15 boxes times 200 milliseconds (each box remember is 200 milliseconds) and that equals 3,000 milliseconds, or 3 seconds! If you count all the Big Boxes from left to right, starting with the first time mark, including the center time mark, to the last time mark on the right, you will have counted 30 Big Boxes. Multiply 30 Big Boxes times 200 milliseconds (each box remember is 200 milliseconds) and that equals 6,000 milliseconds, or 6 seconds! Do you have it? If not read it again until you do. Let's look inside the Big Box at the 5 small boxes. Look below at Figure 3.10

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Figure 3.9 Figure 3.10 illustrates the Big Box with the small boxes inside. There are 5 boxes across, with 5 boxes up and down. Remember, we are only concerned about counting the boxes across from left to right.

Each small box is 40 milliseconds, also expressed as 0.04 sec Two small boxes is 80 milliseconds, also expressed as 0.08 sec Three small boxes is 120 milliseconds, also expressed as 0.12 sec Four small boxes is 160 milliseconds, also expressed as 0.16 sec Five small boxes is 200 milliseconds, also expressed as 0.20 sec Big concept! Very important! Why? "Because when you starting measuring intervals between events, you will need to measure the timing!" An example: "Have you ever heard of the "PR" interval?" That's the time delay between the electrical impulse of the Atrium and the Ventricle.

The "P" wave is the Atrial response, and the "R" wave is the Ventricular response. The normal time period is between 120 milliseconds and 200 milliseconds. This is expressed this way, the normal time period is between 0.12 and 0.20! Why is this important! Just to entice you further, if the "PR" interval is greater than 0.20, your patient has a 1st degree AV (atrial/ventricular) Block! Cool Huh? See you can learn this stuff too! Let's try another. See Figure 3.11 below.

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Figure 3.10 Strip A on Figure 3.11 is only a 3 second strip. How do we know that? There is only a beginning timing mark, and a second timing mark, also there are only 15 big boxes, 15 X 200 = 3000 milliseconds or 3 seconds. Strip B is a magnified view of the first two QRS complexes of Strip A. They are circled. When measuring QRS complexes to QRS complexes (these are actually "R" to "R" waves, more on this later) choose the first complex that is almost on the beginning line of a Big Box (this makes it easier to count). It's almost impossible to find QRS's to "fall" exactly on the lines, so choose the closest. It's best to "round" off to the closest line.

Notice the second QRS actually does not fall right on the line. I used the closest line, look at the black marks that the arrow is touching. There are 2 Big Boxes between QRS's, so...2 X 200 = 400, then 2 small boxes, 2 X 40 = 80, add the two totals together...400 + 80 = 480 milliseconds between each line. Now remember there is 60,000 milliseconds in a minute.

So...60,000 divided by 480 = 125, what is the number 125? Go back and look at the strip in Figure 3.9. What did we estimate the heart rate at? We estimated it 120 beats per minute.

Well, 125 is the exact rate! If, those first 2 QRS's remained the same distance for the all the rest of the QRS's in a minute!

This concept is very important! You must have this rock solid before proceeding. Learning EKG's is like building a house, if the foundation is weak, the house won't stand! Go back and read this section again if you are not sure.lxi

Step 3: Identifying the P Wave Configuration Identifying the P Wave Configuration Analyzing P waves and their relationship with the QRS complex is necessary to determine the type of dysrhythmia. The P wave reflects the atrial contraction and how the electrical current is moving through the atria. The relationship between the P wave and QRS complex provides information regarding the coordination between atrial and ventricular contractions.

Several questions need to be answered when analyzing the P wave.

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Are the shapes and waveforms all the same?

If they appear to be different, the route in which the current is moving through the atria is not on the same pathway. Sometimes the P wave may not exist.

Does each P wave have a QRS complex following it?

In normal conduction pathways, the QRS complex always follows the P wave. If there are additional P waves or QRS complexes present without a P wave in front, the normal conduction pathway may not have been used and the atria and ventricles are not contracting together.

Figure 3.11lxii In Figure 3.12, a sinus rhythm originates from the SA node (#1) with the resulting atrial depolarization being directed toward the positive red electrode (of lead II). This results in an upward shaped P wave. When an impulse originates high in the AV junction (#2), atrial depolarization is directed away from the positive red electrode and an inverted P wave is seen. For junctional rhythms that are initiated lower in the AV junction (#3), often the atria and the ventricles depolarize simultaneously. While the QRS remains narrow (it is a supraventricular rhythm), the P wave is absent because it is buried in the much larger QRS complex. Impulses that originate in the atria (#4) produce a variety of non-symmetrical P waves, often with a biphasic shape (part of the wave up and the other directed downwards).

Step 4: Measuring the PR Interval The PR interval measures the length of time it takes the electrical current to be initiated at the sinoatrial node and travel through the electrical current pathway to cause a ventricular contraction. The PR interval is determined by measuring from the beginning of the P wave, or it's up slope, to the beginning of the QRS complex. This is the first indication of ventricular

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depolarization. Not all tracings will show a Q wave. In the absence of a Q wave, the second caliper tip is placed at the beginning of the R wave. The normal range of the PR interval is 0.12 to 0.20 second.

When determining the measurements, the time interval should always be in multiples of 0.02 second, which represents one-half of the smallest boxes. To effectively determine measurements to 0.01 second, the small box on the EKG paper would need to be divided into four smaller divisions. This can be done effectively only with a computer, not a practitioner's eyes.

PR intervals are also evaluated to ensure that the measurements are the same from one PR interval to the next. If the intervals have different measurements, either the electrical current is being delayed for some reason or it may be initiating from locations other than the sinoatrial node.lxiii Perhaps as important, an irregular PR interval or the presence of lonely P waves (a P wave without a QRS complex immediately after) also speaks volumes. The presences of lonely P waves usually signify the presence of second or third degree AV block. The presence of an entirely chaotic PR interval across an EKG rhythm strip points to an absence of any relationship between the atria and the ventricles. This is known as atrioventricular (AV) dissociation.

Step 5: Measuring the QRS Duration and Analyzing and Naming the Configuration Measuring the QRS complex is essential in determining the duration of time it takes for the ventricles to depolarize or contract. This information is helpful in discriminating between different dysrhythmias. If the QRS complex is narrow, or within the normal limits of 0.06 to 0.10 second, current has traveled through the normal ventricular conduction pathways to activate the ventricles to contract. When the QRS complex is wide, 0.12 second or greater, the current is taking longer than normal to contract the ventricles.

To measure the QRS duration and configuration, place the first caliper point where the QRS complex starts and the second point at the J point, see Figure 3.13 below. The J point is located where the S wave stops and the ST segment is initiated. It marks the point at which ventricular depolarization is completed and repolarization begins. It is important to carefully identify this ending point of the QRS complex, since many times the ST segment may not be at the isoelectric line.

Chapter 3 Interpretation of the Lead II EKG

Figure 3.12 The J point is where the S wave stops and the ST segment is initiated.lxiv Several questions need to be answered when determining the QRS measurement and configuration see Figure 3.14 below.

Figure 3.13 Measure the QRS duration from the beginning of the QRS complex to the J point.lxv Are all the QRS complexes of equal length?

What is the actual measurement, and is it within the normal limits?

Do all QRS complexes look alike, and are the unusual QRS complexes associated with an ectopic beat?

After you have completed these five steps of identifying the components of the rhythm, you will then compare the information to the specific criteria for classifying each of the dysrhythmias.

Rhythm Naming Conventions A few naming conventions require mentioning before examining the 4-step method in detail.

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A cardiac rhythm is usually named first by the location of the originating impulse. For example, rhythms that begin in the SA node are called sinus rhythms.

Rhythms that originate from the AV junction are called junctional rhythms. Ventricular rhythms originate in the ventricle.

After first identifying the location of the generated impulse, then classify it according to rate. A rate faster than 100 a minute (101 a minute or faster) is a tachycardia. The term bradycardia applies to rhythms that are slower than the expected pacemaker rate range (see Table 3.1).

Rates that are neither fast nor slow are just labeled rhythms i.e. sinus rhythm.

Pacemaker Site Sinus Node AV Junction Bundle of His Bundle Branches Purkinje Network

Typical Rate 60-100/minute 40-60/minute 40-60/minute 30-40/minute 20-40/minute

Table 3.1 For example, a rhythm originating from the SA node with a heart rate less than 60 a minute, is labeled a sinus bradycardia. A rhythm that originates from the SA node at a rate above 100 a minute is called a sinus tachycardia. A rhythm that originates from the SA node at a rate of 60-100 a minute is just called a sinus rhythm. Similarly, a rhythm originating from the AV junction with a rate of 46 a minute is a junctional rhythm - not a junctional bradycardia because a junctional rate is expected within this rate range.

Usually, the first word of a rhythm is the location of the initiating impulse. This is followed by a descriptor of the rate - bradycardia, tachycardia or just labels it a rhythm. Next, include any abnormal findings i.e. premature complexes or other abnormal EKG components. A rhythm might be called a sinus tachycardia with a premature ventricular complex (PVC). Sounds impressive, but the naming method is simple.

Lastly, follow up with descriptors of any other noteworthy characteristics of the rhythm. Begin with any abnormalities of the underlying main rhythm. Is there ST deviation? T wave inversion? Prominent Q waves? Complete labeling the rhythm by addressing any extra beats.

Are there any premature beats?

Take an EKG with a heart rate of 52 a minute, narrow QRS complex, inverted P waves, ST elevation and an extra premature beat that has a wide QRS complex. How would this rhythm be labeled? First, narrow QRS complexes with accompanying inverted P waves point to a supraventricular rhythm originating from the AV junction. The premature beat with a wide QRS complex suggests a premature ventricular complex (PVC). The rhythm is then labeled a junctional rhythm with ST elevation and one PVC.

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When all is said, this rhythm sounds complicated and the person labeling the rhythm sounds quite brilliant. The steps, though, are simple.

Remember that the EKG is a two dimensional plotting of voltage (height or amplitude) over time (width or length). The QRS complex is a representation of ventricular depolarization and to a much lesser extent atrial repolarization.lxvi We have been looking at the physical side and the interpretation of the lead II EKG. I want to now change gears for a few chapters and look into what the Bible has to say about its own interpretation.

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Chapter 4 The Bible does not make SENSE to me! WHY? All Scripture is given by inspiration of God, and is profitable for doctrine, for reproof, for correction, for instruction in righteousness: That the man of God may be perfect, thoroughly furnished unto all good works. II Timothy 3:16-17 KJV THE BIBLE The Bible, which I know it to be truth, is the written Word of the one true God. The word "Bible” comes from the Greek word "biblia" which means "the books." The Holy Bible is one volume, which consists of 66 separate books. The word "Scripture" is also used to refer to God's Word. This word comes from a Latin word "scriptura" which means "writing." When the word "Scripture" is used with a capital "S" it means the sacred writings of the one true God. The word "bible" is not used in the Holy Bible, it is a word used by men as a title for all of God's words.

Many people try to studying the Bible the same way they study any other book. They take their Bible, open it, and start to read. But often their study does not last long. They find it difficult to understand what they read. They do not recognize how the Bible relates to everyday living and may even think it is a rather dull book. The Bible explains that only certain people will be able to understand God's Word. People fail at Bible study because they are not spiritually prepared to study the Word of God. Whoever is of God listens to God. [Those who belong to God hear the words of God.] This is the reason that you do not listen [to those words, to Me]: because you do not belong to God and are not of God or in harmony with Him. John 8:47 (AMP) The Bible is like a door, which leads into the presence of God. Behind that door are great spiritual treasures. But you must have the key to unlock the door or you will never be able to enter in and explore these treasures. The Bible reveals how to understand God's Word. It provides the key to unlock the door to spiritual understanding.

THREE LANGUAGES The Bible was originally written in three languages. Most of the Old Testament was written in Hebrew except for parts of the books of Daniel and Nehemiah, which were written in Aramaic. The New Testament was written in Koinē Greek. The word koinē (κοινή) is the Greek word for "common", and is here understood as referring to "the common dialect".

Manuscript comes from Latin manu (hand) and scriptum (written). The original manuscript (the original parchment the author physically wrote on) is called the "autographa." None of the original autographa of the Bible are still in existence. However, many manuscripts exist which autographa. Holy Bible versions are translations of the accepted manuscripts into current languages. For example the King James Version was translated from the Hebrew and Greek into 16th Century English. We have different translation for the simple fact that the languages changed over time.. From early times men saw the necessity of translating the Bible so everyone could read it in their own language.

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No translation is exact because no two languages are exactly alike. Some words used in the Bible do not even exist in some languages. For example, there is a tribe of Indians in Ecuador, South America, called the Auca Indians. When missionaries first contacted them, these Indians did not know how to read or write. There were no words in their language for "writing" or "book."

The Auca Indians did have a custom of carving identification marks on their property. Since there were no words in their language for scriptures, writing, or book, when the Bible was translated for them it was called "God's Carving." This identified it as something belonging to God. This is just one example of the difficulties in translating the Bible into various languages.

VERSIONS There are many different versions of the Bible. The word "version" means a Bible written in a language different from those in which God's Word was originally written. There are two main types of versions of the Bible: translations and paraphrases.

TRANSLATION A translation is an effort to express what the Greek, Hebrew, and Aramaic words actually say in a different language than the original. It gives as nearly as possible a literal word-by-word translation. Extra words are inserted only when necessary for the reader to understand the meaning.

PARAPHRASE A paraphrase does not attempt to translate the original language word for word. A paraphrase translates thought by thought. This type of bible version uses modern language and idioms to try to capture the thought and essence behind the original text. Paraphrase versions are generally easier to read but remember they are not an exact translation of God's Word.

PREREQUISITES TO BIBLE STUDY A prerequisite is something you must do before you can do something else. The Bible is the Word of God. It is not like any other book and you cannot study it as you do other books.

There are prerequisites before you can begin if you are to understand the deep spiritual things of God. If you want to understand the Bible you must first know the Author of the Bible. Jesus said, "He that is of God heareth God's words; ye therefore hear them not, because ye are not of God." John 8:47 The Message translation says it this way: "Anyone on God's side listens to God's words. This is why you're not listeningâ&#x20AC;&#x201D;because you're not on God's side." John 8:47.

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You cannot understand God's Words without knowing God. How do you come to know God? Jesus told Nicodemus, who was a religious leader in the nation of Israel:in John 3:3 Verily, verily I say unto thee, Except a man be born again he cannot see the kingdom of God. A man may be educated, learned, cultured, and even religious, but the understanding of Scripture will be hidden from him until his spiritual eyes have been opened by the new birth a new relationship. This brings me back to my analogy earlier in this book on the differences in Religion vs. Relationship.

As I stated before; Religion to me is similar to when I write down the address for a call in a specified subdivision and I drive the ambulance to that subdivision but stop only at the entrance. Am I at the call? NO! Relationship to me is, Intimacy. Intimacy means, in-to-mesee! Jesus asks me to see into Him and I am to ask Him to see into me. This is not achieved until I have turned into the subdivision and have driven the ambulance to the actual physical address of the call; call out on scene (10-23). I am then to get out of my ambulance grab the needed medical or trauma equipment, airway kit and cardiac monitor and walk into the residents and take over patient care.

Who would you rather answer the call to help you or your family member in a time of need, those that have religion and only come to the subdivision or those that have an intimate and personal relationship and will come all the way into the house? Christianity is not about religion at all but it is all about right relationships and being rightly related to others. God's relationship with Jesus and the Holy Spirit, God's relationship with Man. True Christianity then turns to look at a man's (woman's) relationship with others and to see if they are rightly or wrongly related.

Nicodemus asked Jesus, "How can these things be?" He did not understand what Jesus meant. Jesus answered and said, "Art thou a master of Israel and knowest not these things?"

John 3:10 Nicodemus was a religious leader of Israel, yet he did not know about being born again. In fact, he asked . . . How can a man be born when he is old? can he enter the second time into his mother's womb and be born? John 3:4 Jesus explained to Nicodemus that the new birth of which He was speaking was a spiritual birth. This new birth experience comes through faith in Jesus Christ. You must confess you are a sinner. You must believe Jesus died for your sins, ask forgiveness for your sins, and accept Him as your personal Savior and then start the daily walk of making Jesus Lord of your life. 12Therefore, my dear ones, as you have always obeyed [my suggestions], so now, not only [with the enthusiasm you would show] in my presence but much more because I am absent, work out (cultivate, carry out to the goal, and fully complete) your own salvation with reverence and awe and trembling (self-distrust, with serious caution, tenderness of conscience, watchfulness against temptation, timidly shrinking from whatever might offend God and discredit the name of Christ). Philippians 2:12 (AMP)

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The person who has not been born again cannot receive the truth of God's Words: But the natural man receiveth not the things of the Spirit of God; for they are foolishness unto him, neither does he know them, because they are spiritually discerned. I Corinthians 2:14 The unsaved man may admire the Bible for its literary beauty and value. He may study it historically or geographically. But the spiritual truths of God's Word will remain hidden until he receives forgiveness of sin: For the preaching of the cross is to them that perish foolishness; but unto us which are saved it is the power of God. I Corinthians 1:18 GOD'S PROVISIONS From the moment you accept Jesus as your Lord and Savior and experience the new spiritual birth, your mind will begin to understand spiritual truths in God's Word. Just as a newborn baby in the natural world needs physical nourishment from food, a person who is spiritually reborn needs nourishment. Their food for this spiritual growth and development is from the Word of God. There are two ways God has provided to help you study His Word.

We will discuss in a later chapter the seven reasons why the Bible is sometimes not understood. Why the Bile is not taken to heart or acted on by Christians that really love God. Also will discuss why Christians do not allow Jesus and even allow the Holy Spirit to move in their lives.

TEACHER God chooses certain believers as leaders in the Church. One of the special leadership positions is that of being a teacher of God's Word. "And God hath set some in the church, first apostles, secondarily prophets, thirdly teachers " I Corinthians 12:28 God provides teachers to explain/reveal God's Word and guide you and me to spiritual maturity.

THE HOLY SPIRIT (A SPECIAL TEACHER) To me the Holy Spirit is a SPECIAL ED TEACHER: Special education teachers carry the responsibility of educating children who are diagnosed with a number of physical, mental and emotional disabilities. They work with legally required federal paperwork called an IEP, or Individualized Educational Plan. The IEP outlines the necessary supports, accommodations and goals for an individual child to succeed. These goals can encompass both academic and behavioral concerns. These teachers work with children who can vary from mild to severe disabilities, using specialized techniques to help them reach their goals.lxvii I see the Holy Spirit as my special education teacher. He has prepared an IEP for me to follow that will take me from being a child / babe in Christ (Carnal Christian) to becoming a mature (Spiritual Christian) that He wants all to become in Him. I know that I still have areas that the Holy Spirit wants us to work on. He wants me to face and overcome a number of physical, mental and emotional disabilities that I still have. I still have areas in my life that if allowed would love to run rampant and destroy my life. What about you?

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God has a second way for you to learn His Word. He commands you to study it yourself: 15 Study to shew thyself approved unto God, a workman that needeth not to be ashamed, rightly dividing the word of truth. 2 Timothy 2:14 God has provided a special Teacher to help you and I when we study His Word. When Jesus was living on earth He personally taught His followers the truths of God. But Jesus knew that after His death and resurrection He would be returning to Heaven so He told His followers that a special Teacher would be sent to help them understand God's Word. That Teacher is the Holy Spirit.

But the comforter, which is the Holy Ghost, whom the Father will send in my name, He shall teach you all things, and bring all things to your remembrance, whatsoever I have said unto you. John 14:26 Howbeit when He, the Spirit of truth is come, He will guide you into all truth; for He shall not speak of Himself; but whatsoever He shall hear that shall He speak and He will shew you things to come. John 16:13 The coming of the Holy Spirit is recorded in Acts Chapter 2. God wants you to experience this same infilling of the Holy Spirit. Through the Holy Spirit you receive a special ability from God to understand His Word: But the anointing which ye have received of Him abideth in you, and ye need not that any man teach you; but as the same anointing teacheth you of all things and is truth and is no lie and even as it hath taught you ye shall abide in Him. I John 2:27 The Holy Spirit is a creative power. It was the Spirit of God that breathed into man the breath of life, "And the LORD God formed man of the dust of the ground, and breathed into his nostrils the breath of life; and man became a living soul." Genesis 2:7. It was that same Spirit that raised Jesus from the dead. "But if God himself has taken up residence in your life, you can hardly be thinking more of yourself than of him. Anyone, of course, who has not welcomed this invisible but clearly present God, the Spirit of Christ, won't know what we're talking about. But for you who welcome him, in whom he dwells—even though you still experience all the limitations of sin—you yourself experience life on God's terms. It stands to reason, doesn't it, that if the alive-and-present God who raised Jesus from the dead moves into your life, he'll do the same thing in you that he did in Jesus, bringing you alive to himself?

When God lives and breathes in you (and he does, as surely as he did in Jesus), you are delivered from that dead life. With his Spirit living in you, your body will be as alive as Christ's!" Romans 8:9-11.

It is that creative power of the Holy Spirit that takes an ordinary study time and turns it into a CREATIVE study of God's Word.

GOD'S WORD: MILK AND MEAT There are two levels of spiritual depth in God's Word. We call these the "milk" level and the "meat" levels. The "milk" of God's Word refers to simple truths that even a child can

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understand, such as the plan of salvation. The "meat" of God's Word refers to deeper spiritual truths, which are not so easy to understand.

Some people have received Jesus as their Savior and been filled with the Holy Spirit, but they do not seem to grow in their understanding of God's Word. They are still feeding on the milk of the Word.

In the natural world there is nothing wrong with milk for a newborn baby. The same is true in the spiritual world. When you are first born again you should desire the milk of God's Word: As newborn babes, desire the sincere milk of the word, that ye may grow thereby. I Peter 2:2 But there comes a time in the natural world that a baby must start to eat solid foods if he is to mature physically. This is also true in the spiritual world. There is a time when you must move on from the milk of God's Word to the meat: For every one that useth milk is unskillful in the word of righteousness; for he is a babe. But strong meat belongeth to them that are of full age, even those who by reason of use have their senses exercised to discern both good and evil. Hebrews 5:13-14 Paul said that when it was time for believers to move from spiritual milk to meat, some were not ready, "For when for the time, ye ought to be teachers, ye have need that one teach you again which be the first principles of the oracles of God; and are become such as have need of milk and not of strong meat." Hebrews 5:12 Why was this so? Why is it that some believers go deep into God's Word while others never get beyond a surface understanding of the Bible? Why are some people always hungering for "deeper things" in God's Word instead of experiencing them? Paul wrote: And I brethren, could not speak unto you as unto spiritual, but as unto carnal, even as unto babes in Christ. I have fed you with milk and not with meat; for hitherto ye were not able to bear it, neither yet now are ye able. For ye are yet carnal: for whereas there is among you envying, and strife, and divisions, are ye not carnal, and walk as men? I Corinthians 3:1-3 They could not move from milk to meat because they were carnal Christians. This means they were spiritually immature. They had envy, strife, division, and other sins in their lives.

When a Christian is carnal, he will not be able to understand the deeper truths of God's Word.

He will remain on milk until he repents and grows up enough spiritually that he can digest meat.

It is God's desire that you move from the milk to the meat of His Word. This is how you increase your knowledge of God's Word: Whom shall He teach knowledge And who shall be made to understand doctrine? Them that are weaned from the milk and drawn from the breasts. Isaiah 28:9 It is important that you move from the milk to the meat for it is upon spiritually mature believers that God pours out His Spirit:

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Whom shall He teach knowledge? and whom shall He make to understand doctrine? Them that are weaned from the milk and drawn from the breasts. For precept must be upon precept, precept upon precept; line upon line, line upon line; here a little, and there a little; For with stammering lips and another tongue will He speak to this people. To whom He said, This is the rest wherewith ye may cause the weary to rest; and this is the refreshing: yet they would not hear. Isaiah 28:9-12 God wanted to bless His people with an outpouring of the Holy Spirit. He wanted to revive them and give them spiritual rest, but they could not enter in because they had not heard His Words. They could not move on to spiritual meat because they were not weaned from the milk of the Word.

HOW TO MOVE FROM MILK TO MEAT Now, the big question is . . . How, does a newborn Christian move from the milk to the meat of God's Word?

DESIRE THE MILK First, you must desire the milk of the Word. You must gain an understanding of the basic principles of the Word of God: As newborn babes, desire the sincere milk of the word that ye may grow thereby. I Peter 2:2 You cannot start with spiritual meat. You must first desire and learn to digest spiritual milk.

BE OBEDIENT TO GOD'S WORD Being obedient to God's Word is the most important step. Carnal Christians do not obey what they learn in the milk of God's Word so they are not able to mature on to the meat. The Bible teaches that it is not enough just to hear His Word. You must be obedient. You must become a "doer" of the Word and not a "hearer" only: But be ye doers of the word, and not hearers only, deceiving your own selves. James 1:22 An increase in spiritual understanding comes through meditation on and obedience to God's Word. This is how we move from milk to meat. David wrote: Thou through thy commandments hast made me wiser than mine enemies. . . I have more understanding than all my teachers: for thy testimonies are my meditation. I understand more than the ancients, because I keep thy precepts . . . Through thy precepts I get understanding: Therefore I hate every false way . . . Portions of Psalms 119:99-104 Because David kept God's precepts and was a doer of the Word, his understanding increased. God will not take you on to the deeper revelations if you have not acted upon what you have learned in the milk of the Word.

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SEARCH FOR THE MEAT In the natural world, chewing meat requires more physical effort than drinking milk. The same is true in the spiritual world. Discovering the meat of God's Word requires more spiritual effort than living on the milk of the Word.

Proverbs Chapter 2:1-5 tells you and I how to search for the meat: 1

My son, if thou wilt receive my words, and hide my commandments with thee; 2So that thou incline thine ear unto wisdom, and apply thine heart tounderstanding; 3Yea, if thou criest after knowledge, and liftest up thy voice for understanding; 4If you seekest her as silver and searchest for her as for hid treasures: 5Then shalt thou understand the fear of the Lord and find the knowledge of God. Proverbs 2:1-5 These are the steps to discovering and understanding the knowledge of God: 1. Receive my words: You must be teachable.

2. Hide my commandments with thee: You must accept the Word and integrate it into your life and spirit. Do not try to change the Word to agree with your way of living.

3. Incline thine ear unto wisdom: Really listen to what God is saying to you through His Word. Listening requires changes in living where indicated.

4. Apply thine heart to understanding: Apply yourself diligently to understanding (interpreting) the Word. Doing this with your whole heartâ&#x20AC;Ś Your MIND, Your WILL, Your EMOTIONS and Your PERSONALITY / CHARACTER. 5. Seek her as silver and search for her as for hid treasures: If someone told you there was a hidden treasure in property you own, what would you do? You would start digging. You would conduct a systematic search until you found the treasure. It would become a priority of your life.

When you make God's Word a priority and begin to systematically search for His wisdom, you will find it. But it must become a priority of life. You must approach it with as much excitement and dedication as if you were searching for treasure.

If you follow these guidelines that we found in Proverbs Chapter 2:5-12 and search for the meat of God's Word, then these will be the results: 5

Then shalt thou understand the fear of the LORD, and find the knowledge of God. 6 For the LORD giveth wisdom: out of his mouth cometh knowledge and understanding. 7 He layeth up sound wisdom for the righteous: he is a buckler to them that walk uprightly. 8 He keepeth the paths of judgment, and preserveth the way of his saints. 9 Then shalt thou understand righteousness, and judgment, and equity; yea, every good path. 10 When wisdom entereth into thine heart, and knowledge is pleasant unto thy soul; 11 Discretion shall preserve thee, understanding shall keep thee: 12 To deliver thee from the way of the evil man, from the man that speaketh froward things; Proverbs 2:5-12

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Then shalt thou understand the fear of the Lord: Verse 5 "The fear of the LORD is to hate evil [SIN]: pride, and arrogancy, and the evil way [SINFUL WAYS], and the froward mouth, do I hate." Proverbs 8:13

2. And find the knowledge of God: Verse 5 3. Then shalt thou understand righteousness, and judgment, and equity; yea every good path: Verse 9 4. It will be pleasant unto thy soul: (You will find satisfaction) Verse 10 5. Discretion shall preserve thee: Discretion, the ability to make sound judgment and decisions. Verse 11 6. Understanding shall keep thee: Verse 11 7. You will be delivered from all evil: Verse 12 Let me share some practical suggestions for studying the Bible.

SET A SPECIAL TIME Set a special time each day when you will study. The time you select will depend on your personal schedule or preference. Some prefer to study early in the morning when they are fresh and rested. Some find their best time to be late at night when everyone else in their household has retired. Whatever time you select, set it apart as a regular appointment time with God to study His Word.

SELECT A SPECIAL PLACE Select a place that is as free from noise and interruption as possible. Be sure to have good lighting to enable you to read without eye strain. If it is possible, select a place where you can leave your study materials, i.e., Bible, pencil, paper, and any Bible study books you may have. This way you do not have to spend time each day collecting these items before you start your study.

START A SPECIAL WAY Start each study session with prayer. Ask God to open your understanding so you will be able to receive His Word. The Psalmist David prayed: Let my cry come near before thee, O Lord; give me understanding according to thy Word.

Psalm 119:169lxviii

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Chapter 5 Origin and the Purpose of the Bible ORIGIN OF THE BIBLE The Bible is the written Word of God. He inspired the words in the Bible and used approximately 40 different men to write down His words. These men wrote the Bible as you and I know it over a period of 1500 years. The perfect agreement of these writers is one proof that they were all guided by a single author. That author was God. Some of the writers wrote down exactly what God said: Take thee a roll of a book, and write therein all the words that I have spoken unto thee against Israel . . . Jeremiah 36:2 Other writers wrote what they experienced or what God revealed concerning the future: Write the things which thou hast seen, and the things which are, and the things which shall be hereafter. Revelation 1:19 All of the writers wrote under God's inspiration the words of His message for us.

THE PURPOSE OF THE BIBLE The Bible itself records its main purpose: 16

Every Scripture is God-breathed (given by His inspiration) and profitable for instruction, for reproof and conviction of sin, for correction of error and discipline in obedience, [and] for training in righteousness (in holy living, in conformity to God's will in thought, purpose, and action), 17So that the man of God may be complete and proficient, well fitted and thoroughly equipped for every good work. II Timothy 3:16-17 (AMP) The Scriptures are to be used to teach doctrine, to reprove and correct from evil (SIN), and to teach righteousness. They will help you live right and equip you to work for God. INSPIRATION OF THE BIBLE One of the most important things the Bible reveals about itself is that it is a book inspired by God. Through the inspiration of the Holy Spirit, God spoke to holy men to write His message.

Look up II Timothy 3:16-17 in your Bible. These verses confirm that God's Word is inspired.

They also reveal that it is profitable in four major areas of Christian life: -For doctrine -For reproof -For correction -For instruction in righteousness

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These verses are the main objectives of God's Word. These result in the man of God being perfect (mature) and thoroughly furnished (equipped) for all good works.

PURPOSES OF THE WORD God gave His Word to accomplish specific purposes. A purpose is a goal or objective.

According to the Bible, some of these purposes are as follows: -The Word produces faith in the Gospel: Acts 4:4 -It cleanses: John 15:3; Ephesians 5:26 -If you hear and believe, it brings eternal life: John 5:24 -It is the basis for eternal judgment: John 12:48 -Unclean spirits are cast out by the Word: Matthew 8:16; Luke 4:36 -Miraculous signs follow preaching of the Word convincing of the truth of the Gospel: Mark 16:20 -It gives assurance of salvation: I John 1:2-6 -You are born again by the Word: I Peter 1:23; Psalms 119:41 -The Word bears record of the truth of the Gospel: I John 5:7 -You are sanctified by the Word: I Timothy 4:5 -There is hope in His Word: Psalms 130:5; Psalms 119:49, 81 -There is healing in His Word: Psalms 107:20 -It keeps you from the path of the destroyer: Psalms 17:4 -It is spirit and life: John 6:63 -Faith is increased by the Word: Romans 10:17 -It brings comfort: I Thessalonians 4:18: Psalms 119:50, 52 -It brings spiritual nourishment: I Timothy 4:6 -It brings answered prayer: John 15:7 -It is the key to success: Joshua 1:8 -If you hear and keep it you are blessed: Luke 11:28 -It is profitable for spiritual growth: II Timothy 3:16-17 -It brings blessings when it is kept and cursings when it is not kept: Deuteronomy 28 -It is a weapon in the time of temptation: Matthew 4 -It converts the soul: The law of the LORD is perfect, converting the soul: the testimony of the LORD is sure, making wise the simple. Psalms 19:7 -It makes wise the simple: Psalms 19:7 -It enlightens: Psalms 19:8 -It warns: Psalms 19:11 -Keeping the Word brings great reward: Psalms 19:11 -It permits access to Heaven: Revelation 22:14 -It brings the blessing of walking in righteousness: Psalms 119:1-3 -It makes you wiser than your enemies, teachers, and the ancients: Psalms 119:98-104

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-It quickens: Psalms 119:25 -It strengthens: Psalms 119:28 -It is the basis of God's mercy towards you: Psalms 119:58 -It brings delight: Psalms 119:92 -It gives the simple understanding: Psalms 119:130, 169; 104 -It brings deliverance: Psalms 119:170 THE WORD IS NOT VOID As we have seen, there are many purposes for God's Word. The Bible teaches that the Word will accomplish the purposes for which it exists. Read Isaiah 55:11 with me, "So shall my word be that goeth forth out of my mouth: it shall not return unto me void, but it shall accomplish that which I please, and it shall prosper in the thing whereto I sent it." Here God says that His Word will not return void which means that God does not make empty promises. What He says will happen. Every word of the Bible was written for a purpose and that purpose will be accomplished.

RESPONSE TO THE WORD It is not enough to hear, read, or study God's Word. The Bible teaches that you must respond to God's Word. To save space I will only listing those scriptures that pertain directly to the HEART, for the rest I will only show the scripture reference; please go and look them up for yourself when you have time. The Bible tells each of us that we are to: -Let it fall upon good ground in your heart: Mark 4, Luke 8:15 But as for that [seed] in the good soil, these are [the people] who, hearing the Word, hold it fast in a just (noble, virtuous) and worthy heart, and steadily bring forth fruit with patience. Matthew 13 -Hear it and do it to be wise: John 12:47 -Keep the Word: John 14:23 -Believe on Jesus in order for God's Word to abide in you: John 5:38 -Continue in His Word: John 8:31 -Not live only on physical food, but also for the Word: Matthew 4:4; Luke 4:4; Deuteronomy 8:3 -Praise His Word: Psalms 56:4, 10 -Give thanks for it: Psalms 119:62 -Magnify His Word even above His name: Psalms 138:2 -Engraft His Word in your heart: James 1:21, "So get rid of all uncleanness and the rampant outgrowth of wickedness, and in a humble (gentle, modest) spirit receive and welcome the Word which implanted and rooted [in your hearts] contains the power to save your souls." (AMP) -Be a doer of the Word and not a hearer only: James 1:22-23 -Ask forgiveness for sin so His Word can abide in you: I John 1:10 -Desire the milk of His Word: I Peter 2:2

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-Let the Word of God dwell in you richly: Colossians 3:16 -Rightly divide the Word of God: II Timothy 2:5 -Search the Scriptures: John 5:39; Acts 17:11 -Declare His Word: Psalms 119:26-27 -Choose His Word: Psalms 119:30 -Stick to His Word: Psalms 119:31 -Run the way of His Word: Psalms 119:32 -Keep it: Psalms 119:33 -Observe it: Psalms 119:34 -Delight in it: Psalms 119:35; 70; 77; 143; 174 -Incline your heart unto it: Psalms 119:36 Incline my heart to Your testimonies and not to covetousness (robbery, sensuality, unworthy riches) (AMP) -Desire to have it established in your life: Psalms 119:38 -Long after it: Psalms 119:40 -Use it to answer other: Psalms 119:42 -Hope in it: Psalms 119:43, 47 -Keep it forever: Psalms 119:44 -Seek His precepts: Psalms 119:45 -Be willing to speak it before leaders: Psalms 119:46 -Meditate on it: Psalms 119:48; 78; 148 -Not decline from it: Psalms 119:52 -Walk according to its teachings: Psalms 119:59 -Not delay to keep His Word: Psalms 119:60 -Not forget it: Psalms 119:61, 83, 93, 153, 176 -Choose companions who also fear the Word and keep it: Psalms 119:63 -Believe it: Psalms 119:66; 128 -Keep it with your whole heart: Psalms 119:69 The arrogant and godless have put together a lie against me, but I will keep Your precepts with my whole heart. (AMP) -Value it more than gold and silver: Psalms 119:72 -Desire to learn it: Psalms 119:73 -Hope in the Word: Psalms 119:74; 81 -Find comfort in it: Psalms 119:76; 82 -Desire for it to change your heart: Psalms 119:80 Let my heart be sound (sincere and wholehearted and blameless) in Your statutes, that I may not be put to shame. (AMP) -Not forsake it: Psalms 119:87 -Seek after it: Psalms 119:94 -Consider it: Psalms 119:95 -Long for God's Word: Psalms 119:131 -Order your steps in the Word: Psalms 119:133

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A Paramedicâ&#x20AC;&#x2122;s view of Christianity -Be grieved when God's Word is not honored: Psalms 119:136, 158 -Stand in awe of God's Word: Psalms 119:161 -Love it: Psalms 119:163, 165, 167 -Speak His Word: Psalms 119:172

RESPONSIBILITY FOR THE WORD In addition to making the proper response to God's Word, you have a responsibility for the Word of God. The early Church assumed this responsibility as they went everywhere preaching the Word of God (Acts 8;4; 13:49; 12:24). They asked God for boldness to speak the Word (Acts 4:29 and 31) and the Word of God increased throughout the world because of their efforts (Acts 6:7; 19:20) Here is what the Bible reveals about YOUR responsibility for the Word of God: -You are to preach His Word throughout the world: Matthew 16:15; Luke 24:47 And that repentance [with a view to and as the condition of] forgiveness of sins should be preached in His name to all nations, beginning from Jerusalem. (AMP); Mark 16:15.

-If you are taught in God's Word then you have a responsibility to teach others: Galatians 6:6 Let him who receives instruction in the Word [of God] share all good things with his teacher [contributing to his support]. (AMP) -You are to preach the Word: II Timothy 4:2 -You are to speak His Word without fear: Philippians 1:4 -God puts His Word in you so you can speak it to others: Deuteronomy 18:18-19; Isaiah 51:16 Jeremiah 1:9; 3:12; 5:14; 26:12; Ezekiel 2:6-7.

-You should not speak your own words but you should speak His words: Isaiah 58:13 -You are not to be ashamed of the Word: Mark 8:38 For whoever is ashamed [here and now] of Me and My words in this adulterous (unfaithful) and [preeminently] sinful generation, of him will the Son of Man also be ashamed when He comes in the glory (splendor and majesty) of His Father with the holy angels. (AMP) -You are to teach it to your children: Deuteronomy 6:6-9 6And these words which I am commanding you this day shall be [first] in your [own] minds and hearts; [then] 7You shall whet and sharpen them so as to make them penetrate, and teach and impress them diligently upon the [minds and] hearts of your children, and shall talk of them when you sit in your house and when you walk by the way, and when you lie down and when you rise up. 8And you shall bind them as a sign upon your hand, and they shall be as frontlets (forehead bands) between your eyes. 9And you shall write them upon the doorposts of your house and on your gates. (AMP) Deuteronomy 6:6-9 Write these commandments that I've given you today on your hearts. Get them inside of you and then get them inside your children. Talk about them wherever you are, sitting at home or walking in the street; talk about them from the time you get up in the morning to when you fall into bed at night. Tie them on your

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hands and foreheads as a reminder; inscribe them on the doorposts of your homes and on your city gates. (MSG)lxix

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Chapter 6 Interpretation of Gods Word the Bible We use the cardiac EKG to interpret how our physical hearts are doing. What do we use to interpret our spiritual lives?

The Bible states: Study to shew thyself approved unto God, a workman that needeth not to be ashamed, rightly dividing the word of truth. II Timothy 2:15 "Rightly dividing" as used here is taken from the rules for Old Testament sacrifices and means to "cut straight." In the Old Testament, when a person brought a sacrifice for sin, the animal was divided into three parts (Here we see that number 3 again). One part was offered to God. Another part was given to the one who brought the offering. The third part went to the priest. From this practice the expression "rightly dividing" developed. It means to "give to each that which belongs to him."

In Bible study it is important to rightly divide the Word of God. This means you must understand what is being said to whom. You must also interpret and apply the meaning correctly.

There are three major groups to which the Word addresses itself. These are listed in I Corinthians 10:32: Give none offense, neither to the Jews, nor to the Gentiles, nor to the Church of God. All Scriptures were given FOR us, but not all verses are directed TO us. For example, God told Noah to build an ark. The story is recorded as an example from which you are to learn spiritual truths but it does not mean YOU should build an ark. Some of the Bible is directed to the Jews. Portions are directed to the Gentiles (nations other than the Jews). Other portions are directed to the Church (all those who are true believers in Jesus Christ).

In order to find the correct meaning from the Bible you must learn to rightly divide it. Another word for this is "interpretation" which means to give something proper meaning. You must learn how to arrive at the proper meaning for each Scripture. Jesus pointed out to the religious leaders of His time: . . . Ye do err, not knowing the Scriptures or the power of God. Matthew 22:29 Spiritual error results from #1 not knowing God's Word and #2 not obeying God's Word. Just think about this for a few minutes, what could happen to one or more of our cardiac patient's medical care if we made an error and did not interpret their EKGs correctly. I would say this would cause anything from giving them the wrong medication, the wrong dosage of a medication, the wrong electrical therapy and could move on to not treating the patient's life threatening dysrhythmias at all.

As we read in chapter three, there is a systematic approach to reading and interpreting an EKG. Now lets look at the principles you must follow in order to properly interpret the Bible.

There are six basic rules for interpreting the Bible which help to "rightly divide" the Word of God.

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THE RULE OF DIVINE AUTHORITY The rule of divine authority means that we accept the Bible as the final authority. We believe that the entire Bible is inspired by God, from Genesis through Revelation: All Scripture is given by inspiration of God, and is profitable for doctrine, for reproof, for correction, for instruction in righteousness. II Timothy 3:16 For the prophecy came not in old time by the will of man; but holy men of God spake as they were moved by the Holy Ghost. II Peter 1:21 There are two different types of inspiration: Verbal and plenary inspiration.

By verbal inspiration we mean that God inspired every word in the original manuscripts. By plenary inspiration we mean full inspiration of all Scripture as opposed to partial inspiration.

Every portion of the Bible is inspired.

When we accept the rule of divine authority, then there is no conflict between the Bible and history or science. If there is an apparent conflict it is because: 1. We have failed to understand science or history. or else. 2. The current scientific knowledge is not accurate. When conflicts are apparent, the Bible is taken as the final authority because it is the divinely inspired Word of God. In the past, when apparent conflicts between the Bible and history or science arose, later investigations always proved the Bible to be correct.

Let's review just a few of them where the Bible was proven to be correct: Scientific Facts in the Bible 1. Only in recent years has science discovered that everything we see is composed of invisible atoms. Here, Scripture tells us that the "things which are seen were not made of things which do appear." (Hebrews 11:3 Through faith we understand that the worlds were framed by the word of God, so that things which are seen were not made of things which do appear.)

2. Medical science has only recently discovered that blood-clotting in a newborn reaches its peak on the eighth day, then drops. The Bible consistently says that a baby must be circumcised on the eighth day. (Luke 2:21 And when eight days were accomplished for the circumcising of the child, his name was called JESUS, which was so named of the angel before he was conceived in the womb.)

3. At a time when it was believed that the earth sat on a large animal or a giant (1500 B.C.), the Bible spoke of the earth's free float in space: (Job 26:7 "He...hangs the earth upon nothing").

4. The prophet Isaiah also tells us that the earth is round: (Isaiah 40:22 "It is he that sits upon the circle of the earth"). This is not a reference to a flat disk, as some skeptic maintain, but to a sphere. Secular man discovered this 2,400 years later. At a time

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A Paramedicâ&#x20AC;&#x2122;s view of Christianity when science believed that the earth was flat, this was the Scriptures that inspired Christopher Columbus to sail around the world.

5. God told Job in 1500 B.C.: (Job 38:35 "Can you send lightnings, that they may go, and say to you, Here we are?"). The Bible here is making what appears to be a scientifically ludicrous statementâ&#x20AC;&#x201D;that light can be sent, and then manifest itself in speech. But did you know that radio waves travel at the speed of light? This is why you can have instantaneous wireless communication with someone on the other side of the earth. Science didn't discover this until 1864 when "British scientist James Clerk Maxwell suggested that electricity and light waves were two forms of the same thing" (Modern Century Illustrated Encyclopedia).

6. Job 38:19 asks, "Where is the way where light dwells?" Modern man has only recently discovered that light (electromagnetic radiation) has a "way," traveling at 186,000 miles per second.

7. Science has discovered that stars emit radio waves, which are received on earth as a high pitch. God mentioned this in Job 38:7: "When the morning stars sang together..."

8. "Most cosmologists (scientists who study the structures and evolution of the universe) agree that the Genesis account of creation, in imagining an initial void, may be uncannily close to the truth" (Time, Dec. 1976).

9. Solomon described a "cycle" of air currents two thousand years before scientists "discovered" them. (Ecclesiastes 1:6 "The wind goes toward the south, and turns about unto the north; it whirls about continually, and the wind returns again according to his circuits").

10. Science expresses the universe in five terms: time, space, matter, power, and motion.

Genesis 1:1, 2 revealed such truths to the Hebrews in 1450 B.C.: "In the beginning [time] God created [power] the heaven [space] and the earth [matter] . . . And the Spirit of God moved [motion] upon the face of the waters." The first thing God tells man is that He controls of all aspects of the universe.

11. The great biological truth concerning the importance of blood in our body's mechanism has been fully comprehended only in recent years. Up until 120 years ago, sick people were "bled," and many died because of the practice. If you lose your blood, you lose your life. Yet Leviticus 17:11, written 3,000 years ago, declared that blood is the source of life: "For the life of the flesh is in the blood."

12. All things were made by Him (John 1:3 All things were made by him; and without him was not any thing made that was made.), including dinosaurs. Why then did the dinosaur disappear? The answer may be in Job 40:15-24. In this passage, God speaks about a great creature called "behemoth." Some commentators think this was a hippopotamus. However, the hippo's tail isn't like a large tree, but a small twig.

Following are the characteristics of this huge animal: It was the largest of all the creatures God made; was plant-eating (herbivorous); had its strength in its hips and a tail like a large tree. It had very strong bones, lived among the trees, drank massive

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amounts of water, and was not disturbed by a raging river. He appears impervious to attack because his nose could pierce through snares, but Scripture says, "He that made him can make his sword to approach unto him." In other words, God caused this, the largest of all the creatures He had made, to become extinct.

13. Encyclopedia Britannica documents that in 1845, a young doctor in Vienna named Dr. Ignaz Semmelweis was horrified at the terrible death rate of women who gave birth in hospitals. As many as 30 percent died after giving birth. Semmelweis noted that doctors would examine the bodies of patients who died, then, without washing their hands, go straight to the next ward and examine expectant mothers. This was their normal practice, because the presence of microscopic diseases was unknown.

Semmelweis insisted that doctors wash their hands before examinations, and the death rate immediately dropped to 2 percent. Look at the specific instructions God gave His people for when they encounter disease: "And when he that has an issue is cleansed of his issue; then he shall number to himself even days for his cleansing, and wash his clothes, and bathe his flesh in running water, and shall be clean" (Leviticus 15:13). Until recent years, doctors washed their hands in a bowl of water, leaving invisible germs on their hands. However, the Bible says specifically to wash hands under "running water."

14. Luke 17:34-36 says the Second Coming of Jesus Christ will occur while some are asleep at night and others are working at daytime activities in the field. This is a clear indication of a revolving earth, with day and night at the same time.

15. "During the devastating Black Death of the fourteenth century, patients who were sick or dead were kept in the same rooms as the rest of the family. People often wondered why the disease was affecting so many people at one time. They attributed these epidemics to 'bad air' or 'evil spirits.' However, careful attention to the medical commands of God as revealed in Leviticus would have saved untold millions of lives.

Arturo Castiglione wrote about the overwhelming importance of this biblical medical law: 'The laws against leprosy in Leviticus 13 may be regarded as the first model of sanitary legislation' (A History of Medicine)." Grant R. Jeffery, The Signature of God With all these truths revealed in Scripture, how could a thinking person deny that the Bible is supernatural in origin? There is no other book in any of the world's religions (Vedas, Bhagavad-Gita, Koran, Book of Mormon, etc.) that contains scientific truth. In fact, they contain statements that are clearly unscientific. Hank Hanegraaff said, "Faith in Christ is not some blind leap into a dark chasm, but a faith based on established evidence." lxx THE RULE OF LITERAL INTERPRETATION To interpret the Bible literally means to believe it means exactly what it says. Always interpret the Bible literally unless the context clearly indicates otherwise. When the Bible says Israel crossed the Jordan River on dry ground, accept it literally. When the Bible tells about the walls of Jericho falling down, accept it as it is recorded by the Holy Spirit.

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The Bible does contain various "types" and "symbols". Certain persons, places, or events, while literal in themselves, also represent something that will happen in the future. This is known as fore shadowing.

A symbol stands for a meaning in addition to its ordinary one. For example, in Mark 14:22-25 22 And while they were eating, He took a loaf [of bread], praised God and gave thanks and asked Him to bless it to their use. [Then] He broke [it] and gave to them and said, Take. Eat. This is My body. 23He also took a cup [of the juice of grapes], and when He had given thanks, He gave [it] to them, and they all drank of it. 24And He said to them, This is My blood [which ratifies] the new covenant, [the blood] which is being poured out for (on account of) many.

25 Solemnly and surely I tell you, I shall not again drink of the fruit of the vine till that day when drink it of a new and a higher quality in God's kingdom. (AMP) the wine [of the juice of grapes], is used as a symbol of the blood of the Lord Jesus Christ. (They were not drinking actual blood.) Symbols are often used in Bible prophecy. For example the great image of which Nebuchadnezzar dreamed in Daniel has symbolic significance. Each part of the image represented a future world kingdom (Daniel 2). The Bible usually explains symbols when they are used. For example, Daniel's interpretation of the symbolic image is recorded in Daniel 2:31-45.

Jesus often used parables when He taught. A parable is a story that is told for the purpose of illustrating a spiritual truth. Whenever Jesus used a parable it is always stated in the Bible. If it does not say it was a parable then the story should be accepted as an actual event.

When it comes to explaining the concept of foreshadowing to some on in EMS I will ask them. Have you ever thought about the fact that EMS does not use the Caduceus but we do use the Star of Life?

The Caduceus has 1 Staff and 2 Snakes and Wings founded on Greek Mythology. The Star of Life, on the other hand has only 1 Staff and 1 Snake, some say it also was from Greek Mythology or the "Worm" Theory.

I believe that this symbol comes from the Bible as see in Number 21: 6-9 6Then the Lord sent fiery (burning) serpents among the people; and they bit the people, and many Israelites died.

7 And the people came to Moses, and said, We have sinned, for we have spoken against the Lord and against you; pray to the Lord, that He may take away the serpents from us. So Moses prayed for the people. 8And the Lord said to Moses, Make a fiery serpent [of bronze] and set it on a pole; and everyone who is bitten, when he looks at it, shall live. 9And Moses made a serpent of bronze and put it on a pole, and if a serpent had bitten any man, when he looked to the serpent of bronze [attentively, expectantly, with a steady and absorbing gaze], he lived.

In the study of Theology this is what they call foreshadowing. This really happened to Children of Israel while they were in the wilderness. Moses made a bronze Snake (1) and then set the snake onto a pole. The scripture goes on to say that if a serpent had bitten any man, when he looked to the serpent of bronze [attentively, expectantly, with a steady and absorbing gaze], he lived. Numbers 21:9b This snake on the pole was also telling

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(foreshadowing) us that the same thing would have to happen to Jesus and his death on a pole we know as the Cross at Calvary. John 3:14 and 15 tells us â&#x20AC;Ś Jesus said that as Moses lifted up the serpent in the wilderness, so must the Son of Man be lifted up, "that everyone who believes in Him [who cleaves to Him, trusts Him and relies on Him] may not perish, but have eternal life and [actually] live forever!"

THE RULE OF CONTEXTUAL CONSIDERATION Every verse of the Bible should be studied in its context. This means it should be studied in relation to the verses, which precede and follow it as well as in relation to the rest of the Bible. Many false doctrines and cults have been created because verses or parts of verses were taken out of their context.

For example, the Bible says there is no God. Did you know that? You will find this in Psalm 14:1.

Right there it says, "there is no God." But if we read all the passage then we have this: The fool hath said in his heart, There is no God. Psalms 14:1 The complete verse in its context is quite different in meaning than the portion removed from the context.

To study a verse in its context asks the following questions: 1. Who Is Speaking or Writing? Although the entire Bible is God's Word, different men were used in writing and speaking it.

2. What Is Being Said? Summarize the main points of what is being said by the speaker or writer.

3. To Whom Is It Being Said? Israel? The Gentile nations? The Church? A specific individual?

4. Why Was It Said? What is the purpose in the passage? The Bible itself states purposes for some books and passages: 30

And many other signs truly did Jesus in the presence of His disciples, which are not written in this book: 31 But these are written, that ye might believe that Jesus is the Christ, the Son of God; and that believing ye might have life through His name.

John 20:30-31 For other parts of Scripture the reason for writing is not so clearly stated. You must examine the context more closely to determine why the message was recorded.

5. When Was It Said?

The time and circumstances of some scriptures help us understand the meaning. For example, when there was confusion in church services at the church of Corinth Paul

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Did this mean women could not sing, pray, teach, or worship out loud in the Church?

To find the answer, we must examine when, why, and to whom this was said. In Jewish church services men were seated on one side of the building and women on the other. The Corinthian women were disrupting services by shouting questions to their husbands on the other side of the room. This was the occasion when Paul found it necessary to write: Let your women keep silence in the churches; for it is not permitted unto them to speak; but they are commanded to be under obedience, as also saith the law. I Corinthians 14:34

Interpreting a Scripture within its context helps explain the meaning of the passage. Taking a verse out of context can result in incorrect understanding. Often the context of a Scripture in the Bible gives the interpretation. A good example of this is the parable of the sower in Matthew 13:1-9. If you continue to read the context, the parable is interpreted in verses 1823. In many cases similar to this the Bible interprets itself within the context. This is why contextual consideration is important.

THE RULE OF FIRST MENTION The rule of first mention is as follows: The first time a word, phrase, object, or incident is mentioned in the Bible, it gives the key to its meaning anywhere else it occurs.

For example, in Genesis 3 there is the first mention of fig leaves. Here, Adam used fig leaves to try to cover his own sin and nakedness by his own efforts. Fig leaves speak of selfrighteousness, rejection of God's remedy, and an attempt to justify ones self before God. This is the meaning of fig leaves wherever they are mentioned afterwards in the Bible. For example, the last time fig leaves are mentioned is by Jesus in Matthew 21 and Mark 11 and Mark 13. Here we find a fig tree with leaves but no fruit. Jesus cursed it and it withered away.

To understand this act we need to remember the law of first mention and go back to Genesis 3. Fig leaves represent man's rejection of God's remedy and a self-righteous attempt to justify himself. The fig tree represented the self-righteous nation of Israel who had rejected Jesus. They rejected Him as King and would not accept His plan of salvation from sin. They were trying to be righteous through their own self-efforts.

THE RULE OF REPETITION The entire Bible is divinely inspired. There are no unessential parts of the Bible. Each word is inspired and necessary. For this reason, when something is repeated in Scripture it is for special emphasis. It means that a truth is of such special importance that it needs to be repeated.

John 3 illustrates this rule of repetition. Jesus tells Nicodemus of the necessity of the new birth experience and repeats it three times:

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Except a man be born again, he cannot see the kingdom of God. John 3:3 then we read it again this way. Except a man be born of water and of the Spirit he cannot enter into the kingdom of God. John 3:5. Then yet again within the same chapter for a third time we read.

Marvel not that I say unto thee, Ye must be born again. John 3:7 Whenever the Bible repeats, it is the Holy Spirit's way of saying "Stop and really look at this."

THE RULE OF CUMULATIVE REVELATION This rule is actually stated in the Bible: 20

Know this first that no prophecy of the Scripture is of any private interpretation. 21 For the prophecy came not in old time by the will of men; but holy men of God spake as they were moved by the Holy Ghost. II Peter 1:20- 21 The Schofield Bible gives this translation: "No prophecy of scripture is its own interpretation; That is, it is not isolated from all that the Word has given elsewhere."

The rule of cumulative revelation is this: The full truth of God's Word on any subject must not be gathered from an isolated passage. The cumulative (total) revelation of the entire Bible says regarding a truth must be considered. This is why it is called the rule of "cumulative" revelation.

You cannot base your doctrine, teaching, or beliefs on a few isolated verses about a subject.

You must keep studying until your interpretation becomes consistent with the whole of the Scriptures. lxxi

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Chapter 7 God's View of the Human Heart In the King James Version (KJV) we find that the English word, "heart", is found 946 times in 823 different verses. There are 724 verses with the word heart in the Old Testament and 99 times in the New Testament. Frequently, the translators of the bible would interpret "heart," for several different Hebrew and Greek words. Sometimes, the translators would use the English word "heart" for the Greek and Hebrew words "mind", "will", "conscience", "emotions", "soul affections", "personality", "character" or, "human nature."

The word "heart" is also translated with the holistic view of a person's center, of all their physical, emotional, intellectual, and moral activities. "Heart" can also be translated in English, as the center of something. Exodus 15:8 says "And with the blast of thy nostrils the waters were gathered together, the floods stood upright as an heap, [and] the depths were congealed in the heart of the sea." We see in Exodus 15:8 that the translators used the word "heart of the sea," which also could be said "center of the sea." We also see another example in Matthew 12:40 which says, "For as Jonas was three days and three nights in the whale's belly; so shall the Son of man be three days and three nights in the heart of the earth." As a physical organ, the "heart" is the center of our physical life; the pump that moves our blood throughout our body. Take a moment and ponder the futility of the body, without a heart, in these two verses. 1 Samuel 25:37 says "But it came to pass in the morning, when the wine was gone out of Nabal, and his wife had told him these things, that his heart died within him, and he became [as] a stone." Proverbs 14:30 says "A sound heart [is] the life of the flesh: but envy the rottenness of the bones."lxxii Jeremiah 17:10 says "I the LORD search the heart, I try the reins, even to give every man according to his ways, and according to the fruit of his doings." GOD will reward all of us according to our ways. The heart is the center of our natural and spiritual life. The heart is the "home of the personal life," and hence a man is designated, according to his heart. This includes the open and hidden emotional, intellectual and moral activities of man. Our heart is the home of our conscience (Romans 2:15) and, is naturally wicked (Genesis 8:21). If we do not change the default setting of being naturally wicked, it will contaminate our whole life and character. Matthew 12:34 says, "for out of the abundance of the heart the mouth speaketh."

We can tell what our heart believes, by what we say, especially when the pressure is on us.

Jesus said in Matthew 15:18-20 that "those things that proceed out of the mouth come forth from the heart; and they defile a man. For out of the heart proceed evil thoughtsâ&#x20AC;Ś". That is why our hearts must be renewed. GOD said in Ezekiel 36:26 that, "a new heart also will I give you, and a new spirit will I put within you; and I will take away the stony heart out of your flesh, and I will give you an heart of flesh." In Ezekiel 11:19-21, GOD tells us why we need a heart of flesh and not of stone, "And I will give them one heart, and I will put a new spirit within you; and I will take the stony heart out of their flesh, and will give them an heart of flesh: That they may walk in my statutes, and keep mine ordinances, and do them: and they shall be my people, and I will be their God. But [as for them] whose heart walketh after the heart of their detestable things and their abominations, I will recompense their way upon their own heads, saith the Lord GOD." Before any of us can willingly obey GOD, we should pray, as David prayed in Psalms 51:1014 "create in me a clean heart, O God; and renew a right spirit within me. Cast me not away

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from thy presence; and take not thy Holy Spirit from me. Restore unto me the joy of thy salvation; and uphold me [with thy] free spirit. [Then] will I teach transgressors thy ways; and sinners shall be converted unto thee. Deliver me from blood guiltiness, O God, thou God of my salvation: [and] my tongue shall sing aloud of thy righteousness." (AMP) The regeneration process starts at the time of our salvation, and, the process of salvation works on our heart.lxxiii The process of salvation begins in the heart by the believing reception of the testimony of God, while the rejection of that testimony hardens the heart. "Hardness of heart evidences itself by light views of sin; partial acknowledgment and confession of it; pride and conceit; ingratitude; unconcern about the word and ordinances of God; inattention to divine providences; stifling convictions of conscience; shunning reproof; presumption, and general ignorance of divine things."lxxiv Hardness of heart, caused by sin and actively sinning, is what I like to call Christian heart disease. In the physical, the term "heart diseases" refers to diseases of the heart and the blood vessel system within it. Before I started studying this topic of hardness of heart being a form of heart disease for the Christian, I was not aware that there are more than fifty different types of heart diseases; the most common type is known as coronary artery disease.

Some people are born with heart disease (known as congenital heart disease); others develop during a person's lifetime. Because there are so many heart disease types, it may be helpful to separate them into problems in the: Heart chambers, Heart muscle itself, Heart valves, Coronary arteries and coronary veins, Electrical system and the Heart's lining.

Congestive heart failure, cardiomyopathy, and valvular heart disease are among the heart disease types.lxxv I found something very interesting one afternoon as I was doing a word study on the word HEART with my Dakes Bible. What I found was that throughout the Bible we see that there are also at least fifty kinds of hearts listed in the Bible. Let's review them.

Fifty Kinds of Hearts 1. Broken: (Weakened in strength, spirit, etc. tamed, trained, or reduced to submission) Psalm 34:18 The Lord is close to those who are of a broken heart and saves such as are crushed with sorrow for sin and are humbly and thoroughly penitent. (AMP) 2. Contrite: (Feeling or showing regret for bad behavior or for one's sins or offenses, penitent) Psalm 51:17 My sacrifice [the sacrifice acceptable] to God is a broken spirit; a broken and a contrite heart [broken down with sorrow for sin and humbly and thoroughly penitent], such, O God, You will not despise. (AMP) 3. Grieved: (To distress mentally; cause to feel grief or great sorrow)

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Genesis 6:6 And the Lord regretted that He had made man on the earth, and He was grieved at heart. (AMP) See even God can get discouraged from time to time. Why do we think that just because we are Christian, it should never happen to us. Psalm 73:21 For my heart was grieved, embittered, and in a state of ferment, and I was pricked in my heart [as with the sharp fang of an adder]. (AMP) 4. Willing: (The faculty of conscious and especially of deliberate action; the power of control the mind has over its own actions: the freedom of the will; the act or process of using or asserting one's choice) Exodus 35:29 The Israelites brought a freewill offering to the Lord, all men and women whose hearts made them willing and moved them to bring anything for any of the work which the Lord had commanded by Moses to be done. (AMP) I like the fact that this verse in its self shows us all that we ALL have a free will to choose to serve God or choose to serve our selves.

5. Discouraged: (To deprive of courage, hope, or confidence; dishearten; dispirit; to express or make clear disapproval of; frown upon) Numbers 32:7-9 7 Why do you discourage the hearts of the Israelites from going over into the land which the Lord has given them? 8 Thus your fathers did when I sent them from Kadesh-barnea to see the land! 9 For when they went up to the Valley of Eshcol and saw the land, they discouraged the hearts of the Israelites from going into the land the Lord had given them. (AMP) 6. Obstinate: (Firmly or stubbornly adhering to one's purpose, opinion, etc.; not yielding to argument, persuasion, or entreaty. Characterized by inflexible persistence or an unyielding attitude; inflexibly persisted in or carried out) Deuteronomy 2:30 But Sihon king of Heshbon would not let us pass by him; for the Lord your God hardened his spirit and made his heart obstinate, that He might give him into your hand, as at this day. (AMP) 7. Proud: (feeling pleasure or satisfaction at one's achievements, possessions, connections; having a (too) high opinion of oneself; arrogant) Psalm 101:5 Whoso privily slanders his neighbor, him will I cut off [from me]; he who has a haughty look and a proud and arrogant heart I cannot and I will not tolerate. (AMP) 8. Wicked: (Evil by nature and in practice; having committed unrighteous acts; "a sinful person") Proverbs 6:18 A heart that manufactures wicked thoughts and plans, feet that are swift in running to evil (AMP)

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9. Trembling: (To vibrate or quiver: a state of change; "they were in a state of steady motion" - shaking or trembling [usually resulting from weakness or stress or disease]- To feel fear or anxiety) Deuteronomy 28:65 And among these nations you shall find no ease and there shall be no rest for the sole of your foot; but the Lord will give you there a trembling heart, failing of eyes [from disappointment of hope], fainting of mind, and languishing of spirit. (AMP) 10. Perfect: (Lacking nothing essential to the whole; complete of its nature or kind - Being without defect or blemish - Unblemished; faultless - Correct or precise perfect timing Excellent in all respects) 1 Kings 8:61 Let your heart therefore be perfect with the LORD our God, to walk in his statutes, and to keep his commandments, as at this day. (KJV) 11. Double: (Characterized by duplicity; deceitful: speak with a double tongue. - Deliberate deceptiveness in behavior or speech. â&#x20AC;&#x201C; This is seen in an instance of deliberate deceptiveness; double-dealing.)

James 4:8 Draw nigh to God, and he will draw nigh to you. Cleanse your hands, ye sinners; and purify your hearts, ye double minded. (KJV) I like how the Amplified Bible states this verse: Come close to God and He will come close to you. [Recognize that you are] sinners, get your soiled hands clean; [realize that you have been disloyal] wavering individuals with divided interests, and purify your hearts [of your spiritual adultery]. (AMP) Does this not sound like a PPE class "If it is wet or sticky and not your, do not touch it without your gloves on." Sin is the same way! Stay away from it at all cost. If you do get your hands soiled get them cleaned off by the washing of the Blood of Jesus.

12. Tender: (Soft or delicate in substance; not hard or tough: Delicate or soft in quality: Delicate, soft, or gentle: Easily moved to sympathy or compassion; kind: Affectionate or loving) Ephesians 4:32 And become useful and helpful and kind to one another, tenderhearted (compassionate, understanding, loving-hearted), forgiving one another [readily and freely], as God in Christ forgave you. (AMP) 13. Soft: (Gentle, mild, warm-hearted, or compassionate: Smooth, soothing, or ingratiating: soft words. Not harsh or severe, as a penalty or demand. To be responsive or sympathetic to the feelings, emotions, needs, etc., of others; tender-hearted.)

Job 23:16 For God maketh my heart soft, and the Almighty troubleth me: (KJV) The Amplified states that God has made my heart faint, timid, and broken.

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14. Pure: (Free from anything of a different, inferior, or contaminating kind; Unmodified by an admixture; Clean, spotless, or unsullied: [pure hands] Untainted with evil; innocent: [pure in heart] Free of or without guilt; guiltless) 1 Peter 1:22 Since by your obedience to the Truth through the [Holy] Spirit you have purified your hearts for the sincere affection of the brethren, [see that you] love one another fervently from a pure heart. (AMP) 15. Upright: (In Plumb {with the Word of God}: Something standing erect or vertical, [as a piece of timber] Adhering to rectitude; righteous, honest, or just: an upright person. Being in accord with what is right: The state of being upright or vertical.)

Psalm 32:11 Be glad in the Lord and rejoice, you [uncompromisingly] righteous [you who are upright and in right standing with Him]; shout for joy, all you upright in heart! (AMP) 16. Clean: (Free from dirt; unsoiled; unstained: Free from pollution; unadulterated; pure: Habitually free of dirt: Morally pure; innocent; upright; honorable: to lead a clean life.)

Psalm 51:10 Create in me a clean heart, O God, and renew a right, persevering, and steadfast spirit within me. (AMP) 17. Fixed: (Fastened, attached, or placed so as to be firm and not readily movable; firmly implanted; stationary; rigid. Set or intent upon something; steadily directed: a fixed stare.

Definitely and permanently placed: [a fixed buoy; a fixed line of defense] Put in order.)

Psalm 112:7 He shall not be afraid of evil tidings; his heart is firmly fixed, trusting (leaning on and being confident) in the Lord. (AMP) 18. Subtle: (Fine or delicate in meaning or intent; difficult to perceive or understand: Requiring mental acuteness, penetration, or discernment: Characterized by mental acuteness or penetration: Cunning, wily, or crafty: Skillful, clever, or ingenious) Proverbs 7:10 And, behold, there met him a woman with the attire of an harlot, and subtle of heart. (KJV) Here the Amplified states that the woman had a sly and cunning of heart.

19. Froward or Perverse: Froward: (Willfully contrary; not easily managed: Obstinate, willful, disobedient, fractious, wayward, unmanageable, and difficult.) Perverse: (Willfully determined or disposed to go counter to what is expected or desired; contrary. Wayward or cantankerous. Persistent or obstinate in what is wrong. Turned away from or rejecting what is right, good, or proper; wicked or corrupt. Contumacious, disobedient. Stubborn, headstrong. Evil, bad, sinful.)

Proverbs 11:20 They that are of a froward heart are abomination to the LORD: but such as are upright in their way are his delight. (KJV) The Amplified words it this way; they who are willfully contrary in heart and the New Living Translation calls it a crooked heart.

Proverbs 12:8 A man shall be commended according to his wisdom: but he that is of a

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perverse heart shall be despised. (KJV) Here the New Living translation wording states that a warped mind is despised.

20. Wise: (Having the power of discerning and judging properly as to what is true or right; possessing discernment, judgment, or discretion. Having knowledge or information as to facts, circumstances, etc.)

Proverbs 10:8 The wise in heart will accept and obey commandments, but the foolish of lips will fall headlong. (AMP) I enjoy reading The Message by Eugene Peterson; he really does not pull any punches. Here is what I mean let's read this verse in The Message Proverbs 10:8 A wise heart takes orders; an empty head will come unglued. (MSG) 21. Merry: (Full of cheerfulness or gaiety; joyous in disposition or spirit: Laughingly happy; mirthful; festively joyous; hilarious: Causing happiness; pleasant; delightful.)

Proverbs 15:13-15 13 A merry heart maketh a cheerful countenance: but by sorrow of the heart the spirit is broken. 14 The heart of him that hath understanding seeketh knowledge: but the mouth of fools feedeth on foolishness. 15 All the days of the afflicted are evil: but he that is of a merry heart hath a continual feast. (KJV) The Message reads like this, 13 A cheerful heart brings a smile to your face; a sad heart makes it hard to get through the day. 14 An intelligent person is always eager to take in more truth; fools feed on fast-food fads and fancies. 15 A miserable heart means a miserable life; a cheerful heart fills the day with song. (MSG) Proverbs 17:22 A merry heart doeth good like a medicine: but a broken spirit drieth the bones. (KJV) 22. Sorrowful: (Characteristic feeling of sadness, grief, or regret associated with loss, bereavement, sympathy for another's suffering: The outward expression of grief or sadness full of or feeling sorrow; grieved; sad: Showing or expressing sorrow; mournful; plaintive: Involving or causing sorrow) Proverbs 15:13 A glad heart makes a cheerful countenance, but by sorrow of heart the spirit is broken. (AMP) 23. Haughty: (Disdainfully proud; snobbish; scornfully arrogant; supercilious) Jeremiah 48:29 We have heard of the [giddy] pride of Moab, the extremely proud oneâ&#x20AC;&#x201D; his loftiness, his arrogance, his conceit, and the haughtiness of his heart. (AMP) 24. Fretting: (To feel or express worry, annoyance, discontent, or the like: To cause corrosion; gnaw into something: To make a way by gnawing, corrosion, wearing away: To become eaten, worn, or corroded: To torment; irritate, annoy, or vex: An irritated state of mind; annoyance; vexation: A worn or eroded place) Proverbs 19:3 The foolishness of man subverts his way [ruins his affairs]; then his heart is resentful and frets against the Lord. (AMP) So what does The Message have to say on

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this verse let's read it together? I think that you will like it. People ruin their lives by their own stupidity, so why does GOD always get blamed? (MSG) 25. Heavy: (Deep or intense; profound: a heavy thinker: Depressed with trouble or sorrow; showing sorrow; sad: a heavy heart: Sober, serious, or somber) Proverbs 25:20 He who sings songs to a heavy heart is like him who lays off a garment in cold weather and like vinegar upon soda. (AMP) 26. Unsearchable: (Not searchable; not lending itself to research or exploration; not to be understood by searching; hidden; unfathomable; mysterious) Proverbs 25:3 As the heavens for height and the earth for depth, so the hearts and minds of kings are unsearchable. (AMP) 27. Despiteful: (Expressing malice or hate) Ezekiel 25:15 Thus saith the Lord GOD; Because the Philistines have dealt by revenge, and have taken vengeance with a despiteful heart, to destroy it for the old hatred.

28. Bitter: (Marked by strong resentment or cynicism: Very difficult to accept or bear: Harsh or corrosive in tone [sulfurous, sulphurous, venomous, virulent, vitriolic]: Expressive of severe grief or regret: proceeding from or exhibiting great hostility or animosity: Causing a sharply painful or stinging sensation) James 3:14 But if you are bitterly jealous and there is selfish ambition in your heart, don't cover up the truth with boasting and lying. (NLT) 29. New: (Having just (or relatively recently) come into being or been made or acquired or discovered: Other than the former one(s): Different: Having no previous example or precedent or parallel: Of a kind not seen before: Lacking training or experience) Ezekiel 18:31 Cast away from you all your transgressions by which you have transgressed against Me, and make you a new mind and heart and a new spirit. For why will you die, O house of Israel? (AMP) Ezekiel 36:26 A new heart will I give you and a new spirit will I put within you, and I will take away the stony heart out of your flesh and give you a heart of flesh. (AMP) And 2 Cor. 5:17-18 17 Therefore if any person is [ingrafted] in Christ (the Messiah) he is a new creation (a new creature altogether); the old [previous moral and spiritual condition] has passed away. Behold, the fresh and new has come!

18 But all things are from God, Who through Jesus Christ reconciled us to Himself [received us into favor, brought us into harmony with Himself] and gave to us the ministry of reconciliation [that by word and deed we might aim to bring others into harmony with Him]. (AMP) 30. Stony: (Inflexible; cruel; unrelenting; pitiless; obdurate; perverse; cold; morally hard; appearing as if petrified; as, a stony heart; a stony gaze)

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Ezekiel 36:26 A new heart will I give you and a new spirit will I put within you, and I will take away the stony heart out of your flesh and give you a heart of flesh. (AMP) 31. Flesh: (As suggesting the idea of softness) Ezekiel 11:19 And I will give them one heart [a new heart] and I will put a new spirit within them; and I will take the stony [unnaturally hardened] heart out of their flesh, and will give them a heart of flesh [sensitive and responsive to the touch of their God]. (AMP) 32. Uncircumcised: (Spiritually Impure: Heathen) Acts 7:51 You stubborn and stiff-necked people, still heathen and uncircumcised in heart and ears, you are always actively resisting the Holy Spirit. As your forefathers [were], so you [are and so you do]! (AMP) 33. Meek and Lowly: (Meek: Humble in spirit or manner; Mild of temper; not easily provoked; not vain, or haughty, or resentful; forbearing; submissive: Gentle; mild; soft; yielding; unassuming; humble. Lowly: Humbly; meekly; modestly: Not lofty or sublime; humble) Matthew 11:29 Take My yoke upon you and learn of Me, for I am gentle (meek) and humble (lowly) in heart, and you will find rest (relief and ease and refreshment and recreation and blessed quiet) for your souls. (AMP) 34. Honest and Good: (Honest: Characterized by integrity or fairness and straight forwardness in conduct, thought, speech; upright; just; equitable; trustworthy; truthful; sincere; free from fraud, guile, or duplicity; not false Good: Possessing desirable qualities; adapted to answer the end designed; promoting success, welfare, or happiness; serviceable; useful; fit; excellent; admirable; commendable; [not bad, corrupt, evil, noxious, offensive, or troublesome] Possessing moral excellence or virtue; virtuous; pious; religious; Kind; benevolent; humane; merciful; gracious; polite; Propitious) Luke 8:15 And the seeds that fell on the good soil represent honest, good-hearted people who hear God's word, cling to it, and patiently produce a huge harvest. (NLT) 35. Overcharged: (To charge too much or too fully: To fill too full: Exaggerate, overdraw) Luke 21:34 And take heed to yourselves, lest at any time your hearts be overcharged with surfeiting, and drunkenness, and cares of this life, and so that day come upon you unawares.

36. Troubled: (Characterized by or indicative of distress or affliction or danger or need: Unrest or disorder or insubordination: To put into confused motion; to disturb; to agitate.

To disturb; to perplex; to afflict; to distress; to grieve; to fret; to annoy; to vex) John 14:1-3, 27 Let not your heart be troubled: ye believe in God, believe also in me. 2 In my Father's house are many mansions: if it were not so, I would have told you. I go to

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prepare a place for you. 3 And if I go and prepare a place for you, I will come again, and receive you unto myself; that where I am, there ye may be also. And 27 Peace I leave with you, my peace I give unto you: not as the world giveth, give I unto you. Let not your heart be troubled, neither let it be afraid.

37. Single: (One only, as distinguished from more than one; consisting of one alone; individual; separate; Performed by one person, or one on each side: Uncompounded; pure; unmixed. Not deceitful or artful; honest; sincere) Acts 2:46 And they, continuing daily with one accord in the temple, and breaking bread from house to house, did eat their meat with gladness and singleness of heart.

38. Foolish and Darkened: (Foolish: Devoid of good sense or judgment; Having or revealing stupidity; "ridiculous behavior"; Marked with, or exhibiting, folly; void of understanding; Weak in intellect; without judgment or discretion; silly; unwise. Weakness of mind or silliness; exhibiting a want of judgment or discretion; as, a foolish act: Absurd; ridiculous; despicable; contemptible. Darkened: Become or made dark by lack of light; To make dark or black; to deprive of light; to obscure; To render dim; to deprive of vision: To cloud, or perplex; to render less clear or intelligible: To cast a gloom upon: To make foul; to sully; to tarnish) Romans 1:21 Because when they knew and recognized Him as God, they did not honor and glorify Him as God or give Him thanks. But instead they became futile and godless in their thinking [with vain imaginings, foolish reasoning, and stupid speculations] and their senseless minds were darkened. (AMP) 39. Impenitent: (Not penitent or remorseful [unrepentant, unremorseful]: Impervious to moral persuasion: Not penitent; not repenting of sin; not contrite; of a hard Heart: One who is not penitent: The trait of refusing to repent: The condition of being impenitent; failure or refusal to repent; hardness of heart: A state of mind intermediate in point of time between sin and punishment.)

Romans 2:5 But by your callous stubbornness and impenitence of heart you are storing up wrath and indignation for yourself on the day of wrath and indignation, when God's righteous judgment (just doom) will be revealed. (AMP) 40. Circumcised: Being cleansed from sin: [Let us cleanse ourselves from all filthiness of the flesh and spirit, perfecting holiness in the fear of God 2 Corinthians 7:1] As a consequence, the believer has the virtues of Christ, and aims to fulfill, [Be ye therefore perfect, even as your Father which is in heaven is perfect. Matthew 5:48]).

Romans 2:29 No, a true Jew is one whose heart is right with God. And true circumcision is not merely obeying the letter of the law; rather, it is a change of heart produced by God's Spirit. And a person with a changed heart seeks praise from God, not from people. (NLT)

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41. Evil: (Morally bad or wrong; "evil purposes"; "an evil influence"; [depraved, vicious, harmful, injurious, immorality, wickedness, iniquity]: Tending to cause great harm: Having or exerting a malignant influence: Morally objectionable behavior: That which causes harm or destruction or misfortune: The quality of being morally wrong in principle or practice: Moral badness, or the deviation of a moral being from the principles of virtue imposed by conscience, or by the will of the Supreme Being, or by the principles of a lawful human authority; disposition to do wrong; moral offence; wickedness; depravity.

Having or exhibiting bad moral qualities; morally corrupt; wicked; wrong; vicious; as, evil conduct, thoughts, heart, words, and the like.)

Hebrews 3:12 Be careful then, dear brothers and sisters. Make sure that your own hearts are not evil and unbelieving, turning you away from the living God. (NLT) 42. True: (Consistent with fact or reality; not false: devoted [sometimes fanatically] to a cause or concept or truth; "true believers bonded together against all who: Having a legally established claim: Make level, square, balanced, or concentric: Actual; not counterfeit, adulterated, or pretended; genuine; pure; real) Hebrews 10:22 Let us all come forward and draw near with true (honest and sincere) hearts in unqualified assurance and absolute conviction engendered by faith (by that leaning of the entire human personality on God in absolute trust and confidence in His power, wisdom, and goodness), having our hearts sprinkled and purified from a guilty (evil) conscience and our bodies cleansed with pure water. (AMP) 43. Melted: (To soften, as by a warming or kindly influence; to relax; to render gentle or susceptible to mild influences; sometimes, in a bad sense, to take away the firmness of; to weaken) Joshua 2:11 When we heard it, our hearts melted, neither did spirit or courage remain any more in any man because of you, for the Lord your God, He is God in heaven above and on earth beneath. (AMP) 44. Deceitful: (Intended to deceive: Marked by deliberate deceptiveness especially by pretending one set of feelings and acting under the influence of another: [ambidextrous, Double-MINDED, double-dealing, duplicitous, two-faced, double-tongued] Full of, or characterized by, deceit; serving to mislead or insnare; trickish; fraudulent; cheating; insincere) Mark 7:21-23 For from within, [that is] out of the hearts of men, come base and wicked thoughts, sexual immorality, stealing, murder, adultery, 22 Coveting (a greedy desire to have more wealth), dangerous and destructive wickedness, deceit; unrestrained (indecent) conduct; an evil eye (envy), slander (evil speaking, malicious misrepresentation, abusiveness), pride (the sin of an uplifted heart against God and man), foolishness (folly, lack of sense, recklessness, thoughtlessness). 23 All these evil

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[purposes and desires] come from within, and they make the man unclean and render him unhallowed. (AMP) 45. Hard: (Resistant to pressure; not readily penetrated: Physically toughened; rugged: Mentally toughened; strong-minded: Requiring great effort or endurance: a hard assignment: Oppressive or unjust in nature or effect: Lacking compassion or sympathy; callous) Deuteronomy 15:7 If there is among you a poor man, one of your kinsmen in any of the towns of your land which the Lord your God gives you, you shall not harden your [minds and] hearts or close your hands to your poor brother. (AMP) 46. Whorish: (Resembling a whore in character or conduct; addicted to unlawful pleasures; incontinent; lewd; unchaste) Ezekiel 6:9 And they that escape of you shall remember me among the nations whither they shall be carried captives, because I am broken with their whorish heart, which hath departed from me, and with their eyes, which go a whoring after their idols: and they shall lothe themselves for the evils which they have committed in all their abominations.

47. Mischievous: (Naughtily or annoyingly playful: Badly behaved: Deliberately causing harm or damage: Causing mischief: Harmful; hurtful; detrimental; noxious; pernicious; destructive) Proverbs 28:14 Happy is the man that feareth alway: but he that hardeneth his heart shall fall into mischief.

48. Diabolical: (Relating to, or characteristic of the devil: Showing the cunning or ingenuity or wickedness typical of the devil: extremely evil or cruel; expressive of cruelty or befitting hell) Acts 5:3-4 Peter said, "Ananias, how did Satan get you to lie to the Holy Spirit and secretly keep back part of the price of the field? Before you sold it, it was all yours, and after you sold it, the money was yours to do with as you wished. So what got into you to pull a trick like this? You didn't lie to men but to God." (MSG) 49. Covetous: (Immoderately desirous of acquiring wealth; Greedy) 2 Peter 2:14 They have eyes full of harlotry, insatiable for sin. They beguile and bait and lure away unstable souls. Their hearts are trained in covetousness (lust, greed), [they are] children of a curse [exposed to cursing]! (AMP) 50. Compassionate: (Showing merciful compassion: showing recognition of unusually distressful circumstances: share the suffering of: Having a temper or disposition to pity; sympathetic; merciful: To have compassion for; to pity; to sympathize with)

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Ephesians 4:32 And become useful and helpful and kind to one another, tenderhearted (compassionate, understanding, loving-hearted), forgiving one another [readily and freely], as God in Christ forgave you. (AMP) We have just looked at the fifty types of human hearts as spoken about from the Bible, we also know that the Bible teaches that God Himself searches and knows all hearts. This is seen in 1 Chronicles 28:9 And you, Solomon my son, know the God of your father [have personal knowledge of Him, be acquainted with, and understand Him; appreciate, heed, and cherish Him] and serve Him with a blameless heart and a willing mind. For the Lord searches all hearts and minds and understands all the wanderings of the thoughts. If you seek Him [inquiring for and of Him and requiring Him as your first and vital necessity] you will find Him; but if you forsake Him, He will cast you off forever! (AMP) During this study, I also found, that the Bible has a lot to teach about the differences in the character and personality traits of a renewed heart versus that of an un-renewed (Mature Christian vs. Carnal Christian) heart. The human personality is what others see from the outside. The human character is what Gods sees not just from the outside but who we truly are when no one is around, just you and God. Let's first look at what the Bible has to say about what the Christians heart is to look like, and how are we to show others that we are living with a renewed heart.

Characteristics of the Renewed Heart [One that is CHANGED from the inside out] Prepared to Seek GOD 2 Chronicles 19:3 "Nevertheless there are good things found in thee, in that thou hast taken away the groves out of the land, and hast prepared thine heart to seek God." Ezra 7:10 "For Ezra had prepared his heart to seek the law of the LORD, and to do [it], and to teach in Israel statutes and judgments." And Psalms 10:17 "LORD, thou hast heard the desire of the humble: thou wilt prepare their heart, thou wilt cause thine ear to hear:" Fixed on GOD Psalms 57:7 "My heart is fixed, O God, my heart is fixed: I will sing and give praise." and Psalms 112:7 "He shall not be afraid of evil tidings: his heart is fixed, trusting in the LORD." Joyful in GOD 1 Samuel 2:1 "And Hannah prayed, and said, My heart rejoiceth in the LORD, mine horn is exalted in the LORD: my mouth is enlarged over mine enemies; because I rejoice in thy salvation." and Zechariah 10:7 "And [they of] Ephraim shall be like a mighty [man], and their heart shall rejoice as through wine: yea, their children shall see [it], and be glad; their heart shall rejoice in the LORD." Perfect with GOD 1 Kings 8:61 "Let your heart therefore be perfect with the LORD our God, to walk in his statutes, and to keep his commandments, as at this day." and Psalms 101:2 "I will behave myself wisely in a perfect way. O when wilt thou come unto me? I will walk within my house with a perfect heart."

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Upright Psalms 97:11 "Light is sown for the righteous, and gladness for the upright in heart." and Psalms 125:4 "Do good, O LORD, unto [those that be] good, and [to them that are] upright in their hearts."

Clean Psalms 73:1 "Truly God [is] good to Israel, [even] to such as are of a clean heart."

Pure Psalms 24:4 "He that hath clean hands, and a pure heart; who hath not lifted up his soul unto vanity, nor sworn deceitfully." and Matthew 5:8 "Blessed [are] the pure in heart: for they shall see God." Tender 1 Samuel 24:5 "And it came to pass afterward, that David's heart smote him, because he had cut off Saul's skirt." and 2 Kings 22:19 "Because thine heart was tender, and thou hast humbled thyself before the LORD, when thou heardest what I spake against this place, and against the inhabitants thereof, that they should become a desolation and a curse, and hast rent thy clothes, and wept before me; I also have heard [thee], saith the LORD." Single and Sincere Acts 2:46 "And they, continuing daily with one accord in the temple, and breaking bread from house to house, did eat their meat with gladness and singleness of heart" and Hebrews 10:22 "Let us draw near with a true heart in full assurance of faith, having our hearts sprinkled from an evil conscience, and our bodies washed with pure water."

Honest and Good Luke 8:15 "But that on the good ground are they, which in an honest and good heart, having heard the word, keep [it], and bring forth fruit with patience."

Broken, Contrite Psalms 34:18 "The LORD [is] nigh unto them that are of a broken heart; and saveth such as be of a contrite spirit." and Psalms 51:17 "The sacrifices of God [are] a broken spirit: a broken and a contrite heart, O God, thou wilt not despise."

Obedient Psalms 119:112 "I have inclined mine heart to perform thy statutes alway, [even unto] the end." and Romans 6:17 "But God be thanked, that ye were the servants of sin, but ye have obeyed from the heart that form of doctrine which was delivered you."

Filled with the Law of GOD Psalms 40:8 "I delight to do thy will, O my God: yea, thy law [is] within my heart." and Psalms 119:11 "Thy word have I hid in mine heart, that I might not sin against thee."

Awed by the word of GOD Psalms 119:161 "Princes have persecuted me without a cause: but my heart standeth in awe of thy word."

Filled with the Fear of GOD Jeremiah 32:40 "And I will make an everlasting covenant with them, that I will not turn away from them, to do them good; but I will put my fear in their hearts, that they shall not depart from me."

Meditative Psalms 4:4 "Stand in awe, and sin not: commune with your own heart upon your bed, and be still. Selah." and Psalms 77:6 "I call to remembrance my song in the night: I commune with mine own heart: and my spirit made diligent search."

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Circumcised Deuteronomy 30:6 "And the LORD thy God will circumcise thine heart, and the heart of thy seed, to love the LORD thy God with all thine heart, and with all thy soul, that thou mayest live." and Romans 2:29 "But he [is] a Jew, which is one inwardly; and circumcision [is that] of the heart, in the spirit, [and] not in the letter; whose praise [is] not of men, but of God." Void of Fear Psalms 27:3 "Though an host should encamp against me, my heart shall not fear: though war should rise against me, in this [will] I [be] confident."

Desirous of GOD Psalms 84:2 "My soul longeth, yea, even fainteth for the courts of the LORD: my heart and my flesh crieth out for the living God." Enlarged Psalms 119:32 "I will run the way of thy commandments, when thou shalt enlarge my heart." and 2 Corinthians 6:11 "O [ye] Corinthians, our mouth is open unto you, our heart is enlarged."

Faithful to GOD Nehemiah 9:8 "And foundest his heart faithful before thee, and madest a covenant with him to give the land of the Canaanites, the Hittites, the Amorites, and the Perizzites, and the Jebusites, and the Girgashites, to give [it, I say], to his seed, and hast performed thy words; for thou [art] righteous:" Confident in GOD Psalms 112:7 "He shall not be afraid of evil tidings: his heart is fixed, trusting in the LORD." Sympathizing Jeremiah 4:19 "My bowels, my bowels! I am pained at my very heart; my heart maketh a noise in me; I cannot hold my peace, because thou hast heard, O my soul, the sound of the trumpet, the alarm of war." and Lamentations 3:51 "Mine eye affecteth mine heart because of all the daughters of my city."

Prayerful 1 Samuel 1:13 "Now Hannah, she spake in her heart; only her lips moved, but her voice was not heard: therefore Eli thought she had been drunken." and Psalms 27:8 "[When thou saidst], Seek ye my face; my heart said unto thee, Thy face, LORD, will I seek."

Inclined to Obedience Psalms 119:112 "I have inclined mine heart to perform thy statutes alway, [even unto] the end."

Wholly Devoted to GOD Psalms 9:1 "I will praise [thee], O LORD, with my whole heart; I will shew forth all thy marvellous works." Psalms 119:10 "With my whole heart have I sought thee: O let me not wander from thy commandments." Psalms 119:69 "The proud have forged a lie against me: [but] I will keep thy precepts with [my] whole heart." and Psalms 119:145 "I cried with [my] whole heart; hear me, O LORD: I will keep thy statutes."

Zealous 2 Chronicles 17:6 "And his heart was lifted up in the ways of the LORD: moreover he took away the high places and groves out of Judah." and Jeremiah 20:9 "Then I said, I will not make mention of him, nor speak any more in his name. But [his

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Wise Proverbs 10:8 "The wise in heart will receive commandments: but a prating fool shall fall." Proverbs 14:33 "Wisdom resteth in the heart of him that hath understanding: but [that which is] in the midst of fools is made known." and Proverbs 23:15 "My son, if thine heart be wise, my heart shall rejoice, even mine."

A Treasury of Good Matthew 12:35 "A good man out of the good treasure of the heart bringeth forth good things: and an evil man out of the evil treasure bringeth forth evil things."

Now we will look at what the Bible has to say about what the non-Christians heart looks like, some of these same characteristics can also be seen in the new Christian, or the carnal Christian and those that are not allowing the Holy Spirit to have His way in their lives. If a Christian stops allowing God to change them then they are no longer growing or moving forward with God so then they are choosing to move backwards and are starting to backslide, more on this subject can be found in Chapter 12.

Characteristics of an Unrenewed Heart Hateful to GOD Proverbs 6:16,18 "These six [things] doth the LORD hate: yea, seven [are] an abomination unto him: â&#x20AC;Ś An heart that deviseth wicked imaginations, feet that be swift in running to mischief," and Proverbs 11:20 "They that are of a froward heart [are] abomination to the LORD: but [such as are] upright in [their] way [are] his delight."

Full of Evil Ecclesiastes 9:3 "This [is] an evil among all [things] that are done under the sun, that [there is] one event unto all: yea, also the heart of the sons of men is full of evil, and madness [is] in their heart while they live, and after that [they go] to the dead."

Full of Evil Imaginations Genesis 6:5 "And GOD saw that the wickedness of man [was] great in the earth, and [that] every imagination of the thoughts of his heart [was] only evil continually." and Genesis 8:21 "And the LORD smelled a sweet savour; and the LORD said in his heart, I will not again curse the ground any more for man's sake; for the imagination of man's heart [is] evil from his youth; neither will I again smite any more every thing living, as I have done" Full of Vain Thoughts Jeremiah 4:14 "O Jerusalem, wash thine heart from wickedness, that thou mayest be saved. How long shall thy vain thoughts lodge within thee?"

Fully set to do Evil Ecclesiastes 8:11 "Because sentence against an evil work is not executed speedily, therefore the heart of the sons of men" Desperately Wicked Jeremiah 17:9 "The heart [is] deceitful above all [things], and desperately wicked: who can know it?"

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Far from GOD Isaiah 29:13 "Wherefore the Lord said, Forasmuch as this people draw near [me] with their mouth, and with their lips do honour me, but have removed their heart far from me, and their fear toward me is taught by the precept of men:" and Matthew 15:8. "This people draweth nigh unto me with their mouth, and honoureth me with [their] lips; but their heart is far from me."

Not perfect with GOD 1 Kings 15:3 "And he walked in all the sins of his father, which he had done before him: and his heart was not perfect with the LORD his God, as the heart of David his father." and Acts 8:21 "Thou hast neither part nor lot in this matter: for thy heart is not right in the sight of God." Not prepared to seek GOD 2 Chronicles 12:14 "And he did evil, because he prepared not his heart to seek the LORD." A Teasury of Evil Matthew 12:35 "A good man out of the good treasure of the heart bringeth forth good things: and an evil man out of the evil treasure bringeth forth evil things." and Mark 7:21 "For from within, out of the heart of men, proceed evil thoughts, adulteries, fornications, murders," Darkened Romans 1:21 "Because that, when they knew God, they glorified [him] not as God, neither were thankful; but became vain in their imaginations, and their foolish heart was darkened."

Prone to Error Psalms 95:10 "Forty years long was I grieved with [this] generation, and said, It [is] a people that do err in their heart, and they have not known my ways:" Prone to depart from GOD Deuteronomy 29:18 "Lest there should be among you man, or woman, or family, or tribe, whose heart turneth away this day from the LORD our God, to go [and] serve the gods of these nations; lest there should be among you a root that beareth gall and wormwood;" Impenitent Romans 2:5 "But after thy hardness and impenitent heart treasurest up unto thyself wrath against the day of wrath and revelation of the righteous judgment of God;" Unbelieving Hebrews 3:12 "Take heed, brethren, lest there be in any of you an evil heart of unbelief, in departing from the living God." Blind Ephesians 4:18 "Having the understanding darkened, being alienated from the life of God through the ignorance that is in them, because of the blindness of their heart:" Uncircumcised Leviticus 26:41 "And [that] I also have walked contrary unto them, and have brought them into the land of their enemies; if then their uncircumcised hearts be humbled, and they then accept of the punishment of their iniquity:" and Acts 7:51 "Ye stiffnecked and uncircumcised in heart and ears, ye do always resist the Holy Ghost: as your fathers [did], so [do] ye."

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Of little worth Proverbs 10:20 "The tongue of the just [is as] choice silver: the heart of the wicked [is] little worth."

Deceitful Jeremiah 17:9 "The heart [is] deceitful above all [things], and desperately wicked: who can know it?"

Deceived Isaiah 44:20 "He feedeth on ashes: a deceived heart hath turned him aside, that he cannot deliver his soul, nor say, [Is there] not a lie in my right hand?" and James 1:26 "If any man among you seem to be religious, and bridleth not his tongue, but deceiveth his own heart, this man's religion [is] vain."

Divided Hosea 10:2 "Their heart is divided; now shall they be found faulty: he shall break down their altars, he shall spoil their images."

Double 1 Chronicles 12:33 "Of Zebulun, such as went forth to battle, expert in war, with all instruments of war, fifty thousand, which could keep rank: [they were] not of double heart." and Psalms 12:2 "They speak vanity every one with his neighbour: [with] flattering lips [and] with a double heart do they speak."

Hard Ezekiel 3:7 "But the house of Israel will not hearken unto thee; for they will not hearken unto me: for all the house of Israel [are] impudent and hardhearted." Mark 10:5 "And Jesus answered and said unto them, For the hardness of your heart he wrote you this precept." and Romans 2:5 "But after thy hardness and impenitent heart treasurest up unto thyself wrath against the day of wrath and revelation of the righteous judgment of God;" Haughty Proverbs 18:12 "Before destruction the heart of man is haughty, and before honour [is] humility." Jeremiah 48:29 "We have heard the pride of Moab, (he is exceeding proud) his loftiness, and his arrogancy, and his pride, and the haughtiness of his heart."

Influenced by the Devil John 13:2 "And supper being ended, the devil having now put into the heart of Judas Iscariot, Simon's [son], to betray him;" Carnal Romans 8:7 "Because the carnal mind [is] enmity against God: for it is not subject to the law of God, neither indeed can be."

Covetous Jeremiah 22:17 "But thine eyes and thine heart [are] not but for thy covetousness, and for to shed innocent blood, and for oppression, and for violence, to do [it]." and 2 Peter 2:14 "Having eyes full of adultery, and that cannot cease from sin; beguiling unstable souls: an heart they have exercised with covetous practices; cursed children:" Despiteful Ezekiel 25:15 "Thus saith the Lord GOD; Because the Philistines have dealt by revenge, and have taken vengeance with a despiteful heart, to destroy [it] for the old hatred;"

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Ensnaring Ecclesiastes 7:26 "And I find more bitter than death the woman, whose heart [is] snares and nets, [and] her hands [as] bands: whoso pleaseth God shall escape from her; but the sinner shall be taken by her."

Foolish Proverbs 12:23 "A prudent man concealeth knowledge: but the heart of fools proclaimeth foolishness." and Proverbs 22:15 "Foolishness [is] bound in the heart of a child; [but] the rod of correction shall drive it far from him."

Fretful Against the Lord Proverbs 19:3 "The foolishness of man perverteth his way: and his heart fretteth against the LORD." Idolatrous Ezekiel 14:3-4 "Son of man, these men have set up their idols in their heart, and put the stumblingblock of their iniquity before their face: should I be enquired of at all by them? Therefore speak unto them, and say unto them, Thus saith the Lord GOD; Every man of the house of Israel that setteth up his idols in his heart, and putteth the stumblingblock of his iniquity before his face, and cometh to the prophet; I the LORD will answer him that cometh according to the multitude of his idols;" Mad Ecclesiastes 9:3 "This [is] an evil among all [things] that are done under the sun, that [there is] one event unto all: yea, also the heart of the sons of men is full of evil, and madness [is] in their heart while they live, and after that [they go] to the dead."

Mischievous Psalms 28:3 "Draw me not away with the wicked, and with the workers of iniquity, which speak peace to their neighbours, but mischief [is] in their hearts." and Psalms 140:2 "Which imagine mischiefs in [their] heart; continually are they gathered together [for] war."

Proud Psalms 101:5 "Whoso privily slandereth his neighbour, him will I cut off: him that hath an high look and a proud heart will not I suffer." and Jeremiah 49:16 "Thy terribleness hath deceived thee, [and] the pride of thine heart, O thou that dwellest in the clefts of the rock, that holdest the height of the hill: though thou shouldest make thy nest as high as the eagle, I will bring thee down from thence, saith the LORD." Rebellious Jeremiah 5:23 "But this people hath a revolting and a rebellious heart; they are revolted and gone."

Perverse Proverbs 12:8 "A man shall be commended according to his wisdom: but he that is of a perverse heart shall be despised."

Stony Ezekiel 11:19 "And I will give them one heart, and I will put a new spirit within you; and I will take the stony heart out of their flesh, and will give them an heart of flesh:" and Ezekiel 36:26 "A new heart also will I give you, and a new spirit will I put within you: and I will take away the stony heart out of your flesh, and I will give you an heart of flesh."

Stout Isaiah 10:12 "Wherefore it shall come to pass, [that] when the Lord hath performed his whole work upon mount Zion and on Jerusalem, I will punish the fruit of the stout heart of the king of Assyria, and the glory of his high looks."

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Elated by Sensual Indulgence Hosea 13:3 "Therefore they shall be as the morning cloud, and as the early dew that passeth away, as the chaff [that] is driven with the whirlwind out of the floor, and as the smoke out of the chimney."

Elated by Prosperity 2 Chronicles 26:16 "But when he was strong, his heart was lifted up to [his] destruction: for he transgressed against the LORD his God, and went into the temple of the LORD to burn incense upon the altar of incense."

Studies Destruction Proverbs 24:2 "For their heart studieth destruction, and their lips talk of mischief."

Often Judicially Stupefied Acts 28:26-27 "Saying, Go unto this people, and say, Hearing ye shall hear, and shall not understand; and seeing ye shall see, and not perceive: For the heart of this people is waxed gross, and their ears are dull of hearing, and their eyes have they closed; lest they should see with [their] eyes, and hear with [their] ears, and understand with [their] heart, and should be converted, and I should heal them."

Often Judicially Hardened Exodus 4:21 "And the LORD said unto Moses, When thou goest to return into Egypt, see that thou do all those wonders before Pharaoh, which I have put in thine hand: but I will harden his heart, that he shall not let the people go."

As we continue to study the Bible and it's teaching on the human heart we find that God has set forth eighteen commands concerning the heart; that you and I as Christians are to adhere to. These commands are as follows:

Eighteen Commands Concerning the Heart 1. Apply the heart to understanding: Proverbs 2:2 Making your ear attentive to skillful and godly Wisdom and inclining and directing your heart and mind to understanding [applying all your powers to the quest for it] (AMP) 2. Open the heart to wisdom: Proverbs 2:10 For skillful and godly Wisdom shall enter into your heart, and knowledge shall be pleasant to you. (AMP) 3. Keep the commandments: Proverbs 3:1 My son, forget not my law or teaching, but let your heart keep my commandments; (AMP) 4. Write commandments on it: Proverbs 3:3 Let not mercy and kindness [shutting out all hatred and selfishness] and truth [shutting out all deliberate hypocrisy or falsehood] forsake you; bind them about your neck, write them upon the tablet of your heart.

(AMP) 5. Trust in the Lord with it: Proverbs 3:5 Lean on, trust in, and be confident in the Lord with all your heart and mind and do not rely on your own insight or understanding.

(AMP)

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6. Keep it with all diligence: Proverbs 4:23 Keep and guard your heart with all vigilance and above all that you guard, for out of it flow the springs of life. (AMP) 7. Bind commandments upon it: Proverbs 6:21 Bind them continually upon your heart and tie them about your neck. (AMP) 8. Do not lust in it: Proverbs 6:25 Lust not after her beauty in your heart, neither let her capture you with her eyelids. (AMP) 9. Do not be inclined to sin: Proverbs 7:25 Let not your heart incline toward her ways, do not stray into her paths. (AMP) 10. Have an understanding heart: Proverbs 8:5 O you simple and thoughtless ones, understand prudence; you [self-confident] fools, be of an understanding heart. (AMP) 11. Be wise in it: Proverbs 16:21 The wise in heart are called prudent, understanding, and knowing, and winsome speech increases learning [in both speaker and listener].

(AMP) 12. Retain wisdom in it: Proverbs 14:33 Wisdom rests [silently] in the mind and heart of him who has understanding, but that which is in the inward part of [self-confident] fools is made known. (AMP) 13. Be merry in heart: Proverbs 15:15 All the days of the desponding and afflicted are made evil [by anxious thoughts and forebodings], but he who has a glad heart has a continual feast [regardless of circumstances]. (AMP) 14. Study answers with it: Proverbs 15:28 The mind of the [uncompromisingly] righteous studies how to answer, but the mouth of the wicked pours out evil things. (AMP) 15. Increase its knowledge: Proverbs 18:15 The mind of the prudent is ever getting knowledge, and the ear of the wise is ever seeking (inquiring for and craving) knowledge. (AMP) 16. Apply it to instruction: Proverbs 23:12 Apply your mind to instruction and correction and your ears to words of knowledge. (AMP) 17. Do not use it to envy sinners: Proverbs 23:17 Let not your heart envy sinners, but continue in the reverent and worshipful fear of the Lord all the day long. (AMP) 18. Give heart to wisdom: Proverbs 23:26 My son, give me your heart and let your eyes observe and delight in my ways, (AMP) We also find that the Bible teaches us that there are fifteen things that Christians are to do with our whole HEART (Mind, Will, Emotions and Personality / Character) and they are the following.

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Fifteen Things to be Done with All the Heart 1. Return to the Lord: Jeremiah 24:7 And I will give them a heart to know (recognize, understand, and be acquainted with) Me, that I am the Lord; and they will be My people, and I will be their God, for they will return to Me with their whole heart. (AMP) 2. Walk before Him: 1 Kings 2:4 That the Lord may fulfill His promise to me, saying, If your sons take heed to their way, to walk before Me in truth with all their heart and mind and with all their soul, there shall not fail you [to have] a man on the throne of Israel. (AMP) 3. Serve Him: Joshua 22:5 But take diligent heed to do the commandment and the law which Moses the servant of the Lord charged you: to love the Lord your God and to walk in all His ways and to keep His commandments and to cling to and unite with Him and to serve Him with all your heart and soul [your very life]. (AMP) 4. Love Him: Matthew 22:37 And He replied to him, You shall love the Lord your God with all your heart and with all your soul and with all your mind (intellect). (AMP) 5. Keep His word: Deuteronomy 26:16 This day the Lord your God has commanded you to do these statutes and ordinances. Therefore you shall keep and do them with all your [mind and] heart and with all your being. (AMP) 6. Follow Him: 1 Kings 14:8 And rent the kingdom away from the house of David and gave it to youâ&#x20AC;&#x201D;and yet you have not been as My servant David, who kept My commandments and followed Me with all his heart, to do only what was right in My eyes, (AMP) 7. Seek Him: 2 Chronicle 15:12-15 12 And they entered into a covenant to seek the Lord, the God of their fathers, and to yearn for Him with all their heart's desire and with all their soul; 13 And that whoever would not seek the Lord, the God of Israel, should be put to death, whether young or old, man or woman. 14 They took an oath to the Lord with a loud voice, with shouting, with trumpets, and with cornets. 15 And all Judah rejoiced at the oath, for they had sworn with all their heart and sought Him [yearning for Him] with their whole desire, and He was found by them. And the Lord gave them rest and peace round about. (AMP) 8. Praise Him: Psalm 9:1 I will praise You, O Lord, with my whole heart; I will show forth (recount and tell aloud) all Your marvelous works and wonderful deeds! (AMP) 9. Trust in Him: Proverbs 3:5 Lean on, trust in, and be confident in the Lord with all your heart and mind and do not rely on your own insight or understanding. (AMP) 10. Believe in Him: Romans 10:9-10 9 Because if you acknowledge and confess with your lips that Jesus is Lord and in your heart believe (adhere to, trust in, and rely on the

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truth) that God raised Him from the dead, you will be saved. 10 For with the heart a person believes (adheres to, trusts in, and relies on Christ) and so is justified (declared righteous, acceptable to God), and with the mouth he confesses (declares openly and speaks out freely his faith) and confirms [his] salvation. (AMP) 11. Obey Him: Psalm 119:34, 69 34Give me understanding and I will obey your instructions; I will put them into practice with all my heart. 69 Arrogant people smear me with lies, but in truth I obey your commandments with all my heart. (NLT) 12. Observe the truth: Psalm 119:34 Give me understanding, and I shall keep thy law; yea, I shall observe it with my whole heart. (KJV) 13. Entreat God's favor: Psalm 119:58 I entreated Your favor with my whole heart; be merciful and gracious to me according to Your promise. (AMP) 14 Keep commandments: Psalm 119:69 Arrogant people smear me with lies, but in truth I obey your commandments with all my heart. (NLT) 15. Cry to God: Psalm 119:145 I cried with my whole heart; hear me, O Lord; I will keep Your statutes [I will hear, receive, love, and obey them]. (AMP) Throughout this chapter, we have been looking at the human heart, as God does. We have seen that God has shown in His word that there are at least 50 kinds of hearts that we as humans live with. Humans also show different characteristics of heart between the person who has a renewed heart and is growing as a Christian; and the person who is either a nonChristian or the Christian who is choosing to backslide. In backsliding, the Christian has allowed sin to harden their heart again; this hardening of heart if left unrepented will lead to that Christians heart returning to the state it was prior to them becoming a Christian, that of an unrenewed heart.

Throughout the Bible we also saw that God has given you and me eighteen commands concerning our hearts to keep personally as we grow in our relationship with Him. There are also, fifteen things that we as Christians are to do with our HEART; that is with our Mind, Will, Emotions and Personality / Character.

In the following chapters, I will show that we can trace the Christians actions in heart on the EKG as we do our patients when we place them on the cardiac monitor as a four or twelve lead EKG. I pray that this will bless you as much as it has me.

It is time for a spiritual EKG, what will we see?

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Chapter 8 Interpreting Rhythms Originating from the Sinus Node Cardiac rhythms may be divided into two categories: supraventricular (above the ventricles) and ventricular rhythms. The origin of supraventricular rhythms (a single pulse or a continuous rhythm) is in the atria or AV junction, and the activation proceeds to the ventricles along the conduction system in a normal way.

Lets review the following Sinus Rhythms a little more closely, first from the physical prospective then that of the spiritual. As we place our first patient on the Christian cardiac monitor we see the following rhythm.

NORMAL SINUS RHYTHM

Figure 8.1lxxvi Normal sinus rhythm is the rhythm of a healthy normal heart, where the sinus node triggers the cardiac activation. This is easily diagnosed by noting that the three deflections, P-QRS-T, follow in this order and are differentiable. The sinus rhythm is normal if its frequency is between 60 and 100/min.

Sinus rhythm is reflective of a normally functioning conduction system. The electrical current is following the normal conduction pathway without interference from other bodily systems or disease processes.lxxvii Criteria for Classification Rhythm: The intervals between the two P and two R waves will occur in a consistent pattern.

Rate: Both the atrial and ventricular rate will be between 60 and 100 beats.

P wave configuration: The P waves will have the same shape and are usually upright in deflection on the rhythm strip. A P wave will appear in front of every QRS complex.

PR interval: The PR interval measurement will be between 0.12 and 0.20 second, which is within normal limits. Each PR interval will be the same, without any variations.

QRS duration and configuration: The QRS duration and configuration measurement will be between 0.06 and 0.10 second, which is within normal limits. Each QRS duration and configuration will be without any variations from PQRST complex to complex.

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What's Unique about this Rhythm?

Sinus rhythm is the only rhythm for which all five steps of (The Five- Step Method to Interpreting EKG) are within normal limits.

Clinical Significance Sinus rhythm is the desired rhythm. Patients with this rhythm should have normal cardiac output. Normal cardiac output means that the heart is beating adequately, pumping blood to the body's organs to maintain normal function. Signs and symptoms of adequate cardiac output include an alert and oriented patient with no difficulty breathing, no chest pain or pressure, and a stable blood pressure.

Because this is a normal rhythm, no intervention is necessary. If the patient's rhythm returns to sinus rhythm from another dysrhythmia, it is always important to make sure that the patient is not experiencing problems with low cardiac output, which indicates that the heart is not pumping adequately see Table 8.1lxxviii below. Be on the lookout for and be ready to treat your patient if they start displaying symptoms of low cardiac output.lxxix Observe for any of these signs and symptoms associated with decreased cardiac output during EKG monitoring Neurological

Cardiac

Respiratory

Urinary

Peripheral

Change in mental status

Chest pain

Difficulty breathing

Decreased urinary

Hypotension

Palpitation

Shortness of breath

Light-headedness Chest discomfort

Frothy sputum

Pale skin output of less than

Skin cool and

Dizziness Confusion Loss of consciousness

Enlarged cardiac size Fluid present in lungs Congestive heart failure Lung congestion

30 cc in one hour

clammy to the touch

Table 8.1 Signs and Symptoms of Decreased Cardiac Output

What does this mean to the Christian heart?

This is the EKG of the Christian that God wants us all to be. This Christian is actively growing in their personal relationship with God. They are allowing the Holy Spirit to lead and guide them through their daily lives as they grow from the Carnal (babes in Christ) into the Spiritual (mature) Christians that Gods wants us to become. This Christian is thinking on the right things, choosing to act on the right things, they have their emotions in check and they are actively walking out their salvation with the fear of the Lord.

What is the normal Christian life? The Apostle Paul gives us his own definition of the normal Christian life in Galatians 2:20. It is "no longer I, but Christ." Here he is not stating something

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special or peculiar but only presenting God's normal for a Christian, who can be summarized in the words: I live no longer, but Christ lives His life in me.

As I first stated in Chapter 3, Normal Sinus Rhythm is the standard that we use to look at all other cardiac rhythms'. I also mentioned that the instrument that God uses to measure if we are meeting His standards is the Plumb Line. We see in the book of Amos 7:7-8 7 Then he showed me another vision. I saw the Lord standing beside a wall that had been built using a plumb line. He was using a plumb line to see if it was still straight. 8 And the LORD said to me, "Amos, what do you see?" I answered, "A plumb line." And the Lord replied, "I will test my people with this plumb line. I will no longer ignore all their sins. (NLT) This portion in scripture is taking place sometime in the 8th century B.C. during the reign of Uzziah, King of Judah. It has been said that Israel, at this time was experiencing a period of great prosperity and peace but as with most cultures that face this, Israel also saw a rapid decline in her morals that was undermining her society.

Dr. Bruce Thompson in his book, Walls of my Heart had this to say: A seamy smog of social injustice obscured Israel's view and lost its divinely given direction.

Into this Challenging arena God called Amos, a shepherd and dresser of fig trees, to represent His cause. Amos' mission was to denounce the social and religious corruption and warn of God's impending judgment. Even his name, Amos, is related to a Hebrew verb meaning "to bear a load." With Moses, God chose a rod to demonstrate His truth and values, but with Amos He chose a plumb line.

A plumb line in its simplest form is a small inverted cone of lead, attached by a cord to a cylindrical piece of wood of the same diameter. It is used by builders to ascertain the vertical direction for the construction of a wall. The weighted end always points toward the center of the earth, as it responds to an otherwise invisible force called gravity.

Construction workers have found this simple but profound instrument of inestimable value. They realize that if their building is to be stable and stand, its studs and walls must line up with the plumb line. If not, the building could topple down.

Beneath Israel's affluence was moral decay. God depicts the nation as a wall that is out of line and about to topple down. To demonstrate the extent of the instability He drops the plumb line of His law alongside His people. He shows that any day the nation could fall and be scattered by its enemies as blocks of a wall. God has never ceased to extend the plumb line of His word alongside the lives of those He has called to be his people. He continues to do this with us, the people of this century, so we might know the truth and find the way to a stable, secure life.lxxx It is a known fact that once you and I walk away from or turn from the TRUTH of who God is as the "Great I AM" that we lose sight of the TRUTH of "Who I Am" in Him. God makes it quite clear in His Word that He has only one answer to every human need and that answer is His Son, Jesus Christ.

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God also makes it very clear that we all build walls within our hearts (Mind, Will, Emotions and Personalities) and as long as we build them on Him and His law that they will be plumb.

But as we walk away from Him and His Truth found in the law of His Word (Jesus and the written word the Bible) that our walls start to lean in one direction or the other and are no longer found to be plumb.

We find the scriptural bases for this thought process of the walls of our hearts in Jeremiah 4:19 [It is not only the prophet but also the people who cry out in their thoughts] My anguish, my anguish! I writhe in pain! Oh, the walls of my heart! My heart is disquieted and throbs aloud within me; I cannot be silent! For I have heard the sound of the trumpet, the alarm of war. (AMP) Oh, the walls of my heart! This statement is the reason that God called Amos to bring Israel and now you and I back to the place where God and His Truth the word is our plumb line.

God says that "I will test my people" that is you and I the Christian. God goes on to say that He was going to test each of us "with this plumb line."

As stated above the plumb line is a simple tool used to determine whether or not something is perfectly vertical and upright. The Bible is a Christian's "Plumb Line" to which we align our lives. God goes on to say that "I will no longer ignore all their sins." This means that God knows that we still have sin in our lives and that he will be working on us until we go to meet Him as seen in Philippians 1:6 There has never been the slightest doubt in my mind that the God who started this great work in you would keep at it and bring it to a flourishing finish on the very day Christ Jesus appears. (MSG) So then, you may ask; why the need for the plumb line and what are we to learn from it? The first thing we see from the text is the plumb line is to be used in construction. Secondly, the plumb line is used for testing what is built. And, thirdly, it appears from the text that the plumb line is used in the work of destruction, for the casting down of that which is found not to be straight. 2 Corinthians 10:3-6 The world is unprincipled. It's dog-eat-dog out there! The world doesn't fight fair. But we don't live or fight our battles that way窶馬ever have and never will.

The tools of our trade aren't for marketing or manipulation, but they are for demolishing that entire massively corrupt culture. We use our powerful God-tools for smashing warped philosophies, tearing down barriers erected against the truth of God, fitting every loose thought and emotion and impulse into the structure of life shaped by Christ. Our tools are ready at hand for clearing the ground of every obstruction and building lives of obedience into maturity. (MSG) Everything that God builds is built plumb, straight, square and fair.

Let me paraphrase what C. H. Spurgeon had to say on this matter: In spiritual matters, whenever God is dealing with souls, He always uses the plumb line. In beginning with us, He finds that the very foundation of our nature is out of the perpendicular and, therefore, He does not attempt to build upon it, but He starts to dig it out. So the foundation of human merit must be cleared right out and flung away, for God could not build squarely upon it. With such a foundation as that, the plumb line would never mark a perpendicular wall.

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C. H. Spurgeon goes on to say, we are not to judge ourselves or others simply by the eyes. If we do we will find that a wall we thought to be plumb that was not and another wall we thought to be out of plumb to that was. Our eyes will deceive us, but the plumb line will show whether the wall is upright or not. We must continue to use the plumb line of God's Word to show us where we are out of plumb in our lives and allow the Holy Spirit tear down and rebuild the walls in our lives to His Plumb Line the Bible.

One of the walls that needs to be tested is the wall of self-righteousness, another wall, built by a man who says that he is doing his best and trusting in Christ to make up for his deficiencies. So, if you and I are trying to make ourselves look self-righteous or we know that we have trust issues with God. When God holds up His plumb line to our lives it will shows that the walls in our lives are out of the perpendicular and that it will have to come down. lxxxi You may ask what walls, I don't have any walls in my life. We all have walls that we have built over the years; these are walls of hurt caused by rejection and rebellion. The Greek word for the wall, the partition that I'm talking about is "phragmos." From it, we get our word partition, which means a "fencing in." That's what the enemy does to you he walls you and me in; he fences you and me in. It's a barrier it's a dividing wall. We see in Ephesians 2:14 For He Himself is our peace, who has made the two one and has destroyed the barrier, the dividing wall of hostility. He takes the walls that divide us, walls in which we are doing one thing on the inside, and God, through the Holy Spirit is trying to do something else on the outside.lxxxii I see it like this, these wall some have been built by us while other walls have been built by those that we have allowed to offend, wound and make us feel rejected. These walls that have been built into our lives are like being in prison. I have long said that all people have been in or are presently in prison, some are in prison and behind bars made by men and for the rest of usâ&#x20AC;Ś Well, if we have not allowed God to destroy the barriers or the dividing walls in or lives' we too are in prison. We have made these prisons ourselves or have allowed other people too placed us in them. Then there is the enemy as stated above that walls us in or puts us into spiritual prisons as we believe the lies he tells.

Then we have those of us that have allowed God to destroy the walls of our hearts and got out of our personal prisons. We followed Him well for some time then we allowed this live to dictate to us and lie to us and we started putting ourselves back into prison. In the study of Restorative Justice we call this a relapse. As a minister I call it backsliding, as a Paramedic I see this in the arrhythmias known as reentrant arrhythmias. This will be discussed in detail in a later chapter.

The judgment of the Christian by Jesus as seen in John 5:22 In addition, the Father judges no one. Instead, he has given the Son absolute authority to judge. (NLT) means a comparison between God's character and ours. God's measure is God Himself. God is like a straight wall and His plumb line is His righteousness and His glory. When God applies His heavenly plumb line (Jesus, a perfect vertical standard) to our constructions, it will be evident what is crooked. We are all lost because we do not measure up to God's glory. What we build

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will crumble because we do not keep the straight wall of God's character in view while we build.lxxxiii We will visit the plumb line again in a later chapter. For now, come join me, as look into the issue of timing as it has to do with God as seen on the Christian EKG. Lets first look at the Christian in a Sinus Bradycardic rhythm.

SINUS BRADYCARDIA

Figure 8.2 lxxxiv A sinus rhythm of less than 60 beats a minute is called sinus bradycardia. This may be a consequence of increased vagal or parasympathetic tone. Sinus bradycardia originates from the SA node and travels the normal conduction pathway. The only difference between this rhythm and sinus rhythm is that the rate is less than the normal inherent rate of the SA node.

Criteria for Classification Rhythm: The R-R interval and P-P interval will occur on a regular and constant basis.

Rate: The atrial and ventricular rates will be equal and less than 60 beats per minute.

P wave configuration: The shapes of each of the P waves are identical. There is a P wave in front of each of the QRS complexes. No additional P waves or QRS complexes are noted.

PR interval: The PR interval measurement will be between 0.12 and 0.20 second, which is within normal limits. Each PR interval will be the same.

QRS duration and configuration: The QRS duration and configuration measurement will be between 0.06 and 0.10 second, which is within normal limits. Each QRS duration and configuration will be the same, without any variations from QRS complex to complex.

What's Unique about this Rhythm?

For sinus bradycardia, the heart rate is less than 60 and all other measurements are within normal limits.

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Clinical Significance The patient who exhibits sinus bradycardia may or may not experience signs and symptoms of low cardiac output. When administering an EKG to a patient with a slow heart rate, it is important to observe for the symptoms of low cardiac output. Remember, though the patient may look all right, he or she can quickly experience difficulties with low cardiac output. If you observe symptoms of low cardiac output, you may need to administer a medication or start pacing the patient.lxxxv

What does this mean to the Christian heart?

Timing is everything to God. I believe that responding to God, and His requests, in His timing is part of doing His will. In fact, the Bible talks a lot about timing. Ecclesiastes 3:1 says, There's an opportune time to do things, a right time for everything on the earth: (MSG) I like to teach it this way: God wants you and me to do His will; in His way; in His timing.

In the world of EMS, every call we respond to we have a record of the call number and times, right? What about every intervention we give, with every set of vital signs we take? We have to put the TIME we did them don't we? I see this life as a matter of timing, how about you. As you are reading this; stop for a minute and look around you, how many clocks and how many calendars do you have in your home, office and vehicles? If you are on duty you had better be wearing a watch on our wrist? It is part of our uniformâ&#x20AC;Ś Do you have the time displayed on your iPods, your phones and your laptops? We are always aware of the time. If you do not think timing is important to you and me in EMS; let one of your runs end up in court and then see what the lawyers have to say to you about "TIME" I asked my wife one afternoon how she defined love and she stated back to me your TIME! With that said lets take the time to read Ecclesiastes 3:1-8 To everything there is a season, and a time for every matter or purpose under heaven: 2 A time to be born and a time to die, a time to plant and a time to pluck up what is planted, 3 A time to kill and a time to heal, a time to break down and a time to build up,4 A time to weep and a time to laugh, a time to mourn and a time to dance,5 A time to cast away stones and a time to gather stones together, a time to embrace and a time to refrain from embracing,6 A time to get and a time to lose, a time to keep and a time to cast away,7 A time to rend and a time to sew, a time to keep silence and a time to speak, 8 A time to love and a time to hate, a time for war and a time for peace. (AMP) As we were reading the above verse, did you notice that the word time is mentioned about 30 times before verse 8! So it must be the key to this passage and to our lives and daily walk with God and the leadings of His Holy Spirit.

Did you also notice that there are twenty-eight statements made between verses 2-8.

Fourteen of them are negative, fourteen are positive. For every negative, there is a positive truth in scripture, and in life. Think about it! How many times have we been there for the birth of a baby, how many codes have we all run? God, Himself has appointed the time and date for our birth and our death.

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They are no surprises to God. God is sovereign over time, but we are subject to it. The exact moment that we're born; we start our journey toward the grave. Our time on earth is but a puff of smoke, or a mist according to James 4:14 Yet you do not know [the least thing] about what may happen tomorrow. What is the nature of your life? You are [really] but a wisp of vapor (a puff of smoke, a mist) that is visible for a little while and then disappears [into thin air]. (AMP) As was stated before the only difference between this rhythm and normal sinus rhythm is that the rate is less than the normal inherent rate of the SA node. Spiritually, I see the Christian that is in a sinus bradycardic rhythm, as a Christian that is no longer responding to the Holy Spirit as quickly as they once did. The Christian is still responding just doing so slower then they use to causing them to get behind God and His timing for their lives.

Getting behind God means missing opportunities that God provides for us in the here and now moment. Proverbs 3:27-29 Never walk away from someone who deserves help; your hand is God's hand for that person. Don't tell your neighbor "Maybe some other time" or "Try me tomorrow" when the money's right there in your pocket. Don't figure ways of taking advantage of your neighbor when he's sitting there trusting and unsuspecting. (MSG) Then we read James 4:17 So any person who knows what is right to do but does not do it, to him it is sin. (AMP) So why would someone who is a Christian and is thinking on the right things have trouble responding to and acting on the right things within Gods leadings and in His timing. I find many reasons for this sometime in my on life. There are times in my Christian walk that I find myself not wanting to move forward with God and that means that I am now moving backwards in my relationship with God. When I thought and prayed about it. My reasons were to numerous to write in this chapter. But I found underneath each of my excuses lie something deeper. What was it, it was a heart issue like fear, procrastination, stubbornness, misguided belief systems, selfishness, unbiblical prioritization, laziness, worldliness, slowness and hardness of heart, to name a few.

Here is a good test for you to do, ask yourself this question; what keeps me from doing the good that God prompts me to do? For me one of my most common excuses is: I'll get to it later. Here are some others that I have had when God was leading me to do something for Him. "This is too inconvenient; it can't be God's will."

"It's not my job. Someone else will take care of it."

"I'm too busy."

As we grow in His will, His way and in His timing; we begin to allow God to deal with us and to change us from the inside out. As we grow we will have to make decisions that will ultimately determine our receptiveness to receive from God. If we choose to allow God to have total control of our life to such an extent that we recognize that we have changed. You

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will find that we no longer respond to situations in the same way, meaning that God has had an effect on our emotions, if we let Him. We begin to find strength to resist sin. But let me say this: If our relationship with Him does not produce change and give us strength to resist sin, then we need to examine our lives and relationship in Christ.

Let's move on to the Christian that as we look at their EKG we see that they are in a Sinus Tachycardia.

SINUS TACHYCARDIA

Figure 8.3 lxxxvi Sinus tachycardia is a condition in which the sinoatrial node fires and the electrical impulse travels through the normal conduction pathway but the rate of impulse firing is faster than 100 beats per minute. It occurs most often as a physiological response to physical exercise or psychical stress, but may also result from congestive heart.

Criteria for Classification Rhythm: The R-R interval and P-P interval will be equal and constant.

Rate: Both the atrial and ventricular rates will be the same, between 100 and 150 beats per minute.

P wave configuration: The P waves will have the same shape and usually are upright in deflection on the rhythm strip. There will be a P wave in front of every QRS complex.

PR interval: The PR interval measurement will be between 0.12 and 0.20 second. This is within normal limits. Each PR interval will be the same, without any variations.

QRS duration and configuration: The QRS duration and configuration measurement will be between 0.06 and 0.10 second, which is within normal limits. Each QRS duration and configuration will be the same, without any variations from QRS complex to complex.

What's Unique about this Rhythm?

For sinus tachycardia, the heart rate is greater than 100 and all other measurements are within normal limits.

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Clinical Significance The effect of this rhythm on the patient depends on the rate of tachycardia above the patient's normal resting heart rate. For example, if the patient's normal resting heart rate is 90 and now the patient is exhibiting a rate of 108 beats per minute after walking the hallway, the tachycardia would be expected and is viewed as the patient's normal response to exercise.

However, if the patient's normal heart rate is 60 and it is now 140, the patient is probably experiencing symptoms of low cardiac output. Often the patient will complain of palpitations or "heart fluttering" with faster rates. If the patient has had a recent myocardial infarction, sinus tachycardia is considered to be more serious or even life threatening.

When caring for a patient who is experiencing sinus tachycardia, observe for signs and symptoms of low cardiac output and by ready to treat if intervention required.lxxxvii What does this mean to the Christian heart?

A heart rhythm that is going to fast that it causes an inadequate filling of the patients ventricles, that is the Christians Will and Personality / Character, as a result, we will see the Christian as getting ahead of God or choosing to deliberately by-pass God and His plan or timing for our personal lives. In the next chapter we will go deeper into Gods will verses our personal will. This Christian is the Burger King Christian, you know "Have it your way". We want what we want right now, thank you very much! But God's timing is not our own!

The Bible tells us in Deuteronomy that God goes before us and not the other way around.

Remember, what I said earlier in this chapter; we are to always be in His will; in His way; and in His timing. Let's read the verse together, Deuteronomy 31:8 It is the Lord Who goes before you; He will [march] with you; He will not fail you or let you go or forsake you; [let there be no cowardice or flinching, but] fear not, neither become broken [in spirit depressed, dismayed, and unnerved with alarm]. (AMP) How often do we run ahead of God? We make plans, good plans, admirable plans and even noble ones. Once we have made our plan, we bring it to God and ask Him to bless it.

As Christians, we must be able to hear from God. The Bible is the written record of God speaking to us and not at us. The Bible is the Words of God speaking to us, to penetrate through us to our HEARTs to bring CHANGE in our lives to make us to be daily more and more like Christ. If we will only choose to listen to His voice in the Bible as we read it, we will be able to hear Him personally speaking to us. As we develop our ability to hear Him in His Word, we will soon find ourselves beginning to hear Him in our spirit as we go about our daily lives and in our quiet times.

Here is the kicker, we will all from time to time, as we develop our ability to hear God through His Word and expect Him to speak to us and direct our lives; have times of willfully and other times of unintentionally getting ahead of Gods plan and timing for our lives.

Lets read about one of those times when King David went ahead of God, we find it in the book of 2 Samuel 7:1-3 Before long, the king made himself at home and God gave him peace from his enemies. Then one day King David said to Nathan the prophet, "Look at this: here I

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am, comfortable in a luxurious house of cedar, and the Chest of God sits in a plain tent."

Nathan told the king, "Whatever is on your heart, go and do it. God is with you". (MSG) David had a wonderful idea for a building project. It was an admirable idea - the people would surely back him up. His prophet gave the blessing to go ahead so it must be ok. But it was not to be. Later in the same chapter, God gives a message to Nathan to pass along to David.

In verses 8-11, God essentially says "I have never had a cedar house before and it is not your job to build me one now". In spite of what Nathan had told David earlier, God had not blessed this plan. God tells him that it will be his son that will build the temple; David has just killed too many men.

It has been said that without an understanding of God's Word it is difficult for God to speak to us. We must know His Word to ensure that when He speaks, it is indeed the voice of God. Jesus talks about this simple principle in John 10:27 My sheep listen to my voice; I know them, and they follow me. (NLT) and this is one of the most important aspects of hearing from God and being led by the timing of God Our goal in treating these patients (Christians) is to slow the heart rate down and get them back in God's timing for their lives. This would be that Christian themselves praying, asking for forgiveness, then asking for the Holy Spirits guidance in searching the Bible for scriptures to stand on. They then must choose to walk away from the hindrances and the temptations that have lead them to sin. If the Christian is found to be unstable in their choices or actions, there will be a need for the Christian to seek out Christian counseling to get to the heart and root of this spiritual issue.

For our next rhythm we will look at the Christian, who is having the first of many abnormalities in an otherwise normal rhythmic pattern that we will be discussing in this book. The following Christian is found to be in a Sinus dysrhythmia. This is a condition in which the heart rate remains within normal limits but is influenced by the respiratory cycle and variations of vagal tone (a condition in which impulses over the vagus nerve cause a decrease in heart rate), causing the rhythm to be irregular.

So then, how does this happen? It is like this, when the patient inhales air, the pressure inside the chest cavity increases right? This inhaled air, in turn then causing pressure on the heart, specifically the sinoatrial node; causing the heart rate to slow with this increase in pressure. As the patient exhales, the chest cavity pressure decreases, allowing the SA node to fire more easily. Therefore, the heart rate will increase during exhalation. Please join me as we explore what this means for the Christian.

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SINUS ARRHYTHMIA

Figure 8.4 lxxxviii If the sinus rhythm is irregular such that the longest PP- or RR-interval exceeds the shortest interval by 0.16 s, the situation is called sinus arrhythmia. This situation is very common in all age groups.

As stated above, Sinus dysrhythmia is a condition in which the heart rate remains within normal limits but is influenced by the respiratory cycle and variations of vagal tone, causing the rhythm to be irregular.

Criteria for Classification Rhythm: The interval between the P-P and R-R waves will occur at irregular periods.

Rate: Both the atrial and ventricular rates will be the same, between 60 and 100 beats per minute.

P wave configuration: The P waves will have the same shape and usually are upright in deflection on the rhythm strip. There will be a P wave in front of every QRS complex.

PR interval: The PR interval measurement will be between 0.12 and 0.20 second. Each PR interval will be the same, without any variations.

QRS duration and configuration: The QRS duration and configuration measurement will be between 0.06 and 0.10 second. Each QRS duration and configuration will be the same, without any variations from QRS complex to complex.

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What's Unique about this Rhythm?

For sinus dysrhythmia, the P-P and R-R intervals will progressively widen then narrow following the patient's breathing pattern.

Clinical Significance Patients usually show no clinical signs or symptoms with sinus dysrhythmia. If the irregularity is severe enough to decrease the heart rate to the 40s, the patient may complain of palpitations or dizziness. This depends on how slow the heart beats when the SA node is suppressed from the respiratory or vagal influences. lxxxix What does this mean to the Christian heart?

This is the Christian that is having a Positional Identity issues that are influenced by their respiratory cycle. To me the respiratory cycle symbolically shows us the exchange that took place for you and me at the Cross and all that Jesus did for us personally at the time of our salvation. This Christian has a Positional Identity Disorder (PID).

When we asked Jesus into our hearts, and repent of our sins, He, through His BLOOD, forgives us our sins, by taking away the (carbon dioxide) sin and giving us (oxygen) Salvation. This Christian is having some sort of problems with forgiveness, righteousness, rejection, the old man and his sin, as stated above PID. This Christian could also be having issues with the changes that God is making within the Christian's life as seen in the following list of the things that change at the moment we ask Jesus to be our Savior, known as the New Birth.

1. A change of heart (new heart), will, motives, desires, life and conduct, and, not an organism.

2. A change of masters, not of constitutional makeup of body, soul, or spirit 3. An adoption of one from the satanic family into the family of God 4. A change of nature, but, not the coming into existence of that nature 5. A change of favor, a new standing before God 6. A change of character, state and service We also find this disorder in the Christians who search for his or her identity and significance in anything other than God Himself. The PID positive, Christian is one who does not know who he/she is in Christ. PID is trying to become who you already are. PID is when you mistake what you do for who you are. Having been saved, you have not really acted on the basis of all you have become and you have forgotten who you are in Christ, if in fact you ever really knew.

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Dr. Paul W. Carlin stated in his paper, Positional Identity Disorder In Search of Who You Are: The Church's Number One Congregational Health Problem The most important teaching recorded in the Bible for the believer is "positional truth."

Positional truth is a phrase that describes the believer's spiritual standing before God. Before God, there is a difference in our position and our condition, in our standing and our state. It is life-changing when a Christian comes to understand the difference.

Getting It Right 2 Corinthians 15:22 explains "position" like this: "For as in Adam all die, even so in Christ shall all be made alive." Every person is either "in Adam" or "in Christ." Through the natural birth a person is "in Adam." Through the spiritual birth a person is "in Christ." Ephesians 2:13 explains the from-Adam-to-Christ salvation experience like this: "But now in Christ Jesus, you who were once [so] far away, through (by, in) the blood of Christ have been brought near." (AMP) Through the miracle of the new birth, God spiritually repositions a person from in Adam to in Christ. Before God, the saved, born again person is no longer "in Adam," but now "in Christ." At the moment of the new birth, a person passes from death to life.

Paul the Apostle addresses the Christian believers in Ephesus (Eph. 1:1), in Philippi (Phil. 1:1) and in Colossae (Col. 1:2) as being "in Christ Jesus." 2 Corinthians 5:17 says it like this: "Therefore, if any man be in Christ, he is a new creature: old things are passed away and behold, all things become new."

Our "standing" before God is all that we are in God's mind by virtue of our union with our Lord and Saviour, Jesus Christ. Our standing in Christ is absolutely perfect just as Christ is perfect. God reckons us perfect, because we believe in Christ and belong to Him. "Christ gave himself for our sins â&#x20AC;Ś. For by the one offering He made forever perfect in the sight of God all those whom He is making holy." (Heb. 10:14 TLB) But as to our "state," how far from perfect that is. There is a difference in our standing and our state just as there is a difference in our position and our condition. Positionally, we are in Christ. Conditionally, however, we are in the world. So as far as our standing before God is concerned, the Prodigal was a son (his standing); but so far as his state was concerned, he was in a far country. (Luke 15:11-24) The Bible also describes our union with Christ by using the word "with." The truth is you were crucified with Christ (Gal. 2:20), dead with Christ (Rom. 6:8; Col 2:20), buried with Christ (Rom. 6:4; Col 2:12), quickened with Christ (Eph. 2:5; Col. 2:13) raised with Christ (Eph. 2:6; Col 3:1), living with Christ (Rom. 6:8), glorified with Christ (Rom. 8:17), reigning with Christ (2 Tim. 2:12) and hid with Christ (Col. 3:3)â&#x20AC;Ś Positional Identity Disorder is not a mental disorder. You will not find it listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM IV). PID is a spiritual disorder. PID may, however, well be your source of problematic thinking, darkened emotions, and godless behavior.xc

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We know that God's desire for all Christians is to be progressively conformed to the image of Christ. I know that I am a work in progress. And this is clearly seen in the Bible, Philippians 1:6 states that: I am convinced and sure of this very thing, that He Who began a good work in you will continue until the day of Jesus Christ [right up to the time of His return], developing [that good work] and perfecting and bringing it to full completion in you. (AMP) Then in the very next chapter of the same book we read one of my favorite verses in the Bible.

Philippians 2:12 Therefore, my dear ones, as you have always obeyed [my suggestions], so now, not only [with the enthusiasm you would show] in my presence but much more because I am absent, work out (cultivate, carry out to the goal, and fully complete) your own salvation with reverence and awe and trembling (self-distrust, with serious caution, tenderness of conscience, watchfulness against temptation, timidly shrinking from whatever might offend God and discredit the name of Christ). (AMP) As stated above we all are a works in progress. We then find the Bible teaching us this in 1 John 2:6 Those who say they live in God should live their lives as Jesus did. (NLT) This will involve us growing in our relationship with God in prayer, study of His Word, and dependence upon the power of the Holy Spirit. Pursuing God's will is therefore a matter of obediently choosing what He knows is best for us.

This is not merely a once-for-all choice, but a series of choices made during the course of each day. God's will for our lives is dynamic, not static. As we travel into the unexplored territory of the future, it requires a walk of dependent faith to stay on the cutting edge of God's desires. Instead of giving us a photograph of His entire plan, God reveals it like a film, one frame at a time, in the course of our daily experiences. God's sovereignty and our responsibility mysteriously merge together in time to realize His eternal design for our lives.

Before the foundation of the world, God incorporated our decisions into the fabric of His plan.xci So as I start to close this chapter, I have a question for you. Are you PID positive? I know that there have been times in my life that I have been. The good news is that there is a treatment for PID. It is not only treatable, but it is curable.

Dr. Paul W. Carlin went on to say: There are three treatment steps to the cure: 1. Knowing. You cannot do an end run around the cross. Romans 6:6-8 says, "Knowing this, that our old man is crucified with Him â&#x20AC;Ś Now if we be dead with Christ, we believe that we shall also live with Him." God wants you to know that when Christ died, you died; when He was buried, you were buried; when He was resurrected, you were resurrected. The first step knows that Christ did a finished work on the cross that included us. It is not what you can do, but what He has already done.

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2. Reckoning. Romans 6:11 says, "Likewise, reckon ye also yourselves to be dead indeed unto sin, but alive unto God through Jesus Christ our Lord." Reckoning is the bottom line. The old man is dead! You no longer have to be a slave to the old self. Once you were in Adam. Now you are in Christ. The reckoning process is like having your own funeral. When Christ died, you died. So now you have closure.

You give it up! You exchange self-effort for His finished work on the cross. You quit trying and start trusting or abiding in Him. 3. Yielding. Romans 6:13 says, "Yield yourselves unto God, as those that are alive from the dead and your members as instruments of righteousness unto God." By faith, you exchange your life for His life. You yield yourself to Christ, His finished work and allow Him to live His life through you. That is the life of rest. There is a rest, here and now, for the people of God. (Heb. 4:9-11) Here are your seven Biblically true, personal, Christian PID busters: 1. I am deeply loved by God. (1 John 4:9-10) 2. I am completely forgiven and am fully pleasing to God. (Rom. 5:1) 3. I am totally accepted by God. (Col. 1:21-22) 4. I am a new creation - complete in Christ. (2 Cor. 5:17) 5. I am what I am by the grace of God. (1 Cor. 15:10) 6. I can do all things through Christ who gives me strength. (Phil 3:9) 7. I am a work in progress. (Phil. 1:6; 2:13)xcii In the next chapter on interpreting rhythms originating from the atria we will be discussing God's plans and His will for you and our response to His plans and leadings in our thinking.

We will also look into our own emotional response to the leadings of the Holy Spirit.

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Chapter 9 Interpreting Rhythms Originating from the Atria Arrhythmia may be classified by rate (as seen in Chapter 8 normal sinus rhythm, tachycardia and bradycardia), or mechanism (automaticity, reentry, junctional, fibrillation). It is also appropriate to classify by site of origin: A cardiac dysrhythmia (also known as arrhythmia and irregular heartbeat) is any of a large and heterogeneous group of conditions in which there is abnormal electrical activity in the heart. The heartbeat may be too fast or too slow, and may be regular or irregular.

Atrial dysrhythmias are caused by an ectopic beat in either the right or the left atria. However, the atrial origin is outside the SA node, which interrupts the inherent rate of the SA node. The heart works on the principle that the fastest impulse will control the heart rate. Since the atrial ectopic beat is generating electrical impulses faster than the sinoatrial node, the ectopic beat will override the sinoatrial node impulse and cause the atria and ventricles to depolarize.

Dysrhythmias that are caused by the atrial ectopic site include premature atrial complexes (PAC), atrial tachycardia, atrial flutter, and atrial fibrillation.

Atrial dysrhythmias occur from conditions that cause pressure on the atria such as damage to the atria from myocardial infarction, valvular problems, or neurological influences (pertaining to the nervous system). When the area is stressed or damaged, the cells become unstable and the electrical state may cause depolarization to occur more easily. xciii Atrial dysrhythmias within the Christian heart are caused by an ectopic beat in either the right (The Mind) or the left (The Emotions) atria. As we study the following dysrhythmias let us reason together and explore the Christian thought process and the emotional response that those thoughts cause you and I to have.

As stated above, the heart works on the principle that the fastest impulse will control the heart rate. So then we can also say that the thought that makes itself known first in our minds or emotions' and travels through our normal thought process to be acted on unless it is brought into captivity of the God's Word, will usually produce thoughts and emotions that are not always pleasing to God. God's Word states that we are to bring every thought into captivity… that means EVERY last one of them.

As we look at the following rhythms and the type of Christians associated with each of the different Atria rhythms. I wanted to remind myself and you the reader what God's word says to us about our thought life and the emotions that we create with our thoughts.

We read in 2 Corinthians 10:3-5 with verse 5 being the HEART of the matter at hand. The world is unprincipled. It's dog-eat-dog out there! The world doesn't fight fair. But we don't live or fight our battles that way—never have and never will. The tools of our trade aren't for marketing or manipulation, but they are for demolishing that entire massively corrupt culture.

We use our powerful God-tools for smashing warped philosophies, tearing down barriers erected against the truth of God, fitting every loose thought and emotion and impulse into the structure of life shaped by Christ. Our tools are ready at hand for clearing the ground of every obstruction and building lives of obedience into maturity. (MSG)

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The above verses stated that God has given was some Power-Tools to be used to smash this worlds warped philosophies (beliefs, world views), tearing down barriers erected against the truth of God, fitting every loose thought and emotion and impulse into the structure of life shaped by Christ. The New Living Translation of that same verses states that â&#x20AC;Ś we knock down strongholds of human reasoning and to destroy false arguments. 5 We destroy every proud obstacle that keeps people from knowing God. We capture their rebellious thoughts and teach them to obey Christ. (NLT) Then verse 5 in the Amplified says it this way â&#x20AC;Ś we refute arguments and theories and reasonings and every proud and lofty thing that sets itself up against the [true] knowledge of God; (AMP) The first atrial dysrhythmia we are going to look at is the rhythm of Normal Sinus with Premature Atrial Complexes (PAC).

NORMAL SINUS with Premature Atrial Complexes (PAC)

Figure 9.1 xciv Premature atrial complexes (PACs) are electrical impulses that originate in the atria and initiate an early impulse that interrupts the inherent regular rhythm.

Criteria for Classification Rhythm: The regularity between the P-P interval and R-R interval is constant with the exception of the early complexes. There will be a section of the rhythm that is regular and occasionally an early complex.

Rate: The rates of the atria and ventricles will usually be within normal limits of 60 to 100, depending on the frequency of the PACs. P wave configuration: The P waves will have the same configuration and shape. The early beat will have a different shape than the rest of the P waves on the strip. This P wave may be flattened, notched, biphasic (have two phases), or otherwise unusual. It may even be hidden within the T wave of the preceding complex. Evidence that the P wave is hidden within the T wave includes a notch in the T wave, a pointed shape, or being taller than the other T waves.

PR interval: The PR interval will measure within normal limits of 0.12 to 0.20 second. The early beat will probably have a different PR measurement than the normal complexes but will be within normal limits.

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QRS duration and configuration: The QRS duration and configuration will be within normal limits of 0.06 to 0.10 second.

Determine the underlying rhythm of sinus rhythm, sinus bradycardia, sinus tachycardia, or sinus dysrhythmia when identifying PACs. The rhythm strip must be labeled with this underlying rhythm and the type of PAC. An example of this terminology is "sinus rhythm with trigeminal PACs" (trigeminy refers to a pattern in which every third complex is a premature beat).

What's Unique about this Rhythm?

A premature atrial complex is a beat earlier than it should be with a positively deflected P wave.

Clinical Significance With each PAC, the atria do not achieve the maximum blood capacity prior to contraction.

This lack of blood causes a decrease in cardiac output and less volume in the ventricles prior to ventricular contraction. Therefore, in the patient who has prior cardiac disease, frequent PACs can cause the patient to experience symptoms of low cardiac output. When caring for a patient with PACs, observe the patient for signs and symptoms of low cardiac output.

Monitoring the amount or frequency of PACs is essential. The patient may complain of palpitations from the early beats. The severity of the patient's complaints is related to the frequency of the PACs. In addition, frequent PACs may indicate that a more serious atrial dysrhythmia may follow. The more frequent occurrence indicates that the ectopic focus (cardiac cell that functions as an ectopic beat) may continue and take control of the heart rate.xcv What does this mean to the Christian heart?

The Christian that is found in a Normal Sinus rhythm with PAC's is seen as the "WHAT IF" Christian.

Mark 9:23 Jesus said, "If? There are no 'ifs' among believers. Anything can happen."

(NLT) Before we get into the "What If", let's take some time and look at what the Christian mind is and is not. I want to start off and cover what the Christian Mind is NOT! The following list was compiled with the help of Dr. Davey Naugle of Dallas Baptist University.

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The Christian mind is not just thinking by Christians or just thinking about Christian things.

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The Christian mind is not just categorizing all things as right or wrong

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The Christian mind is not just employing a Christian line of clichĂŠs

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The Christian mind is not just supporting Christian causes and issues

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The Christian mind is not just memorizing Scripture, or having a quiet time, or asserting Christian doctrines and a correct system of theology

So what is the Christian Mind!

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The Christian mind is a way of thinking about the issues and areas of life on the basis of the fundamental assumptions and teachings of Scripture.

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The Christian mind is a way of seeing the world and life within it from a distinctively theistic and biblical point of view. This is known as having a Christian World View.

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The Christian mind is a spiritual and intellectual condition of mind and heart whereby the totality of things is viewed and interpreted through the grid of the biblical themes of creation, fall, and redemption.

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The Christian mind is grounded in objective truth rooted in God and revealed in creation, humanity, Christ, and Scripture.

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The Christian mind is wholistic in nature, addressing the totality of life and not just some narrow religious sphere (there is a Christian mind on art, politics, journalism, agriculture, social science, homemaking, plumbing, money, cloth es, food, scholarship, etc.).

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The Christian mind honors the creation and its cosmic redemption in Christ and is characterized by a sacramental cast that regards the ordinary things of everyday life as spiritually significant, rather than trying to live on a super-spiritual, anti-creational or non-creation plane divorced from God's very good world.

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The Christian mind is not for intellectuals only, nor a head-trip for egg-heads, but is for all serious and thoughtful believers who desire to love God with their minds Matthew 22:37 And He replied to him, You shall love the Lord your God with all your heart and with all your soul and with all your mind (intellect).(AMP) Who seek the mind of the Christ as seen in 1 Corinthians 2:16 For who has known or understood the mind (the counsels and purposes) of the Lord so as to guide and instruct Him and give Him knowledge? But we have the mind of Christ (the Messiah) and do hold the thoughts (feelings and purposes) of His heart. Who desire to grow into the measure of the stature that belongs to the fullness of Him Ephesians 4:13 [That it might develop] until we all attain oneness in the faith and in the comprehension of the [full and accurate] knowledge of the Son of God, that [we might arrive] at really mature manhood (the completeness of personality which is nothing less than the standard height of Christ's own perfection), the measure of the stature of the fullness of the Christ and the completeness found in Him. (AMP)xcvi

Now that I have shown what a Christian Mind is and is not, I can move onto what I call the "WHAT IF" Christian. This is the Christian that is asking a lot of questions and getting even more answers. The problem here is that the answers are not necessarily coming from the

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truth of God's Word. This Christian is looking to everybody else to get the answers to their questions, except the only one who can truly answer them.

When we get down to the bottom line with this Christian, we find that they are usually showing at least four of the fifty kinds of hearts mentioned in Chapter 7 all rolled into one. We will find this Christian to be discouraged, bitter, fretting and grieved.

This Christian has become discouraged: (To deprive of courage, hope, or confidence; dishearten; dispirit; to express or make clear disapproval of; frown upon) we read about this in the book of Numbers 32:7-9 Why do you discourage the hearts of the Israelites from going over into the land which the Lord has given them? Thus your fathers did when I sent them from Kadesh-barnea to see the land! For when they went up to the Valley of Eshcol and saw the land, they discouraged the hearts of the Israelites from going into the land the Lord had given them. (AMP) If this Christian turns and starts to get his or her hope and encouragement from God and stands on Romans 5:5 And this hope will not lead to disappointment. For we know how dearly God loves us, because he has given us the Holy Spirit to fill our hearts with his love.

(NLT) Then they will convert back into a normal sinus rhythm but if they do not find or hold onto this hope they will become Bitter: (Marked by strong resentment or cynicism: Very difficult to accept or bear: Expressive of severe grief or regret) this is found in James 3:14 But if you are bitterly jealous and there is selfish ambition in your heart, don't cover up the truth with boasting and lying. (NLT) Here again the Christian is holding onto the lies that he or she beliefs and not wanting to or refusing to accept the TRUTH found in God's Word. 1 John 2:4-6 Whoever says, I know Him [I perceive, recognize, understand, and am acquainted with Him] but fails to keep and obey His commandments (teachings) is a liar, and the Truth [of the Gospel] is not in him. 5 But he who keeps (treasures) His Word [who bears in mind His precepts, who observes His message in its entirety], truly in him has the love of and for God been perfected (completed, reached maturity). By this we may perceive (know, recognize, and be sure) that we are in Him: 6 Whoever says he abides in Him ought [as a personal debt] to walk and conduct himself in the same way in which He walked and conducted Himself. (AMP) The verse above states what we will find if the Christian starts to hold onto and acting on this TRUTH. It tells us in verse 5 that he who keeps Gods Word in his thinking and acts on it will reach maturity in Him. If the Christian still keeps believing the lies, and not the TRUTH we will see that the PAC's will increase and will be affecting both right and left atrium, so what started as a thought is now producing a very strong emotional response. The Christian is now experiencing fretting: (To feel or express worry, annoyance, discontent, or the like: an irritated state of mind; annoyance) Proverbs 19:3 The foolishness of man subverts his way [ruins his affairs]; then his heart is resentful and frets against the Lord. (AMP) So what does The Message have to

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say on this verse let's read it together? I think that you will like it. People ruin their lives by their own stupidity, so why does GOD always get blamed? (MSG) The idea of an irritated state of mind, can be seen in the Bible as "a thorn in the flesh" it is known as a source of constant irritation, affliction, or inconvenience; a perpetual pain-in-theneck. It has been said that a sect of Pharisees used to place thorns in the hem of their cloaks to prick their legs in walking, and make them bleed.xcvii Paul used the term thorn in the flesh in 2 Corinthians 12:7-10 Even though I have received such wonderful revelations from God. So to keep me from becoming proud, I was given a thorn in my flesh, a messenger from Satan to torment me and keep me from becoming proud.

Three different times I begged the Lord to take it away. Each time he said, "My grace is all you need. My power works best in weakness." So now I am glad to boast about my weaknesses, so that the power of Christ can work through me. That's why I take pleasure in my weaknesses, and in the insults, hardships, persecutions, and troubles that I suffer for Christ. For when I am weak, then I am strong. (NLT) If this Christian still does not change their thinking, they will become mentally distressed. This is called being grieved (To distress mentally; cause to feel grief or great sorrow). This state of mind is seen in Genesis 6:6 And the Lord regretted that He had made man on the earth, and He was grieved at heart. (AMP) See even God can get discouraged from time to time.

Psalm 73:21 For my heart was grieved, embittered, and in a state of ferment, and I was pricked in my heart [as with the sharp fang of an adder]. (AMP) The What IF?? Christian is in need of a CHANGE of Heart. This change can only come from them allowing God to change them from the inside out. As in the physical real a wound has to heal from the inside out, if you cover it up before it is properly healed it will fester and get infected; that in its self will cause even worse problems for us want it? We will discuss spiritual wounds of the heart some later in this chapter.

If you have found yourself in this spiritual heart rhythm; I encourage you to stop what you are doing. Spend some time seeking God's face, ask for His forgiveness and start looking to and living out Gods truth found in His Word. Remember it is OK for you and I to ask "What If" and even "Why" questions. We need to just know where to turn too to find the right answers and that is from God and His Word. The Christian recording artist Nichole Nordeman has a song called "What If" I think that you would enjoy listing to it.

We have been looking at the Christian who has been in a normal sinus rhythm with PAC's. As the PAC's increase in frequency we need to consider a Wandering Atrial Pacemaker. This Christian has a wounded heart and if left untreated will lead the Christian to wanderer, further from the Truth and will become a spiritual nomad, itinerant or a vagrant in their thinking.

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WANDERING ATRIAL PACEMAKER (WAP)

Figure 9.2 xcviii Wandering Atrial Pacemaker (WAP) is a rhythm in which the pacemaker site shifts between the SA node, atria, and/or the AV junction. The P wave configuration changes in appearance during the pacemaker shift. At least three different P wave configurations in the same lead indicate a wandering atrial pacemaker.

Criteria for Classification Rhythm: Slightly irregular Rate: Should be within normal limits of 60 to 100 beats per minute P wave configuration: Continuous change in appearance PR interval: Varies QRS duration and configuration: Usually within normal limits What's Unique about this Rhythm?

WAP has a changing P wave configuration with at least three variations in one lead. The rhythm may be irregular.

Clinical Significance WAP is a normal finding in children, older adults, and well-conditioned athletes and does not usually cause clinical signs and symptoms. However, it may also be related to some types of organic heart disease and drug toxicity. xcix What does this mean to the Christian heart?

I have a whole lot to say about this Christian, the Christian with the Wandering Atrial Pacemaker has been offended and is allowing the offense to rule in their lives. They are living in what is known as a cycle of offense and if this heart is left untreated the offense will led to the Christian feeling dejected, then rejected and if still untreated will become a wounded and scared Heart but more about that later in the next chapter.

The start of cycle of offense can be clearly seen in Mark 4:16-17 And in the same way the ones sown upon stony ground are those who, when they hear the Word, at once receive and

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accept and welcome it with joy; 17 And they have no real root in themselves, and so they endure for a little while; then when trouble or persecution arises on account of the Word, they immediately are offended (become displeased, indignant, resentful) and they stumble and fall away. (AMP) If the Christian allows this cycle of offence to continue in their lives, they will more then likely become a spiritual itinerant, vagrant, vagabond or nomad, one who moves from one place to another, or just wanders around rather than settling permanently in one location. This Christian has allowed the offenses in their lives to be the reason that they start to wandered off from God and His truth to start believing lies as seen in James 5:19-20. My dear friends, if you know people who have wandered off from God's truth, don't write them off. Go after them. Get them back and you will have rescued precious lives from destruction and prevented an epidemic of wandering away from God. (MSG) I like what John Bevere had to say in his book Bait of Satan, on How Spiritual Vagabonds Are Born. â&#x20AC;Ś Once you leave the place God has chosen for you, your root system begins to dwarf. The next time it will be easier for you to flee from adversity because you have been careful not to root yourself too deeply. You end up coming to the place where you have little or no strength to endure hardship or persecution.

You then become a spiritual vagabond, wandering from place to place, suspicious and afraid that others will mistreat you. Crippled and hindered in your ability to produce true spiritual fruit, you struggle in a self-centered life, eating the remains of the fruit of others.

Look at Cain and Abel, the first sons of Adam. Cain brought an offering to the Lord from the works of his own hands, the fruit of his vineyard. It was brought forth with much toil. He had to clear the ground of rocks, stumps, and other debris. He had to plow and cultivate the soil. He had to plant, water, fertilize, and protect his crops. He put much effort in his service toward God. But it was his own sacrifice rather than obedience toward God's way. It symbolized the worship of God by one's own strength and ability rather than by God's grace.

Abel, on the other hand, brought an offering of obedience, the choice firstborn of his flock and their fat. He did not labor as Cain did to bring this forth, but it was dear to him. Both brothers would have heard how their mother and father had attempted to cover their nakedness with fig leaves which represented their own works to cover their sin. But God demonstrated acceptable sacrifice by covering Adam and Eve with the skin of an innocent animal. Adam and Eve were ignorant of this unacceptable covering of their sin. But having been shown God's way they were no longer ignorant, nor were their children.

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A Paramedicâ&#x20AC;&#x2122;s view of Christianity Cain had tried to win God's acceptance apart from His counsel. God responded by showing He would accept those who came to Him under His parameters of grace (Abel's sacrifice) and would reject what was attempted under the domain of the "knowledge of good and evil" (Cain's religious works). He then instructed Cain that if he would do good, he'd be accepted; but if he would not choose life, then sin would master him.

Cain was offended with the Lord. Rather than repent and do what was right, allowing this situation to strengthen his character, he vented on Abel his anger and offense with God. He murdered Abel. God said to Cain: So now you are cursed from the earth, which had opened its mouth to receive your brother's blood from your hand. When you till the ground, it shall no longer yield its strength to you. A fugitive and a vagabond you shall be on the earth. Genesis 4:11-12 The thing Cain feared most, to be rejected by God, he brought as a judgment on himself. The very medium through which he tried to win God's approval was now cursed by his own hand. The bloodshed now brought a curse. The ground would no longer give up its strength to him. Fruit would come only through great effort.

Offended Christians also cut off their own ability to produce fruit. Jesus compared the heart with soil in the parable of the sower. Just as Cain's fields were barren, the soil of an offended heart is barren, poisoned by bitterness. Offended people still may experience miracles, words of utterance, strong preaching, and healing in their lives.

But these are gifts of the Spirit, not fruits. We will be judged according to fruit, not gifting. A gift is given. Fruit is cultivated.

Notice that God said Cain would become a fugitive and a vagabond as a result of his actions. There are numerous spiritual fugitives and vagabonds in our churches today.

Their gifts of singing, preaching, prophesying, and so on are not received by the leadership in their previous church, so off they go. They are running aimlessly and carry an offense, looking for that perfect church that will receive their gift and heal their hurts.

They feel beat up and persecuted. They feel as if they are modern-day Jeremiahs. It is "just them and God," with everyone else out to get them. They become unteachable.

They get what I call a persecution complex: "Everyone is out to get me." They comfort themselves that they are just a persecuted saint or prophet of God. They are suspicious of everyone. This is exactly what happened to Cain. Look what he says: I shall be a fugitive and a vagabond on the earth, and it will happen that anyone who finds me will kill me. Genesis 4:14 Consider that Cain had the persecution complex -- everyone was out to get him! It is the same today. Offended people believe everyone is out to get them. With this

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attitude it is difficult for them to see areas in their own lives that need change. They isolate themselves and conduct themselves in such a manner that invites abuse.

A man who isolates himself seeks his own desire; he rages against all wise judgment.

Proverbs 18:1 God never created us to live separately and independently of each other. He likes it when His children care for and nurture each other. He is frustrated when we sulk and feel sorry for ourselves, making everyone else responsible for our happiness. He wants us to be active members of the family. He wants us to get our life from Him. An isolated person seeks only his own desire, not God's. He receives no counsel and sets himself up for deception.

I am not talking about seasons in which God calls individuals apart to equip and refresh them. I'm describing those who have imprisoned themselves. They wander from church to church, relationship to relationship, and isolate themselves in their own world. They think that all who do not agree with them are wrong and are against them.

They protect themselves in their isolation and feel safe in the controlled environment they have set up for themselves. They no longer have to confront their own character flaws. Rather than facing the difficulties, they try to escape the test. The character development that comes only as they work through conflicts with others is lost as the cycle of offense begins again.c The Christian, who has wandered off from God's truth and has entered into the cycle of offense, will have a heart that is distracted, discouraged, deceived, disillusioned, disgruntled and divided (double). As we start to ponder what has caused this Christian to wander, please keep in mind that we all can, and probably have or will wander (error) from the truth at some point in our lives as Christians.

Now Notice how James describes this Christian James 5:19-20 My dear brothers and sisters, if someone among you wanders away from the truth and is brought back, 20 you can be sure that whoever brings the sinner back will save that person from death and bring about the forgiveness of many sins. (NLT) "If anyone among you wanders ("do err" - KJV) from the truth." The Greek word for "wanders" is interesting. It is the word "Planao", which is a form of the Greek word "Planetes". Does that sound familiar to you it should, we derive our English word "Planet" from it.

The basic meaning of the Greek word means "to wander or stray." Now, the people in the time that this was written liked to look at the stars at night just like you and I do. And when they looked, they noticed that certain "stars" or light bearing bodies seemed to move around more than others so they called them "wandering stars" (as Jude calls false teachers in Jude 1:13).

What they were seeing were the planets (as they appeared as stars to them), but they were really planets, whose changing orbits, kept them "wandering" or "straying" from the ancient

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Greek's perspectives. So, this is the imagery that James employs to describe a Christian who has strayed to the point of being "backslidden". The Backslidden Christian has "gone off course" spiritually, so to speak. They are not where they once were spiritually. You might also say they have gotten off the "straight and narrow" path. This is the essence of backsliding but more on that in Chapter 12.

When we talk about spiritual wandering or straying, we need to identify the two distinct but interrelated kinds of straying. They are known as Doctrinal and Practical Error.

Doctrinal Error - Untrue Beliefs held by Christians. Paul told Titus, Speak the things which are proper for sound doctrine. Titus 2:1. The fact that Paul tells Titus to teach "sound doctrine" tells us that there is such a thing as "unsound doctrine" and believe me there is.

As an example let's say that the Christian decides that because of grace we are no longer bound to obey the Ten Commandments. This error is what we call antinomianism and is not uncommon today. What this Christian failed to realize is that in the Sermon on the Mount, Jesus Christ not only reaffirmed our obligations to obey the law but raised the standard by insisting that we obey it from the heart (with all our Mind, Will, Emotions and also with our Character and Personality). So antinomianism is a wandering from the truth.

Practical Error - Sinful Behavior Practiced by Christians. 3 John 1:4 I have no great joy that to hear that my children walk (or live) in truth. Then in John 3:21 But he who practices truth [who does what is right] comes out into the Light; so that his works may be plainly shown to be what they areâ&#x20AC;&#x201D;wrought with God [divinely prompted, done with God's help, in dependence upon Him]. This verse tells us that we are to practice "truth" so then this "truth" is something we not only believe but also do. That is, we are to be living a live in accordance with the standards of truth as defined by the Scriptures. But when we engage in any type of behavior that is unbiblical, sinful, we are "wandering from the truth."ci Have you ever known a believer who has wandered away from the clear teaching of Scripture? How about you; have you ever done so? These Christians may be active in a local church, and yet over a period of time slowly, almost imperceptibly, they wander away from the truth. Because most of us have known someone (perhaps even yourself) who has wandered away from the truth, let's think about and observe what I think to be some of the causes that have led a Christian to wander.

I see the first cause to be the Christian that is Distracted: Perhaps we get distracted from our devotion to Christ and His church, because of some good thing we want to do. It could be a cause we are concerned about; even a friend we would like to influence for Christ. We might want to get an education, or acquire some training so we can get a better job. We might decide our family needs to become more of a priority in our life.

No matter how worthwhile our pursuit might be, if we do not continually draw on our resources in Christ and allow the Lord and His Word to direct our path, we might wander

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away. Our good goal may become more important to us than even our own faith. I have seen this happen literally hundreds of times in churches.

What can we do to assist the distracted wanderers? We can help them to once again focus their priorities on Godly Values. Let's look at the following verses and think about what is being said to us as we read.

Matthew 6:30-33 If God gives such attention to the appearance of wildflowersâ&#x20AC;&#x201D;most of which are never even seen don't you think he'll attend to you, take pride in you, do his best for you?

What I'm trying to do here is to get you to relax, to not be so preoccupied with getting, so you can respond to God's giving. People who don't know God and the way he works fuss over these things, but you know both God and how he works. Steep your life in God-reality, Godinitiative, God-provisions. Don't worry about missing out. You'll find all your everyday human concerns will be met. (MSG) 1 Timothy 6:9-12 But if it's only money these leaders are after, they'll self-destruct in no time.

Lust for money brings trouble and nothing but trouble. Going down that path, some lose their footing in the faith completely and live to regret it bitterly ever after. 11-12 But you, Timothy, man of God: Run for your life from all this. Pursue a righteous life a life of wonder, faith, love, steadiness, courtesy. Run hard and fast in the faith. Seize the eternal life, the life you were called to, the life you so fervently embraced in the presence of so many witnesses. (MSG) Luke 10:38-42 As Jesus and the disciples continued on their way to Jerusalem, they came to a certain village where a woman named Martha welcomed him into her home. 39 Her sister, Mary, sat at the Lord's feet, listening to what he taught. 40 But Martha was distracted by the big dinner she was preparing. She came to Jesus and said, "Lord, doesn't it seem unfair to you that my sister just sits here while I do all the work? Tell her to come and help me." 41 But the Lord said to her, "My dear Martha, you are worried and upset over all these details!

42 There is only one thing worth being concerned about. Mary has discovered it, and it will not be taken. (NLT) The second cause I find to be the Christian that is Discouraged: At times our wandering is because we have gotten out of the habit of spiritually feeding ourselves, or of attending church. As a result, we become weak and lethargic in our faith do not live up to the commands of Scripture, especially in a testing time. Rather than returning to the Word, we may become discouraged and wander away because we think our faith is not working for us. But the real problem is that we are not working our faith and there is an enemy who is on the prowl and wants to lead us astray.

With the discouraged wanderers we are to assist them in rekindling their inner life, we see this in Matthew 6:5-18 and help them to put their hope once again in God as we are taught in Psalm 42:1-11. You will see what I am talking about as we read these passages together shall we?

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Matthew 6:5-18 And when you come before God, don't turn that into a theatrical production either. All these people making a regular show out of their prayers, hoping for stardom! Do you think God sits in a box seat? 6 "Here's what I want you to do: Find a quiet, secluded place so you won't be tempted to role-play before God. Just be there as simply and honestly as you can manage. The focus will shift from you to God, and you will begin to sense his grace. 713 "The world is full of so-called prayer warriors who are prayer-ignorant. They're full of formulas and programs and advice, peddling techniques for getting what you want from God. Don't fall for that nonsense. This is your Father you are dealing with, and he knows better than you what you need. With a God like this loving you, you can pray very simply. Like this: Our Father in heaven, Reveal who you are. Set the world right; Do what's best-as above, so below. Keep us alive with three square meals. Keep us forgiven with you and forgiving others. Keep us safe from ourselves and the Devil. You're in charge! You can do anything you want! You're ablaze in beauty! Yes. Yes. Yes. 14-15 "In prayer there is a connection between what God does and what you do. You can't get forgiveness from God, for instance, without also forgiving others. If you refuse to do your part, you cut yourself off from God's part. 16-18 "When you practice some appetite-denying discipline to better concentrate on God, don't make a production out of it. It might turn you into a small-time celebrity but it won't make you a saint. If you 'go into training' inwardly, act normal outwardly. Shampoo and comb your hair, brush your teeth, wash your face. God doesn't require attention-getting devices. He won't overlook what you are doing; he'll reward you well. (MSG) Psalm 42:1-11 As the hart pants and longs for the water brooks, so I pant and long for You, O God. 2 My inner self thirsts for God, for the living God. When shall I come and behold the face of God? 3 My tears have been my food day and night, while men say to me all day long, Where is your God? 4 These things I [earnestly] remember and pour myself out within me: how I went slowly before the throng and led them in procession to the house of God [like a bandmaster before his band, timing the steps to the sound of music and the chant of song], with the voice of shouting and praise, a throng keeping festival. 5 Why are you cast down, O my inner self? And why should you moan over me and be disquieted within me? Hope in God and wait expectantly for Him, for I shall yet praise Him, my Help and my God. 6 O my God, my life is cast down upon me [and I find the burden more than I can bear]; therefore will I [earnestly] remember You from the land of the Jordan [River] and the [summits of Mount] Hermon, from the little mountain Mizar. 7 [Roaring] deep calls to [roaring] deep at the thunder of Your waterspouts; all Your breakers and Your rolling waves have gone over me. 8 Yet the Lord will command His loving-kindness in the daytime, and in the night His song shall be with me, a prayer to the God of my life. 9 I will say to God my Rock, Why have You forgotten me?

Why go I mourning because of the oppression of the enemy? 10 As with a sword [crushing] in my bones, my enemies taunt and reproach me, while they say continually to me, Where is your God? 11 Why are you cast down, O my inner self? And why should you moan over me and be disquieted within me? Hope in God and wait expectantly for Him, for I shall yet praise Him, Who is the help of my countenance, and my God. (AMP)

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The third cause is to be Deceived: There are occasions when we wander because we believe a lie, and only later discover the lie has deceived us and led us off course.

I like what Dr. Paul W. Carlin had to say in his book, Satan and the Saint: A Look into The Dark Side Of Christian Behavior, about Christians being deceived. â&#x20AC;Ś Satan blinds the minds of unbelievers will not come as a surprise to anyone. But many Christians fail to realize that Satan also deceives the minds of believers. I have mentioned this satanic device, deceit, first in this discussion because it is the device which the devil uses against us the most, and it is also the most dangerous weapon he possesses.

Deception, which covers both lies and trickery, is the fountain from which all other satanic stratagems flow. In this connection, it is interesting to take note of how much the Bible says about deception generallyâ&#x20AC;Ś The Satanic deception that undermines Christians falls into three categories or types: self-deception, societal-deception, satanic-deception. Interestingly, these types roughly co respond with the three traditional enemies of those who are involved in the Christian walk: the World, the Flesh and the Devil.

Self-Deception Self-deception is a product of the flesh. In Scripture, 1 John 1:8 deals with people's self-deception concerning their own innocence - in other words, their belief that they personally are sinless. Says John, "If we say that we have no sin, we deceive ourselves, and the truth is not in us."

The Greek word "planeo" (deceive), in terms of human beings viewed subjectively or personally, means a wandering from the right path; in terms of objective events, events occurring outside of us, it means to perpetrate fraud. Actually it means to defraud yourself.

When self-deception is at work, an individual believes what he or she wants to believe because, to some extent, believing this way benefits him toward some desired end, an end which he foresees will be physically, emotionally, monetarily or spiritually satisfyingâ&#x20AC;Ś Societal Deception This deception likewise is rooted in pride. Its flavor is that of the world. Ephesians 4:14 Then we will no longer be immature like children. We won't be tossed and blown about by every wind of new teaching. We will not be influenced when people try to trick us with lies so clever they sound like the truth. (NLT) paints a frightening picture of Satan,

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who is cunning craftiness personified, as he cooperates with the sleights or tricks of ordinary men who are deceiving their fellows: …

Societal deception is dangerous because of the power of the "herd" instinct in man.

People like to "follow the crowd" and "be where the action is" and "hang out at the most popular watering holes." This herd instinct greatly nourishes societal, or social, deception.

Satanic Deception While self-deception is internal, rising in the flesh, or in the godless natural man of our personal makeup, and while social deception is perpetrated on us by our fellow men as a group, satanic deception is the devil's direct work in us. World, flesh and devil the Christian's three greatest enemies are reinforced and promoted through deception.

Revelation 12:9 provides us with three names for Satan. He is the devil, literally "the slanderer;" he is Satan, literally, "adversary;" and his is planeo, literally, "the deceiver."

(The term is most often used for religious deceit.) This is the word which is used for Satan in Revelation 20:10.

2 John 7 describes Satan as "planos," roving like a tramp, an imposter, a misleader: "For many deceivers are entered into the world, who confess not that Jesus Christ is come in the flesh. This is a deceiver and an antichrist." The word is descriptive of an imposter of the vagabond or tramp sort. The same word is used regarding "seducing spirits" (planos) in 1 Timothy 4:1.

The New American Standard Translation has the term "deceitful spirits." When one emphasizes the slanderer, liar, destroyer and accuser characteristics of Satan, but forgets that he is, first and foremost, the deceiver…

Sin Deception We established earlier that there were three areas of deception. But actually there are four. There are three which correspond to the world, the flesh, and the devil. And then there is one more, sin deception.

This could have been treated as part of the self-deception syndrome, because the verse referring to sin deception is Romans 7:11. "For sin, taking occasion by the commandments, deceived me, and by it slew me."

Paul states that it is the sin principle, the flesh, which exerts a controlling force over our actions. The Law is not the cause of sin which results in death. Sin, through its devious and deceptive maneuvering, is what slays man. Sin is a deceiver…

Satan never gives us! Therefore, the child of God must always be alert. How tragic are the results when we yield our members as instruments of sin. It might be helpful for us to gain some insight into just how Satan uses his evil spirits in the deception process.

How does he deceive the believer?

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Jessie Pen-Lewis, in her War on the Saints, lists the various ways: • Satan does it, first, by obtaining the consent of the person's will to some evil thought or action.

• Second, by counterfeiting the presence of God as the one who is influencing the believer.

• Third, by counterfeiting the Person of God within the believer's own person.

• Fourth, by suggestions to the mind.

• Fifth, by steering false counselors toward the believer.

• Sixth, by engineering counterfeits of various divine, human, Satanic and angelic things.

• Seventh, through teachings delivered by demons.

• Eighth, by contriving supernatural visions and voices.

• Ninth, by pushing situation to their extremes.

Again, Satan's first objective is to deceive, so as to gain communication with, entrance to, and confidence of the believer, so that he or she will imagine that all of his workings are of God.cii As the old Church Lady would say on the show 'Saturday Night Live', "Could it be Satan".

We will read and study this more in Chapter 10. For now let's review what we can do to help the deceived wanderers: Reaffirm the truth to them in love and Replace the lie!!! Now that sounds familiar like what is taught in Belief Therapy® 101.

Ephesians 4:15, 25 15 Instead, we will speak the truth in love, growing in every way more and more like Christ, who is the head of his body, the church. 25 So stop telling lies. Let us tell our neighbors the truth, for we are all parts of the same body. (NLT) 1 Timothy 1:3-7 When I left for Macedonia, I urged you to stay there in Ephesus and stop those whose teaching is contrary to the truth. 4 Don't let them waste their time in endless discussion of myths and spiritual pedigrees. These things only lead to meaningless speculations, which don't help people live a life of faith in God. 5 The purpose of my instruction is that all believers would be filled with love that comes from a pure heart, a clear conscience, and genuine faith. 6 But some people have missed this whole point. They have turned away from these things and spend their time in meaningless discussions. 7 They want to be known as teachers of the law of Moses, but they don't know what they are talking about, even though they speak so confidently. (NLT) 1 Timothy 6:20-21 Timothy, guard what God has entrusted to you. Avoid godless, foolish discussions with those who oppose you with their so-called knowledge. 21 Some people have wandered from the faith by following such foolishness. (NLT)

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2 Timothy 2:17-19 This kind of talk spreads like cancer, as in the case of Hymenaeus and Philetus. 18 They have left the path of truth, claiming that the resurrection of the dead has already occurred; in this way, they have turned some people away from the faith. 19 But God's truth stands firm like a foundation stone with this inscription: "The Lord knows those who are his," and "All who belong to the Lord must turn away from evil." (NLT) Here the forth cause is the Christian that is Disillusioned: Some begin their new faith in Christ with the mistaken idea that all their problems will be solved, and they will not have to go through any more hard times. They also believe all people who call themselves Christians will live an exemplary life. Some will go through a hard time and/or witness Christians not living up to their expectations, and will become disillusioned and just wander away from the faith.

The truth is, the normal way for us to grow is through hard times, and other Christians will fail us. If we insist on a hardship-free life with perfect fellow Christians, we will be disillusioned.

Remember the life of Paul and his associate, Demas.

The Holy Spirit will need to return the disillusioned wanderers focus to Jesus, the Author and Finisher of their Faith.

Hebrews 12:1-3 Do you see what this means—all these pioneers who blazed the way, all these veterans cheering us on? It means we'd better get on with it. Strip down, start running—and never quit! No extra spiritual fat, no parasitic sins. Keep your eyes on Jesus, who both began and finished this race we're in. Study how he did it. Because he never lost sight of where he was headed—that exhilarating finish in and with God—he could put up with anything along the way: Cross, shame, whatever. And now he's there, in the place of honor, right alongside God. When you find yourselves flagging in your faith, go over that story again, item by item, that long litany of hostility he plowed through. That will shoot adrenaline into your souls! (MSG) So when we find ourselves down and out and in need of a pick me upper, the Bible tells us to tell ourselves the stories of God's goodness to us personally. Now that would have to be a shoot of HIGH DOSE Epinephrine 1:1000 into your souls! Wow now let's thinks this one over… A High Dose of Epie anyone? … Into Where? You really mean it into our Minds, our Wills, our Emotions and then into our character and personalities. Now that would lead to some major changes in our lives would it not?

We move on to the fifth cause we are going to talk about and that is the Christian that is Disgruntled: This is the first wanderer that has believed the devils lies to the point that the Christians emotions are actively involved and usually not in a good way. These people are angry at someone for inappropriate or even appropriate behavior or statements. Their anger and

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bitterness robs them of their joy, and they wander. This is a very big cause for those of us that work and live EMS. In Make Anger Your Ally, Neil Clark Warren writes: "When people get angry, the results are almost always negative - even frightful."

Neil Warner in his book, Make Anger Your Ally, cites four classic mismanaged anger styles or behaviors that people employ to express their anger. They include: somatizers, selfpunishers, exploders, and underhanders. Warner goes on to explain each anger styleâ&#x20AC;Ś Somatizers: Somatizers, as the name implies (soma means body), represent a passive behavior style that takes its toll on the body. Somatizers are individuals who choose not to overtly express their feelings of anger, but rather suppress these feelings for fear that to show anger will result in the rejection or the loss of approval of those who have caused a grievance. Consequently, this mismanagement style promotes the martyr role for those who choose it. Somatizers distinguish themselves from other mismanaged anger behavior styles in that when anger feelings remained suppressed, these emotional responses soon manifest as physical symptoms such as migraine headaches, ulcers, colitis and temporomandibular joint dysfunction (TMJ).

Self-Punishers: A second passive behavior style of mismanaged anger involves those people who channel their anger into guilt. These people often get angry with themselves for getting angry with others. As a result, they deny themselves a proper outlet or catharsis of their anger. Instead, they punish themselves with control measures which in effect lower self-esteem. For example, these limits of control can be seen in food intake (overeating or starvation), excessive drinking, and even styles of clothing, all of which deflate self-esteem.

Exploders: Exploders represent the stereotype of uncontrolled aggression. Exploders are people who express their anger in a hostile manner, either verbally or physically.

Like a volcano, they erupt, spreading their hot lava in a path of destruction toward any person around them. Exploders pent up their feelings of anger and then often erupt at people or objects which are not associated with the primary cause of frustration.

Explosive behavior is sometimes displaced onto others, where feelings of anger are suppressed toward the provoker, but then released or projected onto innocent victims including employees, spouses, and children who were unrelated to the original cause.

In many cases explosive anger is used as a form of intimidation to maintain control of a situation or other people's emotions. It is this behavior that is targeted by psychologists as indicative of Type A personality and the factor most closely associated with coronary heart disease.

Underhanders: Like the exploder, the underhander exhibits an active style of mismanaged anger that inflicts mild abuse to individuals within one's proximity. What separates underhanded behavior from the explosive style is that underhanders usually target their aggression directly at the cause of the threat in what they perceive to be socially acceptable means. Underhanders seek revenge for injustices to their ego and try to sabotage their "enemy" with little acts of aggression in a somewhat socially acceptable way. Examples include walking in late for a staff meeting and sarcastic

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comments (verbal sabotage), both of which demonstrates a need to gain control of the aggressor. Underhanders see themselves as life's victims and although their anger is often directed at the cause, resolution is rarely accomplished.

Warner points out that every individual tends to employ all of these mismanagement styles at some point, depending on the situation and people involved. One style, however, becomes the dominant behavior in each personality and is used most extensively in daily interactions. It should be pointed out that none of these four behavior patterns is healthy (e.g. to switch from a somatizer to an exploder is not recommended). Warner suggests that one begin to recognize his or her feelings of anger, and then channel them to more creative outlets.

Warner goes on to explainâ&#x20AC;Ś Human anger is thought to be uniquely comprised of conscious thought, physiological changes, some form of related behavior. Therefore, the most successful strategies of dealing with anger involve cognitive coping strategies, relaxation techniques, and behavior modification. The following is a list of suggested ways to creatively deal with your anger. There are both effective and non-effective ways to deal with the various shades of this emotion. The best suggestion is to learn a variety of ways so that one or more can be available when situations arise that trigger the anger response in you.

Based on the works of Carol Tavris (1982) and Harold Weisinger (1985), and in the spirit of self-help 12-step programs to modify behaviors, the following suggestions are provided to help you learn to manage your anger more creatively.

1. Know your anger style 2. Learn to self-monitor your anger 3. Learn to de-escalate your anger 4. Learn to out think your anger: "Learn to construct rather than destruct."

5. Get comfortable with all your feelings and learn to express them constructively 6. Plan in advance 7. Develop a support system 8. Develop realistic expectations for yourself and others 9. Learn problem solving techniques 10. Stay in shape 11. Turn complaints into requests 12. Make past anger pass:ciii June Hunt in her book Biblical Counseling Keys had this to say about Anger and Learning to Act Rather than React.

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What Is the Magnitude of Anger?

Anger, like heat, has many degrees. It ranges from mild, controlled irritations to hot, uncontrolled explosions. In fact, anger is a wide umbrella word that covers many emotions.

Indignation is simmering anger provoked by something appearing unjust or unworthy and is often seen as justified. Jesus became indignant when the disciples were preventing people from bringing their children to Jesus so that He might touch them and bless them. "When Jesus saw this, he was indignant. He said to them, 'Let the little children come to me, and do not hinder them, for the kingdom of God belongs to such as these.'" (Mark 10:14) Wrath is burning anger accompanied by a desire to avenge. Wrath often moves from the emotion of anger to the outward expression of anger. In Romans 1:18-20, God expresses His wrath as divine judgment upon those who commit willful sin. "The wrath of God is being revealed from heaven against all the godlessness and wickedness of men who suppress the truth by their wickedness." (Romans 1:18) Fury is fiery anger so fierce that it destroys common sense. The word fury suggests a powerful force compelled to harm or destroy. Some members of the Sanhedrin were so angry with Peter and the other apostles for proclaiming that Jesus was God that "they were furious and wanted to put them to death" (Acts 5:33). That is why the Bible says, "Anger is cruel and fury overwhelming." (Proverbs 27:4) Rage is blazing anger, involving loss of self-control, violence, and temporary insanity.

After an outburst of rage, how many times have we heard this cry of remorse, "I can't believe I did that!" Yet there will always be those who vent their rage toward other people and even toward God. "A man's own folly ruins his life, yet his heart rages against the LORD." (Proverbs 19:3) What Is the Misuse of Anger?

Periodically, everyone feels the heat of anger, but how you handle the heat determines whether you are misusing it. The small flame that lights a cozy campfire, if left unchecked, can just as quickly ignite a fierce forest fire. Conversely, the initial spark of anger that could be used for good, if snuffed out, can keep anger from accomplishing its designated purpose. Evaluate how you may be mishandling your anger.

Prolonged anger . . . the "simmering stew" . . . is held in for a long time. This anger is a result of an unforgiving heart toward some past offence and offender. Unforgiveness eventually results in resentment and a deep bitterness that affects all relationships.

Pressed down anger . . . the "pressure cooker" . . . is denied or hidden from yourself and others. Usually resulting from a fear of facing your own negative emotions, this kind of anger creates a deceitful heart and leads to untruthful communication with others. Failure to honestly confront and resolve your

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A Paramedicâ&#x20AC;&#x2122;s view of Christianity negative feelings can result in self-pity, self-contempt, and self-doubt . . . ultimately sabotaging most relationships.

Provoked anger . . . the "short fuse" . . . is quick and impatient, instantly irritated or incensed. A testy temper is often expressed with criticism or sarcasm under the guise of teasing.

Profuse anger . . . the "volatile volcano" . . . is powerful, destructive, hard to control. This way of releasing anger is characterized by contempt, violence, and abuse toward others. â&#x20AC;Ś Unexpected fires are often started and fuelled by one of four sources: seeping oil, seeping gas, molten lava, or coal bed methane (a flammable gas that can cause mining explosions). In a similar way, anger is started and fuelled by one of four sources: injustice, hurt, fear, or frustration. Anger is a secondary response to one or more of these four sources. Probing into buried feelings from your past is painful.

Therefore, it can seem easier to stay angry than to uncover the cause, turn loose of your "rights," and grow in maturity.

1. Injustice: Your right is violated. Everyone has an inner moral code that produces a sense of right and wrong, fair and unfair, just and unjust. When you perceive that an injustice has occurred against you or others (especially those whom you love), you can feel anger. If you hold on to this kind of offence, the unresolved anger will begin to make a home in your heart.

BIBLICAL EXAMPLE: KING SAUL King Saul's unjust treatment of David evoked Jonathan's anger. When Jonathan, son of Saul, heard his own father pronounce a death sentence on his dear friend David, he asked, "'Why should he be put to death? What has he done?' . . . But Saul hurled his spear at him Jonathan to kill him. Then Jonathan knew that his father intended to kill David. Jonathan got up from the table in fierce anger; on that second day of the month he did not eat, because he was grieved at his father's shameful treatment of David" (1 Samuel 20:32-34).

2. Hurt: Your heart is wounded. Everyone has a God-given inner need for unconditional love. When you experience rejection or emotional pain of any kind, anger can become a protective wall that keeps people and pain away.

BIBLICAL EXAMPLE: 12 SONS OF JACOB Joseph was the undisputed favorite of the twelve sons of Jacob. Feeling hurt and rejected by their father, the older sons became angry and vindictive toward their younger brother! "Now Israel [Jacob] loved Joseph more than any of his other sons, because he had been born to him in his old age; and he made a richly ornamented robe for him. When his brothers saw that their father loved him more than any of them, they hated him and could not speak a kind word to him" (Genesis 37:3-4).

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3. Fear: Your future is threatened. Everyone is created with a God-given inner need for security. When you begin to worry, feel threatened, or get angry because of a change in circumstances, you may be responding to fear. A fearful heart reveals a lack of trust in God's perfect plan for your life.

BIBLICAL EXAMPLE: KING SAUL Saul became angry because of David's many successes on the battlefield. He was threatened by David's popularity and feared he would lose his kingdom. (Read 1 Samuel 18:5-15, 28-29.) "Saul was very angry . . .'They have credited David with tens of thousands,' he thought, 'but me with only thousands.' . . . Saul was afraid of David, because the LORD was with David but had left Saul." (1 Samuel 18:8, 12) 4. Frustration: Your performance is not accepted. Everyone has a God-given inner need for significance. When your efforts are thwarted or do not meet your own personal expectations, your sense of significance can be threatened. Frustration over unmet expectations of yourself or of others is a major source of anger.

BIBLICAL EXAMPLE: CAIN Both Cain and Abel brought offerings to God, but Cain's offering was clearly unacceptable. Cain had chosen to offer what he himself wanted to give rather than what God said was right and acceptable. When Cain's self-effort was rejected, his frustration led to anger, and his anger led to the murder of his own brother.

"In the course of time Cain brought some of the fruits of the soil as an offering to the LORD. But Abel brought fat portions from some of the firstborn of his flock. The LORD looked with favour on Abel and his offering, but on Cain and his offering he did not look with favor. So Cain was very angry, and his face was downcast. . . .

Now Cain said to his brother Abel, 'Let's go out to the field.' And while they were in the field, Cain attacked his brother Abel and killed him." (Genesis 4:3-5, 8) Do You Respond or React When You Are Angry?

What happens when you feel angry? Have you ever evaluated how others see you?

An appropriate response is expressing your thoughts and feelings with restraint, understanding, and concern for the other person's welfare. "A man of knowledge uses words with restraint, and a man of understanding is even-tempered."

(Proverbs 17:27) An inappropriate reaction is expressing your thoughts and feelings in such a way that stirs up anger in others so that it produces strife. Proverbs, the book on wisdom, paints this graphic picture â&#x20AC;Ś"As churning the milk produces butter, and as twisting the nose produces blood, so stirring up anger produces strife." (Proverbs 30:33)civ Since we are talking about the Christian that is disgruntled and angry I think we need to read Ephesians 4:26-27, 29-32. After reading these verses we will really see what God thinks

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about anger. We are first going to read the verse in the Amplified Bible and then we will also read the same verse from the Message Bible.

26

When angry, do not sin; do not ever let your wrath (your exasperation, your fury or indignation) last until the sun goes down. 27 Leave no [such] room or foothold for the devil [give no opportunity to him]. 29 Let no foul or polluting language, nor evil word nor unwholesome or worthless talk [ever] come out of your mouth, but only such [speech] as is good and beneficial to the spiritual progress of others, as is fitting to the need and the occasion, that it may be a blessing and give grace (God's favor) to those who hear it. 30 And do not grieve the Holy Spirit of God [do not offend or vex or sadden Him], by Whom you were sealed (marked, branded as God's own, secured) for the day of redemption (of final deliverance through Christ from evil and the consequences of sin). 31 Let all bitterness and indignation and wrath (passion, rage, bad temper) and resentment (anger, animosity) and quarreling (brawling, clamor, contention) and slander (evil-speaking, abusive or blasphemous language) be banished from you, with all malice (spite, ill will, or baseness of any kind).

32 And become useful and helpful and kind to one another, tenderhearted (compassionate, understanding, loving-hearted), forgiving one another [readily and freely], as God in Christ forgave you. (AMP) 26-27

Go ahead and be angry. You do well to be angryâ&#x20AC;&#x201D;but don't use your anger as fuel for revenge. And don't stay angry. Don't go to bed angry. Don't give the Devil that kind of foothold in your life. 29 Watch the way you talk. Let nothing foul or dirty come out of your mouth. Say only what helps, each word a gift. 30 Don't grieve God. Don't break his heart. His Holy Spirit, moving and breathing in you, is the most intimate part of your life, making you fit for himself. Don't take such a gift for granted. 31-32 Make a clean break with all cutting, backbiting, profane talk. Be gentle with one another, sensitive. Forgive one another as quickly and thoroughly as God in Christ forgave you. (MSG) June Hunt called the following list, looking at Anger through the Lens of Anger.

Anger is appropriate at certain times.

v. 26

Anger must be resolved, or it becomes sinful.

v. 26

Anger can be curtailed.

v. 26

Anger, if not stopped, can be used by Satan.

v. 27

Anger, if prolonged, gives ground to Satan.

v. 27

Anger can lead to unwholesome talk.

v. 29

Anger can grieve the Holy Spirit.

v. 30

Anger can be totally cancelled.

v. 31

Anger becomes sin when it results in bitterness.

v. 31

Anger must be eradicated before it turns to rage.

v. 31

Anger must be let go before it leads to fighting.

v. 31

Anger must be overcome before it leads to slander.

v. 31

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v. 31

Anger can be conquered through kindness and compassion. v. 32 Anger can be fought and defeated through forgiveness.

v. 32

Ephesians 4:26 says, "When angry, do not sin" Therefore, God clearly intends for you to experience the emotion of anger and to use it for some positive purpose. For example, He can use your anger to spark your awareness of a blazing spiritual problem that needs to be snuffed out. God often allows fiery trials so that you can become mature in the character of Christ.cv Hunt also went on to talk about how the anger we face can bring about a lot of positives changes in our lives if we allow it to and allow God to have His way in our lives. Below is a list of positives that she listed.

Anger can be used to bring positive change in your life.

Anger can give insight into your past hurts.

Anger can bring your true feelings to light.

Anger can reveal your inappropriate ways of trying to meet your own needs.

Anger can help you realize your need for the Lord.

Anger can uncover your need to set healthy boundaries.

Anger can be the foundation on which forgiveness is built.

Anger can produce intimacy in relationships, when appropriately verbalized.

Anger can be used by God to convict others of sin, when appropriately displayed.

Anger can be a positive Christian witness, when appropriately handled.cvi We all know from working in EMS that being disgruntled and being stress is something we face with every shift. This Stress which leads to Anger and other issues is one of the most serious occupational hazards in EMS. Stress and anger is known to affect our health, job performance, career and ethical decision-making, morale and family life.

As a Licensed Christian Counselor and a Qualified Mental Health Professional I know from personal experience in the office counseling other EMS professionals and while working on an ambulance myself. That many times, EMS personnel experience stress caused by frustration. The frustration can stem from a number of factors. From the difficulty in finding and reaching the proper address, site or scene, to having improper or inadequate communication, and, the lack of or outdated equipment; these and many other frustrations, experienced by members of EMS, may lead to stronger, more conscious emotions.

Compound the stress and frustrations of EMS with the sense of urgency, of the situation, of the calls that we respond to; both of these emotional responses add fuel the adrenaline dump that our bodies do to get us through the calls. This adrenaline dump known to you and I as an

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adrenaline rush, some providers become addicted to the rush, provided by adrenaline. They are constantly seeking out circumstances that will provide the feelings associated with the adrenaline rush which turns them into an adrenaline junkie.

The constant exposure, to life-threatening situations, highly stressful events along with the human casualties, suffering, death and carnage, can all lead to chronic (long-term) stress, which, in turn, can result in high blood pressure, post-traumatic stress disorder (PTSD) and, an increased susceptibility to heart disease, diabetes, and cancer. Chronic stress may also cause "psychological problems, including depression, withdrawal, apathy, and relationship problems, in general". EMS personal are also affected by the multitude of mentally and emotionally challenging emergency calls which they respond to, these calls in themselves affect EMS personnel physically, mentally, and emotionally and, most of all spiritually.

It is known FACT and taught in some EMS related text books that stress involves both mind and body and that there is no separation between the two. They are equally affected. It is also known that unresolved emotional stress perpetuates more feelings of stress, and physical symptoms of stress soon begin to appear. As the saying goes, "The body becomes the battlefield for the war games of the mind," meaning that all the body's physiological systems (such as the digestive, immune, or nervous systems) reflect the difficulties of a mind in turmoil.

Do you know what pushes your buttons and angers or frustrates you? Here are a few that I can think of: faulty or false fire alarms at 3 a.m., incompetent partners, the average annoying citizen, arrogant communication problems with citizens or physicians, low pay, poor advancement opportunities, and insufficient funds for new equipment, just to name a few.

These may all be valid reasons to feel frustrated, but the question is how to move beyond those issues that are beyond your control.

It has been stated that a calloused heart is counterproductive to the work of an EMS professional. But I see this all the time in the EMS professionals that I see, talk to and counsel with. I see this both in the Christians and non-Christians alike that stay any time in EMS. Now then, from the spiritual side of EMS, we know that the stressors we face day-in and dayout in this field will cause you to have a calloused (Hard) heart. Yes as stated above "a calloused heart is counterproductive to the work of an EMS professional" but I see it happening daily and I know that somewhere in the world of EMS it is happening right now.

This is exactly what this whole book is about. When a person responds to God's grace of salvation, God will grant the person, repentance to accept Christ as his or her personal savior. The Holy Spirit will dwell in the person and the process of transformation of the Christian can begin. The Christian's attitudes and values in life should change over time to become more and more in line with God's. The Bible likens this to the replacement of the old stony heart with a new fleshly one. This is seen in Ezekiel 11:19 And I will give them one heart [a new heart] and I will put a new spirit within them; and I will take the stony [unnaturally hardened] heart out of their flesh, and will give them a heart of flesh [sensitive and responsive to the touch of their God], (AMP). Then it is restated in Ezekiel 36:26 A new heart will I give

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you and a new spirit will I put within you, and I will take away the stony heart out of your flesh and give you a heart of flesh. (AMP) The life of unsaved, natural man is represented by the cold hard heart while life in Christ is symbolized by the soft and tender heart. Just as a physical heart can suffer from a heart attack, so too can a spiritual heart. There are many scriptural references where Christians are warned against hardening their spiritual hearts because they believe lies and not the Truth taught in the Bible or by returning to sin.

Hebrews 3:8 Do not harden your hearts, as [happened] in the rebellion [of Israel] and their provocation and embitterment [of Me] in the day of testing in the wilderness (AMP) Hebrews 3:15 Then while it is [still] called Today, if you would hear His voice and when you hear it, do not harden your hearts as in the rebellion [in the desert, when the people provoked and irritated and embittered God against them]. (AMP) Hebrews 4:7 Again He sets a definite day, [a new] Today, [and gives another opportunity of securing that rest] saying through David after so long a time in the words already quoted, Today, if you would hear His voice and when you hear it, do not harden your hearts. (AMP) Even Jesus is known to have directly asked His disciples whether or not if their hearts were hardened! Mark 8:17 Jesus knew what they were saying, so he said, "Why are you arguing about having no bread? Don't you know or understand even yet? Are your hearts too hard to take it in? (NLT) And as I will show in the coming chapters a hardened spiritual heart is a prime candidate for a spiritual heart attack.

I want to pray for you the reader: Daddy, I bind satan and any of his demonic forces according to Matthew 18:18-19 Verily I say unto you, Whatsoever ye shall bind on earth shall be bound in heaven: and whatsoever ye shall loose on earth shall be loosed in heaven.

19 Again I say unto you, That if two of you shall agree on earth as touching any thing that they shall ask, it shall be done for them of my Father which is in heaven. From hindering and lying to those that are reading this today. I want to stand in the gap for my fellow readers. Holy Spirit, please reveal yourself personally to all that are praying right now, and bring us to the point where we can be and desire to be like-minded with you on this matter of anger and being disgruntled. May you lead and guide us to grow and mature in you and quite Harding our hearts to you, your Word and your guidance. No spiritual heart attacks as we allow you full access to every area of our lives in Jesus name. I thank you in advance for all you are doing in all our live. I pray, in Jesus Name Amen.

The Holy Spirit will need to assist the Disgruntled Wanderers and remind them that He loves and accepts them as they are BUT!! He also requires us to grow up in Him. This Christian will have to ask for God's help as they work out their salvation by following and doing daily what is spoken about in Ephesians 4:31-32. I want to read it again so we keep it fresh in our mind.

31 Let all bitterness and indignation and wrath (passion, rage, bad temper) and resentment (anger, animosity) and quarreling (brawling, clamor, contention) and slander (evil-speaking, abusive or blasphemous language) be banished from you, with all malice (spite, ill will, or baseness of any kind). 32 And become useful and helpful and kind to one another, tenderhearted (compassionate, understanding, loving-hearted), forgiving one another [readily and freely], as God in Christ forgave you. (AMP)

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For now we need to get back on track and finish up with the Christian that is angry and disgruntled. I want to go back to June Hunt and her book Biblical Counseling Keys for a few moments. I want us to look the list that she compiled on the subject of Change and Altering your Attitudes. This will bless and TEACH you if you let it.

We find the way to change and alter our attitudes outlined in Philippians 2:2-8. We need to read the verse first then we will discuses what steps that we need to take to alter our attitudes.

Philippians 2:2-8 Make my joy complete by being like-minded, having the same love, being one in spirit and purpose. Do nothing out of selfish ambition or vain conceit, but in humility consider others better than yourselves. Each of you should look not only to your own interests, but also to the interests of others. Your attitude should be the same as that of Christ Jesus: Who, being in very nature God, did not consider equality with God something to be grasped, but made himself nothing, taking the very nature of a servant, being made in human likeness. And being found in appearance as a man, he humbled himself and became obedient to death even death on a cross! (NIV) Have the goal to be like-minded with Paul.

v. 2

Do not think of yourself first.

v. 3

Give the other person preferential treatment.

v. 3

Consider the other person's interests.

v. 4

Have the attitude of Jesus Christ.

v. 5

Do not emphasize your position or rights.

v. 6

Look for ways to serve with a servant's heart.

v. 7

Speak and act with a humble spirit.

v. 8

Be willing to die to your own desires.

v. 8cvii

The last cause that I want to mention is the sixth one and it is the Christian that is Divided: We find that James (The half-brother of Jesus) talks about this Christian in the first chapter of the book in the New Testament that bears his name. Join me as we read what James had to say about the Christian that is divided and is trying to go in two opposite directions at the same time. This Christian is characterized by duplicity; deceitful: speak with a double tongue and they are deliberately deceptive in their behavior or speech; double-dealing.

James 1:5-8 If any of you is deficient in wisdom, let him ask of the giving God [Who gives] to everyone liberally and ungrudgingly, without reproaching or faultfinding, and it will be given him. 6 Only it must be in faith that he asks with no wavering (no hesitating, no doubting). For the one who wavers (hesitates, doubts) is like the billowing surge out at sea that is blown hither and thither and tossed by the wind. 7 For truly, let not such a person imagine that he will receive anything [he asks for] from the Lord, 8 [For being as he is] a man of two minds (hesitating, dubious, irresolute), [he is] unstable and unreliable and uncertain about everything [he thinks, feels, decides]. (AMP)

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Dr. Paul W. Carlin in his book, Mastering Life Through Belief Therapy 速 Why We Do What We Do When We Do It, had the following to say about Christians being divided.

James described millions of hurting and healing people in James 1:8. "A doubleminded man is unstable in all of his ways." He again challenged the double-minded in James 4:8: "Draw nigh to God, and He will draw nigh to you. Cleanse your hands, ye sinners; and purify your hearts, ye double minded."

The phrase is comprised of two Greek words: Dis (dis) (twice) psuche (psoo-khay') (soul). Dispuchos (dip'-soo-khos) means two souls. It could be a multiple personality. It certainly describes an unstable person.

Jacob was the second son if Isaac and Rebekah and the younger twin brother of Esau. Jacob is an outstanding example of the presence of two natures. Like Dr. Jekyll and Mr. Hyde, Jacob was good and bad. His character was full of interest and difficulty, because of its weakness and strength. Jacob had a many-sided life, full of inconsistencies. He was a man of guile, yet a man of prayer. He was the victim of his mother's partiality (Genesis 25:28). He was selfish. When his brother came in from the fields after working, Jacob would not give him food without bargaining over it.

He was naturally crafty and deceitful. He violated his conscience when he allowed his mother to draw him away from the path of honor and integrity. He practiced deception on his blind father with the covering of a kid skin. Then he told a deliberate lie to obtain a spiritual blessing. He violated the sacred when he blasphemously used the Lord's name to further his evil plans.

A quick survey of Jacob might help visualize this two-natured man. There were two remarkable spiritual experiences in his life - at Bethel and Peniel. Jacob cheated (Genesis 25:29-34), deceived (Genesis 27:1-29), was compelled to flee (Genesis 27:43; 28:1-5), was brought to a higher level of relationship (Genesis 28:10-22), had a romance spoiled and was paid back in his own style of deception (Genesis 29:15-30), was prayerful (Genesis 32:9-12, 24-30), received a divine call to the promised land (Genesis 31), was disciplined by God through affliction (Genesis 37:28; 42:36), was a man of faith (Hebrews 11:21), and was blessed with sons who became the foundation of a nation (Genesis 48:49; Numbers 24:19).

David shines as another classic example of the two-natured man. He was the youngest of the eight sons of Jesse the Bethlehemite, the second and greatest king of Israel. However, David was both a saint and a sinner. The general trend of his life was spiritual (1 Samuel 13:14; 1 Kings 15:5). What other man has had the distinction of being called a man after God's own heart?

However, driven by his darker side, David violated divine law (Deuteronomy 17:17; 2 Samuel 5:13), yielded to immorality, deception and murder (2 Samuel 11), and was rebuked by Nathan the prophet (2 Samuel 12). The sins of David produced a dysfunctional family filled with anger, hatred, incest, insurrection, and murder.

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A Paramedicâ&#x20AC;&#x2122;s view of Christianity He covered his adultery and murder, but he could not escape the anguish of guilt.

David's confession was not one of a cold, formal acknowledgment of guilt, but a true and heartfelt humbling of himself before God. His cry for mercy, pardon, and restoration in Psalm 32 and Psalm 51 have pointed the way back for many people who have fallen into the power of the double mind.cviii

James 4:8 Draw nigh to God, and he will draw nigh to you. Cleanse your hands, ye sinners; and purify your hearts, ye double minded. (KJV) now let's read James 4:7-10 in the Message 7-10 So let God work his will in you. Yell a loud no to the Devil and watch him scamper. Say a quiet yes to God and he'll be there in no time. Quit dabbling in sin. Purify your inner life. Quit playing the field. Hit bottom, and cry your eyes out. The fun and games are over. Get serious, really serious. Get down on your knees before the Master; it's the only way you'll get on your feet. (MSG) Then the Amplified of James 4:8 states it this way, Come close to God and He will come close to you. [Recognize that you are] sinners, get your soiled hands clean; [realize that you have been disloyal] wavering individuals with divided interests, and purify your hearts [of your spiritual adultery]. (AMP) The last version that I want look at this verse in is the New Living Translation states James 4:8 Come close to God, and God will come close to you. Wash your hands, you sinners; purify your hearts, for your loyalty is divided between God and the world. (NLT) Does this not sound like a PPE class "If it is wet or sticky and not your, do not touch it without your gloves on." Sin is the same way! Stay away from it at all cost. If you do get your hands soiled get them cleaned off by the washing of the Blood of Jesus.

We have looked into six different types of wanderers and we ended with the Divided Wanderers. So what does this Christian need to do to get back on fire for God and the life they had before they wandered away. This Christian needs to repent, and there is a necessity for this Christian to believe and not doubt, and not be divided in their loyalties between God and this world.

Now we come to the most important question in this chapter. What should we do if we see this happening to a person we know? If a person leaves the faith, shouldn't we just let them go? After all, they have made their choice, and we cannot force them to return. We cannot force them to change their ways, but James says there is something we can do. He closes his letter by speaking of a wanderer who apparently does not set out to rebel, but eventually does end up wandering from the truth.

James indicates a very specific way to respond to this distracted, discouraged, deceived, disillusioned, disgruntled, divided wanderer.

The biblical solution to wandering is likened to a Search and Rescue mission. These Christian are to be rescued by other Christians. Obviously this shows me that being a Christians is to say that we are a part of a local church body and we are never to function on our own. There are cases that I know about, where people have gone missing and don't get reported until a year or more later. The problem here is that they were not part of a community and by the time their absence was noticed it was too late for them. So let's be careful that we don't put ourselves beyond the possibility of rescue by failing to attend the services and gatherings of the church.

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The importance of this rescue mission is found in James 5:19-20 My dear friends, if you know people who have wandered off from God's truth, don't write them off. Go after them. Get them back and you will have rescued precious lives from destruction and prevented an epidemic of wandering away from God. (MSG) This passage I think is actually aimed more at the rescuers rather than the wanderers. And I believe that failure to rescue is every bit as much a problem in the church today as is the problem of wandering. I have seen case after case where churches did nothing to rescue wandering members. Let me give you some of the excuses found in the paper written by Paul Cornford entitled: Restoring Fallen Brethren: James 5:19-20 The "judgment" excuse: How many people hide behind this one! They reason that it is not for them to judge whether another Christian is wandering from the truth. But nobody is asking us to "judge" anyone. If you caught your son or your daughter taking illegal drugs would you say nothing for fear of judging them? You would certainly speak to them about it because of your love for them not in order to judge them.

Furthermore, we don't lead off with an accusation but rather with a question for although the brother may "seem" to be wandering there may a perfectly good explanation for his behavior.

The "business" excuse: This excuse says, "It's none of my business". Isn't it? Since when was a genuine spiritual concern for my brothers and sisters in Christ not my business. And if it's none of my business to rescue a fellow Christian from spiritual lostness then neither is it my business to rescue him from physical lostness. Clearly, the "business" excuse is indefensible.

The "job" excuse: This excuse says, "It's not my job". But we only have to turn back to James 5:19 to see how wrong this argument is for the word James uses is which "tis" (τις) translates into "some one". Let's read it again: "Brethren, if anyone among you wanders from the truth, and someone turns him back". There is nothing in this to suggest that this someone has to be an elder or a minister. When anybody joins the church it is not only the elders or the minister who undertakes to care for him but it is the entire congregation. This is what love is. And to fail to take responsibility especially in the area of rescue is to fail to love the wanderer.

So we have gone ahead and mounted the rescue mission by going to the brother concerned and we have spent many hours persuading him of the error of his way and we have succeeded. What have we done? James wants to make it perfectly clear that the rescue has been very worthwhile. He wants us to know that to rescue a sinner is to "save a soul from death and cover a multitude of sins". By death I believe he means nothing less than eternal death.cix The proper response as we saw described in James 5:19-20 is what I like to call the 5 R's of liberating the Wanderers. The 5 R's are Rescue, Remembrance, Reroute, Repentance and Restoration. Let's discus them a little more shall we.

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The 5 R's of Liberating the Wanderer Rescue James 5:19-20 My dear friends, if you know people who have wandered off from God's truth, don't write them off. Go after them. Get them back and you will have rescued precious lives from destruction and prevented an epidemic of wandering away from God. (MSG) Rescue or deliver means to set free from confinement or danger. Rescue implies freeing from imminent danger by prompt or vigorous action. Deliver implies release usually of a person from confinement, temptation, slavery, or suffering.

Remembrance James 5:19-20 My brothers and sisters, if one of you should wander from the truth and someone should bring that person back, 20 remember this: Whoever turns a sinner from the error of their way will save them from death and cover over a multitude of sins. (NIV) As seen above in the NIV verse 20 says ". . .remember this." The recipients of James might forget; so they need to be reminded. Likewise, we may forget! We may forget how important it is to take the initiative and bring a wanderer back, because we get involved in our own life and family. We may also forget we were brought back too!

Notice specifically what we are to remember: Reroute James 5:19-20 My brothers and sisters, if one of you should wander from the truth and someone should bring that person back, 20 remember this: Whoever turns a sinner from the error of their way will save them from death and cover over a multitude of sins. (NIV) This phrase describes a tender and pastoral response. The implication is obvious: someone needs to go after the sinning believer, or he/she may not come back.

Who specifically can do the "turning?" The "whoever" of verse 20 and "someone" of verse 19 make it clear it isn't just the elders or church leaders who are responsible to turn a sinner from their error. I wonder how many straying believers are not back in the community because we have not taken the initiative to go after them. What is your response when someone fails, or is not around the church for awhile? Do you write them off, or do you take some responsibility to find out how they are doing?

Do not assume someone else will or should go after the person who is wandering. You may be the only one who sees the wandering taking place. Whatever system of care a local church might have, the best results occur when each person sensitively responds to the nudges of the Holy Spirit (gets an impression to ask how someone is doing), and then follows up on it.

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My strongest encouragement is to respond to the nudges, even if you get embarrassed. Someone's faith may need your intervention. In addition, monitor your friends by putting a spiritual cardiac monitor on them, as you have seen and will see more of as you read this book. If the Holy Spirit brings a concern to you regarding one of your friends, check it out even if you have to risk your friendship. You may be the only one who can help.

Repentance James 5:19-20 My brothers and sisters, if one of you should wander from the truth and someone should bring that person back, 20 remember this: Whoever turns a sinner from the error of their way will save them from death and cover over a multitude of sins. (NIV) Whatever the reason for a person straying from God and the truth, this is the only way we can bring them back a turning, a repentance. Even if someone else contributed to the wandering, this passage reminds us the wanderer is still responsible for his/her actions. We cannot blame someone else for our wandering, so the road back must include our repentance from sin.

It is no fun for a restorer who sometimes must hurt a wanderer in order to get his attention Proverbs 27:6 Faithful are the wounds of a friend, but the kisses of an enemy are lavish and deceitful. (AMP) It can be very painful for both. But if that person returns to the Lord, any pain experienced will be small in comparison to the joy that will be felt when the sinner repents 2 Corinthians 7:8-9 I am not sorry that I sent that severe letter to you, though I was sorry at first, for I know it was painful to you for a little while.

9 Now I am glad I sent it, not because it hurt you, but because the pain caused you to repent and change your ways. It was the kind of sorrow God wants his people to have, so you were not harmed by us in any way. (NLT) How will you know when they repent? The Scripture outlines for us the fruit of repentance in 2 Corinthians 7:10-12. For godly grief and the pain God is permitted to direct, produce a repentance that leads and contributes to salvation and deliverance from evil, and it never brings regret; but worldly grief (the hopeless sorrow that is characteristic of the pagan world) is deadly [breeding and ending in death].11 For [you can look back now and] observe what this same godly sorrow has done for you and has produced in you: what eagerness and earnest care to explain and clear yourselves [of all complicity in the condoning of incest], what indignation [at the sin], what alarm, what yearning, what zeal [to do justice to all concerned], what readiness to mete out punishment [to the offender]! At every point you have proved yourselves cleared and guiltless in the matter. 12 So although I did write to you [as I did], it was not for the sake and because of the one who did [the] wrong, nor on account of the one who suffered [the] wrong, but in order that you might realize before God [that your readiness to accept our authority revealed] how zealously you do care for us. (AMP) If we want to know if a person has truly repented, turned back to God and the truth, then this passage will describe the return journey.

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Godly sorrow brings repentance that leads to salvation and leaves no regret, but worldly sorrow brings death. See what this godly sorrow has produced in you: what earnestness, what eagerness to clear yourselves, what indignation, what alarm, what longing, what concern, what readiness to see justice done. At every point you have proved yourselves to be innocent in this matter. So even though I wrote to you, it was not on account of the one who did the wrong or of the injured party, but rather that before God you could see for yourselves how devoted to us you are.

Study it carefully!

What will be the ultimate result? Besides the return to the community of Christ, James reminds us of some awesome occurrences in the latter part of verse 20. We will call it: Restoration James 5:19-20 My brothers and sisters, if one of you should wander from the truth and someone should bring that person back, 20 remember this: Whoever turns a sinner from the error of their way will save them from death and cover over a multitude of sins. (NIV) James speaks of restoration in verse 20 as seen above. The restoration spoken about here is the act of restoring someone or the condition of someone being restored, back to a former position or a returning to a normal or healthy condition. I see this restoration taking place and having one of two possible outcomes: The first ". . .save him from death." What does that mean? Depending on your theology, would convey one of the following: This person was not a believer in the first place, so when he turned, he became a Believer 1 John 2:9 Whoever says he is in the Light and [yet] hates his brother [Christian, born-again child of God his Father] is in darkness even until now. (AMP) I don't think so, because verse 19 says "one of you..." The implication is that this person is a believer.

Some think if the wanderer is a believer, then this verse means the wanderer's repentance saved him from eternal spiritual death and separation from God; and the second would say. If this verse is not referring to spiritual death, it implies premature physical death as seen in 1 Corinthians 5:5 You are to deliver this man over to Satan for physical discipline [to destroy carnal lusts which prompted him to incest], that [his] spirit may [yet] be saved in the day of the Lord Jesus. (AMP) and then look at what is said in 1 Corinthians 11:30 That [careless and unworthy participation] is the reason many of you are weak and sickly, and quite enough of you have fallen into the sleep of death. (AMP) The Scripture speaks of many who have suffered sickness or premature death due to their sinful ways. Psalm 32:3-4 When I kept it all inside, my bones turned to powder, my words became daylong groans. 4 The pressure never let up; all the juices of my life dried up. (MSG)

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Whatever the interpretation, this verse expresses the seriousness of wandering away, and there will be a price if we do. Proverbs 15:10 It's a school of hard knocks for those who leave God's path, a dead-end street for those who hate God's rules. (MSG) Here that same verse is again but this time in the Amplified Bible Proverbs 15:10 There is severe discipline for him who forsakes God's way; and he who hates reproof will die [physically, morally, and spiritually]. So I know that we got this on I want us to also read it in the following translation. Proverbs 15:10 Whoever abandons the right path will be severely disciplined; whoever hates correction will die. (NLT)cx The verses above show that there is stern discipline that awaits the Christian that chooses to leave God's path and the Christian that hates correction will die. I want to read another few verse to bring this point home. Hebrews 12:4-11 In this all-out match against sin, others have suffered far worse than you, to say nothing of what Jesus went throughâ&#x20AC;&#x201D;all that bloodshed! So don't feel sorry for yourselves. Or have you forgotten how good parents treat children, and that God regards you as his children?

My dear child, doesn't shrug off God's discipline, but don't be crushed by it either. It's the child he loves that he disciplines; the child he embraces, he also corrects. God is educating you; that's why you must never drop out. He's treating you as dear children.

This trouble you're in isn't punishment; it's training, the normal experience of children.

Only irresponsible parents leave children to fend for themselves. Would you prefer an irresponsible God? We respect our own parents for training and not spoiling us, so why not embrace God's training so we can truly live? While we were children, our parents did what seemed best to them. But God is doing what is best for us, training us to live God's holy best. At the time, discipline isn't much fun. It always feels like it's going against the grain. Later, of course, it pays off handsomely, for it's the well-trained who find themselves mature in their relationship with God. (MSG) I don't know about you but those five R words remind me about the Five Rights of medication administration we all learned about in school, known as the P.D.A.R.T. 1. Right Patient 2. Right Drug 3. Right Amount 4. Right Route 5. Right Time Chances are that some of you may not have known that in addition to the well-known 5 right of medication administration, some experts have added 3 more to the list. When it comes to patient safety, it's never a bad time to review some of the basics and increase your awareness of newer recommendations.cxi 6. Right documentation

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7. Right reason 8. Right response I want to end this section on the Christian with the Wandering Atrial Pacemaker with the following selection of scripture found in Psalms 119: 1-16 from the New Living Translation.

This is the only known CURE for the Christian in the rhythm Wandering Atrial Pacemaker.

Please pay close attention to verse 10.

Psalm 119:1-16 Joyful are people of integrity, who follow the instructions of the LORD. 2 Joyful are those who obey his laws and search for him with all their hearts. 3 They do not compromise with evil, and they walk only in his paths. 4 You have charged us to keep your commandments carefully. 5 Oh, that my actions would consistently reflect your decrees!

6 Then I will not be ashamed when I compare my life with your commands. 7 As I learn your righteous regulations, I will thank you by living as I should! 8 I will obey your decrees. Please don't give up on me! 9 How can a young person stay pure? By obeying your word. 10 I have tried hard to find you don't let me wander from your commands. 11 I have hidden your word in my heart, that I might not sin against you. 12 I praise you, O LORD; teach me your decrees. 13 I have recited aloud all the regulations you have given us. 14 I have rejoiced in your laws as much as in riches. 15 I will study your commandments and reflect on your ways.

16 I will delight in your decrees and not forget your word. (NLT) As I have already said and if you have known me personally for any amount of time then you know that I explain (Life and Spiritual happening) to myself and others things in terms that we as Emergency Medical Professionals can understand. So for the remaining part of this chapter we are going to focus on the first few of the Reentrant Arrhythmias we will be discussing in this book. Here in this Chapter we are going to quickly review Atrial Flutter and Atrial Fibrillation know to you and I as A-Fib. Reentrant Arrhythmias can be confined to a single chamber of the heart, or can involve several chambers. Functional reentry: spiral and scroll waves Single or double spiral waves or scroll waves are often generated in excitable cardiac tissue or models of cardiac tissue by a single impulse delivered in the wake of a propagating wave during the vulnerable period.

These reentries do not rotate around obstacles; instead, they are called functional as they rotate around a "functional" obstacle called the core of the spiral or scroll wave.

A single spiral or scroll wave with a fixed repetitious motion (which may be anchored to some anatomical feature such as a blood vessel or scar) likely would lead to a monomorphic tachycardia. A meandering spiral or scroll wave likely would be associated with a polymorphic tachycardia or perhaps fibrillation.

Polymorphic tachycardias and fibrillation also may be associated with "fibrillatory" conduction, in which a rotating spiral or scroll wave fractionates as it propagates throughout the cardiac tissue, or with multiple spiral or scroll waves. In the latter case, the spiral and scroll waves may not be located around stationary cores, but may migrate. Spirals and scrolls may disappear by collision with boundaries or by collision with rotating waves of opposite chirality, and they may be regenerated as a consequence of fibrillatory conduction.

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Clinical evidence exists for this, especially in the case of ventricular fibrillation, which is usually preceded by a short-lived ventricular tachycardia. The transition from tachycardia to fibrillation can occur either by a single relatively stable wave with breakup far from the core, or by waves that continually form and annihilate.cxii The first of these Reentrant Arrhythmias that we are going to discus is Atrial Flutter so let's get our saw out and start cutting into this rhythm shall we?

ATRIAL FLUTTER

Figure 9.3 cxiii Atrial Flutter results from a rapid atrial reentry circuit and an AV node that physiologically cannot conduct all impulses through to the ventricles. The AV junction may allow impulses in a 1:1, 2:1, 3:1 or 4:1 ration or greater, resulting in a discrepancy between atrial and ventricular rates. The AV block may be consistent or variable. In English PLEASE! Much like Atrial Fibrillation the Atria is firing at a greater rate than the Ventricles will accept. In Atrial Flutter these P waves are more organized and form a "sawtooth" or "flutter" pattern. The ratio is the number of P waves vs QRS complexes. The rate is usually regular but can be irregular.

A-Flutter does not usually an indication of an MI. Atrial dilation is a cause of Atrial Flutter so it is usually seen in patients with congestive heart failure.

The ectopic focus may be originating from ischemic areas of the heart with enhanced automaticity (ability to initiate an electrical current) or from a reentry pathway. A reentry pathway is an extra pathway that has developed where a group of cells will generate an impulse faster than the SA node. This impulse then follows a route that allows the impulse to reach the AV node quicker than the normal conduction pathway. The reentry pathway is similar to finding a shortcut to work or school to bypass the normal traffic route to get you to your destination faster. Most often this is a transient dysrhythmia that will lead to more serious atrial dysrhythmia if not treated.

Atrial rates typically fall between 250 and 350 beats per minute, but the ventricular rate can be substantially slower. Atrial flutter can be paroxysmal or persistent and may degenerate to atrial fibrillation. Treatment options for atrial flutter include direct electrical cardioversion and catheter ablation of the underlying reentrant circuit, which often is located in the right atrium but also may be in the left atrium or may involve both atria.cxiv This reentry rhythm is causing the heart to be in a crisis more often then not if left untreated rhythm will lead to more serious atrial dysrhythmia if not treated. This is where on the spiritual

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side of things we start to see the need for Christian Re-Entry Counseling and Re-Entry Crisis Counseling, more on that later.

Criteria for Classification Rhythm: The P-P interval or flutter-to-flutter waves will be regular. The interval set with the calipers will stay constant throughout the rhythm. The R-R interval is usually irregular, but occasionally it may be regular in pattern. The regularity of the R-R interval will depend on the ability of the AV node to limit impulses to ventricles.

Rate: The atrial rate will be between 250 and 350 beats per minute.

P wave configuration: P waves are not seen, and only flutter waves are present. These flutter waves resemble a "sawtooth" or "picket fence." They will be seen best in leads II, III, and aVF. The correlation between P waves and QRS complexes no longer exists. There will be more flutter waves than QRS complexes, and presence of "F" or flutter waves.

PR interval: No identifiable P wave exists, so the PR interval cannot be measured.

QRS duration and configuration: The QRS duration will be within normal limits of 0.06 to 0.10 second.

What's Unique about this Rhythm?

Atrial flutter has a "sawtooth" atrial pattern between the QRS complexes.

Clinical Significance The atrial kick, which occurs when blood is ejected into the ventricles by the atria immediately prior to ventricular systole, is no longer present since the atria do not contract completely, followed by a delay in the ventricular contraction. This loss in atrial kick contributes to a 10% to 30% decrease in cardiac output. Some patients may tolerate this if the heart rate is within normal limits of 60 to 100 beats per minute. But once the heart rate increases significantly and loss of the atrial kick occurs, the patient will demonstrate signs and symptoms of low cardiac output.cxv What does this mean to the Christian heart?

Atrial Flutter often, though not always, originates in the right atrium, whereas Atrial Fibrillation usually comes from the left atrium.cxvi The Christian that is found to be in the rhythm of Atrial flutter, to me is the Christian that is at the beginning of a spiritual cardiac related crisis. This Christian heart (Mind) is entering a crisis and is causing them a lot of mental (Stinking Thinking) problems. This Christian as has been having runs of PAC's as we spoke about at the start of this chapter and as this Christian wandered off there are now in crisis and unless a rescue mission is launched right away the Christian will lead to more serious atrial dysrhythmia if not treated.

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Over the years, growing up in a family where your mother and father more or less ran a HalfWay house before they became popular. Where before going to church on Sunday morning my father would go to the local prison and teach and a grandfather that was Chaplain and a Counselor for the North Carolina Department of Correction. Both of these men did there share of Re-Entry Counseling and Re-Entry Crisis Counseling.

Reentry Counseling started off to help parolees from prison with the goal to prevent relapse and recidivism. Paul Carlin says. "A crisis can be the trigger that leads to a parole violation and re-incarceration." Dr. Carlin started the Christian modality of Reentry Crisis Counseling with the goal in mind of helping to alleviate the parolee's stress of rejection and emotional trauma.

Dr. Carlin and The Therapon Institute have trained several hundred laypeople in this modality and I am one of them.

Here is where I get different, as a Certified Reentry Crisis Counselor I see every person on earth as being in prison. Some behind bars made by men as in a physical prison and then there is the rest of us behind the bars and walls that we have made for ourselves. These prisons that we have made for ourselves were made to protect us but now they harm and hinder us. They were made to keep us safe and keep others out. But now after spending so much time in our own prisons we cannot seem to leave.

There is a saying in Reentry Counselor, "It is easier to get a man out of prison than it is to get the prison out of the man.

I am in no way saying that I know what it is like to be in prison and I know that this is a very different way of looking at Reentry Crisis Counseling but I ask that you please give me some wiggle room as I explain and get deeper into this line of thinking.

So you see I think of Re-Entry Crisis Counseling in the terms of the Rescue Mission to retrieve the wandering Christian and the concept homeostasis. Borrowed from psychology, the term, as understood in crisis theory, refers to the healthy balance between the emotional and cognitive experience and functioning of individuals, allowing them to relate effectively to their environment.

Let's get back to the Christian found to be in Atrial Flutter. This Christian is starting to show signs of what Dr. Paul Carlin in his book, "Living Free" Reentry Crisis Counselingâ&#x201E;˘ identified as causes or trigger of reentry crisis.

So what is a crisis or a better thing to ask is what does it take to set a person off?

In mental health terms, a crisis refers not to a traumatic event or experience, but to how an individual responds to the situation. The events that trigger this crisis can run the gamut of life experience, from developmental hurdles (such as going through puberty) to natural disasters to the death of a loved one.

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Dr. Carlin stated in Causes or Triggers of Reentry Crises I will identify seven "triggers" only because they are the most obvious. In numerology the number "7" is the number for completion. Almost any other trigger can be categorized or merged into one of the seven listed below.

Over-Optimism: Often the parolee will leave prison with expectations of picking up where he/she left off. They sometimes believe the world is going to welcome them with yellow ribbons tied around every tree, that they are going to get the job they want, the ideal apartment, a caring companion and a new car. And then reality sets in society is not so accepting. They don't want a job at Wal-Mart or flipping burgers at McDonaids or on a construction crew or living at home with family. Their expectations were to start at the top of the heap…

Indecision: After leaving a system where most decisions are made for him/her, they enter a do-it-yourself system. In the "free world" we make about 120 decisions a day.

In prison an offender makes about 20 decisions a day. On the streets he/'she must do a "quick shift" into high gear to keep up. The world is not going to slow down so they can get on.

Rejection: The parolee leaves an environment where they had friends, a degree of understanding and support only to be greeted by one rejection slip after another.

Rejection is the Magnum 44 trigger. It is often the most powerful force that drives reentry crises.

Self-Destructive Behavior: Human beings have the unique potential of being counselor and client, and client, therapist and patient, experimenter and subject, or teacher and student within the same skin. This potential is based on the tact that people can change themselves through the same operations they use to change others, and self-reinforcement is perhaps the most commonly used self-controlling operation. The two most important keys to constructive self-reinforcement are changing core beliefs and choice. If these keys were not learned, internalized and appropriated during incarceration, the parolee will he back to his/her old pre-prison negative thinking, darkened environment and acquaintances. We are our own worst enemy. Some people are very slow learners. What the paroles did pre-prison didn't work and it will not work for a post-prison lifestyle.

Intolerance/impatience: Wanting too much too fast. Possessing an entitlement and a welfare mentality. This attitude can be expressed in many ways. It is easily detectable.

Just listen to the parolee talk.

Procrastination: Putting off until tomorrow what you should do today. Sleeping until noon and than wondering why all the good jobs are gone when they go to apply.

Quitting a Support System or Group: Whether the system is a mentor, a local church or an organized group like AA — the parolee just quits Look out! Trouble is on the way.cxvii

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The SAR Team has located the wandering Christian and the Medic placed the Christian on the cardiac monitor and was found to be in Atrial Flutter. This Christians heart as seen in the Bible is said to be foolish, darkened and deceitful in his mind and his thinking.

Foolish and Darkened: The Christian that is said to be Foolish is devoid of good sense or judgment. They are having or revealing periods of stupidity; "ridiculous behavior"; that will be marked with, or exhibiting, folly; void of understanding. These Christian are weak in intellect; without judgment or discretion; they will be silly and unwise. They will show a weakness of mind and will exhibit a lack of judgment or discretion; as, a foolish act: absurd; ridiculous; despicable; contemptible.

The Christian that is said to be darkened in their thinking and that will led to darkened emotions' (as in Atrial Fibrillation) have become spiritually dark by a lack of and depriving them of the Light of God. We will discuss this in detail in an upcoming chapter. This Christian has been rendered dim; has been deprived of Godly vision they have allowed Satan to cloud, or perplex; their thinking and judgments. This is found in Romans 1: 21.

Romans 1:21 Because when they knew and recognized Him as God, they did not honor and glorify Him as God or give Him thanks. But instead they became futile and godless in their thinking [with vain imaginings, foolish reasoning, and stupid speculations] and their senseless minds were darkened. (AMP) Deceitful: The Christian now being deceived and is marked by deliberate deceptiveness especially by pretending one set of feelings and acting under the influence of another. There are full of and are characterized by, deceit; serving to mislead or to ensnare; fraudulent; cheating; insincere.

We find this in Mark 7:21-23 Mark 7:21-23 For from within, [that is] out of the hearts of men, come base and wicked thoughts, sexual immorality, stealing, murder, adultery, 22 Coveting (a greedy desire to have more wealth), dangerous and destructive wickedness, deceit; unrestrained (indecent) conduct; an evil eye (envy), slander (evil speaking, malicious misrepresentation, abusiveness), pride (the sin of an uplifted heart against God and man), foolishness (folly, lack of sense, recklessness, thoughtlessness). 23 All these evil [purposes and desires] come from within, and they make the man unclean and render him unhallowed. (AMP) If this Christian makes the necessary personal and life changes the wandering Christian will be able to return to a level of Christian homeostasis. At that point they will be working on a healthy balance between their emotional and cognitive experience as a Christian and functioning as an individual, allowing them to relate effectively to their new are returned Christian environment. But if not then the Christian will move from Atrial Flutter in to Atrial Fibrillation.

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ATRIAL FIBRILLATION

Figure 9.4 cxviii Atrial fibrillation (AF) is a complex arrhythmia characterized by an extremely rapid atrial rate (350 to 600 beats per minute). Like ventricular fibrillation, during AF multiple wavefronts are present in the atria and compromise the ability of the atria to contract in a coordinated fashion. However, because the atria serve primarily as filling chambers, their contraction is not as necessary for cardiac function, and for this reason AF is not immediately lifethreatening.

Nevertheless, AF can lead to other cardiac problems, including an increased and more irregular ventricular rate along with a significantly increased risk of stroke, which can result from blood stasis in the atria that promotes the development of clots. Like atrial flutter, AF can be paroxysmal or persistent. It also has been documented that even short bouts of atrial fibrillation lead to electrophysiological changes that over time tend to make atrial fibrillation more frequent and longer-lasting (Wijffels et al., 1995). AF can be treated by direct cardioversion but more frequently is treated with antiarrhythmic and/or anti-coagulation drug therapy.cxix AF occurs when electrical impulses come from areas of reentry pathways or multiple ectopic foci, usually from within the left atrium. Each electrical impulse results in depolarization of only a small group of atrial cells rather than the whole atria. This results in the atria not contracting as a whole, causing it to quiver, similar to a bowl of Jell-OTM when shaken.

Multiple atrial activities are recorded as a chaotic wave, often with the appearance of fine scribbles. No P wave can be identified. The waveform of the chaotic "scribbles" is referred to as fibrillatory waves or "f" waves.

Criteria for Classification Rhythm: The P-P interval is unable to be determined because of the fibrillatory waves or f waves. The R-R interval is irregular.

Rate: Atrial rate, if measurable, will be from 375 to 700 beats per minute. It is difficult to determine the atrial rates because each fibrillatory wave is not easy to identify or measure. The ventricular rate is initially between 160 and 180 beats per minute prior to administering medication. Once medication is provided, the ventricular rate is considered under control if the rate is between 60 and 100 beats per minute.

P wave configuration: The P waves cannot be identified. There is chaotic electrical activity, or "f" waves may be seen.

PR interval: The PR interval cannot be measured, since the P wave is not identifiable.

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QRS duration and configuration: The QRS duration and configuration will be within normal limits of 0.06 to 0.10 second and irregular.

What's Unique about this Rhythm?

Atrial fibrillation shows chaotic disorganized activity between QRS complexes.

Clinical Significance The patient will exhibit signs and symptoms of decreased cardiac output. The patient usually has limited cardiac function because of preexisting cardiac conditions, so with the loss of atrial kick, the patient's cardiac output will decrease significantly. Once the heart rate is controlled within the range of 60 to 100 beats per minute, the patient may be able to tolerate the loss of the atrial kick.

Blood will begin to collect in the atria because they are not contracting completely, allowing the opportunity for a clot or thrombus to form. Therefore, the patient has an increased risk of developing and sending an embolism (traveling blood clot) out into the body's systemic circulation, which can then migrate to other vital organs, such as the lungs or brain. The patient may develop a Cerebral Vascular Accident (CVA), Myocardial Infarction (MI), pulmonary embolism, renal infarction, or an embolism in any place that the arterial blood is transported. Essentially, the heart is playing Russian roulette with us because there is no way to predict where the embolism will travel in the body to cause serious damage or even sudden death.

What does this mean to the Christian heart?

The Christian that is found to be in the rhythm of A-Fib is seen usually having some sort of emotional crisis. This Christian's heart (Emotions) is entering a crisis and is causing them a lot of mental and problematic feelings to arise that if left unchecked will led the Christian to wrong actions.

This is the second Christian that we will discuss that fits into the modality of Re-Entry Counseling and Crisis. As we define and look into the symptoms of a Christian's reentry crisis we will start to see clearly the emotional response that these Christians are having and leading them into an emotional crisis.

Crisis (Reentry or not) counseling is intended to be quite brief, generally lasting for a period of no longer than a few weeks. It is important to note that crisis counseling is not psychotherapy.

Crisis intervention is focused on minimizing the stress of the event, providing emotional support and improving the individual's coping strategies in the here and now.cxx The focus is on single or recurrent problems that are overwhelming or traumatic. If a trauma or crisis is not resolved in a healthy manner, the experience can lead to more lasting psychological, social, medical and even worse SPIRITUAL problems. Crisis counseling provides education, guidance and support. Crisis Counseling is not a substitute for individuals who need and are not receiving intensive or long term psychiatric care.

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Knowing the symptoms is the first step in preventing reentry relapse.

As a Qualified Mental Health Professional, a Licensed Belief Therapist and a good street Medic I know from first hand encounters that recognizing some common symptoms of reentry crisis will be helpful. If and when seen in the Christians that we face and see that are spiritually in A Fib, any and all of the following symptoms should be BIG Red Flags and flashing red warning lights. To ignore them can be catastrophic for the rescued Christian still not sure which side of the fence they want to be on.

Confusion: This Christian will from time to time becomes confused and will exhibit signs of disorientation. They often get mixed and even contradicting messages from other Christian that they are around. I want to remind us what the Bible teaches about someone causing someone else to sin and wander way from God. Matthew 18:6 But whoever causes one of these little ones who believe in and acknowledge and cleave to Me to stumble and sin [that is, who entices him or hinders him in right conduct or thought], it would be better (more expedient and profitable or advantageous) for him to have a great millstone fastened around his neck and to be sunk in the depth of the sea.

(AMP) Anxiety: Anxiety usually sets in when the Christian has unrealistic and unfulfilled expectations. There are associated symptoms of mild agitation, racing thoughts, impaired, sleep, and difficulty in calming oneself. It is also interesting that an early encounter with this experience is termed separation anxiety. It is an early developmental disorder that is characterized by a fear of strangers or of separating from one's home or the person to whom one is attached. It is hard for the Christian to accept, but they often suffer from an old man / carnal / worldly separation anxiety.

Philippians 4:6 Do not fret or have any anxiety about anything, but in every circumstance and in everything, by prayer and petition (definite requests), with thanksgiving, continue to make your wants known to God. (AMP) Frustration: Frustration arises from the gap between expectations and attainment.

Frustration is the blocking of goal-directed behavior. A frustrated person is especially likely to respond with hostile behavior in the presence of aggressive cues. Frustration is most often fostered in Christians by non-acceptance and societal resistance, it might be simplistically called "heading down dead ends and hitting brick walls." I have even seen resistance to back-sliders and those that have wandered exhibited in the last place you would expect to find it, the local church.

Frustration most often will lead to anger. However, frustration does not always lead to aggressive behavior.

Depression: Depression: A red flag acting as a warning signal for approaching debilitating clinical depression is depressed moods. Bad moods, which often diminish during the course of a day or two, generally do not interfere with work, friendships, family life and physical health. However, depressed moods may be manifested in a spirit of "giving up." The prolonged condition may very well develop into clinical depression. According to Dr. Frank

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Minirth, a renowned clinical psychiatrist, symptoms of depression tall into five broad categories: (The Complete Life Encyclopedia, Nelson Publishing) Moodiness: It refers to a general mood a person projects by his/her facial expressions, verbal communication and body language.

Painful Thinking: Painful thinking often centers on guilt either authentic guilt (the result of actual mistakes and sin) or false guilt (blaming oneself for actions and consequences of which one is innocent or that could be helped). If the depressed person could think realistically and objectively, he would realize he is taking on responsibility for acts that are beyond his control.

Anxiety: Anxiety and depression often occur together.

Physical Symptoms: Negative mental and emotional activity in the brain stimulates the production of brain chemicals that affect body functions such as sleep, appetite, digestion, sexual interests, and tension headaches, rapid or irregular heartbeat.

Delusional Thinking: This symptom only occurs in cases of severe depression Anger: Anger is an intense emotional reaction, sometimes expressed in overt behavior and sometimes remaining a largely unexpressed feeling. If you need to read more please refer back to the beginning of this chapter for more on anger.

There are five choices the Christian has in dealing with anger. The first three are unhealthy and perpetuate anger.

Suppressing Anger: this is denial.

Open Aggression Anger: a self-centered choice. Operates openly at the expense of others.

Passive Aggressive Anger: operates secretly.

Assertive Anger: assertive, not aggressive, expressions of anger.

Dropping Anger: you accept your inability to control the circumstances. This is the hardest choice to make.

Ephesians 4:26 And "don't sin by letting anger control you." Don't let the sun go down while you are still angry, (NLT) Blame-Shifting: The Christian refuses to assume personal responsibility for their bad behavior. What happens to them is never their fault.

Excuses / Intellectualizing: An excuse is the skin of a reason stuffed with a lie. Excuses are an attempt to justify bad behavior. Intellectualizing is popular among Christians who stiffer from feelings of low self-worth. Intellectualizing is a means by which individuals avoid the awareness of inferiority feelings and other unconscious conflicts by the excessive use of intellectual vocabulary, thinking and discussion. On the surface these activities may seem positive, but they are motivated by a self-defeating effort to hide the truth from him/her.

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Self-Pity: Is the verbal expressions of victimization. When a Christian suffering from self-pity tries to throw at "pity patty" and no one shows up, he/she sinks even deeper into self-pity.

This will bring to a standstill any forward movement.

Self-pity breeds a feeling of loneliness. Loneliness is the painful awareness that we lack close and meaningful contact with others. Lonely people often feel left out, unwanted, rejected and misunderstood.

Suppression / Avoidance: This is not a reference to the typical clinical stereotype "personality disorder." It is the avoidance of an uncomfortable issue or emotion, usually because the timing is not right to deal with it. Unfortunately, the Christian never finds the "right" time, so they never deal with those issues and emotions.

This Christian will be discouraged by shortcomings. This is generally rooted in the negative impressions he/she has experienced in prison. Dr. Carlin is noted to say, "Bars leave sears."

Few people understand this truth. But the scars are caused by wounds received both from emotional, verbal and physical abuses experienced during life. That is why we do what we do in Belief TherapyÂŽ we are here to allow the Holy Spirit to use us to counsel with the Christian as He works to heal their wounded hearts.

Paranoia: is the feeling that everyone is against them. It is a pervasive pattern of mistrust in the motives of others. Everyone is the enemy.

Paranoia produces FEAR: (False Emotions Appearing Real) Fear of intimacy. Fear of being known, Fear of rejection. Fear of acting inappropriately in social situations, fear of having one's work or plans disrupted, or fear of being hurt. One does not have to be a clinical expert to detect any one of these ten "reentry crisis symptoms." These are not the crisis.

They are symptoms of crisis.

Philippians 2:12 Dear friends, you always followed my instructions when I was with you. And now that I am away, it is even more important. Work hard to show the results of your salvation, obeying God with deep reverence and fear. (NLT) The only Fear that we are to have is the fear of the Lord, which is to hate sin as much as God hates it.

Over the last two rhythms we have been talking about Re-Entry rhythms and how they help us to understand and see the Christians that we work with that have wandered away and are in a crisis either in their thinking or with their emotions.

We have also been talking about crisis counseling and its many descriptions. Regardless of the theory and author, there are universal "elements" in the process by which a crisis counselor can help these Christians face and move past distressing and traumatic events in their lives.

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The 8 Elements of Crisis Intervention Education: There is a natural ability within most people to recover from a crisis provided they have the support, guidance and resources they need. The very heart of crisis intervention is to face the impact of a crisis.

Observation and awareness: A crisis in our life can be the result of low self-awareness or not recognizing the impact our behavior has on others as well as the impact it has on our self.

Discovering and using our potential: Every crisis represents an opportunity for personal growth and to discover our highest potential and true self.

Understanding our problems: Understanding and the knowledge and truth that it brings is the fundamental intention of all people. We are to do the best we can with the resources and abilities we have during a crisis. Self-understanding as well as understanding how others may keep us "stuck" is an important key to recovery.

Creating necessary structure: The most important aspect of crisis intervention and counseling is to provide a social "container" for our experience that will allow us to express, explore, examine and become active in ways that help insure the crisis is not prolonged.

Challenging irrational beliefs and unrealistic expectations: Few people, during times of crisis, have the necessary skills to fully examine what they are thinking, what they assume and what they expect from their self and from others. Our thoughts, especially the ones we don't look at, contribute a great deal to how we feel and what we do next in response to our feelings.

Romans 8:5-6 Those who are dominated by the sinful nature think about sinful things, but those who are controlled by the Holy Spirit think about things that please the Spirit. 6 So letting your sinful nature control your mind leads to death. But letting the Spirit control your mind leads to life and peace. (NLT)

It is a known fact that you are going to go where your thoughts take you!

I think it is Review time again. Belief Therapy速 101 So here we go. In Psalm 139:23-24, David cried out to God, Search me, O God, and know my heart; test me and know my anxious thoughts. 24 Point out anything in me that offends you, and lead me along the path of everlasting life. (NLT) Let's read this same verse noted above from the New Living Translation and take a closer look into these verses: "heart" = belief system / " anxious thoughts" = cognition / "anything in me that offends you" = darkened emotions / "lead me along the path of everlasting life" = behavior.

Heart >> Anxious Thoughts >> Anything in me that offends you >> Lead me along the Path (Belief) >> (Cognition) >> (Negative Emotions) >> (Behavior)

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The Bible identifies behavioral problems as being rooted in a heart problem. I believe that all behavioral problems, unless there is a diagnosed physical disorder, are always a spiritual problem. The Bible also makes a strong connection between what we believe and what we think.

Your heart is the home of your belief system. Belief (from within your Mind) <produces> Thought (cognition that is requesting that you act on whatever leads us to your Will) <produces> Feelings (which trigger our Emotions positive or negative) <produce> Behavior (Personality in action for the good or bad) Matthew 15:16-20 states it this way: Jesus replied, "You, too? Are you being willfully stupid?

Don't you know that anything that is swallowed works its way through the intestines and is finally defecated? But what comes out of the mouth gets its start in the heart. It's from the heart that we vomit up evil arguments, murders, adulteries, fornications, thefts, lies, and cussing. That's what pollutes. Eating or not eating certain foods, washing or not washing your hands that's neither here nor there." (MSG) Notice they begin in the heart (our belief system), move to the mind (the cognitive part of man where we think), which triggers the emotions (our feelings) and finally are manifested in our behavior (actions).

Breaking vicious cycles and addictive behavior: Many crises are the result of vicious cycles or addictions. For example, drug and alcohol use can not only destroy our life, but it will confuse how we actually feel about our self, others and the world around us. One cannot know how they feel and what they truly want if their feelings are modified by chemicals, medications, alcohol and other drugs. A painful crisis can lead a person to avoid and escape how they feel. Unhealthy escape and avoidance of emotional pain and distress may involve the use of medication, drugs, alcohol, and sex, thrill seeking, parties or working excessively.

Taking the role of a "victim" can cause others to rescue a person in crisis. Prolonging the crisis by refusal to deal with a crisis can create supportive relationships. When a person becomes dependent on others and "escapes" to feel better, a vicious cycle can develop.

Vicious cycles start with behaviors that are intended to avoid or escape emotional pain, but ultimately these avoidance and escape behaviors create more problems or the same problem we are trying to avoid. The behaviors found in a vicious cycle can actually prolong a crisis.

Study Figure 9.5 below.

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Figure 9.5 cxxi Now let's look at the changes that we will see in our thinking, emotions and actions when we think and Believe TRUTH. Please study Figure 9.6 below.

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Figure 9.6 cxxii Create temporary dependencies: During a crisis, it is often helpful to form brief relationships with others in order to gain support. Crisis counseling and intervention are very helpful and necessary. A healthy dependency is usually temporary and will always lead to increasing independency. Unhealthy dependencies are long term and create increasing dependency rather than independency.

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Facing fear and emotional pain: A crisis is usually a time of fear or sadness. How we respond is important. When people suffer, it is important to help them feel less alone in the world. It is important to help people in crisis solve the problems in their life. People in emotional pain need to be empowered and supported.cxxiii In the next chapter we will be looking at rhythms originating from the Atrial-Junction Node, we will be discussing Premature Junctional Complexes (PJC) and Junctional Rhythms. So let's get digging again.

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Chapter 10 Interpreting Rhythms Originating from the Atrial-Junction Node PREMATURE JUNCTION COMPLEX (PJC)

Figure 10.1 cxxiv A Premature Junctional Complex (PJC) is a single early electrical impulse that originates in the atrioventricular junction. It occurs before the next expected sinus impulse, causing an irregularity in the rhythm.

Criteria for Classification Rhythm: May be occasionally irregular or frequently irregular depending upon the number of PJCs present Rate: Will depend upon the underlying rhythm P wave configuration: The P wave is inverted and may immediately precede or follow the QRS complex.

PR interval: Will be shorter than normal if the P wave precedes the QRS complex, absent if the P wave is buried in the QRS. QRS duration and configuration: The QRS duration and configuration will be between 0.06 and 0.10 second, which is within normal limits.

What's Unique about this Rhythm?

PJCs have an irregular rhythm and the P wave is inverted and may appear before, during, or after the QRS complex.

Clinical Significance When the patient has a healthy heart, isolated PJCs cause no signs or symptoms. If PJCs occur more than four to six per minute, this warns of a more serious condition. An irregular pulse would be noted, and the patient may experience hypotension due to low cardiac output. cxxv

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What does this mean to the Christian Heart?

The Christian that we find to be having Premature Junctional Complexes (PJC) is the Christian that is being hindered by Satan. This Christian has been running in the Christian race of life (and in a Normal Sinus Rhythm) and has come upon some deliberately (Done with or marked by full consciousness of the nature and effects and intentional) placed road blocks.

These road blocks have been placed in the road way to slow us down and even get us to completely stop our life's race in Christ.

Join me as we learn more about this Christian and how they came upon this road block.

Hopefully by now in your Christian walk you know that you cannot succeed on your own. We are to draw on the strength that Christ promises to supply.

I cannot tell you how many times when talking with fellow believers I have been told that if they knew how hard it was going to be to be a Christian they might have not have become one. Then there have been others that have sat there with tears running down their cheeks they tell me that when I responded to the Salvation message I was told come to Jesus and the rest of your life will be fine.

We as Christians must realize that you and I cannot count on life to be a smooth, easy path and know and believe that there are evil supernatural forces out to destroy you.

1 Peter 5:8- 11 Keep a cool head. Stay alert. The Devil is poised to pounce, and would like nothing better than to catch you napping. Keep your guard up. You're not the only ones plunged into these hard times. It's the same with Christians all over the world. So keep a firm grip on the faith. The suffering won't last forever. It won't be long before this generous God who has great plans for us in Christâ&#x20AC;&#x201D;eternal and glorious plans they are!â&#x20AC;&#x201D;will have you put together and on your feet for good. He gets the last word; yes, he does. (MSG) Let's read it again in the Amplified 1 Peter 5:8 Be well balanced (temperate, sober of mind), be vigilant and cautious at all times; for that enemy of yours, the devil, roams around like a lion roaring [in fierce hunger], seeking someone to seize upon and devour. (AMP) This verse yes it does say that, the devil, roams around like a lion roaring that is VERY hunger, seeking someone to seize upon and devour for his dinner. But here is the kicker and every time I think about this it make me smile. A lion roars at a lot of things to say hay I'm here don't mess with me but I love to watch cats in action, and a lion is just a very large cat Right? When was the last time that when you cat was out hunting did they meow before they jumped on that mouse. I don't think so. I think he uses his roaring to try to scare us because he has no teeth.

Satan can and does hinder us if we allow him to do. We read in I Thessalonians 2:18 says Because it was our will to come to you. [I mean that] I, Paul, again and again [wanted to come], but Satan hindered and impeded us. (AMP) Now that you know that Satan can hinder you and I let's get back to the Christian who is in a Normal Sinus with PJC's. You may ask how I know that this Christian has been in a Normal Sinus rhythms and is now having PJC's.

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Well then if you remember back in Chapter 8 we spoke about the Christian that was found to be in a Normal Sinus rhythm and that this was the rhythm that God wants you and I to always be in. This is the Christian that is actively growing in their personal relationship with God. They are allowing the Holy Spirit to lead and guide them through their daily lives as they grow from the Carnal (babes in Christ) into the Spiritual (mature) Christians that Gods wants us to become. This Christian is thinking on the right things, choosing to act on the right things, they have their emotions in check and they are actively walking out their salvation with the fear of the Lord.

But now we see that the Christian has allowed something or someone being used by Satan to hinder them from finishing the Christian race of this life. This is found in Galatians 5:78 You were running the race nobly. Who has interfered in (hindered and stopped you from) your heeding and following the Truth? 8 This [evil] persuasion is not from Him Who called you [Who invited you to freedom in Christ]. (AMP) Now the Christian that was in a Normal Sinus rhythm is allowing Satan to hinder them and this is noted as PJC's on our Christian Cardiac monitor.

The HINDERED Christian Today's Christians are engaged in spiritual warfare which, in its range and intensity, surpasses the conflagration in all of the world wars put together all on ONE field of battle.

In reading Ephesians 6:12 For we are not wrestling with flesh and blood [contending only with physical opponents], but against the despotisms, against the powers, against [the master spirits who are] the world rulers of this present darkness, against the spirit forces of wickedness in the heavenly (supernatural) sphere. (AMP) The expression used in Galatians 5:7, suggests that one has broken up a road, or has placed a sizable object in a road, as a way of halting the progress of someone. So then the hindering is intentional, bold and it was also very successful. As we start to apply this understanding to the spiritual realm, we will see Satan as he really is the hinderer of the Christian spiritually.

Please do not take him lightly here know that he is skilled at creating landslides, cave-ins, washouts, dead ends and detours. Big roadblocks are his specialty.

Satan's idea is to impede your spiritual progress. He does not want us to grow in God or our Christian Faith, and know this as we grow Satan will make it his personal plan to send hindrances your way.

He will attempt to create what would seem to be impossible obstacles both mentally and physically. One of the ways that he is going to do this is to try to shut off the communication that we have with God. So we need to beware that he will try to hinder our prayer and answers we are to be receiving from God. This is seen in Daniel 10, we are told that Daniel's prayer was supernaturally hindered for twenty-one days by the Prince of Persia. Daniel's prayer, we learn, was heard "the first day."

Daniel 10:12 Then he said to me, Fear not, Daniel, for from the first day that you set your

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mind and heart to understand and to humble yourself before your God, your words were heard, and I have come as a consequence of [and in response to] your words. (AMP) The hinderer had to be subdued personally by Michael the Archangel.

As we grow in our personal relationship with God and we allow the Holy Spirit to lead and guide us. It is only then that we will learn to discern and recognize some of this life's hindrance as being Satanic in nature. Satan has a purpose in mind when he wants to hinder us and that purpose is to prevent you from, believing, knowing, obeying and perusing "the truth." If Satan gets us to stop believing in, knowing, obeying and perusing "the truth", then he has won all the battles we will face even before we start.

The good news here is found in 1 Peter 1:22-25 Now that you've cleaned up your lives by following the truth, love one another as if your lives depended on it. Your new life is not like your old life. Your old birth came from mortal sperm; your new birth comes from God's living Word. Just think: a life conceived by God himself! That's why the prophet said, The old life is a grass life, its beauty as short-lived as wildflowers; Grass dries up, flowers droop, God's Word goes on and on forever. This is the Word that conceived the new life in you. (MSG) This verse to me sums up what we are to be about as Christians to always and at all time be followers of the TRUTH. In this field we are always looking for signs and symptoms to help us know what we are dealing with in our cardiac patients. As in the physical we can and will see Spiritual Signs and Symptoms if we know what to be looking for.

Signs and Symptoms of a Hindered Christian 1. He (or she) will be floundering in spiritual stagnation.

2. He will frequently have disagreements which threaten relationships.

3. He will find his prayers unanswered - will be receiving unclear signals, or a delay on God's part, or simply - no answer at all.

4. He will manifest a reluctance to obey the truth.

5. He will display a generally negative attitude.

So how do we fight against this unseen world and all its inhabitants?

We find part of the answer that we seek in 2 Thessalonians 3:3 But the Lord is faithful; he will strengthen you and guard you from the evil one. (NLT) Now I have shown it to you here, go get your Bible and highlight it because God said it and I believe it to be a powerful promise we should remember!

We will also find three other great commands concerning Satan and the Saints of God, let's find them in your Bibles (hiighlight them) and read them together.

1. Live Freely in the Spirit: Galatians 5:16-18 My counsel is this: Live freely, animated and motivated by God's Spirit. Then you won't feed the compulsions of selfishness.

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A Paramedic’s view of Christianity For there is a root of sinful self-interest in us that is at odds with a free spirit, just as the free spirit is incompatible with selfishness. These two ways of life are antithetical, so that you cannot live at times one way and at times another way according to how you feel on any given day. Why don't you choose to be led by the Spirit and so escape the erratic compulsions of a law-dominated existence? (MSG)

2. Put on the whole Armor of God: Ephesians 6:10-18 In conclusion, be strong in the Lord [be empowered through your union with Him]; draw your strength from Him [that strength which His boundless might provides]. 11 Put on God's whole armor [the armor of a heavy-armed soldier which God supplies], that you may be able successfully to stand up against [all] the strategies and the deceits of the devil. 12 For we are not wrestling with flesh and blood [contending only with physical opponents], but against the despotisms, against the powers, against [the master spirits who are] the world rulers of this present darkness, against the spirit forces of wickedness in the heavenly (supernatural) sphere. 13 Therefore put on God's complete armor, that you may be able to resist and stand your ground on the evil day [of danger], and, having done all [the crisis demands], to stand [firmly in your place]. 14 Stand therefore [hold your ground], having tightened the belt of truth around your loins and having put on the breastplate of integrity and of moral rectitude and right standing with God, 15 And having shod your feet in preparation [to face the enemy with the firm-footed stability, the promptness, and the readiness produced by the good news] of the Gospel of peace. 16 Lift up over all the [covering] shield of saving faith, upon which you can quench all the flaming missiles of the wicked [one]. 17 And take the helmet of salvation and the sword that the Spirit wields, which is the Word of God. 18 Pray at all times (on every occasion, in every season) in the Spirit, with all [manner of] prayer and entreaty. To that end keep alert and watch with strong purpose and perseverance, interceding in behalf of all the saints (God's consecrated people). (AMP) Putting on the armor of God (minute by minute, hour by hour and day by day) is the responsibility of the Christian. And frankly, one ought to don this armor with all urgency as we do our Personal Protective Equipment (PPE). Let me put this in better understanding this would like you and I putting on the PPE of a Tactical Medic with helmet and shield.

3. Submit yourselves therefore to God. Resist the devil, and he will flee from you: James 4:7-10 So let God work his will in you. Yell a loud no to the Devil and watch him scamper. Say a quiet yes to God and he'll be there in no time. Quit dabbling in sin.

Purify your inner life. Quit playing the field. Hit bottom, and cry your eyes out. The fun and games are over. Get serious, really serious. Get down on your knees before the Master; it's the only way you'll get on your feet. (MSG) We need to daily walk in the spirit … put on the whole armor of God … and submit to God and resist the devil if we are to maintain our protection. What can the devil do to a Christian? Can he, in fact, do anything he wants to a Christian? The answer is - yes he can, yes he will, yes he does.

Theodore H. Epp wrote in Winning Your War against Satan, "However, many Christians have the mistaken idea that as long as they know God they can ignore the

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Enemy and still win the battle. This delusion is one of Satan's cleverest devices. Much of the Deceiver's success lies in the fact that he so cleverly hides his identity that people do not suspect his evil presence or his purposes. Using these tactics, Satan and his evil forces seek to gain control of the believer and to dominate his life.

Therefore, it is vital for believers to know the methods Satan employs to both oppress and obsess whomever he can among God's people." cxxvi We have just finished studying about the Christian that is showing NS with PJC's. This Christian has been allowing Satan to hinder them. We have discussed how we are to fight against the unseen world and all its inhabitants. If this Christian starts to walk daily in the spirit; If they daily put on the whole armor of God and daily submit to God; If they resist the devil then the devil will flee and the Christian will begin to see changes because Satan has been exposed trying to hinder them.

We all need to remember what is taught in John 10:10 The thief's purpose is to steal and kill and destroy. My purpose is to give them a rich and satisfying life. (NLT) But even better for you and I is that the principle of restoration is throughout God's Word. Like what we find in Proverbs 6:31 But if he is caught, he must pay back seven times what he stole, even if he has to sell everything in his house. (NLT) So now that he is found he Satan must repay us for all he stole.

What happens to the Christian that refuses to accept that they are being hindered and refuse to change? At that point, they are choosing to continue to allow Satan to have his way in their lives, and they are choosing to continue down the Continuum of Sin. This will lead the Christian to becoming deceived; this shows up on the Christian cardiac monitor as a Junctional rhythm.

Let's get started looking into the Christian that is in a Junctional rhythm, shall we?

JUNCTIONAL RHYTHM When we speak of Junctional Rhythms we are referring of course to AV Nodal Rhythms. Let's quickly review the Normal Pathway of the electrical conduction system. The Cardiac Cycle is initiated by the SA Node, this is transferred to the AV Node. The AV Node has the capability to slow down or speed up impulses. The AV Node also has the capability to initiate a cycle, especially if it does not receive a signal from the SA Node. If the AV Node does not receive at least 50-60 electrical signals from the SA Node, it's backup duty is take over the role of the SA Node, and become the pacemaker.

This next concept is sometimes difficult for beginning students to grasp, so stay with me.

Part 1, when cardiac tissue depolarizes or fires, the depolarization goes out into a 360 degree direction. That means up, down, forward, backwards, and sideways. The heart is not a flat surface, but a 3 dimension object. Part 2, electrical responses will travel faster in the Atria than the Ventricles. Part 3, if the AV Node depolarizes first, it's depolarization wave will also go out into a 360 degree pattern. In other words it will travel down to ventricles and back up to the Atria at the same time. The response traveling back up to the Atria is termed "Retrograde Conduction".

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Now the Ventricular Response will appear normal as reflected by the QRS, as long as the conduction system below the AV Node was normal to start with. See, the ventricles are kind of in the dark. They can't see what the Atria are doing; the only way the ventricles can communicate with the Atria anyway is through the AV Node. So if the Ventricles receive a signal from the AV Node, the Ventricles have no idea if the initial response came from the SA Node or AV Node. In a nutshell, the QRS will look as normal as it did before, as long as the conduction system below the AV Node was intact.

Now the BIG question I am leading up to is, "What does the Atrial Response or "P" wave look like?" The answer is... if it was Right Side Up to begin with, or a Positive deflection, it now will look upside down, inverted, or a Negative deflection.

The second BIG question is, "What does that do to the "PR" interval? Well since one of the AV Nodes primary function is to slow down the transmission starting above it, how can it slow down something it started? I kind of answered a question with a question. Of course the answer is, it can't. So the "PR" interval will be very short. Now sometimes there will not be a "PR" interval, because there is not a "P" wave present in the rhythm strip. That does not mean that the Atria are not being depolarized, it simply means you can't see the results on the EKG strip. The "P" wave is "buried" in the QRS complex.

Another way to demonstrate this effect is with rocks and water. If we both were standing at the waters edge of a lake, and we each threw a rock into the water at the very same time, and my rock was 2-3 time bigger than yours. Which person's ripple in the water do you think we would see? Mine of course, because my rock was bigger, making my ripple the biggest, burying your ripple into mine.

Note the "QRS" is narrow, normal looking. Now look at the "P" waves, they are inverted indicating Retrograde Conduction. Look at the "PR" interval, it's very short, less than .12, remember normal is .12-20! The ventricle rate is regular and slow with a rate of about 50.

Junctional Rhythms are less than 60, if they are faster than 60, they are termed Accelerated Junctional Rhythms. This rhythm in Figure 10.2 is a "Junctional Rhythm", because the rate is less than 60! Note: Junctional Rhythms are also known as, Junctional Escape Rhythms.

Figure 10.2 cxxvii The next Rhythm seen in Figure 10.3 below is an Accelerated Junctional Rhythm. Note the absence of "P" waves. Remember, the Atria are contracting, but in a retrograde fashion. The

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"P" waves are not seen here because they are buried in the "QRS" complex. The Ventricular rate is about 80.cxxviii

Figure 10.3 cxxix Criteria for Classification Rhythm: The P-P and R-R intervals are regular and at similar intervals. The P-P interval may be difficult to measure due to the location of the P wave.

Rate: If the P wave is identifiable, the rate will be 40 to 60 beats per minute. The ventricular rate will be 40 to 60 beats per minute. Junctional Rhythms are less than 60, if they are faster than 60, they are termed Accelerated Junctional Rhythms.

P wave configuration: The P wave is usually inverted and may precede, follow, or fall within the QRS complex. It may not be visible at all on the rhythm strip.

PR interval: If the P wave is before the QRS complex, the PR interval will measure less than 0.12 second and will be constant. If the P wave is not before the QRS complex, the PR interval cannot be determined. This is because this P wave is not associated with the next QRS complex.

QRS duration and configuration: The QRS duration and configuration will be within normal limits of 0.06 to 0.10 second.

What's Unique about this Rhythm?

A junctional rhythm may have an inverted or absent P wave or a P wave that follows the QRS complex.

Clinical Significance The patient has a slower heart rate than normal and loses the atrial kick due to the shortening of the interval between the atrial depolarization and ventricular depolarization. These conditions cause the patient to exhibit symptoms of low cardiac output. Common signs and symptoms of low cardiac output displayed include hypotension (low blood pressure) and altered mental status such as confusion or disorientation. Observe for symptoms and monitor the EKG tracing in case a more serious dysrhythmia occurs.cxxx

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What does this mean to the Christian Heart?

Mark Twain wrote, "What a wee little part of a person's life are his acts and his words! His real life is led in his head, and is known to none but himself. All day long, the mill of his brain is grinding, and his thoughts, not those other things, are his history."cxxxi Have you ever thought about why Satan came to Eve as a serpent, and why did he not go to Adam direct? 2 Corinthians 11:3 But I fear that somehow your pure and undivided devotion to Christ will be corrupted, just as Eve was deceived by the cunning ways of the serpent. (NLT) Oswald Chambers one of my all time favorite authors to read and study had this to say in his 1914 book entitled Biblical Psychology he had this to say about Adam and Eve and the Spiritual fall of mankind.

In Adam and Eve we are dealing with the primal creations of God. Adam was created immediately by the hand of God, and Eve was created mediately. Eve stands for the soul side, the psychic side, of the human creation, all her sympathies and her affinities are with the other creations of God around. Adam stands for the spirit side, the kingly, Godward side. Adam and Eve are together the likeness of God, for God said, "Let us make man in our image, male and female created He them." Woman stands not as inferior to man; the revelation made here is that she stands in quite a different relation to all things, and both are required to make the complete, rounded creation of God referred to by the big general term MANKIND. Eve having affinity and sympathy with the creation round about, would naturally listen with very much more unsuspecting interest to the suggestions that came through the subtle creature that talked to her.

The Bible says that Eve was deceived; the Bible does not say that Adam was deceived; consequently Adam is far more responsible than Eve, for Adam sinned deliberately. There was not the remotest conscious intention in Eve's heart of disobeying, she was deceived by the subtle wisdom of Satan via the serpent.

Adam, however, was not deceived in any shape or form; when Eve came to him he understood it was disobedience, and he sinned with a deliberate understanding of what he was doing, so the Bible associates sin with Adam (Rom. 5:12) and transgression with Eve. (1 Tim. 2:14.)â&#x20AC;Ś Perhaps one may legitimately make a distinction between transgression and sin in human conduct. (see Matt. 6:12-15.) Transgression is nearly always an unconscious act; there is no conscious determination to do wrong. Sin is never an unconscious act, as far as culpability is concerned, it is always a conscious determination. Adam was the introducer of sin into this order of things. Original sin is doing without God. A noticeable feature in the conduct of Adam and Eve is that when God turned them out of the Garden they did not rebel. The characteristic of sin in man is "fear and shame." Sin in man is doing without God, but it is not rebellion against God in its first stages, there is no rebellion anywhere in Adam and Eve against God.cxxxii

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Deceived: There are occasions when we wander because we believe a lie, and only later discover the lie has deceived us and led us off course.

I like what Dr. Paul W. Carlin had to say in his book, Satan and the Saint: A Look into The Dark Side of Christian Behavior, about Christians being deceived. Some of this we have already read but some we haven't. â&#x20AC;Ś Satan blinds the minds of unbelievers will not come as a surprise to anyone. But many Christians fail to realize that Satan also deceives the minds of believers. I have mentioned this satanic device, deceit, first in this discussion because it is the device which the devil uses against us the most, and it is also the most dangerous weapon he possesses.

Deception, which covers both lies and trickery, is the fountain from which all other satanic stratagems flow. In this connection, it is interesting to take note of how much the Bible says about deception generallyâ&#x20AC;Ś The Satanic deception that undermines Christians falls into three categories or types: self-deception, societal-deception, satanic-deception. Interestingly, these types roughly co respond with the three traditional enemies of those who are involved in the Christian walk: the World, the Flesh and the Devil.

Self-Deception Self-deception is a product of the flesh. In Scripture, 1 John 1:8 deals with people's self-deception concerning their own innocence in other words, their belief that they personally are sinless. Says John, "If we say that we have no sin, we deceive ourselves, and the truth is not in us." Such an erroneous confession regarding the personal presence of the indwelling principle of sin is the product of a deceived Christian. This absence of truth makes a believer dangerous to himself, not to mention a case of pseudo-spiritual arrogance as he displays himself to other people.

Galatians 6:4 appears to indicate that this form of self deception is born out of comparing one's self with other people. When you do so, you become intolerant of faults in others and think you are above failure. Self-deception in this regard then becomes self-conceit. Look at the verse from the Amplified: "But let every person carefully scrutinize and examine and test his own conduct and his own work. He can then have the personal satisfaction and joy of doing something commendable (in itself alone) without (resorting to) boastful comparison with his neighbor."

Flaw-finders and weakness-watchers are the way they are because finger pointing makes them look good in their own eyes. A critical attitude is self-defeating, however, in that it is self-deceiving. The cure for it is an honest evaluation of your own actions and works.

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A Paramedicâ&#x20AC;&#x2122;s view of Christianity James 1:26 approaches the subject from another perspective: "If any man among you seems to be religious, and bridleth not his tongue, but deceiveth his own heart, this man's religion is vain." An uncontrolled tongue, which no man can tame (James 3:8), is a sure sign of (1) a deceived heart, and (2) an empty Christian profession.

The verse is talking about a person who cannot control his tongue because his religion is empty. However, the individual here thinks he is very religious. So he is cheating himself! James 1:22 addresses self-deception in the area of no-action appropriation that is, non-action, evil omission, or the failure to expedite. "But be ye doers of the word, and not hearers only, deceiving your own selves."

When self-deception is at work, an individual believes what he or she wants to believe because, to some extent, believing this way benefits him toward some desired end, an end which he foresees will be physically, emotionally, monetarily or spiritually satisfying.

In 1 Corinthians 3:18, another interesting word is used for self-deception, "exapateo": "Let no man deceive himself â&#x20AC;Ś" In the original it means "to seduce wholly; to beguile."

This process involves the use of wiles and enticing prospects. A companion word is used in Galatians 6:3. The person who deceives himself could correctly be called a self-seducer.

Jesus was so clearly correct when He taught that what is on the inside of a person is the only thing that can come out of a person (Matt. 5:18-19). The self-deceived Christian's religious profession is empty, nonproductive, useless. Thus, self-defeating and self-destructive.

A person is deceived if he or she is ever learning, but never translates that learning into practical service. The person has "paralogizomai," miscalculated. Self-deception appears to be a manifestation of the sin of pride. Ensnared in it, the individual gets like the self-proclaimed, self-appointed prophet who, in pious platitudes, pronounces the judgment of God upon man and beast, while his fearful hearers tremble because they believe him to be a genuine prophet. Most of this self-deception prophesying is simple exaltation of self resulting from self-deception. True prophets of God are never wrong.

I have not met one modern day "prophet" who never misses. One way or another, he or she manages to stay self deceived about sin, sanctification, sanctity, and seduction.

Satan can deceive you. Satan does deceive you. But satanic deception is not nearly so dangerous as self-deception. It would be the easy way out to lay all the blame for deception on the adversary. The self-deceived Christian is fertile soil for satanic deception. And that is what makes this condition of heart so self-destructive. You are open to the introduction of whatever the master of deceit wishes to deposit in your already cultivated heart.

The cure for self-deception is attention to the Word of God. James 1:25 says, "But who so looketh into the perfect law of liberty, and continueth therein, he being not a forgetful hearer, but a doer of the work, this man shall be blessed in his deeds." The Word of God is the means of regeneration (1:18), a mirror reflecting man's defects

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(1:23), the ethical guide for Christian living (1:25, 28), and the standard for judgment (2:12).

Have you deceived yourself?

Societal Deception This deception likewise is rooted in pride. Its flavor is that of the world. Ephesians 4:14 paints a frightening picture of Satan, who is cunning craftiness personified, as he cooperates with the sleights or tricks of ordinary men who are deceiving their fellows: "whereby they lie in wait to deceive." The complicated combination of Greek words in the verse shows that the methods of deception are of the devil himself, not merely human error.

The Greek word "planets" is translated "deceive" here. We derive our English word "planet" from it. The word means to circle or go around, hence, to go astray. It is describing more the method of deception than the deception itself.

The world of men, under the control of the prince of the world, Satan, circles or surrounds Christians with humanistic value systems until, passing from one affected generation to the next, we have bought the grand scale lie, secular humanism.

1 John 3:7 tells us not to allow any man to "planeo," deceive or defraud us.

Ephesians 5:6 warns us not to allow any man to "apateo," deceive or cheat us with empty words. In 2 Thessalonians 2:3, we are admonished not to let any man "exapateo," seduce or deceive us, according to any means. It is dismaying to see that some fine Christian men/women who would never be taken in by physical seduction are being seduced mentally, spiritually and doctrinally every day. They are deceived!

When Jesus instructed us concerning His Second Coming, in Mark 13:5, He used the word "planeo," "to deceive" or "to defraud," to warn us abut people who will attempt to transmit some teaching which is foreign to the Word of God. In the last days, the Bible tells us society will abound with false teachers who are preaching a gospel that is full of deceptions.

We see this state of affairs around us now. Millions of unsuspecting people are even today being lured into the trendy New Age Movement, in spirit guides and mediums, into the practice of transcendental meditation, and into belief in reincarnation. One of the fastest growing religious groups in the world is the Satanism Movement. Interest in the occult and in ancient pagan worship forms is rising rapidly.

Societal deception is dangerous because of the power of the "herd" instinct in man.

People like to "follow the crowd" and "be where the action is" and "hang out at the most popular watering holes." This herd instinct greatly nourishes societal, or social deception.

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While self-deception is internal, rising in the flesh, or in the godless natural man of our personal makeup, and while social deception is perpetrated on us by our fellow men as a group, satanic deception is the devil's direct work in us. World, flesh and devil the Christian's three greatest enemies are reinforced and promoted through deception.

Revelation 12:9 provides us with three names for Satan. He is the devil, literally "the slanderer;" he is Satan, literally, "adversary;" and his is 'planeo', literally, "the deceiver." (The term is most often used for religious deceit.) This is the word which is used for Satan in Revelation 20:10.

2 John 7 describes Satan as "planeo," roving like a tramp, an imposter, a misleader: "For many deceivers are entered into the world, who confess not that Jesus Christ is come in the flesh. This is a deceiver and an antichrist." The word is descriptive of an imposter of the vagabond or tramp sort. The same word is used regarding "seducing spirits" (planeo) in 1 Timothy 4:1.

The New American Standard Translation has the term "deceitful spirits." When one emphasizes the slanderer, liar, destroyer and accuser characteristics of Satan, but forgets that he is, first and foremost, the deceiver, then one becomes vulnerable to "seducing spirits." We humans never like to admit that we have been fooled by someone. And this is exactly what makes this deceptive spirit of Satan so persuasive and powerful. Our pride, a deep and elemental instinct, works as its ally.

We must never forget. Satan is a deceiver. Deceit is the most dangerous of all his tactics against us. Eve was deceived by Satan. (1 Tim. 2:14) It has been his favorite approach to people ever since. Counterfeiting or faking was not the creation of man, but of Satan. It is the most valuable weapon in his arsenal.

Sin Deception We established earlier that there were three areas of deception. But actually there are four. There are three which correspond to the world, the flesh, and the devil. And then there is one more, sin deception.

This could have been treated as part of the self-deception syndrome, because the verse referring to sin deception is Romans 7:11. "For sin, taking occasion by the commandments, deceived me, and by it slew me."

Paul states that it is the sin principle, the flesh, which exerts a controlling force over our actions. The Law is not the cause of sin which results in death. Sin, through its devious and deceptive maneuvering, is what slays man. Sin is a deceiverâ&#x20AC;Ś Satan never gives us! Therefore, the child of God must always be alert. How tragic are the results when we yield our members as instruments of sin. It might be helpful for us to gain some insight into just how Satan uses his evil spirits in the deception process.

How does he deceive the believer?

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Jessie Pen-Lewis, in her book, War on the Saints, lists the various ways: • Satan does it, first, by obtaining the consent of the person's will to some evil thought or action.

• Second, by counterfeiting the presence of God as the one who is influencing the believer.

• Third, by counterfeiting the Person of God within the believer's own person.

• Fourth, by suggestions to the mind.

• Fifth, by steering false counselors toward the believer.

• Sixth, by engineering counterfeits of various divine, human, Satanic and angelic things.

• Seventh, through teachings delivered by demons.

• Eighth, by contriving supernatural visions and voices.

• Ninth, by pushing situation to their extremes.

Again, Satan's first objective is to deceive, so as to gain communication with, entrance to, and confidence of the believer, so that he or she will imagine that all of his workings are of God.cxxxiii As we stated earlier in this chapter we are always looking for signs and symptoms to help us know what we are dealing with in our cardiac patients. As in the physical we can and will see Spiritual Signs and Symptoms if we know what to be looking for. There are at least 15 signs and symptoms that we can know that a Christian is under satanic deception of one type or another. Those signs and symptoms are as follows: 1. He (or she) will claim to be sinless, perfect.

2. He will boast about his wisdom as opposed to others.

3. He will evidence an uncontrollable tongue.

4. He will learn Bible principles, but not apply them to himself.

5. He will espouse humanistic values.

6. He will adhere to a belief system foreign to the Word of God. 8. He will have cult or occult involvements.

9. He will have a fascination with sin.

10. He will be driven to self-justification.

11. He will be easily influenced with strange new doctrines.

12. He will hold contradicting doctrinal beliefs.

13. He will be marked by restlessness.

14. He will show an inability to reason or to listen to others.

15. He will have a suspicious spirit.

16. He will be marked by abnormal talkativeness or abnormal reserve cxxxiv

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I want to spend some time on the subject of Satan blinding (2 Corinthians 3:15 â&#x20AC;Ś Veils lies upon their minds and heartsâ&#x20AC;Ś) the minds of the unbelievers and his darkening and re-veiling the minds and hearts of the Christians and what was truly lost that very moment that Adam sinned.

2 Corinthians 3:14-18 In fact, their minds were grown hard and calloused [they had become dull and had lost the power of understanding]; for until this present day, when the Old Testament (the old covenant) is being read, that same veil still lies [on their hearts], not being lifted [to reveal] that in Christ it is made void and done away. Yes, down to this [very] day whenever Moses is read, a veil lies upon their minds and hearts. But whenever a person turns [in repentance] to the Lord, the veil is stripped off and taken away. Now the Lord is the Spirit, and where the Spirit of the Lord is, there is liberty (emancipation from bondage, freedom). And all of us, as with unveiled face, [because we] continued to behold [in the Word of God] as in a mirror the glory of the Lord, are constantly being transfigured into His very own image in ever increasing splendor and from one degree of glory to another; [for this comes] from the Lord [Who is] the Spirit. (AMP) Are we aware of what we lost with Adam at the moment that he sinned? As was stated a few pages back, Adam was not deceived in any shape or form; when Eve came to him he understood it was disobedience, and he sinned with a deliberate understanding of what he was doing, so the Bible associates sin with Adam this is found in Romans 5 lets read some of this chapter shall we? Romans 5:12-14 You know the story of how Adam landed us in the dilemma we're in first sin, then death, and no one exempt from either sin or death. That sin disturbed relations with God in everything and everyone, but the extent of the disturbance was not clear until God spelled it out in detail to Moses. So death, this huge abyss separating us from God, dominated the landscape from Adam to Moses. Even those who didn't sin precisely as Adam did by disobeying a specific command of God still had to experience this termination of life, this separation from God. But Adam, who got us into this, also points ahead to the One who will get us out of it. (MSG) We read That sin disturbed relations with God in everything and everyone, but the extent of the disturbance was not clear until God spelled it out in detail to Moses. I will now address Adam and what he really lost and what you and I have lost through him. We will learn what was lost so we will know what we gained the moment we become Christians.

When Adam sinned, a veil covering, as seen in 2 Corinthians 3, came over his head and his life, known as a cloud of darkness. But even more than that, when Adam sinned he lost his Daddy; I say daddy because any man that has reached puberty can father a child but not everyone can be a daddy. The only person that really knows what Adam lost most is Adam himself. Adam is acutely aware of what he lost. Adam walked with and talked with God personally in the garden and God would reveal things to him as they walked, talked and named the animals. God as his daddy came after him, but Adam lost his father.

So what is so important about Adam losing his father? In losing his father Adam, lost the following:

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Adam lost connection to his Father God: Adam lost Gods Fatherhood: [Adam lost who he was] The Father now had to be absent and silent unless Adam came to Him first. A father is to tell his sons and daughters who they are. When fathers don't tell their children who they are he opens it up for everyone else to tell them who they are or should be.

Adam lost revelation: This is because the Father is the source of revelation; revelation comes from your Father [God]. No info coming from father to his children. No direct communication with God as before as they walked together in the garden, Adam was cut off.

What do I mean by being Cut Off? Adam was now veiled and the Father could not reveal His plans for Adams life… Who he was… Who he is… What he is to do… How he is to live…

Adam lost Headship: The loss of headship is like a pillow case or towel being placed over our heads causing us to be ignorant. This has caused us not to use the God given 7 openings in our heads in the way that God intended us to use them. He placed those 7 openings in our head as ways of communication. God has given us two eyes to see and study God's Word, two ears to hear God the still small voice and leadings of the Holy Spirit. We have also been given two nostrils to smell God and all of His goodness, God gave us one mouth to talk to Him and to eat at His table and taste and see that He is good.

So how did Adam live now; he lived through his senses, but sin brought in un-Godly sensuality. God gave us our senses so we can touch, taste, hear, smell and see all that He has given us. Because Adam sinned Satan perverted sensuality, Satan wants us to live our lives by what we can feel (if it feels good, do it). Adam lived by what he stumbled into because His Father was not there to guide him. He lived his life through and by his emotions because he lost his revelation from his Father. The Father is the only one who can reveal who and what he wants you to be. So now anybody who come into Adam's life can lead him.cxxxv SOAP BOX TIME: Satan wants to keep us in the dark about this and if we as men, sons, and Fathers do not do our job as a Daddy then, we fail our kids and our calling. As men of God we are to be the Head of our homes and we are to allow our children to see us studying our Bibles and treating people the way God say to do in the Bible, they are to watch you and I walk out our salvation and they NEED to see use pray. They need to see us have proper emotional responses as seen in John 11:35 the shortest verse in the Bible states that "Jesus wept." Let them know it is ok to cry, to hurt, to feel. These things to me are what I call prayer fuel. When all is going good we all stop praying as much, but when it gets bad we hit our knees.

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God expects us as fathers to have our children hear us speaking life to them, speaking the Word, and praying often not just at bedtime and meals. They also need to see and hear that we listen to God and do what He says in His Word and when we pray we take the time to listen and receive revelation from Him in our talks with God. We are told by God in His Word that he is the Everlasting Father and He wants to be a Daddy to you and I. Isaiah 9:6 For to us a Child is born, to us a Son is given; and the government shall be upon His shoulder, and His name shall be called Wonderful Counselor, Mighty God, Everlasting Father [of Eternity], Prince of Peace. (AMP) Let me share something very personal with you. You see all that my wife and I ever want was to have children and be parents be a mommy and a daddy to the kids that God gave usâ&#x20AC;Ś.

We got pregnant once and then lost Jr at about 12 weeks. I held my child in my hand and looked at his or her hands and feet and I could already see the finger and toe nails, and the arms and legs formed.

As I looked down at Jr's feet through my tears all I could think about was the verse in Romans 10:15 and how will anyone go and tell them without being sent? That is why the Scriptures say, "How beautiful are the feet of messengers who bring good news!" (NLT) My wife and I do not have any biological children born to us but our quiver is full and we are parents to many children some even older then she and I are. We have claimed every child that has ever entered our home as our own. As they all grow up and we marry them off more just keep coming and they all need someone to be a FATHER and MOTHER to them.

We read in 2 Corinthians 3:18 that God removes the veil when we become Christians let's read it together but I want to start at verse 17. 2 Corinthians 3:17-18 Now the Lord is the Spirit, and where the Spirit of the Lord is, there is liberty (emancipation from bondage, freedom). 18 And all of us, as with unveiled face, [because we] continued to behold [in the Word of God] as in a mirror the glory of the Lord, are constantly being transfigured into His very own image in ever increasing splendor and from one degree of glory to another; [for this comes] from the Lord [Who is] the Spirit. (AMP) For the Christian that we found to be in a Junctional rhythm, if they allow God to remove the veil and do the work that He wants to do in them. Then they will be able to start to respond to Satan and his tactics of hindering and deceiving them.

What am I saying hear, once we realize that Satan is trying to place that veil back over our faces we can and should act immediately? Do not be taken in by Satan and his lies, his hindrances' and by all means don't let him deceive you. When Satan tries to get you to believe a lie any lie don't do it, turn your all to God and allow Him to guide you. Did you know that God gave us our senses to live our lives to the fullest and at the same time bring Him glory with our lives and our sensuality?

Like I stated above God gave us our senses so we can touch, taste, hear, smell and see all that He has given us. But first we need to change our un-Godly sensuality into Godly

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sensuality and use our God give senses to perform what Dr. Paul Carlin in his book Mastering Life Through Belief Therapy速 Why We Do What Do When We Do It called the Five-Fold Truth Test.

Dr. Carlin writes: The seeing test: Does it look right?

"The eyes of your understanding being enlightened; that ye may know what is the hope of his calling, and what the riches of the glory of his inheritance in the saints."

Ephesians 1:18 The hearing test: Does it sound right?

"This only would I learn of you. Received ye the Spirit by the works of the law, or by the hearing of faith?" Galatians 3:2 The feeling test: Does it feel right?

"Be afflicted, and mourn, and weep: let your laughter be turned into mourning, and your joy to heaviness." James 4:9 The taste test: Does it taste right?

"O taste and see that the Lord is good: blessed is the man that trustest in Him." Psalm 34:8 The smell test: Does it smell right?

"For we are unto God a sweet fragrance of Christ, in them that are saved, and in them that perish. To the one we are a fragrance of death unto death, and to the other the fragrance of life unto life. And who is sufficient of these things?" 2 Corinthians 2:1516cxxxvi In the next chapter we are going to look at the Christian that is having Supraventricular Dysrhythmias. Please join me as we see where this leads us.

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Chapter 11 Interpreting Supraventricular Dysrhythmias I started Paramedic Class in the fall of 1990; we started our Cardiology course sometime in early 1991. As I sit here and type this I think back on that course and oh how pre-hospital cardiac care has change over just the past 20 years.

We were learning and seeing EKG strips on the LifePak 5 and now there is a LifePak 20. 12 leads were only done in the hospitals. Now look at us 12 leads EKG's and calling the hospital and going straight to a facility with a Cath Lab and Percutaneous Coronary Intervention (PCI) capabilities for the patients with known STEMI are the standard of care.

Being the Dinosaur of EMS that I am, this was way before Adenosine was even thought of being on the trucks. I mean this was when we had to call for orders to do anything including starting IV's and Pulseless Electrical Activity (PEA) was being called EMD (ElectroMechanical Dissociation).

I mean Supra-Ventricular Tachycardia (SVT) was just a rhythm we had to learn to recognize by the rate being 150 to 180 beats per minute (BPM). Paroxysmal Supra-Ventricular Tachycardia (PSVT) was recognized by the rate being greater than 180 BPM and having a witnessed onset or termination. SVT is now being reclassified as an AV Nodal Reentry Tachycardia (AVNRT) or an Atrioventricular reentrant tachycardia (AVRT).

I remember the weekend when the name change took place for the county I was working in that Sunday morning as my partner and I were getting out of our vehicles. To walk into the station and we heard the tones go off for our station, even before we could get in the door.

The call was for an unresponsive patient I told the off going crew we would handle the call.

We jumped in the ambulance and off we went. As we arrived on scene the patient was lying on the floor next to his chair unresponsive, not breathing and had no pulse. My partner started to get out the bag valve mask (BVM) as I did a quick look with the paddles.

We were the only ones on the call First Responders NOT! The patient was in an EMD rhythm, we had the family help with chest compressions. My partner stated he would get the airway so that meant I had to go call the hospital and get orders from the ER doc. Our Medical Director at the time answered the phone and I told him we needed cardiac arrest orders for a patient being in PEA. The Doc stated back, "So your patient needs to pea give him 20 mg's of Lasix and transport. I guess you had to be there for it to be funny.

Now SVT is a relatively non-specific term and does not give any insight into the nature of the arrhythmia just the origin. SVT is a broad umbrella term for any tachycardia originating above the ventricles In fact, any arrhythmia coming from the atria and greater that 100 BPM can be called SVT's.

With the development of Intracardiac Electrophysiologic Studies (EPS) we have seen the classification of SVT dramatically changed, with intracardiac recordings having identified the various mechanisms involved in the condition. Depending on the site of origin of the dysrhythmia, SVT may be classified as an atrial or AV tachyarrhythmia. Another way to separate the arrhythmias is to classify them into conditions having either regular or irregular rhythms.

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SVT and PSVT are triggered by a reentry mechanism. This may be induced by premature atrial or ventricular ectopic beats. Other triggers include hyperthyroidism and stimulants, including caffeine, drugs, and alcohol.

SVT is a classification of rapid heartbeat, usually occurring at a rate greater than 150 beats per minute as seen below in Figure 11.1. Supraventricular refers to an ectopic focus originating above the ventricles, in the atria, or junctional region of the heart. The heart is beating so fast that it is difficult to determine if the source of origin is from the sinus node, atria, or the AV junction. Because the heart rate is so rapid, the atria are contracting as soon as the ventricles are relaxing. This causes the P waves (atrial contraction) to become difficult to identify, because they may occur at the same time as the T waves (ventricle relaxation).

SVT is a common clinical condition that occurs in persons of all age groups, and treatment can be challenging. Electrophysiologic studies are often needed to determine the source of the conduction abnormalities.

Manifestations of SVT are quite variable; patients may be asymptomatic or they may present with minor palpitations or more severe symptoms. Results from electrophysiologic studies have helped to determine that the pathophysiology of SVT involves abnormalities in impulse formation and conduction pathways. The most common mechanism identified is reentry. cxxxvii

Figure 11.1 cxxxviii SUPRAVENTRICULAR TACHYCARDIA The primary difficulty in classifying the actual rhythm is identifying where the tachycardia originates. The P wave may appear before, after, or during the QRS complex, depending on the origin. The PR interval measurement is difficult to assess because you cannot often see the initial upswing of the P wave. Frequently, once at the emergency department or Cardiac Care Unit they will request the paper speed be increased to pull the cardiac complexes apart for further analysis.

Criteria for Classification Please see Figure 11.2 below. The SVT algorithm is to be used to review the criteria for classification of the known SVT rhythms that we acknowledge in cardiology today.

Now that SVT is a broad umbrella term for any tachycardia originating above the ventricles, we will hold what it means to the Christian Heart until we get to the two types of PSVT that we will be discussing in this chapter.

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Figure 11.2 cxxxix The SVT Algorithm

Figure 11.3 cxl PAROXYSMAL SUPRAVENTRICULAR TACHYCARDIA

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PSVT is an episodic condition with an abrupt onset and termination. The only difference between PSVT and SVT is that the onset of the PSVT can be seen as in the example Figure 11.3 above. For accurate interpretation, the beginning or end of the PSVT must be seen.cxli PSVT is a regular supraventricular tachycardia that most often occurs at a rate of between 150 to 240 BPM. Atrial activity is usually not evident although subtle notching or a negative deflection (representing retrograde atrial activity) may sometimes be seen at the tail end of the QRS. PSVT is a reentry tachycardia that almost always involves the AV node (so we see where we get the other name for this rhythm [AVNRT] AV Nodal Reentry Tachycardia). The impulse continues to circulate within the AV node until the reentry pathway is either interrupted (i.e.,

by AV nodal blocking drugs or a vagal maneuver) or until it stops spontaneously. cxlii The most common cause of PSVT is AV Nodal Reentrant Tachycardia AVNRT rhythm. In AVNRT, fast and slow pathways in the AV node form an electrical circuit or loop. The impulse spins around the AV nodal (junctional) area. See Figure 11.4 below.

An understanding of the electrophysiology of AV nodal tissue is very important in comprehending the mechanism of AVNRT. In most people, the AV node has a single conducting pathway that conducts impulses in an anterograde manner to depolarize the bundle of His. In certain cases, AV nodal tissue may have 2 conducting pathways with different electrophysiologic properties. One pathway (alpha) is a relatively slow conducting pathway with a short refractory period, while the second pathway (beta) is a rapid conducting pathway with a long refractory period. The coexistence of these functionally different pathways serves as the substrate for reentrant tachycardia.

Electrophysiologic studies have demonstrated dual AV nodal pathways in 40% of patients.

The onset of AVNRT is triggered by a premature atrial impulse. A premature atrial impulse may reach the AV node when the fast pathway (beta) is still refractory from the previous impulse but the slow pathway (alpha) may be able to conduct. The premature impulse then conducts through the slow pathway (alpha) in an anterograde manner; the fast pathway (beta) continues to recover because of its longer refractory period.

After the impulse conducts in an anterograde manner through the slow pathway (alpha), it may find the fast pathway (beta) recovered. The impulse then conducts in a retrograde manner via the fast (beta) pathway. If the slow pathway (alpha) has repolarized by the time the impulse completes the retrograde conduction, the impulse can reenter the slow pathway (alpha) and initiate AVNRT. Importantly, note that AVNRT does not involve the ventricles as part of the reentry circuit; the necessity of perinodal atrial tissue to the circuit is controversial. Because the impulse typically conducts in an anterograde manner through the slow pathway and in a retrograde manner through the fast pathway, the PR interval is longer than the RP interval. Thus, in patients with typical AVNRT, the P wave is usually located at the terminal portion of the QRS complex. In patients with atypical AVNRT, anterograde conduction is via the fast pathway, while

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retrograde conduction is via the slow pathway. For these atypical patients, the RP interval is longer than the PR interval.

We are now going to move on to the second most common form of PSVT, known as Atrioventricular Reciprocating Tachycardia (AVRT). The incidence rate of AVRT in the general population is 0.1-0.3%. AVRT is more common in males than in females (male-tofemale ratio of 2:1), and patients with AVRT commonly present at a younger age than do patients with AVNRT. In AVRT, the extra connection, which is often called an accessory pathway, joins one of the atria (the upper chambers of the heart) with one of the ventricles (the lower chambers of the heart). The reentrant circuit that produces the arrhythmia is quite large. In typical AVRT, during the reentrant tachycardia the circuitous electrical impulse travels down the AV node to the ventricles, then returns back to the atrium through the accessory pathway, then back down the AV node, and then keeps repeating the same circuit. See Figure 11.4 below.

AVRT is associated with the Ebstein anomaly, although most patients with AVRT do not have evidence of structural heart disease. AVRT occurs in the presence of accessory pathways, or bypass tracts. Accessory pathways are errant strands of myocardium that bridge the mitral or tricuspid valves.

In AVRT, the impulse begins above the ventricles but travels via a pathway other than the AV node and bundle of His. AVRT results from the presence of 2 or more conducting pathways; specifically, the AV node and 1 or more bypass tracts and in AVRT will involve the ventricles.

In a normal heart, only a single route of conduction is present. Conduction begins at the sinus node, progresses to the AV node, and then to the bundle of His and the bundle branches.

However, in AVRT, 1 or more accessory pathways connect the atria and the ventricles. The accessory pathways may conduct impulses in an anterograde manner, a retrograde manner, or both.cxliii

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Figure 11.4 cxliv SVT over View Criteria for Classification Rhythm: The ventricular (R-R) rhythm is usually regular or with minimal irregularity from R-R interval. The atrial rhythm may or may not be seen. This is because other electrical activity is occurring at the same time. Remember, the EKG will record only the activity it "sees" in each lead. The atrial activity is small compared to ventricular activity; therefore, the ventricular activity is the largest amount of energy seen when the EKG tracing is recorded. Depending on whether the P waves are seen, you may not be able to determine regular P waves. If identifiable, they are usually regular.

Rate: The ventricular rate is 150 to 350 beats per minute. The atrial rate will be difficult to determine when P waves are unidentifiable.

P wave configuration: The P waves are usually not identified when the heart rate is this rapid. Remember that when the heart rate increases, the time interval between atrial contraction and ventricular relaxation decreases. Therefore, if there is a P wave present, it may occur simultaneously with the T wave and may be buried within it. The P wave may occur before, during, or after the QRS complex.

PR interval: Usually the PR interval is unable to be determined because the beginning of the P wave cannot be clearly identified.

QRS duration and configuration: The QRS measurement is considered within normal limits when measured at 0.06 to 0.10 second.

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What's Unique about this Rhythm?

Supraventricular dysrhythmias are rate dependent with a rate of greater than 150 beats per minute.

Clinical Significance There are various supraventricular dysrhythmias, all of which may cause the patient to exhibit the same signs and symptoms. The patient may be in either a stable or an unstable condition. The stable patient may only complain of palpitations and state, "I'm just not feeling right" or "My heart is fluttering." When the patient's condition is unstable, he or she may experience any symptom of low cardiac output, which is reflective of the heart not pumping effectively to other body systems. Many patients may present initially with a stable condition and then a few minutes later experience unstable symptoms such as those presented in Table 8.1 on page 131.

Because tachycardia severely deprives the heart of oxygen, treatment should begin as early as possible. It is difficult to predict how long a patient's heart can beat at a rapid rate before it begins to affect the other body systems.cxlv What does this mean to the Christian Heart?

AV Nodal Reentry Tachycardia AVNRT occurs when a reentry circuit forms within or just next to the AV node. The circuit usually involves two anatomical pathways: the fast pathway and the slow pathways, which are both in the right atrium; importantly, note that AVNRT does not involve the ventricles so within the Christian heart this rhythm involves the Christian's Mind and Thinking only.

This Christian is having some stinking thinking, and if left unchecked that stinking thinking will lead to sin. As seen in Mark 7:20 And He said, What comes out of a man is what makes a man unclean and renders [him] unhallowed. (AMP) Sin begins in our thoughts, which as we remember the Bible often calls "the heart." Jesus said, in Mark 7:21-23 For from within, [that is] out of the hearts of men, come base and wicked thoughts, sexual immorality, stealing, murder, adultery, 22 Coveting (a greedy desire to have more wealth), dangerous and destructive wickedness, deceit; unrestrained (indecent) conduct; an evil eye (envy), slander (evil speaking, malicious misrepresentation, abusiveness), pride (the sin of an uplifted heart against God and man), foolishness (folly, lack of sense, recklessness, thoughtlessness). 23 All these evil [purposes and desires] come from within, and they make the man unclean and render him unhallowed. (AMP) No one commits the outward sins listed above without having thought about them and committed them in their mind first. To be able to want to grow in godliness, we must win the battle over personal sin on the level of our thought life. I am not talking about positive thinking here but what I want to call possibility thinking!

I really don't think that when Dr. Paul W. Carlin wrote his book Satan and the Saint: A Look into The Dark Side Of Christian Behavior, or his book entitled "Living Free" Reentry Crisis

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Counselingâ&#x201E;˘ that he was thinking that someone would come along and relate these two wonderful books to the human or what I call the Christian cardiovascular system. But God did. You see as I have stated before that is how my mind works and it is how I think as I read the Bible, God teaches me His Word in terms that I understand because I am a Paramedic.

So let's get on with what God has shown me about the Christian that has been having runs of an AV Nodal Reentry Tachycardia. AVNRT is the third of the six reentry rhythms that we are going to cover in this book and I see AVNRT as the third thing out of the six that a Christian can do to them selves. I see this Christian as the Christian that has started fashioning his or her self as Dr. Paul W. Carlin talked about in his book Satan and the Saint: A Look into The Dark Side Of Christian Behavior.

The verse that is used to back this up is found in 1 Peter 1:13-16 and it reads, "As obedient children, not fashioning yourselves according to the former lusts in your ignorance; but as He which hath called you is holy, so be ye holy in all manner of conversation; because it is written, Be ye holy; for I am holy." (KJV) Now that I have shown you where we get the wording for this Christian I would like to read this passage of Scripture from the Message Bible, here we need to read this together. 1 Peter 1:13-16 So roll up your sleeves, put your mind in gear, be totally ready to receive the gift that's coming when Jesus arrives. Don't lazily slip back into those old grooves of evil, doing just what you feel like doing. You didn't know any better then; you do now. As obedient children, let yourselves be pulled into a way of life shaped by God's life, a life energetic and blazing with holiness. God said, "I am holy; you be holy." (MSG) Paul W. Carlin wrote the following in his book: Satan and the Saint: A Look into The Dark Side Of Christian Behavior.

The same wording is translated in Roman 12:2, "And be not conformed to this world; but be ye transformed by the renewing of your mind, that ye may prove what is good, and acceptable, and perfect will of God." This phrase (suschematizo) is used only in these two instances in the New Testament. They do, however, provide a wealth of insight.

For instance, there is the contrast of the Christian being outwardly conformed to this present world system with his being transformed inwardly by the renewing of the thought life through the power of the Holy Spirit. An accompanying comparison can be made with Philippians 3:21 which tells us the Lord shall "fashion anew, or change outwardly, our physical bodies to be like His glorious body".

The thought in both 1 Peter and Romans is that a Christian is not to assume, either inwardly or outwardly, the appearance of this present world system. The emphasis in 1 Peter is given to prevent regression into a former life-style of lust and to promote personal holiness, which is spiritual health. In Romans the same thought is promoted from a different perspective. The picture is that of a Christian refusing to be poured into the world mold, or into the pattern of this present age.

It certainly appears that conformity to the world system prevents progressive transformation "by the renewing of the mind," which in turn prevents a Christian from

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A Paramedicâ&#x20AC;&#x2122;s view of Christianity knowing and doing the "will of God," which is good, acceptable, and perfect. Once a Christian regresses to the fashion of former lusts, complete with an absence of personal holiness, and he is conformed to this present world system, he becomes selfdefeating. For any Christian, this condition is neither fashionable nor comfortable.

From a Biblical perspective, you are not to strive to be in vogue.

There is ample opportunity for a Christian to absorb and be absorbed by a worldly value system. I have never seen, nor do I recall in church history, a time when compromise and hypocrisy were more popular. Vance Havner once said, "The world is so churchy and the church so worldly that you cannot tell the difference." The average Christian's tolerance for evil is embarrassing. Respect for the ordained ministry is at an all-time lowâ&#x20AC;Ś The secular, humanistic world system and philosophy, which is devoid of God and morally bankrupt must neither infiltrate nor influence the mind of the believer. Satan creates the secular mold, true, but the Christian is responsible for fitting into it. Satan presents to us the appealing fashion or trend, but the believer must willfully adopt it.

However, for a believer to do so is antagonistic to his spiritual nature. As I said earlier, you must not blame the devil for those things for which you are responsible. Satan indeed may create the climate, but you are responsible for your adaptation. As a child of God you are to "put off the old man" and "put on the new man." (Eph. 4:22, 24) To do the spiritually natural thing is, therefore, not to be conformed to this present age, not to fashion yourself according to your former lusts. Just as He Who called you is holy, so you should be holy in manner of your life-style. Have you fashioned yourself after your former lusts:cxlvi

It has been credited to Frank Outlaw to have said, "Watch your thoughts, they become your words; watch your words, they become actions; watch your actions, they become habits; watch your habits, they become character; watch your character, for it becomes your destiny"cxlvii Frank Outlaw was on to something when he wrote the above statement. The Bible teaches that our words can mean the difference between physical, emotional and spiritual pain and comfort, panic and calm and even life and death. The following four verses will attest to this I want to start with Proverbs 10:11 The mouth of the [uncompromisingly] righteous man is a well of life, but the mouth of the wicked conceals violence. (AMP) Then we read Proverbs 12:18 There are those who speak rashly, like the piercing of a sword, but the tongue of the wise brings healing. (AMP) The Bible speaks of our tongues having healing powers in Proverbs 15:4 A gentle tongue [with its healing power] is a tree of life, but willful contrariness in it breaks down the spirit. (AMP) Now we come to the main verse I want to spend a few moments talking about and we find it in Proverbs 18:21 The tongue can bring death or life; those who love to talk will reap the consequences. (NLT) This one verse is telling us that "death and life are in the power of the tongue." Just stop and think for a minute what the Lord is trying to convey to us with these specific words. There are two things to pick up from this verse.

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The first thing that God is trying to tell all of us is that we have a certain amount of "power" in our tongues. Our tongue is referring to the verbal words that we speak out of our mouths to other people. When God is using the word "power," He is telling us that every single one of us has a certain amount of power residing in our mouth and in our tongues with the words that we can release to other people.

And with this kind of power residing in our ability to release spoken words to other people, God then tells us what can happen with this kind of power. This power can either be used to bring life or death to the person that we are speaking to. Think of the responsibility and ramifications of this revelation that our spoken words to other people can either bring them life or bring them death!

You can either choose to learn how to speak and release positive words of love, encouragement, and edification to other people in your own personal dealings with them, or you can choose to release negative words of condemnation, criticism, coldness, and harshness and even death. The choice is yours!cxlviii So what does this have to do with you and I as we answer calls as EMS providers, well as seen above the Bible speaks; to the fact that there is power found in our tongues to bring about healing, life and even death in ourselves and even others we speak to. So then it could be said that what you say can be just as important as what you do.

Pleasant words, good and uplifting type words, and a wholesome tongue can also help serve to lift a person's spirit up, help make their hearts glad and happy, be able to turn away possible wrath and anger, and also help to guard and preserve your own personal life. One wrong word to the wrong person at the wrong time could lead you to having an early departure from this life.cxlix To show this Biblical Truth, to someone with a medical mind and this world of Clinical-Based Medicine better known as Evidence-Based Medicine; I want to first look at a few words from an old BRADY EMS book entitled Patient Communication for First Responders and EMS Personnel: The First Hour of Trauma by Donald Trent Jacobs, PhD. I want to share with you some of what is talked about in the Preface; Dr. Jacobs's had this to say.

Most texts on emergency medical care briefly mention the importance of calming and reassuring the patient and of using proper words and manner of speech when rendering first aid. For example, in Emergency Care and Transportation of the Sick and Injured by the American Academy of Orthopaedic Surgeons, the authors state the following: This means being extremely careful about what is said at the scene. During periods of stress, words that seem immaterial or are uttered in jest might become fixed in the patient's mind and cause untold harm. Conversation at the scene must be appropriate.

But what is "appropriate" conversation? Why do words have such power? What potential is there for the positive influence of words?cl

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Dr. Jacobs's went on in the first chapter of Patient Communication for First Responders and EMS Personnel: The First Hour of Trauma and talked about "The Kansas Experiment."

In 1976, M. Erik Wright, MD, Ph.D., took two groups of paramedics and conducted a simple study based on an incredibly radical notion at the time: that the environment of treatment begins at the first contact.

For this experiment Dr. Wright, divided first responders into two groups and asked of them the following: One (experimental) group was taught a special protocol and the other was not. The experimental group was instructed to separate the patient immediately from the crowd, to keep their conversations to a minimum (and as positive as possible), and to recite this short paragraph whether or not the patient was conscious. This is what they said: "The worst is over. We are taking you to the hospital. Everything is being made ready. Let your body concentrate on repairing itself and feeling secure. Let your heart, your blood vessels, everything bring themselves into a state of preserving your life. Bleed just enough so as to cleanse the wound, and let the blood vessels close down so that your life is preserved.

Your body weight, your body heat, everything, is being maintained. Things are being made ready at the hospital for you. We're getting there as quickly and safely as possible. You are now in a safe position. The worst is over."

The experiment was so successful that, during the training, the paramedics themselves became the proselytizers and they were scared they would invalidate the results.cli I want to now move forward some to the year of 2002, and I want to discuss for a few moments what is now known as Verbal First Aidâ&#x201E;˘ (VFA). As presented in the books The Worst Is Over: What To Say When Every Moment Count, Jodere Group 202 by Judith Acosta, LISW, LCSW-R and Judith Simon Prager, Ph.D. VFA is a specific protocol that simply but effectively allows you, the first responder, to enlist the patient's own healing system in the healing process. When you gain the patient's compliance and belief in the direction of recovery, you aren't the only one trying to improve the situation. The patient becomes your partner in that effort.

VFA has become known as the New Language of Medicine; Mrs. Judith Acosta had this to say about words as healing tools in her article for Ezine, entitled The New Language of Medicine - The Magic of Verbal First Aid. Words as Healing Tools.

Knowing the right words at the right time can make a critical difference-sometimes the difference between life and death. Words, well-chosen, well-said, can facilitate rapid healing of burns, lower an elevated blood pressure, reduce pain and increase compliance. Conversely, words ill-chosen, thoughtlessly used, can cause great damage by encouraging hyperventilation, increasing anxiety and thereby pain

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response and bleeding, destabilizing heart rate and pulse, and over-stimulating the immune system.

The point: What we think, see in our mind's eye, the images we form in response to the words we hear have very distinct physical consequences. Where there is danger, the likelihood of an image or thought eliciting a strong physiological reaction is even higher.clii Mrs. Acosta, went on to speak about Christianity and VFA in another of her articles for Ezine, entitled Words of Grace: Christianity and Verbal First Aid May the words of my mouth and the meditation of my heart be pleasing in your sight, O LORD, my Rock and my Redeemer. Psalm 19:14 For God did not create the heavens and the earth with his hands or in a painting or by angelic hire. He created the very fabric of all existence with his words. He spoke: Let there be light. Let there be day. Let there be night. Let there be a division between the two.

He spoke. And with His Words He created.

And by His utterance and the song that is Heaven and Holy Spirit, they continue to create, and we continue to exist.

It is the one way in which we may be co-creators with God -- we pray, we praise, and we speak.

Words also form the basis for the ways in which we may be cut off forever: by taking His name in vain and by gossiping or committing slander. The first one is plain in scripture: You shall not bear false witness against your neighbor. Exodus 20:16 Do not speak evil of one another, brethren. He, who speaks evil of a brother and judges his brother, speaks evil of the law and judges the law. James 4:11 But I tell you that men will have to give account on the Day of Judgment for every careless word they have spoken. Matthew 12:36 So the tongue is a little member and boasts of great things. How great a forest is set ablaze by a small fire! And the tongue is a fire. The tongue is an unrighteous world among our members, staining the whole body, setting on fire the cycle of nature, and set on fire by hell. For every kind of beast and bird, of reptile and sea creature, can be tamed and has been tamed by humankind, but no human being can tame the tongue-a restless evil, full of deadly poison. With it we bless the Lord and Father, and with it we curse men who are made in the likeness of God. From the same mouth come blessing and cursing. My brethren, this ought not to be so. James 3:5-10

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A Paramedicâ&#x20AC;&#x2122;s view of Christianity The sanctions against gossip are severe, and in Judaism it is likened to murder: The hypocrite with his mouth destroys his neighbor. Proverbs 11:9.

What Does This Mean in Modern Terms?

If we were looking at all these biblical warnings as a scientist, we'd have to ask, "Why?" We would have to wonder, what is this stuff made of, this stuff that we are made of that words are taken so seriously?

I have not been the first one to ask.

Others have asked and studied, and what they have come up with gives credence to the old expression: the scientists climbed the mountain and found the mystics waiting there.

What they found was that from our brains to our buttocks, we are made of the same stuff that everything else is made of hyperstring. The closest anyone has come to understanding what that means is that we are an amazing intricate complex of vibrations, each one tuned in a particular way with a particular intent, each one somehow interacting with all the others to form atoms, molecules, cells, tissue and structure. And together they produce form, thought and behavior. All from vibrations.

We are song.

The Philosophy of Verbal First Aid There are two things upon which Verbal First Aid may properly rest for those of Christian and Jewish faith.

1. That the Bible is correct in its emphasis on the importance of what we say. Words matter. They can kill and they can heal.

2. There are ways you can use them so they are as healing as possible when you need them most.

People of faith have always known and understood how mind and spirit and will impact our behavior and our biology.

People of science focus on how the brain and biochemistry impact our emotions, our thoughts and our behaviors.

Verbal First Aid is the corpus collosum bridging those two worlds, making our wills and spirits line up with our behaviors and our words.

It is a simple protocol for therapeutic communication, and the way it works is essentially very simple. An example:

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Two people meet for the first time in a department store while they are on line at a cashier. But within 30 seconds -- just by talking -- they could make each other laugh, make each other cry, or reach for their blood pressure medication. So, it's hardly a jump at all to say that within 30 seconds, they could help one another to lower their blood pressure, stop their bleeding, or significantly reduce their pain -- just with words.

Words can harm. Words can heal.

Mind Over Matter Has Become Words Over Genetics According to numerous recent studies cited in the book, Verbal First Aid (Penguin, 2010), our minds not only affect how we "feel" (as in whether we have a nice day or not) but how we develop and which genes get expressed or are left dormant. This is of particular importance when we are reaching out to children who are looking to us as adults for guidance on every single new thing they come across in the world whether that's how to deal with a scraped knee or how to manage a wounded heart.

Words not only affect brain function but structure. Scientists have found changes in the limbic system (emotional), prefrontal cortex (labeling), the brain stem, and the frontal lobes (problem solving and executive function) that can be attributed to words and relationships.

As the work of Bruce Lipton and others has demonstrated, words and environments affect genetic expression. A study reported by Gary Sibcy was done with monkeys and gene expression. It turns out that monkeys also have the gene for alcoholism. All the monkeys in the larger group had the gene. They were randomly divided into two groups. One group was raised by its birth mother and the other group raised by teenage monkeys.

Which group became addicted?

In the group raised by proper adult mothers, the genes for alcoholism lay dormant. In the experimental group, they became addicted.

Environment affects our DNA. And, as we all know, the earlier the enrichment (hence the reason for the second book), the better.

In studies of young mothers, those who resented their pregnancies created stress hormones in themselves and their babies in-utero. Those babies developed more slowly and were more anxious.

"If You Have Nothing Nice too Say...": How I Came to Verbal First Aid and the Realization That Words Were So Important A while back I was meeting with an administrator at a local hospital, and a paramedic came in while we were talking about VFA. He said that his team was called just that week to the home of a chronic hypoglycemic that had made numerous inappropriate

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A Paramedicâ&#x20AC;&#x2122;s view of Christianity calls to EMS in the past. This time he was out cold. The wife was ranting and raving about his attitude and behavior.

Assuming that being unconscious meant inaccessible, the paramedics, tired and cranky, joined in, firmly complaining about him being a "pain." Just then, the patient wakes up screaming: "I'm going to kill you. I heard that."

Words can turn a situation around in milliseconds, moving us from a stressed, frightened state in which the sympathetic system is dominant to a safer, calmer state in which the parasympathetic system takes charge. As that paramedic found out, even words uttered in jest or when a patient is unconscious can make a serious difference in the way a medical situation is moved forward.

For me, Verbal First Aid became crucial in my work as a psychotherapist because I got scared. I was in an extensive training program in neurolinguistics and family therapy.

One of the things we learned to do was a Bandler and Grinder technique called eyeaccessing cues. We would alter the syntax and mode of speech so that certain internal processes would be activated.

This is all before the show Lie to Me, but by watching the patient's eyes, we would know how they were processing information: visually (up to their left or up to right), auditorily (to left or right center) or kinesthetically (down to right).

And I remember one patient in particularly whose eyes had gone up to his left (visualremembered) then up to his right (Visual-constructed, i.e., imagined) when I changed the tense of a verb. It terrified me.

What else was I doing with words that I didn't understand? I signed up for more training the next day and until I had a handle on it, I sat with my hand over my mouth.

There are a few principles in Verbal First Aid, in any therapeutic communication.

Distilled to their essence, they are: 1. Rapport -- the critical importance of our relationships with others, particularly when they are in a state of shock, pain, illness, grief, or fear.

2. The Healing Zone -- these states all produce in us (in varying degrees) what is clinically called dissociation. When we dissociate -- even a little -- we are more suggestible to everything that is being said around us. That is simply the way human beings are. It is not something we can easily alter. It has been shown clinically and empirically that what is said at those times is often embedded into our minds. Particularly if what we hear is being said by someone we perceive as an authority.

There are two ways to use these states, which is why we prefer to call them healing zones. We prefer to see the opportunities available to us in them. We can use our words to heal or to harm. We are speaking anyway. Let us then be careful and aware

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of the impact of our words and utilize them to facilitate the physiological responses that will help calm, comfort and save lives.

3. Suggestion -- Every conversation we have is based on the power of suggestion. I go on a trip and I tell you about it so you can be there with me. If I've traveled to Argentina and taken a horseback ride across the Pampas, I'd show you pictures and talk about the sound of the hooves as they pounded into the dirt of the open plains, the smell of asado as we approached camp, the taste of home grown wine and the singing of Gauchos until we fell comfortably asleep in our hammocks.

This is the purpose of conversation -- to bring the listener along with us on a journey of sensation, ideas, inspiration. Words -- whenever and wherever they are used -- are always utilizing the power of suggestion and are always speaking to us physically.

That is part of how God created us. We can use this for good or ill.

How Words Impact Physiology Simply, words generate images, which generate emotions, which create a cascade of chemistry either from the sympathetic nervous system (stress response) or parasympathetic (rest, "all is well" response).

We all know it in our own lives: If we're embarrassed, pointed out and laughed at, our blood floods the capillaries in our cheeks, our heart rates accelerate, gastric juices increase, adrenalin shoots out.

If we have a frightening dream -- which is, after all, just mental images -- we may wake up sweaty, heart palpitating, our muscles tired and twitchy. In fact, a special paralyzing hormone is needed during sleep to keep us from responding to dreams as though they were real.

In tests done with movie reviewers, they found that watching chase scenes produced muscle and skin responses that corresponded to actual driving. In the 1920s American physician and physiologist Edmund Jacobson had patients imagine themselves running or swimming. He tracked the associated muscles and found that they responded subtly to the thought alone.

Three Ethical Presuppositions in Verbal First Aid 1. You're using words.

2. Words have physiological impacts -- they can harm or heal.

3. It behooves us to use words to heal.

Finally, brothers, whatever is true, whatever is noble, whatever is right, whatever is pure, whatever is lovely, whatever is admirable -- if anything is excellent or praiseworthy -- think about such things. Philippians 4:8

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A Paramedicâ&#x20AC;&#x2122;s view of Christianity If what we hear, we think, and if what we think, we see in our minds, and if what we see is what we feel, then the Bible is scientifically sound. We must direct thought -and speech -- to that which heals.cliii

To read more about VFA and the impact it can have on the patients that you and I have from day to day, I encourage you to read the three part article that Judith Simon Prager, Ph.D. wrote for EMS World entitled, Verbal First Aid: What You Say Can Be As Important As What You Do. Mrs. Prager is the co-author with Judith Acosta in their book, The Worst Is Over: What To Say When Every Moment Count and Verbal First Aid: What You Say Can Be As Important As What You Do. I have to confess something to you the reader, the RED words of Jesus in Matthew 12:36-37 have long sent chills down my spine. Most of you have read them: 36 But I tell you, on the Day of Judgment men will have to give account for every idle (inoperative, nonworking) word they speak. 37 For by your words you will be justified and acquitted, and by your words you will be condemned and sentenced. (AMP) I think it is imperative that we get the sense of this text right. The traditional translation of the word "idle" should be challenged. The impression is that all random remarks will be judged and (this is what sends chills down our spine) if we are guilty there is no hope for us. If this were correct then no one would be justified on the last day. A better explanation is that the phrase here means "every deedless word or a word that produces no good effect, and is not calculated to produce any."

Think about this for a moment, can you remember a time in your life when someone had said something negative to you, and you just felt like you had died inside and the life in you just wilted, or perhaps they said some beautiful words to you, then you just blossomed like a flower. I see this as the same principle that is being talked about and taught in Verbal First Aidâ&#x201E;˘.

We need to get back on track here and get back to the mind and our own thoughts. As stated before we need watch your thoughts, and allow the mind of Christ to rule in our lives.

In studying the Bible on the topic of the Christian Mind and Christian Thinking and fashioning ourselves after God and His will and way, I have found the expression "Mind of Christ" in two passages. In 1 Corinthians 2:16 For who has known or understood the mind (the counsels and purposes) of the Lord so as to guide and instruct Him and give Him knowledge? But we have the mind of Christ (the Messiah) and do hold the thoughts (feelings and purposes) of His heart. (AMP) and in 1 Peter 4:1 So, since Christ suffered in the flesh for us, for you, arm yourselves with the same thought and purpose [patiently to suffer rather than fail to please God]. For whoever has suffered in the flesh [having the mind of Christ] is done with [intentional] sin [has stopped pleasing himself and the world, and pleases God], (AMP) Then I found the following in Philippians 2:5 Let this same attitude and purpose and [humble] mind be in you which was in Christ Jesus: [Let Him be your example in humility:] (AMP) But let's not stop there we need to read what Jesus said in Mark 12:30 And you shall love the Lord your God out of and with your whole heart and out of and with all your soul (your life)

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and out of and with all your mind (with your faculty of thought and your moral understanding) and out of and with all your strength. This is the first and principal commandment. (AMP) These words have echoed for thousands of years, beginning with Moses in Deuteronomy 6:5 And you shall love the Lord your God with all your [mind and] heart and with your entire being and with all your might. (AMP) and lead us to Jesus as we saw in the book of Mark.

This is starting to look like a Biblical mandate to develop the Christian mind and a Christian Thought life to me. I see this as being crucial in our day and time. All aspects of our culture and work (most defiantly in the medical field and EMS) have been taken over by nonChristian thinking and ungodly worldviews.

I think that God has given us a mandate to develop our minds as Christians. Actually there are five of them. Jerry Solomon in his paper on The Christian Mind called these five mandates the Mandates for the Mind: Mark 12:30 And you shall love the Lord your God out of and with your whole heart and out of and with all your soul (your life) and out of and with all your mind (with your faculty of thought and your moral understanding) and out of and with all your strength.

This is the first and principal commandment. (AMP) These words have echoed for thousands of years, beginning with Moses and leading to Jesus. They contain the first of what I call Mandates for the Mind: Strive to Know God. To love someone we must know him or her. In the case of my wife, for instance, it would have been absurd to declare that I loved her before ever meeting her. My love for her implies an intimate knowledge about and knowledge of her. In the same manner we are to strive both to know about God and to know Him intimately. Our minds are crucial to this mandate. It is my contention that one of the major problems in contemporary Christianity is that too many of us are attempting know God without using our minds to investigate what He has told us of Himself in Scripture.

The second mandate is that the Christian mind should strive for truth. "Jesus therefore was saying to those Jews who had believed Him, 'If you abide in My word, then you are truly disciples of Mine; and you shall know the truth, and the truth shall make you free'" (John 8:31-32). Abiding in His word implies a continual dedication to using the mind to search the Scriptures, the place where His truth is written.

The third mandate pertains to maturity. Romans 12:2 declares: "And do not be conformed to this world, but be transformed by the renewing of your mind, that you may prove what the will of God is, that which is good and acceptable and perfect." It is pertinent to note that the words conformed, transformed, and prove refer to continuous action. Thus, the Christian mind is to be characterized by continuous development toward maturity. Hebrews 5:14 refers to Scripture as "solid food" as the writer describes the mature mind. He then asserts that the Christian is to "press on [continually] to maturity" (Heb. 6:1). Such maturity is a strategic need in the contemporary church.

The fourth mandate involves proclaiming and defending the faith. The maturing Christian mind will actively engage the minds of those around him. For example, Paul

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A Paramedicâ&#x20AC;&#x2122;s view of Christianity modeled this while in Athens: "[H]e was reasoning in the synagogue with the Jews and the God-fearing Gentiles, and in the market place every day with those who happened to be present. And also some of the Epicurean and Stoic philosophers were conversing with him" (Acts 17:17-18). Paul proclaimed and defended the truth of the gospel in the synagogue with his own people, among the populace, and even with the intellectual elite of the time. Such encounters are easily duplicated in our day.

The fifth mandate refers to the need for study. Philippians 4:8 states: "whatever is true, whatever is honorable, whatever is right, whatever is pure, whatever is lovely, whatever is of good repute, if there is any excellence and if anything worthy of praise, let your mind dwell on these things." Note the final phrase: "let your mind dwell," a clause indicative of the need for concentration, or study. The phrase also includes a command that such study is to be continuous. We are to ponder, or think on the things of God.cliv

If we go back and review in Philippians 4:2-12, we find that Paul is telling us to develop a Christian thought life. God wants to teach each of us to use His critical thinking skills to bring our thought life into the submission of Jesus Christ. Practicing verse 8 is essential if we want to develop and maintain healthy relationships (Philippians 4:2-3 I entreat and advise Euodia and I entreat and advise Syntyche to agree and to work in harmony in the Lord. 3 And I exhort you too, [my] genuine yokefellow, help these [two women to keep on cooperating], for they have toiled along with me in [the spreading of] the good news (the Gospel), as have Clement and the rest of my fellow workers whose names are in the Book of Life. (AMP), and then we see in verse 5 Let all men know and perceive and recognize your unselfishness (your considerateness, your forbearing spirit). The Lord is near [He is coming soon]. (AMP) The thought that I am speaking about is a thought life set in joy as seen in Philippians 4:4 Rejoice in the Lord always [delight, gladden yourselves in Him]; again I say, Rejoice!

(AMP) and peace in Philippians 4:6-7 Do not fret or have any anxiety about anything, but in every circumstance and in everything, by prayer and petition (definite requests), with thanksgiving, continue to make your wants known to God. 7 And God's peace [shall be yours, that tranquil state of a soul assured of its salvation through Christ, and so fearing nothing from God and being content with its earthly lot of whatever sort that is, that peace] which transcends all understanding shall garrison and mount guard over your hearts and minds in Christ Jesus. (AMP) As we know our thoughts form the basis for our behavior, a godly thought life is even more essential to the Christian to do what is seen in Philippians verse 9 Practice what you have learned and received and heard and seen in me, and model your way of living on it, and the God of peace (of untroubled, undisturbed well-being) will be with you. (AMP) Paul's thought life was at the heart of the contentment he had learned in every situation as seen in Philippians 4:10-12 I was made very happy in the Lord that now you have revived your interest in my welfare after so long a time; you were indeed thinking of me, but you had no opportunity to show it. 11 Not that I am implying that I was in any personal want, for I have learned how to be content (satisfied to the point where I am not disturbed or disquieted) in whatever state I am. 12 I know how to be abased and live humbly in straitened circumstances, and I know also how to enjoy plenty and live in abundance. I have learned in any and all

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circumstances the secret of facing every situation, whether well-fed or going hungry, having a sufficiency and enough to spare or going without and being in want. (AMP) Paul is telling us the way to be whole people in our relationships with God, with one another, and within ourselves. But before we look specifically at what Paul is teaching and how to obey it, we need to think about the fact that Paul is not teaching about the power of positive thinking in Philippians 4:8.

We need to read this verse again: Philippians 4:8 For the rest, brethren, whatever is true, whatever is worthy of reverence and is honorable and seemly, whatever is just, whatever is pure, whatever is lovely and lovable, whatever is kind and winsome and gracious, if there is any virtue and excellence, if there is anything worthy of praise, think on and weigh and take account of these things [fix your minds on them].

Paul is teaching us that the Christian's thought life is to be focused on TRUTH and truth alone is found in Scripture. Even though Scripture is not specifically mentioned, it is assumed, because it is the only source for knowing what is true, honorable, right, pure, lovely, and of good repute.

Let's look at the Paul's list again but this time in a little more depth shall we? This list was compiled by Steven J. Cole in his paper on The Christian's Thought Lifeclv the following list also lines up with The Spiritual Dynamics of Responsible Thinking found within the Reentry Crisis Counseling Manuel written by Dr. Carlin.

1. Think on whatever is true: The word means, "true as to fact ... it denotes the actuality of a thing" The "true" is that which corresponds to reality. God Himself is the only final test for truth. Since He is unchanging, the moral standards revealed in His Word, which stem from His holy nature, are also unchanging. They apply to every culture in every age. John 3:33 attests, "God is true" 2. Think on whatever is honorable (NIV = "noble"): The word means "that which inspires reverence or awe; dignified, worthy of respect." It is a character quality required in deacons and deaconesses (1 Tim. 3:8, 11). Elders should keep their children under control "with all dignity" (1 Tim. 3:4). All Christians should "lead a tranquil and quiet life in all godliness and dignity" (1 Tim. 2:2).

3. Think on whatever is right: This word is used of God Himself who is righteous (Rom. 3:26; 1 John 2:29; 3:7) and of Jesus Christ (Acts 3:14; 7:52; 22:14); John writes, "Little children, let no one deceive you; the one who practices righteousness is righteous, just as He is righteous; the one who practices sin is of the devil" (1 John 3:7-8). To think on what is right means to think on the holy nature of God, especially as revealed in the person of Jesus Christ, and to model our behavior after Him. 4. Think on whatever is pure: The word refers to ceremonial purity, but also to the moral purity that is pictured by the ceremonial. It especially means keeping our bodies undefiled by abstaining from sexual sins (see 2 Cor. 11:2; 1 Tim. 5:22; Titus 2:5; James 3:17; 1 Pet. 3:2; 1 John 3:3). In Ephesians 5:3-5 Paul warns, "But do not let

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A Paramedicâ&#x20AC;&#x2122;s view of Christianity immorality or any impurity or greed even be named among you, as is proper among saints; and there must be no filthiness and silly talk, or coarse jesting, which are not fitting, but rather giving of thanks. For this you know with certainty, that no immoral or impure person or covetous man, who is an idolater, has an inheritance in the kingdom of Christ and God." As Christians, we must say no to our sexually impure culture and focus on moral purity.

5. Think on whatever is lovely: The word 'lovely' occurs only here in the New Testament.

It means what is pleasing, agreeable, and attractive. At times we all find ourselves attracted to that which is evil. But this word must be taken with the context, meaning that which is both pure and attractive. Jesus Christ is inherently attractive, and so we should think often on our lovely Savior, who gave Himself for us on the cross.

6. Think on whatever is of good repute: This comes from a compound word meaning to speak well of something (our word "euphemism" comes from this Greek word). It refers to something that "deservedly enjoys a good reputation" (F. F. Bruce, New International Biblical Commentary, Philippians [Hendrickson], p. 146). As Paul says in 1 Corinthians 13, love believes the best about another person, it refuses to believe an evil report about a brother or sister until there is certain evidence to establish it.

Mr. Cole went on to say: To sum up, think on anything of virtue. The word "excellence" (NASB, NIV) means moral virtue. Although it is common in Greek literature, this is the only time Paul uses the word. Peter uses it as a quality of God and thus as the first quality that we are to add to our faith (2 Pet. 1:3, 5). This means that as a new Christian, one of the first things you must do is to stop any behavior that is not in line with God's moral virtues as revealed in Scripture, such as the Ten Commandments, the Sermon on the Mount, and Paul's list of the deeds of the flesh (Gal. 5:19-21). To continue doing such things will hinder your growth in godliness. We must focus our minds on moral virtue.

To sum up, think on anything worthy of praise. The word "praise" is used both of what is praiseworthy in God (Eph. 1:6, 12, 14; Phil. 1:11) and in people (Rom. 2:29; 13:3; 1 Cor. 4:5). Of course, every attribute and deed of God is praiseworthy, and so we should daily think about how great God is and on the marvelous works He has done, both in creation and in history.

Toward other people, even toward those in the world, we should be gracious by focusing on their strong points and good qualities. Even though we all are depraved by nature, because of God's common grace even unbelieving people can be kind, caring, and loving. Ultimately those qualities, even in unbelievers, do not bring glory to the person, but to God. So we should be appreciative and affirming toward people rather than negative and critical.

Think on these things. Paul means to reflect on these qualities that stem from God and should be characteristic of us as children of God. "Give them weight in your decisions" (Beare, cited by Bruce, p. 145). Allow them "to shape your conduct" (Ralph P. Martin,

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Tyndale New Testament Commentaries, Philippians [IVP/Eerdmans], p. 171). In other words, think on these things with a view to doing them.clvi I wanted to share with you something I found very interesting when you STOP and think about it, so here goes. The following quote comes from Roland Allen, a British missionary with long years of experience in the Far East, dealing with education in the mission field. In his critique of educating children of unbelievers in mission schools, he wrote: Christian education is far more the teaching of Christians than teaching given by Christians. Christian education becomes non-Christian in the non-Christian mind.clvii I really like what Noah Webster had to say in 1788 on this topic: The education of youth [is] an employment of more consequence than making laws and preaching the gospel, because it lays the foundation on which both law and gospel rest for success.

I then found the following by Harry Blamires in his 1963 book entitled The Christian Mind, about the Christian Mind: Were there a living Christian mind, the sense of the hard, factual objectivity of Christian doctrine would be widespread, and people would no more find themselves defending, individually and in isolation, the doctrine of the Virgin Birth than they would find themselves defending, individually and in isolation, the second law of thermodynamics. It is only within an essentially secular field of discourse that individual Christians can find themselves illogically called upon to defend their attachment to particular doctrines as though they had personally devised or chosen these doctrines on the basis of private predilection. It is only within a liberal secularist society, dominated by the it's-all-a-matter-of-opinion code, that a street corner orator or a knocker upon your door can assume it appropriate to pin upon you, as an individual Christian, the demand to defend this or that doctrine as though it were your personal possession - to explain your individual attachment to it as clearly and particularly as you would explain why you chose this wall paper or that piece of furniture.

By allowing the Christian mind to be destroyed, we have imposed an intolerable burden upon ourselves as individual Christians. It is not surprising that so many shift the burden from their shoulders. We have accepted secularism's challenge to fight on secularist ground, before a secular audience, and according to the secularist book of rules. Having done so, we look around in dismay at the discovery that our followers are few, our predicament misunderstood, our cause misrepresented. Hastily, we try to plug the gap by pouring out more and more sermons and books of instruction "explaining" our cause, but doctored to the secularist mentality. It is high time to shift our ground.clviii

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Harry Blamires then went on to say in his book entitled The Christian Mind: How Should a Christian Think? Published that same year in 1963 states the following about the Christian Mind: There is, no longer, a Christian mind.

It is a commonplace that the mind of modern man has been secularized. For instance, it has been deprived of any orientation towards the supernatural. Tragic as this fact is, it would not be so desperately tragic had the Christian mind held out against the secular drift. But, unfortunately, the Christian mind has succumbed to the secular drift with a degree of weakness and nervelessness unmatched in Christian history. It is difficult to do justice in words to the complete loss of intellectual morale in the twentieth-century church. One cannot characterize it without having recourse to language which will sound hysterical and melodramatic.

There is, no longer, a Christian mind. There is still, of course, a Christian ethic, a Christian practice, and a Christian spirituality. As a moral being, the modern Christian subscribes to a code other than that of the non-Christian. As a member of the church, he undertakes obligations and observations ignored by the non-Christian. As a spiritual being, in prayer and meditation, he strives to cultivate a dimension of life unexplored by the non-Christian. But, as a thinking being, the modern Christian has succumbed to secularization. He accepts religion - its morality, its worship, its spiritual culture. But, he rejects the religious view of life, the view which sets all earthly issues within the context of the eternal, the view which relates all human problems - social, political, cultural - to the doctrinal foundations of the Christian faith, the view which sees all things here below in terms of God's supremacy and earth's transitoriness, in terms of heaven and hell.clix Mr. Blamires, wrote the above paragraphs back in 1963, that was fifty years ago. In my lifetime I have seen the Christian Faith and the Christian way of thinking really come under a very heavy spiritual attack and God forbid you say anything about or in the name of Jesus Christ anywhere other than in your home or church unless you are using His name in jest or as an expletive.

Like I was able to show in the pages that have preceded, the Christian that we have found to be in an AVNRT rhythm is having some stinking thinking, and if left unchecked that stinking thinking will lead them to willfully sin. Like I stated before no one commits the outward acts of sins, without having thought about them and committed them in their mind first.

I see this Christian as having one or more or even all of the 10 Unhealthy Conditions of The Mind that Dr. Paul Carlin talked about in his paper on Conditions of The Mind and this also lines up with The Spiritual Dynamics of Barriers to Responsible Thinking found within the Reentry Crisis Counseling Manuel written by Dr. Carlin.

He had this to sayâ&#x20AC;Ś What we believe determines how we behave and both determine what we become.

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There are 10 unhealthy conditions of the human mind that will destroy procreative powers. In the book of 1 Peter 1:13, we are instructed to "gird up the loins of your mind." The word "loins" in the New Testament means "procreative powers."

The brain is the most important organ of the human body. The brain is involved in all human behavior. Whether the behavior is abnormal or normal, it could not occur without a functioning brain. In addition, our ability to love, get angry, dream, worship, learn, move, have self-awareness, remember or plan what we will do tomorrow, is impossible without the brain.

Since the Bible does not reference the brain, we conclude there is a mind-brain relationship. For that reason the Bible has much to say about the conditions of the mind.

Spiritual health is not only related to the spirit and soul of man, but to the condition of his mind as well. If the mind of a Christian is unhealthy it is very likely his spiritual life will be unhealthy. The Bible does provide us with insight into the unhealthy conditions of the mind.

It is possible for a Christian to have one or more of the following unhealthy mindsets.

Any one of the conditions will restrict spiritual and emotional procreative powers.

Unhealthy spiritual mindsets, like the 10 we are listing below, will cause people to think problematically. The problematic thought will produce problematic, self-defeating behavior.

When the mind is crammed full of human viewpoint and mental attitude sins, the result is inevitably self-induced misery. We are not talking about mental illness, but unhealthy conditions of the mind.

1. The High-minded References: Romans 11:20-21; 1 Timothy 6:17; 2 Timothy 3:4 The word "highminded" describes a mind held captive by conceit. It is the mind clouded with the obstruction of self-centeredness. Arrogance and self-righteousness are symptoms of one who is "highminded" The highminded mindset is sometimes characterized by social, spiritual and intellectual prejudice. In short, highminded people are "aloof."

2. The Fleshly - Carnal Mind Reference: Romans 8:5-7; 1 Corinthians 3:1-4 The fleshly, carnal mind is occupied with the externals of life. It is a materialistic mindset. Carnality means to be controlled by the weaker elements of the human nature. What appeals to them is what appeals to the flesh.

3. The Forward Mind Reference: 2 Corinthians 9:2 The forward mind is impulsive. It is quick to start, but slow to complete. A forward mind is prone to bad judgments. This impulsive mind is directed toward extravagance and a lack of self-control.

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A Paramedicâ&#x20AC;&#x2122;s view of Christianity 4. The Otherwise Mind Reference: Galatians 5:10; 1 Timothy 5:25 This is the mindset that has believed religious lies. The otherwise mind is filled with religious dogmatism. It easily comes under the control of counterfeit religious emotions, can be easily worked into a frenzy and influenced to believe anything mystic.

5. The Vain Mind Reference: Ephesians 4:17-19; 1 Peter 1:8; Galatians 5:26 Technically the term means "disappointing misery." Practically it means "empty" and "manipulative." The vain mindset is into self-promotion.

6. The Earthly Mind References: Philippians 3:19 This is the mindset that leaves God out of its planning because it is focused on earthly things. The word "earthly" mean "on the earth."

The earthly mindset is occupied with material values, not with eternal values.

7. The Shaken Mind References: 2 Thessalonians 2:2; Heb. 12:27 The word "shaken" describes an agitated mindset. In a Biblical sense it describes the shaking effect of a stormy wind. The shaken mind is easily spooked. It is prone to panic and fatalism.

8. The Defiled Mind References: Titus 1:15-16 The word "defiled" describes the worst form of contamination. In this mindset, the mind and conscience are associated. It is a mind filled with polluted and moral defilement. It is a morally unclean mindset.

9. The Double Mind References: James 1:8; 4:8 The word "double" is comprised of two Greek words: dis (twice) and psuche (soul). "Dispsuchos" means two souls. It could describe a multiple personality. It certainly describes an unstable mindset. The double mind holds two opposite beliefs at the same time.

10. The Reprobate Mind References: Romans 1:28 This is the addictive-obsessive-compulsive mindset. The word "repro- bate" means "unapproved" or "undiscerning."clx

Dr. Paul Carlin talks about a healthy mind and how we as Christians are to strive to obtain a healthy mind in his outline of the The Spiritual Dynamics of a Healthy Mind found within the Reentry Crisis Counseling Manual.

The Spiritual Dynamics of a Healthy Mind 1. We are to have A Renewed Mind: (Cleansing) Making New Controlled by the Holy Spirit

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Romans 12:2 And be not conformed to this world: but be ye transformed by the renewing of your mind, that ye may prove what is that good, and acceptable, and perfect, will of God. (KJV) 2. We are to have A Willing Mind: Controls the Attitude / Altitude / Quick to Start / Slow to Finish 2 Corinthians 8:11-15 Now therefore perform the doing of it; that as there was a readiness to will, so there may be a performance also out of that which ye have.

12 For if there be first a willing mind, it is accepted according to that a man hath, and not according to that he hath not. 13 For I mean not that other men be eased, and ye burdened: 14 But by an equality, that now at this time your abundance may be a supply for their want, that their abundance also may be a supply for your want: that there may be equality: 15 As it is written, He that had gathered much had nothing over; and he that had gathered little had no lack. (KJV)) 2 Corinthians 9:2 For I know the forwardness of your mind, for which I boast of you to them of Macedonia, that Achaia was ready a year ago; and your zeal hath provoked very many. (KJV) 3. We are to have An Eager Mind: Ready / Learning 2 Corinthians 8:19 And not that only, but who was also chosen of the churches to travel with us with this grace, which is administered by us to the glory of the same Lord, and declaration of your ready mind: (KJV) {and [to show] our eager readiness (AMP)} 4. We are to have A Sound Mind: Disciplined / Composed 2 Timothy 1:7 For God hath not given us the spirit of fear; but of power, and of love, and of a sound mind. (KJV) 5. We are to have A Sober Mind: Moderate / Temperate / Discreet Titus 2:6 Young men likewise exhort to be sober minded. (KJV)clxi One of the ways that we are to accomplish this renewing of our minds, develop our Christian mind and a Christian thought life is to read, believe, study, know, memorize, pray and act on the Scriptures. As we really start to read, believe, study, speak out loud, know, memorize, pray and act on the Scriptures we will see our thinking change.

As you begin renewing your mind according to the Word of God, you will begin thinking in a powerful new way. You will move from what the world and sometimes the church teaches as positive thinking and will began developing what is known as possibility thinking! In Mark 9: 23 Jesus said, [You say to Me], If You can do anything? [Why,] all things can be (are possible) to him who believes! (AMP)

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As you meditate on and walk out the truths taught in the Bible you will experience the mind of Christ being activated in you. You will begin to demonstrate the thoughts and intents of His heart. As your thinking expands, your behavior begins to reflect more and more the truths of God found in the His Word.

To obtain the mind of Christ will take some personal investment in time on your part but boy is it worth it. We see according to Matthew 16:23 But Jesus turned to Peter and said, `Get away from me Satan! You are trying to make me do wrong. You are not thinking the way God thinks, but the way people think.' (WE) people without the leading of the Holy Spirit don't just think like God thinks.

Romans 12:2 Do not be conformed to this world (this age), [fashioned after and adapted to its external, superficial customs], but be transformed (changed) by the [entire] renewal of your mind [by its new ideals and its new attitude], so that you may prove [for yourselves] what is the good and acceptable and perfect will of God, even the thing which is good and acceptable and perfect [in His sight for you]. (AMP) As God used Paul to pen these words, he was directing us leave behind all the stinking thinking and choose to and be willing to allow God to change your thinking.

John Maxwell in his first book titled Think on These Things wrote: Your life today is a result of your thinking yesterday. Your life tomorrow will be determined by what you think today. Like it has been said have and to live a transformed life that reflects God's love and true character you know where it will have to start don't you, "between your ears".

As we begin clean out and reclaim that space that we have given up to the enemy between our ears, known as your mind back from the enemy. You know that he is NOT going to want to give up the place that he has had and that you will have to do battle with his lies and confusion. I really like what Joyce Meyers has to say on this subject in her paper on Scriptures for a Sound Mind. Let's read them as we finish up this section in this chapter.

Joyce Meyer has this to sayâ&#x20AC;Ś The first step is to declare out loud that you will not allow any outside force to do your thinking-no man and no spirit. There are spiritual laws that demons must obey. They cannot stay where a man wills them not to stay. Your power is in the Name of Jesus, the Blood of Jesus, and the Word of God. Ask God to give you discernment of the lies of the devil.

Think about what you are thinking about. As you recognize a lie to your mind, always defend yourself out loud. That means speaking to Satan and the evil forces out loud, binding them in the Name of Jesus, and forbidding them to lie to you and to use your mind.

When you catch a lie to your mind, use this prescription regularly-and you will regain peace, your memory, restful nights, and the ability to concentrate and comprehend.

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You are in a battle-you are not alone-for all of God's people fight this same fight (Ephesians 6:12). Make up your mind not to give up! According to Colossians 3:2, set your mind on things above and keep it set! As you begin this battle, it will seem worse than ever. The reason is that the demonic powers are fighting to keep their place in your mind (and in your thinking). Call upon God's grace in the Name of Jesus, and He will give you the power of the Holy Spirit to overcome every evil tendency fully.

Remember, regaining your mind is a process. We all fail at one time or another. God knows our weakness; that is why He gave us 1 John 1:9. Just ask for forgiveness and see the Blood of Jesus washing away your sin. Don't give up! Continue claiming what belongs to you (your mind and your thinking belong to you), and Jesus will help you overcome.

Second Timothy 1:7 says, "For God did not give us a spirit of fear, but of power and of love and of a sound mind!"

ADDITIONAL SCRIPTURES FOR A SOUND MIND When You Hear A Lie Going Through Your Mind, Say Out Loud: 2 Corinthians 10:5 "Satan, you are a liar. I will not receive (or believe) your lie in the Name of Jesus."

1 John 4:4 "I remind you that it is written, 'He that is within me is greater than he that is in the world.' I command you to bow your knee to the Name of Jesus and leave me."

(Now you have pulled the lie out-just as you pull a weed out of the ground. An empty hole remains where the weed was, and you will need to fill the space you cast the lie out of with Scripture.)

Philippians 4:8 Begin to think on the Word or begin to sing a praise song to God. Make a conscious effort to fill your mind with good, pure, wholesome, and lovely thoughts. clxii As we have studied the Christian that has been in an AVNRT rhythm we have resolved that God wants and needs for you and I to posses a healthy Christian mind and to do this we are to have a Renewed, a Willing, an Eager, a Sound and a Sober Mind. To do this we will have to ask God's help to truly fill in the blanksâ&#x20AC;Ś you ask what blanksâ&#x20AC;Ś the ones between your ears of course!

Where you aware that God has His own Cardiac EP and Cath Lab, He talks about it in 1 Samuel 16:7 But GOD told Samuel, "Looks aren't everything. Don't be impressed with his looks and stature. I've already eliminated him. GOD judges persons differently than humans do. Men and women look at the face; GOD looks into the heart." (MSG) For the rest of this chapter we will be studying the Christian that has been sent to God's EP lab and the tests and mapping of their heart reveals that they are in an AVRT rhythm.

In AVRT, the extra connection, which is often called an accessory pathway, joins one of the atria with one of the ventricles. This is to say that the Christian that is found to be in an AVRT rhythm, one side or the other of the Christians heart will be involved in the accessory pathway. That is to say if it is a right heart accessory pathway then we will be seeing issues

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in the Christians Mind and Will, and if it is a left heart accessory pathway then we will be seeing issues with the Christians Emotions and their Character or Personality.

In AVRT, the reentrant circuit that produces the arrhythmia is quite large. In typical AVRT, during the reentrant tachycardia the circuitous electrical impulse travels down the AV node to the ventricles, then returns back to the atrium through the accessory pathway, then back down the AV node, and then keeps repeating the same circuit.

For the Christian that is in a right heart AVRT, we find that the circuitous electrical impulse start their travels in the Christian's Mind. Then the impulse travels down the AV node which to me is known as the Christian's thought process to the Christians Will and then returns back to the Christian Mind through the accessory pathway, then back down to the Christian's Will without a final decision being formulated or followed out by the Christian's Will, and then keeps repeating the same circuit.

This Christian has the beginnings stages of Dissociation of the Christian Mind and Will (DCMW). This Christian is battling God and His authority in all areas of live. They are within themselves committing their minds against their wills at the same time setting both their minds and wills against the claims of God and of Christianity. This dissociation of the mind and will has caused a hardening of the Christian's Spiritual heart by their continued disobedience, and self-will, and stubbornness, against God and His Truth.

Dissociation of the Christian Mind and Will has always been a voluntary act on the part of the Christian. Like I just stated the Christian is voluntary acting on a thought of the mind or of the will. The mind always assigns some reason or reasons for taking up this position of self-will, and for maintaining this position of stubbornness against God as seen in the Christians Actions as in the right heart AVRT. A better word for will is volition. Volition is the power of free choice, it is the ability to pick or choose between alternatives presented to the mind. Now we start to see where the dissociation starts. The Christian Mind presents to the Christian's will a series of choices. He is in only one of two ultimate options: serving God supremely or serving himself as seen in the following two verses. 2 Corinthians 8:3 For I can testify that they gave not only what they could afford, but far more. And they did it of their own free will. (NLT) and then in Colossians 2:23 These rules may seem wise because they require strong devotion, pious self-denial, and severe bodily discipline. But they provide no help in conquering a person's evil desires. (NLT) God has entrusted man with the same ability of free choice that He Himself has. The great importance of this cannot be stressed too much. It is this freedom that makes man "moral". We will discuss this more in a later chapter.

This Christians thinking and their life's choices are not lining up with God or His Word. This in its self will lead to the Christian to no longer believing in truth but the lies that his thinking has told his will to choose to do.

This brings us to the Christian that is in a left heart AVRT, we find that the circuitous electrical impulse starts it's travels in the Christian's Emotions, then the impulse travels down to the

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Christians Character or Personality and then returns back to the Christian Emotions through the accessory pathway, then back down to the Christians Character or Personality without any changes being made in the Christians Character or Personality, and then keeps repeating the same circuit.

This Christian has the beginnings stages of Dissociation of the Christian Emotions and Character / Personality (DCECP). They are tuning their emotions against their Character / Personality. Here again this Christian is setting their feelings against what they know to be true to their Character acting on their emotions inwardly and acting on their emotions outwardly as seen in their Personality. This dissociation of the emotions and character / personality has caused the Christian to be in opposition with their emotional life and their true Godly character and personality. This Christian has also started to harden their hearts because of this dissociation.

Paul W. Carlin wrote the following about the Christian who has opposed themselves in his book: Satan and the Saint: A Look into The Dark Side Of Christian Behavior.

The words are addressed to a young preacher. Paul is instructing Timothy in the delicate pastoral discipline of restoring to spiritual health a peculiar category of people.

In 2 Timothy 2:25-26 we read, "In meekness instructing those that oppose themselves; if God peradventure will give them repentance to the acknowledging of the truth; and that they may recover themselves out of the snare of the devil, who are taken captive at this will."

When dealing with fellow believers who have fallen into error, the Word of God is always remedial, never punitive. The purpose of the servant is to edify the body of Christ, not destroy it. (1 Cor. 14:26) And the context surely provides every reason to believe that Paul was instructing Timothy to handle an erring believer with "meekness."

But not just any erring believer. For those who are identified here are those who "oppose themselves." A strange statement indeed. This is the only place it is used in the Bible, and it is definitely talking about Christians. Doctrinal error was the focal point, but the statement goes much deeper than that.

Can it be that doctrinal error creates behavioral problems and the accompanying disruptive traits which caused the Holy Spirit to classify these Christians as "opposing themselves"? Think so! Rooted in doctrinal error, then, is self-opposition, a very real spiritual problem and one with sinister and far-spreading tentacles.

For the Christian who opposes himself has self at the very center of his interest.

Rather than a healthy Biblical view of self, self sits on the throne of his life. Thus the condition becomes self-defeating and self-destructive. It is exactly the opposite of Galatians 2:20, which says, "I have been crucified with Christ (in Him I have shared His crucifixion); it is no longer I who lives, but Christ (the Messiah) lives in me; and the life I now live in the body I live by faith in (by adherence to and complete trust in) the Son of God, Who loved me and gave Himself up for me." (AMP) Christians who oppose themselves are examples, consciously or not, of the selfdominated life. Gratification of self, that is, obsessive concern with me, my needs, my

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The reason the emphasis in 1 Timothy is to deal with these people in "meekness' is that they are most often oblivious to their condition. Such folks guard against any degree of personal inconvenience. In the ministry, [Paul W. Carlin] has observed, these misguided Christian "ministers" must arrange for things to revolve around their personal fetish â&#x20AC;Ś or else.

Self-opposition runs the gamut from one extreme to another. There is the person who is self-condemning and who has very low self-esteem. Sometimes they blame themselves for what was obviously the fault of someone else. [Paul W. Carlin] was for a time the pastor of a faithful Christian lady who was like this. She could not even ask a question without apologizing for it first. When we do not respect ourselves, few people respect us. For it is extremely difficult to love people who do not love themselves.

When you reject yourself, you become a persona-nongrata, a kind of non-person or nonentity. Then there is self-pity - feeling sorry for yourself. And self-willed. Self-willed Christians also fall into the category of those who oppose themselves.

Self-indulgence is another characteristic of those who oppose themselves. This trait breeds a whole nest full of self-defeating conditions. These can range from an uncontrollable appetite for food, to chronic heavy indebtedness, to adultery.

However, a negative mental attitude is also self-defeating. Negative Christians miss out on a whole lot of good stuff! In general, we can say that the devil does not have to spend much time with the Christian who opposes himself. He, the Christian, does an admirable job of corrupting his own life without the assistance of external influences.

So Satan simply leaves the self-opposing Christians to his own devices. Thus Satan does not defeat you. You defeat yourself.clxiii

Rev. C. G. Finney had this to say in his lecture March 27, 1861, Harden not Your Hearts No. 2, his text for this was found in Hebrews 3:7-8 Wherefore (as the Holy Ghost saith, Today if ye will hear his voice, 8 Harden not your hearts, as in the provocation, in the day of temptation in the wilderness. (KJV) It is a matter of consciousness that the will has indirectly a great control of the feelings.

If the mind commits itself by an act of will to any position, the feelings are brought to adjust themselves to the will's position; not always directly and instantly, but the feelings will soon come to sympathize with the attitude taken by the will. The reason is very obvious, the feelings are influenced by the thoughts, and the thoughts are directed by the will. When the will, then, is committed to a dishonest position, it will always use the intellect dishonestly; and by a dishonest use of the intellect will foster such thoughts as to prevent the feelings.

This is common experience, as everyone knows who has paid any particular attention to his own state of mind. A voluntary stubbornness always locks up the sensibility, and closes it against that class of emotions that would naturally result from a different

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attitude of the will. If the mind takes a position against God, it will use the intellect to justify its position, or to excuse it; consequently it will indulge only in thoughts, and arguments, and reflections, that justify its position, and therefore that poison and pervert the feelings and bring them into sympathy with the will. Men harden their hearts, then, by an uncandid and selfish use of the intellect, assigning to themselves such reasons for their conduct as to justify their taking this position.clxiv Looking at this again, it is a matter of the Mind, where we find the Will being the commandpost and the central headquarters of the personality has control of the Emotions which leads the Christian to the ability to originate their own actions.

Notice there is a distinction between the heart, the thoughts (a cognitive function), our feelings (our emotional response) and our actions or behavior. They all begin in the heart (our belief system), move to the mind (the cognitive part of man where we think), which triggers the emotions (our feelings) and finally are manifested in our behavior (actions).

We think and believe with our mind. We believe (conclude, trust, come to a conviction) with our spirit. We acquire knowledge, but knowledge, what we know, does not become belief until we accept it, confirm it, and appropriate it in our spirit.clxv So then we can say that what we believe determines how we behave and both determine what we become.

For the Christian that is suffering from a known left heart AVRT heart rhythm we find that the Christian is having a dissociation of their Emotions and Character / Personality. This dissociation of their emotions will be seen in their Emotional intelligence (EQ). EQ is emotional intelligence, just like IQ is analytical intelligence. Emotional intelligence is the term we use to describe a complex set of human abilities related to emotional management.

The four key aspects of emotional intelligence as described by Mayer and Salovey (the pioneer researchers in the area) are: 1. Emotional identification, perception and expression 2. Emotional facilitation of thought 3. Emotional understanding 4. Emotional management.

Biblical EQ is the biblical perspective on the above four key skill areas. It doesn't neglect the findings of neuroscience but it adds in the transforming power of the Holy Spirit and the wisdom of Proverbs. It has as its model the emotional life of Jesus Christ with His personal presence, self-control, emotional expressiveness and discernment of situations.

Biblical EQ shows a clear pattern, a master plan that can be used to analyze theories and to determine what is true and false, wise and unwise. Secular theories have no "ideal person" to point to - they merely assemble ideals from their own theories and worldview.

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In Jesus we have a model, a guide, a point to aim our teaching towards and this is invaluable.

The Christian believer is to aspire to have the emotional life of Christ Jesus for that is very much part of being "in His image". Above all Biblical EQ is biblical, founded on faith in the inspired, inerrant and authoritative Scriptures.

Biblical EQ seeks a biblical understanding of our emotions that are based on the emotional life of Jesus Christ. It believes Christ redeemed our emotions. It believes we are to become Christ-like in all aspects of this life including our emotional life. It draws on both secular and Christian insights. It uses the life and ministry of Jesus as the model and the integrating point.

To have the power to change and to get answers that genuinely help people we need two things, a clear destination, and the power to get there in a reasonable amount of time. Our destination is the image of Christ Jesus, our power to get there is the infilling with and transforming work of the Holy Spirit. These are just the some of the great advantages of the gospel, we have hope, and we have lots of hope!

Christians can have their emotional life redeemed so that it is transformed to mirror the emotional life of Jesus Christ and that the Holy Spirit's power and grace is the key to this process. This involves renewing seven key aspects which will be discussed in detail in coming chapters: 1. Renewing our basic perceptions of reality and our perspective on life.

2. Renewing our individual belief system.

3. Renewing the purposes and intents of our heart.

4. Renewing our physical bodies and their influence on our emotions.

5. Renewing our ability to be aware of and to understand our own emotions.

6. Renewing our ability to understand the emotions of other people.

7. Renewing our ability to appropriately express emotion according to the desire of the Holy Spirit.

You and I have to ask what kind of emotions should we as Christians have. While God is emotional there are some emotions that God never has. God is never envious, lustful, greedy, bitter with selfish ambition, small-minded, or petty. Neither is he anxious or fretful but dwells in perfect peace. His emotions are positive, holy, noble and appropriate. God is light and in Him there is no darkness at all.

Since we are called to be "in the image of God" as seen in Romans 8:29 For those whom He foreknew [of whom He was aware and loved beforehand], He also destined from the beginning [foreordaining them] to be molded into the image of His Son [and share inwardly His likeness], that He might become the firstborn among many brethren. (AMP) then it means that at the end of our Christian maturity, our emotions should in some measure share these divine qualities. We should be "walking in the light" as we are taught in 1 John 1:6-7 [So] if we say we are partakers together and enjoy fellowship with Him when we live and move and are walking about in spiritual darkness, we are [both] speaking falsely and do not live and practice the Truth [which the Gospel presents]. 7 But if we [really] are living and walking in the

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Light, as He [Himself] is in the Light, we have [true, unbroken] fellowship with one another, and the blood of Jesus Christ His Son cleanses (removes) us from all sin and guilt [keeps us cleansed from sin in all its forms and manifestations]. (AMP) Thus godliness means forsaking some emotions and embracing others. We should be utterly free from unholy and fleshly emotions and moving toward mature and holy emotional responses. The mature saint of God is filled with love and utterly free from bitter envy and selfish ambition. (James 3:15-18). Petty covetous worldly longings are replaced by the love of the Father (1 John 2:15-17) and perfect love casts our fear so that we dwell in quietness, peace and confidence (1 John 4:18, Isaiah 26:3). Holy people do not easily fly into rages or engage in back-biting and quarrelling rather they are centered people full of love, joy and peace (Galatians 5:19-23). There is thus a grand and holy emotional authenticity that accompanies maturity in Christ.

In his book, Biblical EQ: A Christian Handbook for Emotional Transformation John Edmiston states that our emotions can be broken down into three classes: As a rough guide our emotions can be broken down into three classes: Holy Emotions: Those experienced by God such as compassion, joy, and holy indignation and those that accompany life in the Spirit such as praise, worship and adoration. These emotions are derived from the kingdom of light and the Sprit (Ephesians 5:18-21, Colossians 3:16-17, Galatians 5:22-23) and are in agreement with true wisdom (James 3:17-18) They are the emotions of Christ in us. They are not necessarily religious or pious emotions. Admiring a flower or delighting in beautiful music or focusing on the beautiful and the good can be just as holy as going to church.

(Philippians 4:8) Human Emotions: Based in our human situation and the created order and shared by Jesus during His time on earth. This includes emotions such as grief, pain, fear, abandonment, sadness and sorrow, anxiety, stress, anguish and vulnerability. These emotions are well chronicled in the Psalms. For the Christian they are temporary and in eternity there shall be no more crying or sadness or pain (Revelation 21:4). While these emotions may feel bad they are not evil or toxic. They can be painful but they are not poisonous.

Fleshly Emotions: Are poisonous and destructive and include toxic emotions such as malice, envy, selfish ambition, sensuality, bitterness, overpowering lusts and murderous hatred. They are closely tied up with the works of the flesh and with evil deeds. Their outcome is spiritual death. These emotions were not part of mankind at Creation and are not "natural human reactions" (For instance grief is a natural human reaction but bitterness is fleshly. One can have "good grief" without a trace of bitterness. Bitterness is not natural to the human condition.) Rather these emotions are derived from the kingdom of darkness and have their source in a dark wisdom (James 3:14-16).

This classification helps us see the relative value of our emotional responses and to use the techniques described in the succeeding chapters to assist with our

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A Paramedicâ&#x20AC;&#x2122;s view of Christianity sanctification. It also puts the lie to the old humanist rubric "there are no right or wrong emotions." All emotions are not equal. Some are of much higher value than others and some emotions and impulses are positively wrong. This classification also goes a bit beyond the black and white classification of emotions as 'spiritual" or "unspiritual" that causes so much pain in traditional missionary circles. When pain and disappointment are seen as "unspiritual" we simply add to the burden the person is carrying. Hurt, disappointment, pain and frustration are valid human emotions stemming from our creatureliness encountering a fallen world. Human beings were created good but mortal and it is as we explore this mortality that we find out many useful things about ourselves. The above simple classification also saves us from the error of stopping there with our human emotions and being content simply to explore ourselves at that level. It tells us there is something higher, something beyond our mortality and that it is as we focus on our immortality in Christ that we develop the highest and noblest parts of our being.

We are thus called to participate in the holy emotions so that they transcend the human emotions and overcome the fleshly emotions. By this I mean that we must choose our emotional level and which emotions we will be gripped by. When disappointment strikes we can choose to respond with holy emotions and pray through until we trust God and can praise Him as the Psalmist did or we can respond at the human level and sit down disconsolate in human misery and gradually see it through or we can respond from fleshly emotions and lash out in anger, bitterness, distrust and revenge. Consider Paul in jail in Philippi in Acts 16. He praised God, sang psalms and rejoiced thus transcending the human emotions of pain and discomfort and effectively banishing any fleshly emotions such as bitterness or desire for revenge. Thus Paul participated in holy emotions so that they transcended the human emotions and overcame the fleshly emotions. The human emotions are not denied or seen as wrong rather they are acknowledged but not focused on. They are transcended. The saint focuses on and deliberately chooses to move toward the holy emotions. Prayer, fasting, praise and worship, reading Scripture, meditating on good teaching and doing good works are all helpful in this process. However above and beyond these things we need the work of the Holy Spirit.

The Holy Spirit responds differently to each of theses three categories of emotion. The Holy Spirit rejoices and assists us when we engage in holy responses. He produces them within us so they can justly be called "the fruit of the Spirit". (Romans Chapters 8 & 12, and Galatians 5) On the other hand the Holy Spirit comforts us when the human emotions such as grief overwhelm us (see 2 Corinthians 1). Finally He is determined to break the grip of fleshly emotions such as hatred, lust and revenge. In fact the Spirit wars against such impulses so that we cannot fully give way to our worst desires (Galatians 5:16-18). Thus the Holy Spirit produces holy emotions, comforts overwhelming human emotions and wars against fleshly emotions. However we have a choice in the matter. We can take heed of the Spirit's promptings or we can discard them in fleshly rebellion. This leads Paul to say that the mind set on the flesh and its fractious emotions "is death" but the mind set on the Spirit with His holy emotions is "life and peace"(Romans 8:5-6).clxvi

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Then we can state that: Right Emotions are an important part of Right Character and Right Ethics and Right Emotions undergird Right Choices and Right Destiny.

To emotionally rejoice in truth, to celebrate justice, to delight in noble actions and to embrace compassion and mercy is to have emotions that complement our faith. On the other hand confused emotions can destabilize us and create conflicts. Finally the presence of strong lustful and evil emotions can drive us to sin and blind us to truth. Thus sorting ourselves out emotionally is much more than just getting our act together.clxvii Before we move on to the next chapter on Bundle-branch blocks and the Christians Will and their Character / Personality, let's do a little review shall we? I want to start with words.

Words determine your thinking. Your thinking (MIND) determines your choices.

Your choices (WILL) determine your emotions. Your emotions (EMOTIONS) determine your actions.

Your actions determine your habits. Your habits determine your character.

Your character (CHARACTER) determines your personality. (PERSONALITY) Your personality determines your destiny.

Words are Emotional.

Words trigger Emotions.

Words communicate Emotions.

Words do not have meaning; words carry meaning. Words are more powerful depending on who speaks them to us. It doesn't matter what the actual meaning of the words are that are originally stated, but rather, our interpretation of the words. Once words are spoken, they cannot be taken back.clxviii Negative words produce negative thinking …produces negative emotions …produce negative decisions …produce negative actions …produce negative habits …produce a negative character …produces a negative destination.

Godly words produce Godly thinking … produces Godly emotions … produce Godly decisions … produce Godly actions … produce Godly habits … produce Godly character … produce a Godly destination.

So then if you or I are not happy with our destination, change our personality.

If you or I are not happy with our personality, we need to change our character.

If you or I are not happy with our character, we need to change our habits.

If you or I are not happy with our habits, we need to change our actions.

If you or I are not happy with our actions, we need to change our decisions.

If you or I are not happy with our decisions, we need to change our emotions.

If you or I are not happy with our emotions, we need to change our thinking.

If you or I are not happy with our thinking, we need to change our words.clxix

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Chapter 12 Interpreting Heart Block Rhythms As we have been studying the different types of cardiac rhythms from the Christian prospective, we started with the Normal Sinus Rhythm which is the normal God fearing Christian living a Godly life. We then studied those Christians that get ahead of God as Sinus Tachycardia or those that fell behind Gods leading as Sinus Bradycardia. We then went on to looking at those rhythms originating from the Atrial and Atrial-Junction ranging from PAC's, AFib and A-Flutter to PJC's all of which have to do with the Christian learning to and allowing God to renew their minds. We saw God renewing the minds of the Christian by changing their stinking thinking into Godly thinking and with those changes made; the Christian was finally truly able to control their emotions. Then we reviewed the Supraventricular Dysrhythmias such as SVT which we saw as the Christian having a disassociation seen in-between the Christians will and God's will, because the Christian has to will to do God's will. We now come to the rhythms that we know as Atrioventricular Blocks or just AV Blocks.

Over my twenty plus years of working as a Paramedic, AV Blocks and the patients that I have had to treat that have had them have always had a special place in my heart. The four rhythms that make up the AV Blocks are divided into (here we go again) 3 categories and they are the First, the Second Type I, the Second Type II and the Third Degree. I see these four AV blocks as a spiritual heart problem known to the Christian as backsliding (A Christian willfully choosing to walk-a-way from God).

As we study the AV Blocks, we will start with the Christian that has started to backslide; through the Christian that has become hypocritical (purposely concealing what is really in their hearts by faking their outward conduct). God places the human responsibility to repent of our personal sins, putting our personal trust in, total surrender to and obey Him on you and me. 2 Chronicles 7:14 shows each of us that there is an element of human responsibility when it states "Then, if my people, who bear my name {Christians}, will humble themselves, pray, seek my face and turn from their evil ways {Turn from their personal sins}, I will hear from heaven, forgive their sin and heal their land." (CJB) {Statements added by this author}.

Then we read in Hosea 14:4 I will heal their backsliding, here God was speaking of His people Israel, but now that you and I are adopted into the family of God this means that God will heal our the Christians in their backslidings.

The moment that we personally stop going forward we start to backslide in our personal walk and relationship with God, we start to become stagnant; we become stale, foul [Stinking] and vile (in our thinking, in our choices, in our speaking and in our actions). We start to act foolish you know acting the fool! We find the proof of this in the Bible.

According to Titus 3:3 For we ourselves also were sometimes foolish, disobedient, deceived, serving divers lusts and pleasures, living in malice and envy, hateful, and hating one another.

(KJV) Looking again at Titus in the Message Bible it says the following, let's read Titus 3:3-8, 3-8 It wasn't so long ago that we ourselves were stupid and stubborn, dupes of sin, ordered

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every which way by our glands, going around with a chip on our shoulder, hated and hating back. But when God, our kind and loving Savior God, stepped in, he saved us from all that. It was all his doing; we had nothing to do with it. He gave us a good bath, and we came out of it new people, washed inside and out by the Holy Spirit. Our Savior Jesus poured out new life so generously. God's gift has restored our relationship with him and given us back our lives.

And there's more life to come an eternity of life! You can count on this. (MSG) So then prior to you and me becoming a Christian we acted the fool (foolishness living in folly) as seen by the verse that we just read. Consequently, if you and I start a relationship with God then we turn and start to walk away from God; will we not return to the foolishness as before?

Wisdom and folly are seen as philosophies or perspectives of life. Wisdom based only on the known human intellect and experiences without considering God is known as folly. The characteristics of folly include thoughtlessness, the pursuit of unbridled aspirations, and a lifestyle characterized by envy, greed, and pride. The foolish person is the one who is simpleminded, self-centered, and obviously indifferent to God. They live a life of deliberate sinfulness; maliciousness, and brutality (demonstrating destructive behavior as a way of life) towards themselves and other. Their life's pattern is to continue in willful sin, (spiritual heart disease) to disregard God's plan for their lives (backslidden), and to dismiss anyone who attempts to warn them of sin's consequences.

The speech and actions of fools is an indicate to the self-centered condition of their hearts (their real selves), as Jesus indicated in Mark 7:20-23: And he said, What comes out of a person is what defiles him. For from within, out of the heart of man, come evil thoughts, sexual immorality, theft, murder, adultery, coveting, wickedness, deceit, sensuality, envy, slander, pride, foolishness. All these evil things come from within, and they defile a person.

As I stated before, I associate the AV blocks with the Christian choosing to walk away (backslide) from God and turn again to their foolish ways. Since the fool, in their backslidden state of heart (spiritual heart disease), and all aspects of their lives and relationships are detrimentally affected. The only hope for a fool is to have a change of heart, which is accomplished only by God. I know from personal experience, that backsliding is a very common problem among us Christians. Backsliding involves an accumulation of much seemingly small, hardly noticeable disobedience which gradually harden our heart and make us less and less sensitive to the Holy Spirit's convicting and guiding voice. It may relate to ignoring continually the Holy Spirit's inner promptings about prayer, Bible meditation or active involvement in the church. It can include becoming so busy with daily living and the things which are not in themselves sinful, for example, taking care of the kids, school, church activities or a hobby, which prevent us from having time for personal time with God for personal prayer and Bible study or time to do the things God has called us to do; which in its self then is a form of idolatry.

It can manifest in other ways also. It leads to us gradually losing our first love for Jesus and become spiritually lukewarm. And do you remember what the God say about you or I being

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lukewarm let's read it together. Revelation 3:15-16 I know you inside and out, and find little to my liking. You're not cold, you're not hotâ&#x20AC;&#x201D;far better to be either cold or hot! You're stale.

You're stagnant. You make me want to vomit. (MSG) I don't know about you but over the years in EMS I have seen, smelt, felt more than my share of puke and I do not like the idea of being God PUKE. God's answer to becoming lukewarm and losing our first love for Jesus is found in Revelation 3:19-20 As many as I love, I rebuke and chasten. Therefore be zealous and repent. Behold, I stand at the door and knock. If anyone hears My voice and opens the door, I will come in to him and dine with him, and he with me and Revelation 2:5 Remember therefore from where you have fallen; repent and do the first works, or else I will come to you quickly and remove your lampstand from its place unless you repent.

Once we have become lukewarm towards God, the next step is either repenting and becoming on fire for Him again or becoming colder turning to more foolishness. If the Christian chooses the latter of the two, this will results in a further hardening of their hearts.

People can become so hardened in backsliding, they begin to hate hearing preaching about surrendering to God and forsaking sin. Isaiah 30:9-10 refers to the tragedy of people being like this: That this is a rebellious people, lying children, children who will not hear the law of the Lord; who say to the seers, 'Do not see,' and to the prophets, 'Do not prophesy to us right things; speak to us smooth things, prophesy deceits. clxx At this point the Christian would have had a Spiritual Heart Attack and are on the verge of dying spiritually and totally walking away from God. Backsliding is a very-prevalent, clear and present danger to Christianity! As long as it is possible for Christians to backslide, backsliding will always be a problem of grave concern in Christianity. Backsliding is a heartbreaking problem that doesn't just affect new converts; it even affects preachers, elders, deacons, and long-time church members. God clearly warns us to pay attention because backsliding is a real danger as seen in Hebrews 3:12 Be careful then, dear brothers and sisters. Make sure that your own hearts are not evil and unbelieving, turning you away from the living God. (NLT) The trouble with backsliders is this; their hearts are not right with God.clxxi We read in Proverbs 14:14 The backslider in heart will be filled with his own ways, but a good man will be satisfied from above. This verse shows us the real problem of the backslider; it is a spiritual heart problem and if left unchecked and the sin goes unrepentant the Christian will continue down what is known as The Continuum of Sin please see Figure 12.1. Others in the Christian world call it The Development of Iniquity based on the verse found in Romans 6:19 I speak after the manner of men because of the infirmity of your flesh: for as ye have yielded your members servants to uncleanness and to iniquity unto iniquity; even so now yield your members servants to righteousness unto holiness. Iniquity is any sin that we allow to GROW in our lives and that we give into that lead us away from God.

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Figure 12.1 clxxii In the Development of Iniquity there are five basic steps to falling; from being a Christian living out the righteousness of God. The Christian at some point starts to believe he is righteous rather than it being accounted to him for righteousness. The Christian allows Pride to develop into a lack of submission to authority. Pride vs. Immorality. The Christian becomes ungrateful and starts acting ungodly which in turn starts the process of them becoming the

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Silly Fool which leads to them becoming a Reactionary Fool, then they move on to become the Angry Fool and they ends with becoming the Scorner.

The best way for me to explain to you what we have been discussing up to now in this chapter is to introduce you to what is known as the "Character Deficiency Syndrome" by Garry D. Nation formally of Probe Ministries. Mr. Nation's four degrees within the Character Deficiency Syndrome show what I see to be the four types of AV blocks of the Christian heart and rhythm of the Christian's heart walking away from the very heart beat of God in the form of backsliding.

Mr. Nation states the following in his paper on Character Deficiency Syndrome.

Humanists give two basic responses. Many humanists use the "disease" model.

Peoples' are illnesses that can be cured by the right medicine or therapy. The behaviorist model has also gained popularity in recent years. It says that human problems are essentially "dysfunctions." The very word "dysfunction" seems to suggest almost a mechanical difficulty, which can be fixed by an expert technician in human behavior. These models have some practical usefulness, but they both share two fundamental problems. For one thing, whether we speak of diseases or dysfunctions, we are trying to analyze personal problems by impersonal models. As a result, if we say that someone behaves as he does because he is "sick," or because he comes from a dysfunctional family, we have dehumanized the very person we are trying to help. In the second place, both of these diagnoses tend to play down human responsibility. If I am sick or have come from a dysfunctional environment, how can I be held accountable for my actions?

The Bible, on the other hand, takes a realistic, moral approach to human problems. It asserts that the true crisis we face is not because of economics, or health, or politics, or education. The ultimate responsibility for social order is personal and individual.

Disorder in society is a symptom of a crisis of character.

The wisdom literature of the Bible (which includes Job, Ecclesiastes, some of the Psalms, and especially the book of Proverbs) gives us a sharp description and diagnosis of this crisis of character. It calls it "folly."

Our English word "fool" translates several Hebrew words used widely in the Old Testament for individuals who are lacking in moral character. A fool is not someone who is silly or unintelligent, but one who is unwise. He has never learned that "the fear of the Lord is the beginning of knowledge."

As I said, there are a number of Hebrew words for fool, but they do not all mean exactly the same thing. They have very different shades of meaning. In fact, they indicate at least four progressive stages or degrees of descent into the moral and spiritual depravity which I call Character Deficiency Syndrome.

The first degree is the Simple or Naive Fool, who is unthinking, gullible. He lacks the most basic understanding of moral cause and effect.

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The second degree is the Self-Confident Fool. He is known by his stubbornness, and by his big mouth.

The third degree is the Committed Fool, who has decisively rejected wisdom, and instead pledged his allegiance to destructive ideas and behaviors.

The fourth degree or terminal stage of Character Deficiency Syndrome is reached by the Scornful Fool, a mocker who is openly contemptuous of spiritual truth and moral righteousness.clxxiii As we review the following AV Blocks, we will start off in the physical then as we move into the spiritual, we will first read what Mr. Nation, has to say about each of his four progressive stages or degrees of descent into the moral and spiritual depravity with in his Character Deficiency Syndrome .

I will then show Mr. Nation's four progressive stages or degrees in his Character Deficiency Syndrome; as the three AV Blocks that we see and treat as per-hospital care givers.

Now that I have you attention, let's start with the Simple, Na誰ve or Silly Fool. This stage is known to you and me in EMS as the First Degree AV Block.

FIRST DEGREE AV BLOCK

Figure 12.2 clxxiv Let's discuss the easiest block to diagnose, the First Degree AV Block. Actually calling a First Degree AV Block is really a poor descriptive term. It's really not a "block" per se, but a prolongation or a delay of the "PR" interval. Remember when we discussed the "PR" interval; its function is to permit the atrium time to pump blood to the ventricles, before the ventricles contract. This is kind of a "synching mechanism" to provide an even flow of blood throughout the heart chambers. The Normal "PR" interval is 0.20 or less (200 milliseconds). If the "PR" interval is greater than 0.20, there is a First Degree AV Block present. Look at the last QRS (6th) in Figure 12.2 above. The "PR" interval is greater than "one big block" long, remember one big block is .20 or 200 milliseconds. The "PR" interval in Figure 12.2 extends past "one big box' into the next "three small boxes". One small box remember equals 0.04 (40 milliseconds), 3 times 0.04 equals 0.12 (or 120 milliseconds). 200 plus 120 equals 320 milliseconds or 0.32, this is a long "First Degree AV Block"! The correct term for Figure 12.2

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is, Sinus Rhythm with 1st Degree AV Block. Remember it's still Sinus, because the cycle began in the SA Node.clxxv I like to think of this as one of those big city traffic jams, that if you are anything like me, you hate to drive or sit in. You will at some point still arrive at your destination, but it takes you longer to get there then normal. The same can sometimes be said for the hearts electrical current that starts in the SA node that current will still stimulate ventricular depolarization, but the time it takes to arrive in the ventricles is longer than normal.

Criteria for Classification Rhythm: The regularity between the P-P interval and the R-R interval is constant.

Rate: The rate of the atria and ventricles will usually be within normal limits of 60 to 100 beats per minute.

P wave configuration: The P waves will have the same configuration and shape. Each QRS complex will have a P wave before it. There will be the same number of P waves as QRS complexes.

PR interval: The PR interval will be greater than 0.20 second.

QRS duration and configuration: The QRS duration and configuration will be within normal limits of 0.06 to 0.10 second.

What's Unique about this Rhythm?

When the P-wave always precedes the QRS-complex but the PR-interval is prolonged over 0.2 s, first-degree atrioventricular block is diagnosed.

Clinical Significance The patient will be able to maintain normal cardiac output. No change in the patient should occur with this rhythm. Monitor and observe for further degeneration and development of other heart blocks and report if they occur. It is important to observe the cardiac output parameters to assess the blood supply to the vital organs and to determine how well the patient is tolerating the dysrhythmia.clxxvi What does this mean to the Christian Heart?

Mr. Nation states the following about, Character Deficiency Syndrome's first degree.

The word "fool" might be misleading, because we associate it with lack of intelligence; but in the Bible, neither wisdom nor folly is a matter of intellect. Both are a matter of morality. The fool fails to see the relationship between faith, morality, and a happy life.

His blindness leads him to ignore spiritual and moral reality, and ultimately to defy it.

The key is that both wisdom and folly are a choice. Proverbs describes different kinds of fool. I use the umbrella term, "Character Deficiency Syndrome" to describe all of them. Together they constitute a syndrome because they present a clear, diagnosable pattern of behaviors, all connected in a downward spiral.

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The first degree of Character Deficiency Syndrome is described as the Simple One, or the Naive Fool. This is folly in its latent stageâ&#x20AC;Ś Finally, Proverbs 14:18, "The simple inherit folly, but the prudent are crowned with knowledge." Back in the 4th century A.D., St. Augustine observed that the wages of sin is...more sin! The path of the Naive Fool will lead him into more serious and destructive forms of folly, into deeper stages of Character Deficiency Syndrome. It will, that is, unless something interrupts his progress; unless he decides to wise up and accept the disciplines of sound moral training. .clxxvii I see the Simple, Naive or Silly Fool as the Christian found to be in a First Degree AV Block.

If you remember back in Chapter 2, I stated that I believe as in normal sinus rhythm the P wave starts in the right atrium; as well the tracing of the Christian EKG will start in the right atrium. In the Christian heart, the right atrium is the Mind, which is where we have our own belief system. Your Belief starts from within your Mind (P Wave) and your beliefs are either founded on the TRUTH of Gods word the Bible or a Lie. Your beliefs will produce Thoughts.

Your thoughts will always request that you act on these thoughts, which in turn lead us to your Will (PR Segment). At this point it is up to YOU and it is your CHOICE to start Acting on or not acting on your thoughts by your will, your decision to or not to act on your thought will then start to produces Feelings. This triggers our Emotions (QRS Complex), this emotional response; produces inward and outward Behaviors. I like to think that our Personality (ST Segment), is acting outwardly with our behaviors and our Character (ST Segment), is us acting inwardly with our behaviors.

Simply put this Christian (A Baby Christian or A Carnal Christian) does not truly realize that there are always going to be consequences of our actions. They are slowly doing the right things but are still looking to see if the grass is greener on the other side of the fence. Or they are just sitting on the fence longing for the times they had before Christ (BC)!

This Christian say's I can do this or that a little and not fall into sin. I know my limits and I am not in danger of sinning. I can stop it at any time! But thy must STOP and realize that this indwelling presence (of the Holy Spirit) is a Person, One Who teaches, guides, and communicates the reality of Christ to them. Until the Christian is willing to acknowledge the foolishness and dullness of their soul and are ready to be taught, they themselves BLOCK the will, the ways and the ever so personal promptings of the Holy Spirit. They are talking the talk but are truly very slow to really walk the walk, as clearly seen on the Christian EKG as the First Degree AV Block. Consequently, this Christian is about to go from a First Degree Heart Block into a Second Degree Type I heart Block.

SECOND DEGREE AV BLOCK TYPE I (Mobitz 1 / Wenckebach) Second Degree AV Block Type I is also called Mobitz 1 / Wenchebach. Sometimes I find that if I can find the cause of something first, it helps me to understand the mechanics of the things. Some of the major causes of Second Degree AV Block Type I is Ischemia and Digitalis. What happens is this...the "PR" interval gets longer with each beat, the "PR" interval

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gets so long that it actually gets close to the "LAST" QRS. Well remember the heart must rest to repolarize, if the "P" wave gets too close to the "LAST" "R" wave, the heart won't cycle, you will have a dropped QRS! Look at Figure 12.3. Look at the first QRS and the "PR" interval, it's normal! Look at the second "PR" interval, it's longer! Look at the third "PR" interval, it's really long! Now look at the "T" wave of the third QRS, the next "P" wave is very close to the "T" wave, in fact too close for the next cycle to begin! The results are a "Dropped QRS". Notice how the entire process repeats itself. Now blocks can come and go. If blocks come and go, these are called "intermittent blocks". A little more before we go on, if you measure the "P" to "P" intervals, you will see they march out. The problem is not with the SA Node, but the AV Node, the "PR" interval is getting longer and longer. The correct term for the rhythm in Figure 12.3 is Normal Sinus Rhythm with Second Degree Type I AV Block!clxxviii

Figure 12.3 clxxix There are currently two different types of second degree heart blocks, which were first discovered by Dr. Mobitz. Dr. Wenckebach further investigated the rhythm and was able to identify a similar blockage pattern, but it was different from the one Dr. Mobitz observed. The rhythm Dr. Wenckebach observed was specifically labeled second degree atrioventricular block, Mobitz I, although it is often referred to as a Wenckebach rhythm. It is caused when diseased or injured atrioventricular node tissue conducts the electrical impulse to the ventricular conduction pathway with increasing difficulty, causing a delay in time until one of the atrial impulses fails to be conducted or is blocked. After the dropped atrial impulse, the atrioventricular node resets itself to be able to handle future impulses more quickly and then progressively gets more difficult until it drops or is blocked again. This pattern will repeat itself.

Criteria for Classification Rhythm: The P-P interval will be regular. The R-R interval will be irregular due to the blocked impulse(s).

Rate: Atrial rate will be within normal limits. The ventricular rate will be slower than the atrial rate.

P wave configuration: The P wave configuration will be normal size with an upright P wave. There will be a P wave for every QRS complex, but there will be extra P waves.

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PR interval: The PR interval will vary from one measurement to the next. The PR interval will be progressively longer with each subsequent conducted P wave until the QRS wave is dropped. The PR interval will be short, and then the cycle will begin again.

QRS duration and configuration: The QRS duration and configuration should be within normal limits of 0.06 to 0.10 second.

What's Unique about this Rhythm?

A Mobitz I rhythm has a cyclical extending PR interval until the QRS is dropped. Then the cycle begins again (irregular ventricular response).

Clinical Significance The patient may or may not exhibit symptoms of decreased cardiac out put, depending on the heart rate of the ventricles. As this rate decreases and reaches levels of 40 beats per minute or lower, the patient will show signs and symptoms of low cardiac output. This rhythm is usually due to inflammation around the atrioventricular node, and it is often a temporary condition that will resolve itself and return to a normal heart rhythm. 2nd degree type I blocks are often associated with acute inferior wall myocardial infarctions.clxxx What does this mean to the Christian Heart?

Let's take a few moments to read what Mr. Nation had to say about this Self-Confident Fool.

Previously we discussed the first stage, the Simple or Naive Fool. If his tendency to follow his passions goes unchecked, he will descend to become the Self- Confident Fool. The Bible has more to say about this character-deficient soul than any other. The Hebrew term kesil (ke-SEEL) suggests someone who is full of himself. Like the simple one, he is inclined to make the wrong moral choices, but even more so. The Naive Fool might stumble into a disastrous setup. The Self-Confident Fool will swagger in, convinced that he is the master of the situation.

Proverbs describes the Self-Confident Fool as a soul with no moral understanding. He "has no delight in understanding." Remember, we are talking, not about intellect, but about doing right and not wrong.

He reveals himself by three outstanding characteristics. First, he is extraordinarily stubborn… Second, he is mouthy… Third, he thinks it's fun to cause trouble…

The fate of the Self-Confident Fool is not a happy one: a pursuit of vain riches, or poverty for slothfulness; punishment for misdeeds; shame; and the likelihood of falling deeper into Character Deficiency Syndrome.clxxxi I see the Self-Confident or the Reactionary Fool as the Christian found to be in a Second Degree Type I AV Block also known as Mobitz 1 or Wenchebach.

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It is in this mindset, that this person's life is kept in a cyclical pattern of behaviors that if left uncheck and not brought to God, will lead this person to choose again and again to sin. This is seen on the Christian EKG by the extending PR interval until the QRS is dropped.

When the PR interval is seen getting longer and longer, this is the Christian thinking about resisting the sin and then thinking about and being enticed by the sin more and more. This process happens over and over again, with the Christian spending more time each time thinking about the act of the sin and less time think about Godly things, until the Christian gives into their personal desires and chooses to sin anyway.

We see the dropped QRS on the Christian EKG as the Christian giving into and choosing to act on the sin. They then get up after sinning, asks God for forgiveness, and at this point the PR interval is seen back closer to the QRS on the Christian EKG. As the Christian starts again to be enticed by their personal sin that so easily entangles them causing us to see the PR interval start to get longer and longer.

This goes on until the Christian chooses once again to give in to the sin and acts on it; this is seen on the Christian EKG as yet another dropped QRS. The Christian gets up and asks for forgiveness again; saying in their heart that they will not give in to that sin again but the cycle begins again, and will continue until that Christian starts to walk in the true fear of the Lord.

We find the definition to what is the fear of the lord in Proverbs 8:13 The reverent fear and worshipful awe of the Lord [includes] the hatred of evil; pride, arrogance, the evil way, and perverted and twisted speech I hate. (AMP) This in today's terms means that we are to hate SIN as much as God hates sin.

We can trace the cyclical pattern of behaviors (SINS) to the book of Hebrews in Chapter 12 and is seen on the Christian EKG as the Second Degree (AV Block Type I or Mobitz 1/Wenchebach). Let's read it together, Hebrews 12:1-4 Therefore, since we are surrounded by such a huge crowd of witnesses to the life of faith, let us strip off every weight that slows us down, especially the sin that so easily trips us up. {This is the sin which easily stands around us; the sin which always so clings to us; the sin that is always surrounding us, ever present and ready for you and I to give into and choose to act on, as one to which you and I can be gradually seduced to act on.} And let us run with endurance the race God has set before us. 2 We do this by keeping our eyes on Jesus, the champion who initiates and perfects our faith. Because of the joy awaiting him, he endured the cross, disregarding its shame. Now he is seated in the place of honor beside God's throne. 3 Think of all the hostility he endured from sinful people; then you won't become weary and give up.

4 After all, you have not yet given your lives in your struggle against sin. (NLT) If the Christian does not realize, that Jesus gave His life freely for our struggle against sin, then that Christian will not run to the Cross but instead will turn and run to the sin again and again. That act of running to the sin instead of running to Jesus and the cross leads us our next rhythm the second degree type II.

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SECOND DEGREE AV BLOCK or Mobitz TYPE II Second Degree AV Block Type II. The major cause of this conduction defect is distal to the AV Node, some authors describe the area as just below the Bundle of His. Look at the QRS's in Figure 12.4. Each conducted QRS has a normal "PR" interval. However, the 3rd QRS had three "P" waves in front of it! It "took" three "P" waves before the QRS came through. All of those "P" waves march out! The problem here is...disease below the AV node "Blocked" the signal from getting through! Disease meaning ischemia. Look at the last QRS, it took two "P" waves before the signal got through. The important concept here is...the "PR" interval is regular and the same when the signal gets through, the problem is the signal is not always getting through. Think about this, I have been married for over 20 years to the same woman, sometimes I have to ask my wife a question two or three times before she finally hears the message. Well sometimes the Atriums have to ask the Ventricles the same message 2 or 3 times before the message gets through! The Ventricles just like my wife, when she finally hears the message I get a response. Study the strip in Figure 12.4 carefully. Note the "PR" intervals are the same, note the variable rate of conduction. This strip is Normal Sinus Rhythm with Second Degree Type II AV Block with 3:1 and 2:1 conduction, intermittently.

Often times the QRS is wide in this type of block, this one however, is narrow. clxxxii

Figure 12.4 clxxxiii Second degree atrioventricular block, Mobitz II, is often referred to as the classical heart block because it was the first rhythm observed to have an occasional dropped complex. The atrioventricular node selects which electrical impulses it will block. No pattern or reason for the dropping of the QRS complex exists. Frequently this dysrhythmia will progress to third degree atrioventricular block.

Criteria for Classification Rhythm: The P-P interval will be regular. The R-R interval will be irregular due to the blocked impulse(s).

Rate: Atrial rate will be within normal limits. The ventricular rate will be slower than the atrial rate. The atrial and ventricular rates will not be the same.

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P wave configuration: The P wave configuration will be normal, with a normal size and upright wave. There will be a P wave for every QRS complex, but there will be more P waves than QRS complexes.

PR interval: The PR interval is constant and will remain constant even after the QRS drop occurs.

QRS duration and configuration: The QRS duration and configuration should be within normal limits of 0.06 to 0.10 second.

What's Unique about this Rhythm?

A Mobitz II rhythm has a constant PR interval with blocked QRS complexes (irregular ventricular response).

Clinical Significance Observe the patient for signs and symptoms of low cardiac output since this rhythm frequently will progress very quickly to a third degree atrioventricular block or complete heart block (CHB), usually within seconds. Recognition of the classical block pattern versus the Wenckebach pattern is essential. The classical block is more critical and can quickly lead to a complete heart block and a Code situation. When your patient is experiencing second degree heart block, Mobitz II, you should immediately start to prepare for a Code and application of a temporary external pacemaker. 2nd degree type II blocks are often associated with anterior septal myocardial infarctions.

What does this mean to the Christian Heart?

Here again we need to look at what Mr. Nation had to say about the Committed or Angry Fool.

The Committed Fool is at war with wisdom. He shows it in his haughty attitude: "The way of a (committed) fool is right in his own eyes." He shows it in his haughty words: "In the mouth of the (committed) fool is a rod of pride," and "the mouth of fools pours forth foolishness." He shows it by his angry temper: "A fool's wrath is immediately known." By the time a person reaches this stage, it is impossible to reform him. His foolishness has become part of him. Proverbs 27:22 says, "Though you crush a fool in a mortar like grain with a pestle, yet will his foolishness not depart from him."

Therefore in order to change his behavior it will be necessary to change his nature.

There is a special case of this severe degree of Character Deficiency Syndrome: The Shameless Fool. The Hebrew word is nabal (nah-BAHL). It describes someone who has not only rejected wisdom, not only made a commitment to destructive ideas and behaviors. He is also ignoble, irreverent, boorish, rude, and even vile and villainous.

He is the Committed Fool gone to seed!

This is the Fool of Psalms 14 and 53, who has said in his heart, "There is no God." His practical atheism leads him to doing "abominable works," becoming filthy, and preying

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on the righteous. There is no more obnoxious person depicted in the Scriptures. He is a nasty, shameless man.

The outlook for the Committed Fool is not optimistic. He is in bondage to his own sins: "His own iniquities shall take the wicked himself, and he shall be held with the cords of his sins. He shall die without instruction, and in the greatness of his folly he shall go astray." He can look forward to servitude, misfortune, punishment for crimes, and ultimately death. Yet he is likely through all his troubles to refuse to be responsible for his own choices, and even to blame God for his difficulties: "A man's own folly ruins his life, yet his heart rages against the LORD."clxxxiv I see the Committed or Angry Fool as the Christian found to be in a Second Degree (AV Block Type II) is, also known as Mobitz II. The Christian process known as sanctification is that by which those who are in Christ are conformed by the Holy Spirit into the image of Christ Romans 8:29-30 God knew what he was doing from the very beginning. He decided from the outset to shape the lives of those who love him along the same lines as the life of his Son. The Son stands first in the line of humanity he restored. We see the original and intended shape of our lives there in him. After God made that decision of what his children should be like, he followed it up by calling people by name. After he called them by name, he set them on a solid basis with himself. And then, after getting them established, he stayed with them to the end, gloriously completing what he had begun. (MSG) Sanctification in this life will never be fully complete, which means in this life, that believers will struggle with remaining sin. Paul describes this battle with sin in Romans 7:14-25 14-16I can anticipate the response that is coming: "I know that all God's commands are spiritual, but I'm not. Isn't this also your experience?" Yes. I'm full of myselfâ&#x20AC;&#x201D; after all, I've spent a long time in sin's prison. What I don't understand about myself is that I decide one way, but then I act another, doing things I absolutely despise. So if I can't be trusted to figure out what is best for myself and then do it, it becomes obvious that God's command is necessary. 17-20But I need something more! For if I know the law but still can't keep it, and if the power of sin within me keeps sabotaging my best intentions, I obviously need help! I realize that I don't have what it takes. I can will it, but I can't do it. I decide to do good, but I don't really do it; I decide not to do bad, but then I do it anyway. My decisions, such as they are, don't result in actions. Something has gone wrong deep within me and gets the better of me every time. 21-23It happens so regularly that it's predictable. The moment I decide to do good, sin is there to trip me up. I truly delight in God's commands, but it's pretty obvious that not all of me joins in that delight. Parts of me covertly rebel, and just when I least expect it, they take charge. 24I've tried everything and nothing helps. I'm at the end of my rope. Is there no one who can do anything for me? Isn't that the real question? 25The answer, thank God, is that Jesus Christ can and does. He acted to set things right in this life of contradictions where I want to serve God with all my heart and mind, but am pulled by the influence of sin to do something totally different. (MSG)

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In that passage he notes that even though he desires to do what is good in the eyes of God, he often does what is evil instead. He does the evil he doesn't want to do and fails to do the good that he wants to do. In this, he is describing every Christian's struggle with sin.

My point being, each of us has a sin (or some sins) with which we struggle with and have to over come before they become habitual (Habits [sins] of a believed comfort) in nature. This Christian no longer wants to follow Paul's teaching found in Romans 6:6-11 Could it be any clearer? Our old way of life was nailed to the cross with Christ, a decisive end to that sinmiserable lifeâ&#x20AC;&#x201D;no longer at sin's every beck and call! What we believe is this: If we get included in Christ's sin-conquering death, we also get included in his life-saving resurrection.

We know that when Jesus was raised from the dead it was a signal of the end of death-asthe-end. Never again will death have the last word. When Jesus died, he took sin down with him, but alive he brings God down to us. From now on, think of it this way: Sin speaks a dead language that means nothing to you; God speaks your mother tongue, and you hang on every word. You are dead to sin and alive to God. That's what Jesus did. (MSG) He uses the metaphor of slavery to make this point. We were at one time slaves to sin, but now we are slaves to righteousness Romans 6:17-18 But thank God, though you were once slaves of sin, you have become obedient with all your heart to the standard of teaching in which you were instructed and to which you were committed. And having been set free from sin, you have become the servants of righteousness (of conformity to the divine will in thought, purpose, and action). (AMP) The Christian now believes in a lie of the devil that they are better off with out God, yet the Holy Spirit is still speaking to the Christian's mind (P wave). But the Christian is not responding every time to the Holy Spirits promptings; sometimes it is taking the Holy Spirit 2, 3 or 4 times of prompting before the Christian responds. We see this in the intermittently 3:1 and 2:1 conduction of the P waves to the corresponding QRS and T waves.

The Christians decision to act on or not to act on the Holy Spirits leading or to act on or not to act on their own thoughts that they are better off with out God; will as we know produces Feelings. These feelings will trigger our Emotions (QRS Complex); our emotional response will produce inward (Personality ST Segment), and outward (Character ST Segment) Behaviors for the good or the bad and this all will be caught on the Christian EKG as they once again become a slave to sin, if they do not turn back to God. At the cross, the power of sin was broken and in becoming Christians, we are set free from sin's slavery over us. Therefore, when the Christian sins, it is no longer out of the necessity of his or her nature, but because he or she has willfully choosing to submitting themselves to that sin's dominion. At that moment in this Christian's life he or she is on the verge of totally turning their back on God and because of their choosing to willfully sin and are very slow to or refuse to respond to the prompting of the Holy Spirit until they want to on their terms.

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This Christian, whom we have just been talking about who is in the Second Degree Type II AV Block if no immediate action is taken will quickly lead to a more critical degree of heart block known as complete heart block or the third degree AV Block.

Mobitz I versus Mobitz II To quickly determine the difference between a second degree, Mobitz I (Wenckebach), and a second degree, Mobitz II (classical rhythm), atrioventricular block, look for the dropped beat indicated by a missing QRS complex. For the Wenckebach rhythm, the PR interval in front of the dropped QRS complex will be longer than the PR interval after the dropped QRS complex. Remember the mnemonic "Lengthen, Lengthen, drop equals Wenckebach."

For the classical rhythm, the PR interval in front and behind the dropped QRS complex will be constant. The classical rhythm is a critical condition, unlike the Wenckebach rhythm, which will usually resolve itself. Second degree heart blocks are the only blocks with an irregular ventricular response.clxxxv THIRD DEGREE AV BLOCK / COMPLETE AV BLOCK In this block, which is the most serious of all the blocks, there is no communication at all between the Atrium and the Ventricles. I talk to by wife, but she never hears me. I am doing my thing, and she is doing her thing. Well, the same holds true for the heart. Note the Atrial rate is 50 in Figure 12.5. Count the "P" waves, there are 5 of them, 5 times 10 equals 50.

Note the Ventricle rate is 50 in Figure 12.5. Count the QRS's, there are 5 of them, 5 times 10 equals 50. Now I am not trying to trick you! The Atrial rate is faster than 50. The "P" waves "march out"! Look carefully at the first "T" wave, now look at the second "T" wave. See that extra dip at the beginning, well that's a "P" wave buried in the "T" wave. Now look at the 3rd "T" wave, see the ever-so-slightly bowing out, or rounding of the last part of the "T" wave, that's a "P" wave buried in the "T" wave. Look at the last "T" wave on the end of the strip, it's the same as the second, that's another "P" wave buried in the "T" wave. That's 8 "P" waves, the Atrial Rate is really 80! Can you see this concept! The Atrium are beating independent of the ventricles, there is a BLOCK in communication between the Atria and Ventricles. The ventricular conduction is NOT in a normal pathway, why? Because it's WIDE! The block is probably at, or below the Bundle of His, why? Look at the ventricular rate, its 50! The ventricular pacemaker (termed ventricular escape rhythm) generally fires at 30 per minute.

This is 50 a minute, so it's probably firing in the lower conduction system, and not emanating within the ventricular myocardium it's self! Regardless, this patient is probably FTD (Fixing to Die)! If this patient is symptomatic (unstable), pace him immediately! The strip in Figure 12.5 is Third Degree AV Block.

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Figure 12.5 clxxxvi Third degree atrioventricular block is also known as third degree heart block or complete heart block (CHB). All electrical impulses originating above the ventricles are blocked and prevented from reaching the ventricles. There is no correlation between atrial and ventricular depolarization. As a result, there will be noticeable and suspicious disassociation properties; namely the P-P and R-R intervals. Although the intervals are regular when measured, the atria and ventricles will be firing at completely different rates. This is due to the "block," and as a result the ventricular rate will be slower than the atrial rate (see Figure 12.5). The rate of the ventricular response and the configuration of the QRS complex will be dependent upon the level of the block. If the block is low in the bundle of His, the pacemaker would come from the slow (20 to 40 beats per minute) Purkinje network. The QRS complex in this instance would measure 0.12 second or greater.

If the block is higher and the impulse causing ventricular depolarization is coming from the area of the AV tissue, then the rate is likely to be 40 to 60 beats per minute and the QRS complex will present with a "normal to narrow" appearance measuring 0.06 to 0.10 second.

The ventricular rate and QRS configurations are keys indicating the level of the heart block.clxxxvii Criteria for Classification Rhythm: The P-P interval is regular. The R-R interval is also regular, but the P-P and R-R intervals will be different.

Rate: The atrial rate will be within normal limits of 60 to 100 beats per minute. The ventricular rate is slow, between 20 and 40 beats per minute.

P wave configuration: P waves will be of normal size and configuration, but the location may be buried within the QRS, either before or after the QRS complex. There will be no correlation seen between the P waves and the QRS complex. More P waves will be noted than QRS complexes, and not every P wave will have a QRS complex following it.

PR interval: Appearance of a pattern consisting of a long PR interval followed by a short PR interval is a clue that a complete heart block exists.

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QRS duration and configuration: The QRS duration and configuration will be the same but the measurements may be either within normal limits or wide, depending on the area of the blockage.

What's Unique about this Rhythm?

In third degree AVblock, the P-P and R-R intervals are regular (constant) but firing at different rates.

Clinical Significance The patient has lost coordination between the atria and ventricles; therefore, the atrial kick is lost. Along with the loss of atrial kick and reduced heart rate, the patient will exhibit signs and symptoms of low cardiac output. Often the patient will be unconscious and require immediate medical intervention. In a situation where the patient is in third degree AV block, your first responsibility is to treat the patient. Initiating a Code! A temporary pacemaker should be available and ready for application as deemed necessary.clxxxviii What does this mean to the Christian Heart?

Let's take one last look at what Mr. Nation had to say in his Character Deficiency Syndrome about the Scornful Fool.

We have tracked the stages of Character Deficiency Syndrome from its latent stages in the Naive Fool, through its increasing virulence in the Self-Confident Fool, to its degradations in the Committed Fool and the Shameless Fool. There is one tragic stage left: the Terminal Stage. The Bible calls this person the Scorner.

The Hebrew luts (rhymes with "boots") is a scoffer, a contemptuous person, a mocker who scorns spiritual truth and moral righteousness. He is an evangelist for folly. "Proud and haughty scorner is his name, who dealeth in proud wrath." Other fools may be abominations to God, but the Scorner is even an abomination to men! The Bible expends few words describing such a one. It simply warns the wise believer to stay away from him. "Blessed is the man who . . . sitteth not in the seat of the scornful."

Don't even try to correct him; even if he should seek wisdom, he doesn't want to find it, and you will only earn shame, a blot on your own name, and the hatred of the scorner you are trying to help. Just "cast out the scorner, and contention shall go out; yea strife and reproach shall cease."

The Scorner does serve one civic purpose: he provides an object lesson. When he is punished, the Naive Fool may be "scared straight." As for the Scorner himself, his only end appears to be judgment first the judgment of men, and finally the judgment of God. The Scorner, in all his spiritual hopelessness, appears to be the Old Testament parallel to the one who commits blasphemy against the Holy Spirit, of which Jesus spoke. Jesus said, "whoever speaks against the Holy Spirit, it shall not be forgiven him, neither in this world, neither in the world to come." clxxxix

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Finally, we have come to the Scornful Fool and I see this Fool as the Christian found to be in a Third Degree AV Block also known as Complete Heart Block.

This Christian has been slowly walking away from God, and now has come almost to the point of apostasy. In EMS terminology this Christian is spiritually (FTD) Fixing to Die or better known as spiritually circling the drain. Apostasy is a theological term describing those who have voluntarily and consciously had a willful falling away from, or rebellion against, the Christian faith and truths. It is also seen as the rejection of and the abandoned of ones faith in the God, the Holy Spirit and in Jesus Christ by one who has been a Christian.cxc I believe the Bible teaches man's responsibility and free will within the confines of God's sovereignty. John is the favored Biblical author for the unconditional eternal security folks; John does put forth strong teaching on the security of the believer. He holds out a warning as well. John 15:6 If anyone does not remain in me, he is like a branch that is thrown away and withers; such branches are picked up, thrown into the fire and burned. John is in total agreement with the writer of Hebrews 10:26-27 If we deliberately keep on sinning after we have received the knowledge of the truth, no sacrifice for sins is left, but only a fearful expectation of judgment and of raging fire that will consume the enemies of God. This Christian has by their on actions come to a point that they are living out their life (P waves) and are not responding to God's dealings on their hearts through the Holy Spirit. This is seen on the Christian EKG by all the P waves (The Christians' thoughts) march out on their own and QRS complexes (The Christians actions) doing the same; without their being any correlation being seen between the P waves and the QRS complex. As we read, above this person is now in danger of hells fire do to his or her own doing.

If this Christian does not have a change of heart he or she will cross the line into the land of no return; backsliding is literally playing with fire, because backsliding, sin, hardens the heart; to the point of no return for some. Only God knows when that line is crossed. If you are backslidden, and God is still dealing with you, you haven't crossed the line. Repent while there is timeâ&#x20AC;Ś We find Biblical lists of things that can't remove us from God's love-but in none of those lists does one find self, because self-will (the freedom to choose or reject God) is the only thing that can remove one from God's care.

Finally, falling away takes place by degrees. One does not apostatize in one day. Rather it is the "small" things that take one away from God, the gradual erosion of the things of God in the life of a believer, step by step until the line of apostasy has been crossed. If you're toying with sin, repent! Don't presume upon God's grace!cxci I just wanted to end this chapter with a few thoughts for you and me to ponder a while.

Selah!

Selah is a word used 74 times in the Bible (All 74 times are found in the Old Testament) 71 times in the Psalms and 3 times in Habakkuk and it is said to be a difficult concept to

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translate. I like how The Amplified Bible translates selah as "pause, and think of that". It can also be interpreted as a form of underlining in preparation for the next paragraph.

Dr. Paul W. Carlin stated in his book Mastering Life Through Belief Therapy® Why We Do What We Do When We Do It. The source of destructive consequent behavior lies in what a person believes.

Feelings are not the cause of our emotional difficulties, they are the result. We feel the way we think, and we think the way we believe. It is a matter of Biblical truth that beliefs are the primary source of our attitudes, responses, feelings, and actions. If people believe lies, the lies will produce problematic thinking that will produce darkened emotions that will produce godless behavior.cxcii The last two paragraphs in this chapter are not my words but God's and they speak for themselves. I pray that we allow the Holy Spirit to uncloud our minds so that we can see what He wants us to see, hear what He wants us to hear, smell what He wants us to smell and that we start to speak as he wants us to speak. These two passages are truly meat and not milk, so let's get gnawing shall we…

Galatians 1:6-10 I am shocked that you are turning away so soon from God, who called you to himself through the loving mercy of Christ. You are following a different way that pretends to be the Good News but is not the Good News at all. You are being fooled by those who deliberately twist the truth concerning Christ Let God's curse fall on anyone, including us or even an angel from heaven, who preaches a different kind of Good News than the one we preached to you. I say again what we have said before: If anyone preaches any other Good News than the one you welcomed, let that person be cursed. Obviously, I'm not trying to win the approval of people, but of God. If pleasing people were my goal, I would not be Christ's servant. (NLT) Ephesians 5:1-20 Imitate God, therefore, in everything you do, because you are his dear children. 2 Live a life filled with love, following the example of Christ. He loved us and offered himself as a sacrifice for us, a pleasing aroma to God. 3 Let there be no sexual immorality, impurity, or greed among you. Such sins have no place among God's people. 4 Obscene stories, foolish talk, and coarse jokes—these are not for you. Instead, let there be thankfulness to God. 5 You can be sure that no immoral, impure, or greedy person will inherit the Kingdom of Christ and of God. For a greedy person is an idolater, worshiping the things of this world. 6 Don't be fooled by those who try to excuse these sins, for the anger of God will fall on all who disobey him. 7 Don't participate in the things these people do. 8 For once you were full of darkness, but now you have light from the Lord. So live as people of light! 9 For this light within you produces only what is good and right and true. 10 Carefully determine what pleases the Lord. 11 Take no part in the worthless deeds of evil and darkness; instead, expose them. 12 It is shameful even to talk about the things that ungodly people do in secret. 13 But their evil intentions will be exposed when the light shines on them, 14 for the light makes everything visible. This is why it is said, "Awake, O sleeper, rise up from the dead, and

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Christ will give you light." 15 So be careful how you live. Don't live like fools, but like those who are wise. 16 Make the most of every opportunity in these evil days. 17 Don't act thoughtlessly, but understand what the Lord wants you to do. 18 Don't be drunk with wine, because that will ruin your life. Instead, be filled with the Holy Spirit, 19 singing psalms and hymns and spiritual songs among yourselves, and making music to the Lord in your hearts.

20 And give thanks for everything to God the Father in the name of our Lord Jesus Christ.

(NLT)

Are you being fooled?

Are you living like a fool?

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Chapter 13 Interpreting Rhythms Originating from the Ventricles The ventricle pacemaker cells are found at the Purkinje fibers. This pacemaker is the last of the group of inherent pacemaker cells within the heart. The rate of automaticity is between 20 and 40 beats per minute. Current is initiated within the Purkinje fibers and spreads the electrical stimulation from one ventricular cell to the next. Since current is not traveling down the normal ventricular conduction pathway to activate both the right and left ventricles simultaneously, it will take longer than normal to depolarize the ventricles. A QRS duration and configuration measurement of 0.12 second or greater suggests that this cell-by-cell stimulation of electrical current is occurring to depolarize the ventricles.

PREMATURE VENTRICULAR COMPLEXES A premature ventricular complex (PVC) is caused by an ectopic beat that occurs early in the cycle and originates from the ventricles (see Figure 13.1).

Figure 13.1cxciii Criteria for Classification Rhythm: The P-P and R-R intervals will be regular with early QRS complexes. Every early complex has a full compensatory pause, meaning that two R-R interval periods are required before another electrical impulse can be conducted. These two R-R intervals are placed on the beat before the early complex and evaluated with the following complex if the QRS complex falls after the second point of the calipers.

Rate: The atrial and ventricular rates will be the same as for the underlying rhythm, but the early complexes will provide a faster ventricular rhythm than the normal rhythm.

P wave configuration: The P wave assumes the shape of the underlying rhythm. P waves are not identified on the early ventricular complex.

PR interval: The PR interval measurement follows the underlying rhythm, but in the early complex there is no P wave present.

QRS duration and configuration: The QRS duration measurement follows the underlying rhythm. With the early complexes, the QRS duration must be greater than 0.12 second and will have a bizarre form. The QRS shape will have a QRS wave in one direction and a T wave going in the opposite direction.

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What's Unique about this Rhythm?

A PVC is an early QRS complex that is wide (>0.12 second) and has a bizarre appearance.

There is no P wave.

Clinical Significance The clinical significance of the PVCs will depend on their frequency and the amount of decrease in cardiac output that occurs with each PVC. Since PVCs can occur in normal hearts, patients may tolerate PVCs without a noticeable change in their cardiac output and have no obvious symptoms. In fact, they may be unaware they are having PVCs. Other patients may complain of the "thump or skipping" sensation with each PVC. They may also experience dizziness and other symptoms of low cardiac output. More complex PVCs, such as frequent, multifocal, R-on-T PVCs and coupling, indicate an increased risk of developing a more serious ventricular dysrhythmia (see Table 13.1).

Observe the patient for symptoms of low cardiac output. Patients are provided oxygen, since PVCs often occur because of hypoxic states (suffering from lack of oxygen). Blood samples are drawn to evaluate the hypoxic state as well as electrolyte values, specifically potassium and calcium levels.

Interpolated

Early beat (if they all originate from a single ventricular focus and have similar configurations) Varied shapes and forms of the PVCs (if they original from many different points and have different configurations) PVC occurs during the normal R-R interval without interrupting the normal cycle

Occasional

More than one to four PVCs per minute

Frequent

More than five to seven PVCs per minute

Bigeminy

Every other beat is a PVC

Trigeminy

Every third beat is a PVC

Quadgeminy

Every fourth beat is a PVC PVC occurs on the T wave or the vulnerable period of the ventricle refractory period

Unifocal Multifocal

R on T PVCs Coupling

Two PVCs occur back to back TABLE 13.1 Types of Premature Ventricular Complexescxciv

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PREMATURE VENTRICULAR CONTRACTION: UNIFORM

Figure 13.2 cxcv PREMATURE VENTRICULAR CONTRACTION: MULTIFORM

Figure 13.3 cxcvi PREMATURE VENTRICULAR CONTRACTION: VENTRICULAR BIGEMINY In ventricular bigeminy, the PVC occurs with every other beat.

Figure 13.4cxcvii

Chapter 13 Interpreting Rhythms Originating from the Ventricles

PREMATURE VENTRICULAR CONTRACTION: VENTRICULAR TRIGEMINY In ventricular trigeminy, the PVC occurs with every third beat.

Figure 13.5cxcviii PREMATURE VENTRICULAR CONTRACTION: VENTRICULAR QUADRIGEMINY In ventricular quadrigeminy, the PVC occurs with every fourth beat.

Figure 13.6 cxcix PREMATURE VENTRICULAR CONTRACTION: COUPLETS In a rhythm with PVC couplets, the PVCs occur in pairs.

Figure 13.7 cc

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PREMATURE VENTRICULAR CONTRACTION: R ON T PHENOMENON The PVCs occur so early that they fall on the T wave of the preceding beat. These PVCs occur during the refractory period of the ventricles, a vulnerable period because the cardiac cells have not fully repolarized.

Figure 13.8 cci Criteria for Classification Rhythm: Irregular whenever a PVC occurs Rate: Depends on rate of underlying rhythm P wave configuration: None associated with the PVC PR Interval: None associated with the PVC QRS duration and configuration: Wide (>0.10 sec), bizarre appearance What does this mean to the Christian Heart?

John 4:34 Then Jesus explained: "My nourishment comes from doing the will of God, who sent me, and from finishing his work. (NLT) Every believer has to know the Word of God to do the Will of God in order to complete the Work of God. This brings us to what is discussed in James 2:22-24 You see that [his] faith was cooperating with his works, and [his] faith was completed and reached its supreme expression [when he implemented it] by [good] works. 23 And [so] the Scripture was fulfilled that says, Abraham believed in (adhered to, trusted in, and relied on) God, and this was accounted to him as righteousness (as conformity to God's will in thought and deed), and he was called God's friend. 24 You see that a man is justified (pronounced righteous before God) through what he does and not alone through faith [through works of obedience as well as by what he believes]. (AMP) I see the Christian that is having unifocal PVC's as having trouble with in their Will. I want to first define the word "will" according to Noah Webster in his first dictionary of the American language of 1828.

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According to Noah Webster the word 'will' means: That faculty of the mind by which we determine either to do or forbear an action; the faculty which is exercised in deciding, among two or more objects, which we shall embrace or pursue. The will is directed or influenced by the judgment. The understanding or reason compares different objects, which operate as motives; the judgment determines which is preferable, and the will decides which to pursue. In other words, we reason with respect to the value or importance of things; we then judge which is to be preferred; and we will to take the most valuable. These are but different operations of the mind, soul, or intellectual part of man. Great disputes have existed respecting the freedom of the will. Will is often quite a different thing from desire.ccii I also want to take a quick look at what Winkie Pratney had to say about the Will in his paper entitled, Man and the Origin of Evil, in 1998.

Volition (Will) - Power of free choice - the ability to pick or choose between alternatives presented to the mind. Often the supreme choice of a man's life is called the HEART, being the center and source of all the moral life, and involving control of the thoughts directly, and to a lesser and indirect sense, the state of the feelings. The will is the command-post of the soul, the central headquarters of the personality. cciii Decisions to obey God are determined by us through our will. Paul writes of believers becoming 'obedient from the heart' in Romans 6:17 and then we find the following in Ephesians 6:6 Not with eyeservice, as menpleasers; but as the servants of Christ, doing the will of God from the heart; (KJV). And it is a function of the will to choose to "let the peace of God rule in your heart" Colossians 3:15. The book of Proverbs tells us that 'many are the plans of a man's heart' (19:21) and 'in his heart a man plans his course, but the Lord determines his steps' (16:9).

As we start to look at the WILL we have come full circle and are again back to that number three. We need to take few moments to discuss the three spheres of WILL on the earth: The Human Will, Satan's Will and God's Will.

I want to start with The Human (Self) Will: This is the will of man, the basic selfish nature which desires to walk its own way. When you guide your life by self-will, you make choices on the basis of your will apart from God. The Bible warns about self-will: Jeremiah 10:23 O Lord, I know that the way of man is not in himself; it is not in man that walketh to direct his steps. (KJV) Self-will is the operation of the fleshly nature of man: II Peter 2:10 But chiefly them that walk after the flesh in the lust of uncleanness, and despise government. Presumptuous are they, self-willed; they are not afraid to speak evil of dignities. (KJV) The Bible records the results of self-will: Psalms 81:12 So I gave them up unto their own hearts' lust: and they walked in their own counsels. (KJV)

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Sin, suffering, and trouble in the world today are all results of man living in disobedience to the will of God. David speaks of self-will operating in the lives of wicked men: Psalms 27:12 Deliver me not over unto the will of mine enemies: for false witnesses are risen up against me, and such as breathe out cruelty. (KJV) The Bible states that leaders in the church should not be self-willed: Titus 1:7 For the bishop must be blameless as the steward of God: not self willed. . . (KJV) I now want to turn our attention to Satan's Will: Yes Satan himself has a will. His will has stood in opposition to God's will since eternity past. The Bible actually records five "I wills" of Satan found in the book of Isaiah. Let's read Satan's "I wills" together found in Isaiah 14:1215 How art thou fallen from heaven, O Lucifer, son of the morning! how art thou cut down to the ground, which didst weaken the nations! 13 For thou hast said in thine heart, I will ascend into heaven, I will exalt my throne above the stars of God: I will sit also upon the mount of the congregation, in the sides of the north: 14 I will ascend above the heights of the clouds; I will be like the most High. 15 Yet thou shalt be brought down to hell, to the sides of the pit. (KJV) Satan desires to destroy all that is good in your life. Jesus warned Peter about this: Luke 22:31 And the Lord said, Simon, Simon, behold, Satan hath desired to have you, that he may sift you as wheat. (KJV) Satan wants to sift all that is good out of your life. Jesus said: John 10:10 The thief cometh not, but for to steal, and to kill, and to destroy: I am come that they might have life, and that they might have it more abundantly. (KJV) Paul said some believers are taken captive by the will of Satan: II Timothy 2:26 And that they may recover themselves out of the snare of the devil, who are taken captive by him at his will.

(KJV) Now I want to turn our attention to God's Will: Romans 12:1-2 I beseech you therefore, brethren, by the mercies of God, that ye present your bodies a living sacrifice, holy, acceptable unto God which is your reasonable service. And be not conformed to this world: but be ye transformed by the renewing of your mind, that ye may prove what is that good, and acceptable, and perfect will of God. (KJV)cciv There are two Greek verbs used primarily to describe the will of God: thelo and boulomai.

Thelo (thelema/ suffice of results) emphasizes the motive, desire, and emotions associated with choices, the motive of desire behind the will.

Boulomai (boule) emphasizes absolute determination, purpose, and resolve of the mind apart from emotions associated with choices, emphasizes the mental thinking aspects of the will.

Homer taught that boulomai arose out of conscious consideration free from emotion.

Notice that both Greek words are different approaches to CHOICES associated with free will.

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Both of these words are found in Luke's account of Jesus' Gethsemane prayer. "Father, if Thou art willing (boulomai)/ plan of God), remove this cup from Me; yet not My will (to thelema/ desire to submit to boule), but Thine be done." (Luke 22:42)ccv God Himself must love that number three because as you read above Romans 12:2 shows us that there is three levels to His will, that ye may prove what is that good, and acceptable, and perfect will of God. (KJV) This is known as the GAP. The GAP is an acronym for the good, acceptable and perfect will of God. G - Good A - Acceptable P - Perfectccvi The Good Will of God: Agathos = good in character and beneficial in its effect In the good will of God, the believer is not in the perfect plan for his life but he is within God's sovereign will and moral will. He is not disobedient to God's revealed will, and he is still seeking to find that perfect individual plan of God for His life.

The Acceptable Will of God: Euarestos comes from -eu (well) and arestos (pleasing) This believer is missing the perfect will of God for his life but is still in an acceptable area. He is living in the permissive will of God. He may not even be concerned about God's perfect will for His life. God is permitting him to live in this area, although it is not God's perfect will for him.

The Perfect Will of God: Teleios = the end accomplished as the effect of progress The perfect will of God is accomplished when a believer is in harmony with the moral, sovereign, and individual wills of God for his life. The believer has accepted the sovereign plan of God for his salvation through the new birth experience. He is in harmony with the moral commandments of God's written Word. He also has determined God's specific guidance for his individual life plan.ccvii As Christians we are to choose (WILL) to continually live out the process of living, walking and working in the GAP. As we learn to live daily in the GAP with the ideal life being that we always live in the perfect will of God. We will start to see the personal changes that we have allowed God to make in our Character and Personality come to life. We will also soon discover that a functional Christian life will move from one of the three to the other from time to time. This brings us to what if the Christian chooses to walk and live outside of God's will.

Outside the Will of God: The believer in this realm is choosing (Willing) to be in direct disobedience to God 's will and this leads us to see PVC's on their Christian EKG. If this Christian continues to choose do his will and chooses to stay out of God's will then we will start to see multifocal PVC's show up on the Christian EKG.

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This brings us to the Christian that is having multifocal PVC's and we know that this Christian's Will problem, has now lead to troubles with this Christian's Character and Personality.

Let's start this rhythm off by reading what is stated in 1Timothy 4:7c. Train yourself toward godliness (piety), [keeping yourself spiritually fit]. (AMP) We first need to look again to the Noah Webster's dictionary of 1828.

Noah Webster had this to say about the word piety: 1. Piety in principle, is a compound of veneration or reverence of the Supreme Being and love of his character, or veneration accompanied with love; and piety in practice, is the exercise of these affections in obedience to his will and devotion to his service. Piety is the only proper and adequate relief of decaying man.ccviii The heart, or inner moral choice of man, determines his moral character and personality before God. It is the supreme choice of a man's life, and can be fixed on serving either God or self. Our supreme choice determines our ultimate motive, for good or bad.

Let's review two more words from Noah Webster's dictionary of 1828. Noah Webster had this to say about the word Character: 4. The peculiar qualities, impressed by nature or habit on a person, which distinguish him from others; these constitute real character, and the qualities which he is supposed to possess, constitute his estimated character, or reputation. Hence we say, a character is not formed, when the person has not acquired stable and distinctive qualities. 5. An account, description or representation of anything, exhibiting its qualities and the circumstances attending it; as, to give a bad character o a town, or to a road. 6. A person; as, the assembly consisted of various characters, eminent characters, and low characters.

Noah Webster had this to say about the word Personality: That which constitutes an individual a distinct person, or that which constitutes individuality. The personality of an intelligent being extends itself beyond present existence to what is past, only by consciousness 1. Direct application or applicability to a person; as the personality of a remark.ccix Man's act of choice can only function in one direction at a time. The will cannot choose partially to decide and partially not to decide at the same time. To me the will is like an on-off switch. Man cannot choose in a half-right and half-wrong manner at the same time. The Bible shows moral cannot be mixed: Ephesians 4:18 Their moral understanding is darkened and their reasoning is beclouded.

[They are] alienated (estranged, self-banished) from the life of God [with no share in it; this is] because of the ignorance (the want of knowledge and perception, the willful blindness) that is deep-seated in them, due to their hardness of heart [to the insensitiveness of their moral nature]. (AMP)

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In moral Light or Darkness: 1 John 1:5 And this is the message [the message of promise] which we have heard from Him and now are reporting to you: God is Light, and there is no darkness in Him at all [no, not in any way]. (AMP) and Matthew 6:22-23 The eye is the lamp of the body. So if your eye is sound, your entire body will be full of light. 23 But if your eye is unsound, your whole body will be full of darkness. If then the very light in you [your conscience] is darkened, how dense is that darkness! (AMP) Good or Bad: Matthew 12:33-35 Either make the tree sound (healthy and good), and its fruit sound (healthy and good), or make the tree rotten (diseased and bad), and its fruit rotten (diseased and bad); for the tree is known and recognized and judged by its fruit. 34 You offspring of vipers! How can you speak good things when you are evil (wicked)? For out of the fullness (the overflow, the superabundance) of the heart the mouth speaks. 35 The good man from his inner good treasure flings forth good things, and the evil man out of his inner evil storehouse flings forth evil things. (AMP) Obeying or Disobeying God: 1 John 2:15-17 Do not love or cherish the world or the things that are in the world. If anyone loves the world, love for the Father is not in him. 16 For all that is in the worldâ&#x20AC;&#x201D;the lust of the flesh [craving for sensual gratification] and the lust of the eyes [greedy longings of the mind] and the pride of life [assurance in one's own resources or in the stability of earthly things]â&#x20AC;&#x201D;these do not come from the Father but are from the world [itself].

17 And the world passes away and disappears, and with it the forbidden cravings (the passionate desires, the lust) of it; but he who does the will of God and carries out His purposes in his life abides (remains) forever. (AMP) Living for the Moment (time) or Eternity: 1Corinthians 2:14-15 But the natural, nonspiritual man does not accept or welcome or admit into his heart the gifts and teachings and revelations of the Spirit of God, for they are folly (meaningless nonsense) to him; and he is incapable of knowing them [of progressively recognizing, understanding, and becoming better acquainted with them] because they are spiritually discerned and estimated and appreciated.

15 But the spiritual man tries all things [he examines, investigates, inquires into, questions, and discerns all things], yet is himself to be put on trial and judged by no one [he can read the meaning of everything, but no one can properly discern or appraise or get an insight into him].(AMP) Repentant or Rebellious: Romans 2:4-5 Or are you [so blind as to] trifle with and presume upon and despise and underestimate the wealth of His kindness and forbearance and longsuffering patience? Are you unmindful or actually ignorant [of the fact] that God's kindness is intended to lead you to repent (to change your mind and inner man to accept God's will)?

5 But by your callous stubbornness and impenitence of heart you are storing up wrath and indignation for yourself on the day of wrath and indignation, when God's righteous judgment (just doom) will be revealed. (AMP) Wise or Foolish in life: Ephesians 5:15 Look carefully then how you walk! Live purposefully and worthily and accurately, not as the unwise and witless, but as wise (sensible, intelligent people), (AMP) Pure or Defiled inside: 1 Peter 2:20-23 [After all] what kind of glory [is there in it] if, when you do wrong and are punished for it, you take it patiently? But if you bear patiently with

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suffering [which results] when you do right and that is undeserved, it is acceptable and pleasing to God. 21 For even to this were you called [it is inseparable from your vocation]. For Christ also suffered for you, leaving you [His personal] example, so that you should follow in His footsteps. 22 He was guilty of no sin, neither was deceit (guile) ever found on His lips.

23 When He was reviled and insulted, He did not revile or offer insult in return; [when] He was abused and suffered, He made no threats [of vengeance]; but he trusted [Himself and everything] to Him Who judges fairly.(AMP) In bondage or delivered from sin by God's grace: Romans 6:17-22 But thank God, though you were once slaves of sin, you have become obedient with all your heart to the standard of teaching in which you were instructed and to which you were committed. 18 And having been set free from sin, you have become the servants of righteousness (of conformity to the divine will in thought, purpose, and action). 19 I am speaking in familiar human terms because of your natural limitations. For as you yielded your bodily members [and faculties] as servants to impurity and ever increasing lawlessness, so now yield your bodily members [and faculties] once for all as servants to righteousness (right being and doing) [which leads] to sanctification. 20 For when you were slaves of sin, you were free in regard to righteousness.

21 But then what benefit (return) did you get from the things of which you are now ashamed?

[None] for the end of those things is death. 22 But now since you have been set free from sin and have become the slaves of God, you have your present reward in holiness and its end is eternal life. (AMP) In Faith or Unbelief: Hebrews 11:6 But without faith it is impossible to please and be satisfactory to Him. For whoever would come near to God must [necessarily] believe that God exists and that He is the rewarder of those who earnestly and diligently seek Him [out].

(AMP)ccx As I have shown in the verses above, man can only be serving God supremely or serving himself suprememly.

It is the work of the Holy Spirit in the life of the Christian, to begin the life long process of producing a change of character in the child of God. The promise and hope to us from God is his continuing transformation that will be perfect and complete at the coming of Jesus Christ for His children.

This is seen in Philippians 1:6 And I am convinced and sure of this very thing, that He Who began a good work in you will continue until the day of Jesus Christ [right up to the time of His return], developing [that good work] and perfecting and bringing it to full completion in you. (AMP) and I John 3:2&3 2 Beloved, we are [even here and] now God's children; it is not yet disclosed (made clear) what we shall be [hereafter], but we know that when He comes and is manifested, we shall [as God's children] resemble and be like Him, for we shall see Him just as He [really] is. 3 And everyone who has this hope [resting] on Him cleanses (purifies) himself just as He is pure (chaste, undefiled, guiltless). (AMP) This is guaranteed to us by the resurrection of Christ found in 1 Corinthians 15:20-23 But the fact is that Christ (the Messiah) has been raised from the dead, and He became the firstfruits of those who have fallen asleep [in death]. 21 For since [it was] through a man that death [came into the world, it is] also through a Man that the resurrection of the dead [has come]. 22 For just as [because of their union of nature] in Adam all people die, so also [by virtue of their union of nature] shall

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all in Christ be made alive. 23 But each in his own rank and turn: Christ (the Messiah) [is] the firstfruits, then those who are Christ's [own will be resurrected] at His coming. (AMP) This will be accomplished and it starts with the WILL. Since mankind's will is opposed to God's will for him, the Christian must begin here. In Matthew 6:33 But seek (aim at and strive after) first of all His kingdom and His righteousness (His way of doing and being right), and then all these things taken together will be given you besides. (AMP) The last part of the verse is God's promise to us based upon our acceptance of the first part. God knows our needs better than we know our needs, and He said in Philippians 4:19 But my God shall supply all your need according to his riches in glory by Christ Jesus. (KJV) Then, in Romans 12:1-2 I appeal to you therefore, brethren, and beg of you in view of [all] the mercies of God, to make a decisive dedication of your bodies [presenting all your members and faculties] as a living sacrifice, holy (devoted, consecrated) and well pleasing to God, which is your reasonable (rational, intelligent) service and spiritual worship. 2 Do not be conformed to this world (this age), [fashioned after and adapted to its external, superficial customs], but be transformed (changed) by the [entire] renewal of your mind [by its new ideals and its new attitude], so that you may prove [for yourselves] what is the good and acceptable and perfect will of God, even the thing which is good and acceptable and perfect [in His sight for you]. (AMP) We have the "What" in verse one that we are to present our bodies as a living sacrifice (Christ gave up His body unto death for us; isn't it reasonable for Him to ask that we be a living example for Him?). Verse two provides the "How" to do it. We are not to conform ourselves to be like the world, but to allow the Holy Spirit to transform our lives into Christ's likeness, that we may prove what is that good, and acceptable, and perfect will of God for us.

As I stated before every believer has to know the Word of God to do the Will of God in order to complete the Work of God. His will for us is always good, acceptable, and perfect, and customized for each person by the Holy Spirit.

In I John 2:15-17 Do not love or cherish the world or the things that are in the world. If anyone loves the world, love for the Father is not in him. 16 For all that is in the worldâ&#x20AC;&#x201D;the lust of the flesh [craving for sensual gratification] and the lust of the eyes [greedy longings of the mind] and the pride of life [assurance in one's own resources or in the stability of earthly things]â&#x20AC;&#x201D; these do not come from the Father but are from the world [itself]. 17 And the world passes away and disappears, and with it the forbidden cravings (the passionate desires, the lust) of it; but he who does the will of God and carries out His purposes in his life abides (remains) forever. (AMP) we have the admonition not to love the things of this world, "The lust of the flesh, the lust of the eyes, and the pride of life". John tells us these things will pass away, but the Christian who does the will of God will abide forever. Satan used these three elements, in the Garden of Eden, to deceive Adam/Eve. In Genesis 3:6 And when the woman saw that the tree was good (suitable, pleasant) for food and that it was delightful to look at, and a tree to be desired in order to make one wise, she took of its fruit and ate; and she gave some also to her husband, and he ate. (AMP) as the serpent presented the tree to them they saw that it was, "Good for food" (the lust of the flesh), and that it was "Pleasant to the eyes" (the lust of the eyes), and a tree to be, "Desired to make one wise" (the pride of life)", and they succumbed to Satanic deception.

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Once the Christian has made up his mind to follow and serve the Lord, by listening to the Holy Spirit, then Psalm 37:3-7 Trust (lean on, rely on, and be confident) in the Lord and do good; so shall you dwell in the land and feed surely on His faithfulness, and truly you shall be fed. 4 Delight yourself also in the Lord, and He will give you the desires and secret petitions of your heart. 5 Commit your way to the Lord [roll and repose each care of your load on Him]; trust (lean on, rely on, and be confident) also in Him and He will bring it to pass. 6 And He will make your uprightness and right standing with God go forth as the light, and your justice and right as [the shining sun of] the noonday. 7 Be still and rest in the Lord; wait for Him and patiently lean yourself upon Him; fret not yourself because of him who prospers in his way, because of the man who brings wicked devices to pass. (AMP) provides the framework of how to go about making the choices and decisions of life.

First, one is to TRUST in the Lord, and do good according to Biblical principles. Then we are to delight in wanting to carry out the principles in behavior. Next we have a daily committal of one's life to the Holy Spirit's control, and allowing Him to bring to pass His best for one's development of things for that day.

The admonition is to wait patiently for the Lord, as He is in control. This does not mean that one cannot plan ahead, but to always commit those plans to the Lord, and be willing to shift, if the Lord through circumstances and controlling of the mind orders otherwise. Keeping a sensitive ear to the Holy Spirit and God's principles is the best way to go.

Every person desires joy, happiness, fulfillment, peace, prosperity, success, etc., and God wishes these for His children. But, we must accomplish them in God's way, and by His means, if we are to be truly fulfilled in life.

There are two ways by which we achieve our goals in life; God's way through following Biblical principles guarantees success, whereas for the Christian to follow his selfish ways guarantees failure and sadness. There are three scriptures that have bearing on this: Joshua 1:8 This Book of the Law shall not depart out of your mouth, but you shall meditate on it day and night, that you may observe and do according to all that is written in it. For then you shall make your way prosperous, and then you shall deal wisely and have good success. (AMP); Psalm 1:2-3 But his delight and desire are in the law of the Lord, and on His law (the precepts, the instructions, the teachings of God) he habitually meditates (ponders and studies) by day and by night. 3 And he shall be like a tree firmly planted [and tended] by the streams of water, ready to bring forth its fruit in its season; its leaf also shall not fade or wither; and everything he does shall prosper [and come to maturity]. (AMP); Romans 8:6 Now the mind of the flesh [which is sense and reason without the Holy Spirit] is death [death that comprises all the miseries arising from sin, both here and hereafter]. But the mind of the [Holy] Spirit is life and [soul] peace [both now and forever].(AMP) Let's examine these important ideas.

In Joshua 1:8 Israel's new leader, Joshua, is about to lead Israel into the land of Canaan.

God instructs him as to prosperity and success in their new venture; meditate upon the law of God, day and night, and then both prosperity and success would be guaranteed by God to Israel. It is interesting to note that the word, "Success" is used only one in the Bible, in this verse. The admonition to us today is clear; as we move forward in the unchartered waters of life, as we allow the Word of God to permeate and control our live, God is the guarantor that

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we will be both prosperous, as God evaluates prosperity, as well as be successful in His eyes.

By following His Word, we become re-characterized through the work of the Holy Spirit. The result is a change of character and personality to become more Christ-like, and the evidence is the "Fruit of the Spirit" as seen in Galatians 5:22-24 But the fruit of the [Holy] Spirit [the work which His presence within accomplishes] is love, joy (gladness), peace, patience (an even temper, forbearance), kindness, goodness (benevolence), faithfulness, 23 Gentleness (meekness, humility), self-control (self-restraint, continence). Against such things there is no law [that can bring a charge]. 24 And those who belong to Christ Jesus (the Messiah) have crucified the flesh (the godless human nature) with its passions and appetites and desires.

(AMP) Psalm 1:2-3 But his delight and desire are in the law of the Lord, and on His law (the precepts, the instructions, the teachings of God) he habitually meditates (ponders and studies) by day and by night. 3 And he shall be like a tree firmly planted [and tended] by the streams of water, ready to bring forth its fruit in its season; its leaf also shall not fade or wither; and everything he does shall prosper [and come to maturity]. (AMP) This verse gives to us, by analogy, an affirmation of what was seen in Joshua 1:8 This Book of the Law shall not depart out of your mouth, but you shall meditate on it day and night, that you may observe and do according to all that is written in it. For then you shall make your way prosperous, and then you shall deal wisely and have good success. (AMP). God tells us that when we delight in the law of God day and night, to allow the Holy Spirit, through the Word to permeate our life, then we will be like a tree that is well planted, well watered, good leaves, and prosperous. When one sees that kind of a tree, we realize that it is a good tree. God tells us we can be like that, as we allow His Word to control our life.

Finally, in Romans 8:6 Now the mind of the flesh [which is sense and reason without the Holy Spirit] is death [death that comprises all the miseries arising from sin, both here and hereafter]. But the mind of the [Holy] Spirit is life and [soul] peace [both now and forever].

(AMP), we have a basic principle of life that is plainly understood: "For to be fleshly (i.e. self centered) minded is death, but to be spiritually minded is life and peace". As the Holy Spirit controls and guides the Christian, the fullness of life, with inward peace, becomes the controlling factor in that person. This is God's supreme will for every child of His. Every individual desires to get ahead in life, and God has a formula for that, as found in Deuteronomy 28:13, And the Lord shall make you the head, and not the tail; and you shall be above only, and you shall not be beneath, if you heed the commandments of the Lord your God which I command you this day and are watchful to do them. (AMP) God wants us to be on the cutting edge of life, not on the trailing element. This is the God ordained way to be there.ccxi There are two ways by which any Christian is able to generally discern the will of God for one's life.

The first is the internal (Character) principle: submission of one's will to the control of the Holy Spirit, then allows Him to change the thoughts and intents of the mind and heart, to bring one's internal ideas into conformity to the principles of God's Word this is the Christian's Will

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and their Character. One's desires are now in the process of change, as guided and controlled by the Holy Spirit.

1Timothy 1:4, 19 4 Nor to give importance to or occupy themselves with legends (fables, myths) and endless genealogies, which foster and promote useless speculations and questionings rather than acceptance in faith of God's administration and the divine training that is in faith (in that leaning of the entire human{Character} personality on God in absolute trust and confidence) 19 Holding fast to faith (that leaning of the entire human personality on God in absolute trust and confidence) and having a good (clear) conscience. By rejecting and thrusting from them [their conscience], some individuals have made shipwreck of their faith. (AMP) The {Character} was added by this author.

Then we come to the external (Personality) principle: conditions outside of one's life, over which there may be little or no control, are then controlled by the Holy Spirit, to bring both the internal desires, and the external conditions into conformity to God's will for His child. All this is for our good and maturation.

2 Timothy 1:5 and 22 I am calling up memories of your sincere and unqualified faith (the leaning of your entire {Character} personality on God in Christ in absolute trust and confidence in His power, wisdom, and goodness), [a faith] that first lived permanently in [the heart of] your grandmother Lois and your mother Eunice and now, I am [fully] persuaded, [dwells] in you also. 22 Shun youthful lusts and flee from them, and aim at and pursue righteousness (all that is virtuous and good, right living, conformity to the will of God in thought, word, and deed); [and aim at and pursue] faith, love, [and] peace (harmony and concord with others) in fellowship with all [Christians], who call upon the Lord out of a pure heart. (AMP) The {Character} was added by this author.

Before we end this chapter let's read 2 Timothy 1:26 And that they may come to their senses [and] escape out of the snare of the devil, having been held captive by him, [henceforth] to do His [God's] will. (AMP) As we bring this chapter to an end, we have just been discussing the two ways that any Christian is able to generally discern the will of God for their life. I believe that these same two ways if applied to the life of the Christian that is having multifocal PVC's we will find that the PVC's will start to diminish and even completely stop. By daily choosing to do His will the Christian's with PVC's will be able to stop further damage to their heart.

In the next chapter we will be interpreting the other rhythms that originate in the ventricles, so let's get started.

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Chapter 14 Interpreting the Other Rhythms Originating from the Ventricles IDIOVENTRICULAR RHYTHM Normally, the pacemaker of the heart that is responsible for triggering each heart beat (ventricular contraction) is the SA (Sino Atrial) node. However, if the ventricle does not receive triggering signals at a rate high enough, the ventricular myocardium itself becomes the pacemaker (escape rhythm). This is called Idioventricular Rhythm. Ventricular signals are transmitted cell-to-cell between cardiomyocytes and not by the conduction system, creating wide sometimes bizarre QRS complexes (> 0.12 sec). The rate is usually 20-40 bpm. If the rate is >40 bpm, it is called accelerated idioventricular rhythm. The rate of 20-40 bpm is the "intrinsic automaticity" of the ventricular myocardium. This is the "backup plan" or "redundancy" built into the body!

Figure 14.1 ccxii Criteria for Classification Rhythm: P-P interval cannot be determined. R-R interval is regular.

Rate: Atrial rate cannot be determined due to the absence of atrial depolarization. The ventricular rate is 20 to 40 beats per minute.

P wave configuration: The P wave is usually absent; therefore, no analysis of the P wave can be done.

PR interval: The PR interval cannot be measured because the P wave cannot be identified.

QRS duration and configuration: The QRS duration and configuration measures 0.12 second or greater and will have the classic ventricular "wide-bizarre" appearance.

What's Unique about this Rhythm?

An idioventricular rhythm has an absence of P waves, slow ventricular rate of 20 to 40 beats per minute and wide-bizarre QRS complexes.

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Clinical Significance The patient has a profound loss of cardiac output due to the loss of atrial kick and the slow ventricular rate. The patient will likely be unconscious. This is a medical emergency that will likely require treatment with cardiac medications and/or pacing.

What does this mean to the Christian heart?

The Christian that has been found to be in an Idioventricular rhythm, to me is the Christian that has allowed Satan to take them captive by their choosing to walk away from God and His will. This Christian is in a very bad place in their spiritual life and almost to the point of Apostasy but not there yet. Webster 1828 defines 'apostasy' as an abandonment of what one has professed; a total desertion, or departure from one's faith or religion.

This Christian still has a chance for recovery if they choose to return to God. God's Word states this in 2 Timothy 2:26 And that they may recover themselves out of the snare of the devil, who are taken captive by him at his will. (KJV) As I was reading and studying this the following two words caught my attention "recover themselves".

The word "recover," (ananepho) in the original language means "to sober up, to return to sobriety, to return to one's senses." The metaphor implies that there has been some previous deception by evil influences, as with intoxication. In this context, the word is applied to those who oppose truth not directly so much as by accepting ideas which are perversions of truth.

This causes them to fall into the snare of the devil because they become intoxicated with error. Here the word "snare" means "the allurements of evil by which the devil traps a person." The word is also used in 1 Timothy 6:9 describing seductions to evil which ensnare those who "desire to be rich." 1 Timothy 6:9 But those who crave to be rich fall into temptation and a snare and into many foolish (useless, godless) and hurtful desires that plunge men into ruin and destruction and miserable perishing. (AMP) Dr. Paul W. Carlin in his book, Satan and the Saint: A Look into The Dark Side Of Christian Behavior, had this to say about the Christian that has allowed Satan to take them captive.

The bottom line is the devil's method to numb the conscience, confuse the senses and paralyze the will. Satan's intended purpose is to "take captive" (zogreo, Gr.), to capture men alive, so they cannot do the will of God. The "traps" designed to accomplish the "capture" are countless. The listing of some of them, which we are offering below, is by no means complete.

However, in any listing of Satan's traps, we can intelligently include the following: Pornography, drugs, homosexuality, heavy-metal music, occult videos/ movies/books/jewelry/emblems, sex videos and movies, horror comic books, temper tantrums, moodiness and pouting, avid careerism, success or money manias, and sibling rivalries.

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A Paramedicâ&#x20AC;&#x2122;s view of Christianity Probably the most subtle of all of Satan's traps is the one which he used three times, futilely on Jesus in the wilderness temptations which are described in Matthew 4, namely, proposing alternatives. Satan offered Jesus bread in place of the Word of God; proposed that Jesus tempt the Father instead of trusting Him; invited devotion (worship) of himself rather than of God. The enemy's tactics have not changed. He still offers Christians desirable or appealing alternatives to Christian fellowship, holiness (spiritual health), the Word of God, worship, servanthood, spiritual growth, local church government, and evangelism.

It is interesting how Satan wants to "take us alive." He delights to get Christians involved in doctrinal error, watered-down values, compromised convictions, misdirected ambitions, worldliness, unreasonable desires, irrational biases and wavering priorities.

His aim is to keep you alive and functioning as a Christian, but living in line with alternatives to truth. Satan does not want your local church, for example, to close down. He would much rather that it stays open and with its adherents riveted on things which are alternatives to Divine purpose, i.e., "a name that it lives but is dead."â&#x20AC;Ś Do you see the sinister plot? If the enemy can convince you that something (anything) is better than scriptural reality, you are his "captive" not "to do the will of God." However, if you have been "taken alive" by Satan, the good news is that you can still "recover yourself." You can spiritually sober up! You can submit yourself to God and resist the devil. In short, you do not have to remain his "captive." ccxiii

So then the choice is up to the individual Christian to turn back to God or not. We need to move on to the Christian that is found to be in an accelerated idioventricular rhythms.

ACCELERATED IDIOVENTRICULAR RHYTHM Accelerated idioventricular rhythms occur when the sinoatrial and junctional pacemakers fail to initiate an impulse and all that is remaining is the slow ventricular pacemaker. The primary difference between accelerated idioventricular and idioventricular dysrhythmias is the heart rates. This dysrhythmia still presents with the classic "wide" QRS (0.12 second or greater) complex and an absence of P waves. The impulse rate for this dysrhythmia is 40 to 100 beats per minute. It is simply a faster idioventricular rhythm.

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Figure 14.2 ccxiv Criteria for Classification Rhythm: P-P interval cannot be determined. R-R interval is regular.

Rate: Atrial rate cannot be determined due to the absence of atrial de-polarization. The ventricular rate is 40 to 100 beats per minute.

P wave configuration: The P wave is usually absent; therefore, no analysis of the P wave can be done.

PR interval: The PR interval cannot be measured because the P wave cannot be identified.

QRS duration and configuration: The QRS duration and configuration measures 0.12 second or greater and will have the classic ventricular "wide-bizarre" appearance.

What's Unique about this Rhythm?

The accelerated idioventricular rhythm has an absence of P waves, a ventricular rate of 40 to 100 beats per minute and wide-bizarre QRS complexes.

Clinical Significance The patient may or may not be able to tolerate this dysrhythmia due to the decrease of cardiac output as a result of the loss of atrial kick and the slower ventricular rate. The patient may or may not be unconscious. This patient may require treatment with cardiac medications and/or pacing.

What does this mean to the Christian heart?

This Christian found to be in an Accelerated Idioventricular rhythm; to me is the Christian that has allowed Satan to draw them away.

The reference is in James 1:13-16: Let no one say when he is tempted, I am tempted from God; for God is incapable of being tempted by [what is] evil and He Himself tempts no one.

14 But every person is tempted when he is drawn away, enticed and baited by his own evil desire (lust, passions). 15 Then the evil desire, when it has conceived, gives birth to sin, and sin, when it is fully matured, brings forth death. 16 Do not be misled, my beloved brethren.

(AMP)

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When we read that the Bible states that "When he is drawn away, enticed and baited by his own evil desire (lust, passions)." I have to admit I can't say it any better than Dr. Paul W. Carlin in his book, Satan and the Saint: A Look into The Dark Side Of Christian Behavior, lets read what he had to say about this Christian.

That statement pretty much eliminates our passing the buck. We are drawn away by our own lust. Not the world, not the devil, but our own lust. "Lust" means evil desire, passion. "Entice" means to catch by bait. The word was applied to the hunter, or, more accurately, to the fisherman who lures fish to his hook by use of tasty bait. The object of the enticement ends up on the trap or net. In like manner, the first intent of lust is to draw you out of your place of safety and land you in a trap. The point is that you must first be drawn away before you end up in the trap.

Drawn away?" But from what? Think about it. You are secure in a good local church, in a marriage, in devotion to God, in a daily program of Bible reading and prayer, or perhaps even a ministry. It is a position of spiritual health. However, inside of you there is a restlessness or unrest that builds into a lust. Subsequently, certain conditions or opportunities around you form an enticement. You begin then, ever so slowly, to be "drawn away".

The enticements, or bait, begin to get more attractive. And the strange thing is, with every step away, the circumstances that developed into enticements become more frequent . . . and the desires become bolder and stronger. Then one day you find yourself developing or arranging the opportunities, with your conscious or unconscious intention being to fulfill your own suppressed fantasy. The key word here is "suppressed"; what is being suppressed is direct opposition to your being "taken captive to the obedience of Christ."

Returning to our test from James, the verb construction in verse 15 is "hath conceived," literally meaning "has become pregnant." And the expression "brings forth sin" means to give birth to sin. Then when the ugly offspring, sin, has been birthed and finally grows to adulthood, that which issues from this whole process is death. For the Christian, this could mean the death of conscience, or spiritual health, or a marriage, of a ministry - or of any number of good spiritual things.

The familiar pattern is clear. First there is the attraction, then the conception, then the nurturing to maturity. It is sad but nevertheless true that some Christians enjoy the intrigue and mystery of the enticement phase. But even sadder is the fact that far too many enjoy the nurturing of sin to maturity. This pattern is clear also: sin fascinates, then it assassinates; it thrills, then it kills.

My point here is not a simple one, and the gist of it is not an easy pill to swallow. For you see, the work of God lays the blame for the finished product, sin, at our own door we are drawn away by "our own" lust. So you see that what you do is not your wife's fault. It is not your husband's fault. It is not your job's fault. It is not brought on by pressure. It is not caused by money. Or by affluence. Or by society. "The enemy is us!"

It is me! It is you! It is our own lust!

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Let me make an observation that you may not either understand, or agree with.

Infidelity in a marriage is perhaps one of the greatest fears of a spouse. However, realistically speaking, if your husband or wife wants to be unfaithful, there is nothing you can do to prevent it. He or she will find a way. If that restless lure is there, he or she is the only one who can stop the infidelity. This is a rather crude illustration of one's being "drawn away of his own lust," but it is accurate. The erring mate will become very creative and exceedingly aggressive during his or her passage from the attraction, to the conception, to the birth and finally the maturity. And the one who is indeed being drawn away, though he or she will recognize the fact, will normally be the last to admit it. Meantime, the guilty party will know exactly what he or she is doing.

What we are saying here about infidelity will not make infidelity any less painful for the betrayed spouse, but there is some degree of relief in understanding the process.

The same is true at any level of defection. Any solicitation to evil is from man's own inner lust. Any attempt at self-excuse is based on ignorance both of God and the nature of temptation. "According to the Testaments, every individual must personally struggle against evil spirits of deceit, who are ruled by the devil, or Beliar. They exploit human drives and frailties to promote their evil ends. ccxv Well said and we will now go on to the Christian that is found to be in the rhythm of Ventricular Tachycardia.

VENTRICULAR TACHYCARDIAS Ventricular tachycardia (VT) occurs when three or more PVCs occur in a row and the ventricular rate is generally around 100 to 200 beats per minute and may be either sustained (lasting longer than 30 seconds) or nonsustained. VT refers to an arrhythmia characterized by rapid ventricular rates Causes include reentry and, less commonly, abnormal automaticity.

In addition, VT sometimes is associated with anatomical reentry around scar tissue. It is common for VT to precede ventricular fibrillation, and it has been posited that this transition may arise from the rapid fractionation of reentrant waves that formed at the onset of tachycardia.

VT can be described as monomorphic or polymorphic depending on its appearance on the EKG. In monomorphic VT, the EKG appears as an undulating signal with broad QRS complexes that all have similar shapes. In polymorphic VT, the shapes of the QRS complex are different and may be indicative of multiple ectopic foci. Torsades de pointes ("twisting of the points") is an important type of polymorphic VT in which the amplitudes of the QRS complexes vary in a sinusoidal pattern.

This arrhythmia often results from triggered activity in the context of other electrophysiological abnormalities, especially a prolonged QT interval, which may result not only from electrolyte imbalances and congenital prolongation but also from the use of many drugs, including a number of antiarrhythmic drugs. Prolongation of cardiac action potentials, especially when the prolongation primarily affects the plateau phase, can increase the likelihood of early after depolarization development.ccxvi

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There are three rhythms that we will be reviewing that make up Ventricular Tachycardia, this could get a little long so we need to get started. As stated above, VT sometimes is associated with anatomical reentry around scar tissue. In the case of the Christian heart we are going to see that scar tissue is the main causes for VT. We will be looking into the Christians life that can be described as monomorphic which is the Christian that is dealing with being offended. The Christian described as polymorphic, we find that Christian is having problems with rejection. Then in the case of Torsades de Pointes we will find the Christian that is dealing with being wounded.

You may ask how we can have Christians that may fall into anyone or all of these areas of being Offended, Rejected and Wounded. I want to turn your attention to the book of 1 Samuel Chapter 22 and I want to read verse 1 & 2 in a few different versions for us to see these men for who they were.

1 Samuel 22:1-2 Amplified Bible: So David departed and escaped to the cave of Adullam: and when his brothers and all his father's house heard it, they went down there to him. 2 And everyone in distress or in debt or discontented gathered to him, and he became a commander over them.

And there were with him about 400 men. (AMP) The Message: 1-2 So David got away and escaped to the Cave of Adullam. When his brothers and others associated with his family heard where he was, they came down and joined him.

Not only that, but all who were down on their luck came aroundâ&#x20AC;&#x201D;losers and vagrants and misfits of all sorts. David became their leader. There were about four hundred in all. (MSG) Complete Jewish Bible: David left there and took refuge in the Cave of 'Adulam. When his brothers and the rest of his father's family heard of it, they went down to see him there. 2 Then all the people in distress, in debt or embittered began gathering around him, and he became their leader; there were about four hundred with him. (CJB) Knox Bible: Afterwards David moved on, and took refuge in the cave of Odollam. His brethren and all his father's kindred followed him there; 2 and soon a band of men gathered about him, the ill-used, the debtors, the disaffected, and David became their leader, so that he had some four hundred men at his heels. (KNOX) To me those that were Distressed, In-Debt, Down on their luck, Losers, Vagrants, Misfits, Embittered, Ill-Used, Disaffected and Discontented in David's day are just like you and I today that are dealing with our own feelings of being Offended, Rejected and Wounded. Let's fasten our seat belts as we get ready for a spiritual Pre-cordial Thump.

VENTRICULAR TACHYCARDIA (VT): MONOMORPHIC In monomorphic VT, QRS complexes have the same shape and amplitude. It is important to confirm the presence or absence of pulses because monomorphic VT may be perfusing or nonperfusing.

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Monomorphic VT will probably deteriorate into VF or unstable VT if sustained and not treated

Figure 14.3 ccxvii Criteria for Classification Rhythm: The P-P interval is usually not identifiable due to the large ventricular activity recorded. The R-R interval is usually regular, but it may be slightly irregular at times.

Rate: Atrial rate cannot be determined because the P-P interval cannot be recognized.

The ventricular rate is between 100 and 200 beats per minute.

P wave configuration: The P wave is usually absent; therefore, no analysis of the P wave can be done.

PR interval: The PR interval cannot be measured because the P wave is not able to be identified.

QRS duration and configuration: The QRS duration and configuration measures greater than 0.12 second and will have a bizarre appearance with an increase in amplitude.

The T wave will be in the opposite direction (usually downward) from that of the QRS complex.

What's Unique about this Rhythm?

Ventricular tachycardia has a classic "sawtooth" appearance and a rate in excess of 100 beats per minute, with, no P wave.

Clinical Significance The patient will have a decrease in cardiac output due to the decrease in ventricular filling time and the loss of the atrial kick. Some patients can tolerate the dysrhythmia for a short time and will have a pulse and remain conscious, whereas other patients will be unresponsive immediately. About 50% of the patients will become unconscious immediately, with no pulse or respiration.

As soon as you recognize ventricular tachycardia on the monitor or EKG equipment, you should check the patient for unresponsive. A Code is called and CPR is initiated. Emergency equipment such as a defibrillator, medications, and intubation equipment are necessary. If the patient is responsive, initiate a treatment plan of medications and electrical treatments.

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What does this mean to the Christian heart?

I see the Christian that is in a monomorphic VT as the Christian that is dealing with being offended and boy does that start to build up scar tissue in our hearts. An Offense as defined in Vine's Greek (skandalon) as the name of the part of the trap on which the bait hung that lured the animal into the trap or a hindrance or a stumbling block. So then Satan uses offenses as bait to lure you and I into a life-time of bitterness, resentment, unforgiveness, and even hatred. If we allow the spirit of offense to come in, and take hold in our lives then it becomes a hindrance and a stumbling block to us. It causes us to stumble in our walk with God. Webster 1828 defined 'offend' as: To displease; to make angry; to affront. It expresses rather less than 'make angry,' and without any modifying word, it is nearly synonymous with displease. We are offended by rudeness, incivility and harsh language. Children offend their parents by disobedience, and parents offend their children by unreasonable austerity or restraint [sternness or restrictions]. Actually, many things offend us; and we are offended far too easily and too often.

Joyce Meyer in her paper on Dealing with Offence had this to say.

We will determine not to be offended, and we will seek to keep offense out of our lives.

Proverbs 4:23 - Guard your heart with all diligence for out of it flows the issues of life.

Philippians 1:9-10 (NKJV) - And this I pray, that your love may abound still more and more in knowledge and all discernment, that you may approve the things that are excellent, that you may be sincere and without offense till the day of Christ . . .

Psalm 119:165 - Great peace have they who love Your law; nothing shall offend them or make them stumble.

Six types of offense: 1. Taking offense 2. Giving offense 3. Offended by the truth 4. Offended at God 5. Offending the Holy Spirit 6. Offending yourself There will be no offense in heaven. Matthew 13:41 - When Christ sends the "reaper angels," they will gather up all offense. Matthew 24:10 - An end-time attack Offense and Cold Love Matthew 24:12 - The love of the body grows cold because of the lawlessness [of offense] and other iniquities. Matthew 24:11 - When people are offended, they are more easily deceived. Love is spiritual warfare, and we cannot love with offense in our hearts. We cannot pray or worship properly with offense in our hearts. Mark 11:22-26 -

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We must walk in love for our prayers of faith to be answered. We must forgive!

Matthew 6:9-15 - Forgive others for prayer to work. Matthew 5:23-24 - Leave your gift at the altar and make peace with your brother.

Offense turns into deeper problems Resentment, unforgiveness, bitterness (which makes the entire life and person bitter), and hatred Proverbs 17:9 - Love covers offenses. Cover - To close, conceal, hide, or keep a secret. We must learn how to have "closure" on offenses. Don't even leave a crack in the door; close it permanently. I Peter 4:8 - Above all things have intense love, for love covers a multitude of sins (forgives offenses). I Corinthians 13:5 - Love is not touchy, fretful, or resentful - people are, but love isn't. If we truly want to be like Jesus, we must give up our right to act like ordinary people. I Corinthians 3:3 - Paul told the believers they were acting like mere unchanged men. They had strife between them.

People easily offended are: 1. Selfish - Anytime they don't get their way, they get offended.

2. Insecure - Their love tank is empty; and when they don't get their way, they feel rejected.

3. Negative - They believe the worst and should believe the best.

4. An easy mark for Satan - he baits the trap, and they take the bait every time.

5. Miserable - Being offended makes you more miserable than the other person.

6. Hindering God's plan for their lives - they cannot go forward with wrong things in their hearts.

7. Unwise - Any time God tells us in His Word not to do something and we do it anyway, it is unwise.

8. Not free - forgiveness is freeing.

Matthew 18:34-35 - The offended individual has no peace of mind. Without peace, he has no joy. Most of the ground that Satan gains in the life of a believer is gained through unforgiveness!!

Champions Refuse To Be Offended I Samuel 17:28-30 - David turned away from offense. I Samuel 16:1-13 - David could have been offended because he was left out. His father did not even consider him as a possible choice for king. The fact that he did not become offended shows at least one of the reasons why he was God's choice. II Timothy 4:16 - At Paul's first trial, no one stood with him. He refused to be offended. Satan has launched an aggressive attack to keep us offended. Each individual may have hundreds of opportunities each week.

Offense is not a "little problem" - it is a demon! Jesus had numerous occasions to be offended, but He refused them all.

1. His own relatives were ashamed of Him.

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A Paramedicâ&#x20AC;&#x2122;s view of Christianity 2. His disciples often acted like spoiled brats. They would not even stay awake and pray with Him one hour before His Crucifixion. They never really understood Him. (We get very offended when people don't understand us.)

3. Peter denied Him. 4. The Pharisees constantly tried to entrap Him. John 13:3 - Jesus knew Who He was.

1. I believe His security in Father God allowed Him to refuse offense.

2. If we are secure, we are free to be more concerned about what people are doing to themselves rather than what they are doing to us!ccxviii

I believe that there are two elements to an offense: (1) the injury the act of being hurt and then (2) the debt or IOU the offended person feels they are owed something as a result of the injury. As a victim or as the recipient of an offense, we want the offending person to apologize, to say they are sorry, to take back the words they said or the things they did, and to accept responsibility for making restitution or for amending the offense.

Dr. Arlin Epperson had the following to say about offenses in his paper on Healing of the Spirit.

Offenses sometimes occur because of unrealized expectations. In expecting a certain behavior from someone, we can be setting ourselves up for feeling offended. (An example would be an aunt who lives out of state sending a baby shower gift and expecting, but not receiving, a "thank you acknowledgment." In this instance, the aunt's well-grounded, traditional expectation of a courtesy thank you note is met by a less-established or unintentionally forgotten reply.) When we have certain expectations of others (whether they are well-grounded or not) we often set ourselves up for offense by expecting specific behaviors or actions from them. When others do not act accordingly, as we believe they should, we conclude they have let us down, and feelings of irritability may follow. This happens often between parents and children or between spouses. Individuals with a spirit of control will have significant problems in this area. The offender didn't do what we thought he should, or what we wanted him to do, so we become offended and the spirit of anger enters.

Offense also comes through false, unrealistic, or exaggerated expectations of ourselves such as when we seek recognition, affirmative acceptance, or confirmation, and it doesn't occur (a spirit of rejection is at work in this example). We become angry and resentful. Satan sees (and uses the fact) that we take the words and actions of others in ways "not intended."

When we are offended, we become bound, and "whatsoever thou shalt bind on earth shall be bound in heavenâ&#x20AC;Ś" (Mat. 16:19). When we develop resentment against an offender we not only become bound ourselves, we bind them as well. When we become offended we develop a hardened heart to protect us, we begin to build walls around our heart. These walls may reduce the hurt of future offenses but they also keep out the love of God, which heals us.

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The normal response to being offended is to try to deny it, forget it, or bury it in our subconscious. This condition is only temporary; offenses surface again in another form such as physical illness, lack of peace, etc. Some of the conditions which cultivate one's sense of being offended include: insults, attacks, wounding, division, separation, broken relationships, betrayal, and backsliding.

When we allow an offense to remain in our heart, it causes severe spiritual consequences. Unhealed offenses eventually turn into hatred, bitterness, and hardness of heart. We ultimately end up with a wounded spirit. An offense is the ultimate cause that directs many to leave their church fellowship and/or to fall from the faith. Many individuals seek revenge. However, scripture advises, "Recompense to no man evil for evilâ&#x20AC;Ś Vengeance is mine; I will repay, saith the Lord" (Rom. 12:17-19).

Bitterness develops from unfulfilled revenge; it is a "root." Hebrews 12:14-15 cautions us: "â&#x20AC;Ś lest any root of bitterness springing up trouble you, and thereby many be defiled." If roots are nurtured (watered, protected, fed, and given attention), they increase in depth and strength. They become hard to pull out. The harvest they reap includes anger, resentment, jealousy, hatred, strife, hardness of heart, and discord. When we become offended, our ability to produce righteous fruit is stagnated.

Concerning Forgiveness When a serious sin has been committed against a person, particularly against a child (such as sexual, physical, or verbal abuse), or when a life-threatening, frightening, or a highly unsafe experience or traumatic event occurs (such as a divorce), the one offended remembers the panic, violation, trauma, pain, sense of disloyalty or abandonment, confusion, shame and guilt, and later revisits the situation over and over again in his or her mind. This recalling of a traumatic memory (known as PTSDâ&#x20AC;&#x201D; post-traumatic stress disorder) scientists now believe may be even worse than the disabling physiological response suffered at the time of the initial event. It is believed this recalling of a traumatic memory or event reconsolidates the memory, writing it more strongly into the mind. PTSD is suffered by up to 6% of boys and 15% of girls (refer to http://www.medicinenet.com/posttraumatic_stress_disorder/article.htm). In these cases, forgiveness is extremely difficult for the traumatized person without the help of an intercessor and inner healing.

When offenses are not forgiven, unforgiveness sets in and eventually opens a door for a spirit of unforgiveness to take residence in the soul of the person. This dark spirit has acquired the spiritual legal right to be there, because it is feeding off the perceived or realized impression of injustice and the repeated visitation to the memory of the trauma. This spirit of unforgiveness can become very entrenched. However, when the offended person extends forgiveness, the legal right of the dark spirit to stay has been removed and it must leave when commanded to do so in the name of Jesus.

The one offended and seeking healing will find it very difficult to forgive until the experience is healed and the spirit of unforgiveness is cast out. Make note that, should the one offended sincerely forgive their abuser, "feelings" of unforgiveness may return because the spiritual ground has not been renounced and given to the Lord. This step

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A Paramedicâ&#x20AC;&#x2122;s view of Christianity (returning ground to the Lord) is vital to the process of inner healing and is discussed more fully in the section titled "Healing of Hurts, Emotions and Memories." Other noteworthy fundamentals include: 1. If we want to close the open gate of unforgiveness and be released from this bondage, we first must accept that Jesus Christ forgave us of our sinsâ&#x20AC;&#x201D;He cancelled out our IOU's (debts) and we must do likewise (Mat. 6:12, 15; Mat. 18:35).

2. Forgiveness isn't free. In the Old Testament, animals, doves, fruit, and grain were offered in sacrifice for sin. In the New Testament, Christ offered his life for forgiveness of sin.

3. Forgiveness is similar to being given an "executive pardon," where the offender is for-given the crime and does not have to pay the resultant debt for the offense.

4. Forgiveness is an act of our agency and will; it is not a feeling; however, the feeling of forgiveness does follow as we forgive others.

5. When we exercise our agency to forgive, all the powers of heaven (by His design) come to our aid.

6. Forgiveness may also require forgiving God. 7. We must also forgive ourselves and accept God's forgiveness for ourselves, as we are similarly to "love thy neighbor as thyself" (Mat. 22:39).

8. Know that, as soon as we confess, God forgives us (1 John 1:9).

9. If the offending person is a Christian, Mat 5:25-27 requires you to reconcile with your brother before bringing a gift to the altar. Forgiveness is not however dependent upon reconciliation. Your forgiveness doesn't require the offender's cooperation or their act of reconciliation. But scripture does remind us that we are to "bless and curse not," so offering a prayer of blessing upon them should follow.

10. Expect Satan to try to deceive you at a later time, to make you "think" you have not forgiven or that it takes a very long time to forgiveâ&#x20AC;&#x201D;both of which are lies.

11. Many people are bound by bitterness against dead people. You must forgive them also.

12. If someone is holding a sin against you, it is their problem, not yours. They have to get it right before God, just like you do. Forgiveness doesn't require reconciliation. Whether they get it right with God really doesn't have anything to do without because you are standing alone before God in the integrity of your heart.ccxix

This brings us to the Christian found to be in a polymorphic VT and I see this Christian as someone that is dealing with rejection. Just as the QRS complexes vary in shape and amplitude so does the rejections that this Christian faces. Whether or not these rejections are real or preserved they cause the same problem either way.

Rejection is one of Satan's most effective forms of oppression. Rejection may keep a sinner from coming to God for salvation and a Christian from reaching his or her full potential in

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God; it undermines, breaks, and prevents normal and harmonious relations between family members, marriage partners, fellow workers, and friends. It also distorts our image of God as a loving heavenly Father who loves us and who wants only the best for us.ccxx

VENTRICULAR TACHYCARDIA (VT): POLYMORPHIC In polymorphic VT, QRS complexes vary in shape and amplitude. The QT interval is normal or long.

Figure 14.4 ccxxi Criteria for Classification Rhythm: Regular or irregular Rate: 100-250 bpm P wave configuration: None or not associated P R Interval: None QRS duration and configuration: Wide (0.10 sec), with the QRS bizarre appearance What's Unique about this Rhythm?

Ventricular tachycardia has a classic "sawtooth" appearance and a rate in excess of 100 beats per minute, with, no P wave.

Clinical Significance The patient will have a decrease in cardiac output due to the decrease in ventricular filling time and the loss of the atrial kick. Some patients can tolerate the dysrhythmia for a short time and will have a pulse and remain conscious, whereas other patients will be unresponsive immediately. About 50% of the patients will become unconscious immediately, with no pulse or respiration.

As soon as you recognize ventricular tachycardia on the monitor or EKG equipment, you should check the patient for unresponsive. A Code is called and CPR is initiated. Emergency equipment such as a defibrillator, medications, and intubation equipment are necessary. If the patient is responsive, initiate a treatment plan of medications and electrical treatments.

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What does this mean to the Christian heart?

This Christian is dealing with rejection. The dictionary defines rejection as "an act of throwing away or discarding someone or something," which implies a lack of value in the person or thing thrown away. Being rejected, then, makes us feel valueless or worthless.

Dr. Arlin Epperson had the following to say about rejection in his paper on Healing of the Spirit.

Being denied love is at the root of rejection. Rejection (whether active or passive, real or imaginary) robs Jesus Christ of His rightful position as Lord in the lives of His children and keeps believers from experiencing the vitality and quality of life He alone can give.

Rejection results in wounding of the heart sometimes so painful that the mind refuses to deal with it, so we bury it in our subconscious. Later, it surfaces in other ways to cause us problems. Rejection is the greatest undiagnosed and most untreated malady within the Body of Christ today. Regrettably, a large majority of those coming for prayer suffer from feelings of rejection.

Symptoms of Rejection Low self-image, insecure, withdrawn personality, self-condemning, self-hate, try to please others, worthless, believe I am a failure, agony within, inferior, question my identity, display a façade, starved for love, promiscuous, can't love spouse, unworthy, fear of rejection, don't know who I am, approval-seeking, self-rejecting, feel abandoned, self-accusing, can't accept love, depressed, can't give love, internal hurt/pain, no lasting relationships, earn acceptance by being good or by hard work Root Causes of Rejection The root causes of rejection can be found from one or more of a number of sources, which are listed below (a thorough explanation of each one follows): 1.

2.

3.

4.

5.

6.

7.

Heritage rejection Generational rejection Timing and manner of conception Events and attitudes of the mother and father during pregnancy Baby not bonding with the mother or father Rejection causes after birth Being an adopted child, or forced either to live with relatives or in a foster home, or to live in a different culture.

8. Factors that cause rejection during early childhood 9. Problems in school caused by teachers or schoolmates (that cause rejection) 10. Multiple causes of rejection later in life

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1. Heritage Rejection: Satan is the father of rejection. Rejection came with Satan's temptation of Eve and, ultimately, Adam. There was no rejection prior to Satan's temptation, as "â&#x20AC;Ś God saw everything that he had made, and, behold, it was very good" (Gen. 1:31). In accepting Satan's suggestion to eat the forbidden fruit, Adam and Eve rejected God and fell into disobedience and sin. They were being covetous (of what the serpent hinted God had denied them) and rebellious (by over-stepping the only restriction God had made).

As a result, they were rejected by God, cursed, and forced to leave the garden.

Eve (and all the women who came after her) were promised pain in childbirth and subjection to man. God cursed the ground and told Adam that he would eat bread by the sweat of his brow (Gen. 3:16-19). God no longer communicated with them as He had earlier.

Adam and Eve committed what is generally called original sin. Therefore, all the children born to them (and their descendants) inherited sin as a spiritual gene, thereby turning original sin into hereditary sin. Subsequently, the whole human race has had the same sinful nature; also, the curse of rejection and the penalty of spiritual death has been passed down through the process of conception and birth (Rom. 5:12).

Cain, as the first naturally-born child, was the first recipient of the "hereditary sin" curse. He was rebellious, argumentative, and disobedient, and did not offer an appropriate sacrifice, as God required. He rejected God and God rejected Cain. Because Cain "belonged to the evil one" (1 John 3:12), any consideration of how Satan is able to manipulate humanity into feeling rejected must begin with Cain.

While both Cain and Abel were born with hereditary rejection, it was Cain who appeared to be most affected. God reasoned with Cain to encourage him to make the right choice: "Then the Lord said to Cain â&#x20AC;Ś If you do what is right, will you not be accepted?" (Gen. 4:7). Cain was being offered a second chance but he rejected it.

Because of Cain's decision and the ultimate murdering of his brother, God rejected him and placed him under a curse, thus some refer to rejection as the "Cain Syndrome." Cain's self-pity, accusing God of over-reacting, fear of rejection, victimization, death, and abandonment (Gen. 4:13-14) helps us better understand the range of symptoms of many who suffer rejection today.

2. Generational Rejection: We see from the above paragraph that all the descendents of Adam and Cain carry a predisposition to heritage rejection.

However, not all persons actually inherit a spirit of rejection. Abel's sacrifices were acceptable to the Lord. As we will see in a later section, many curses are conditional. When we are disobedient, the promised curses come upon us (Deut. 28 and 30). Cain received a curse of rejection (because of the heritage rejection potential and his sins of disobedience and rebellion) while Abel did not.

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Generational sin is discussed in depth in the section on "Healing from Generational Influences." Suffice it to say that when our forefathers were disobedient, they incurred a curse (in this case rejection) and it continues to pass as a curse of rejection upon the heads of the children to the third and fourth generation, as stated in Exodus 20:5: " . . . I the Lord thy God am a jealous God, visiting the iniquity of the fathers upon the children unto the third and fourth generation of them that hate me."

When those who come for prayer review the symptoms of their ancestors, many find that their mothers or fathers, grand-parents or aunts and uncles reflect the symptoms of having a curse of rejection as well.

3. Timing and Manner of Conception: The following are specific ways rejection can begin within an individual. Pray the Lord will enlighten you as to the cause(s) of rejection in your life: a. One or both parents did not want to conceive b. Parents not married c. Conception may have been the result of lust during a "one night stand" or through the act of adultery d. The mother is very young and ill-prepared to be a mother e. There may not have been sufficient financial resources to provide for a baby f. Sexual abuse, rape, incest 4. Events and Attitudes of the mother and father during pregnancy: In the book The Secret Life of the Unborn Child (Thomas Verney, MD ISBN 0-440 50565-8), the author quotes research about the capabilities of babies inutero, which are noted to be able to: a. Hear b. Have a taste in music c. Feel the love or the lack of love of the mother d. Learn both the father's and mother's voice e. Experience anxiety if the mother smokes f. React when the mother even thinks about a cigarette g. Make decisions about how to react after birth (such as in refusing to bond) h. Form attitudes and personality traits i. Feel rejected if the father is absent or shows signs of not caring j. Respond (to turn in the womb) to be under the mother's hand when it is placed on her stomachâ&#x20AC;Ś Factors that may cause rejection while inutero 1. Attempted abortion 2. Mother didn't want to be pregnant 3. Use of drugs, alcohol, or tobacco during pregnancy 4. Child is planned to be put up for adoption 5. Parents married because the mother was pregnant

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6. Mother has hate and resentment for missed opportunities because of being pregnant 7. Mother wanted a child of one sex and got the other sex (identity confusion)…

Results of rejection after birth that occurred while inutero 1. Continuously cries 2. Refuses the breast 3. Refuses a mother's comfort 4. Senses "I am not wanted; I am a burden" 5. Refuses affection 6. Wishes they hadn't been born 7. Experiences problems with bonding…

5. Baby not Bonding with the Mother or Father: a. Baby not held or loved adequately by either or both parents b. Mother's insecurity in coping with motherhood c. Experience of physical abuse …

6. Rejection causes after birth: a. Love deficit b. Being compared to another child c. Abuse of any kind d. Fear e. Adoption f. Being made fun of by schoolmates, neighbors, etc. g. One or more parents are absent h. Divorce of parents i. Abandonment of the family by one of the parents A World War II experience in England revealed: • England built orphanages for children whose mom's died and whose dad's were at war. • One third died for no reason or their heart quit operating. • Others did not grow, would not eat, or their head grew but not their body. • Children looked like little old men and women, with gray skin. • They lacked love; young British women were called in to hold them, rock them, and feed them. • This experience confirmed the fact that our need for love is greater than our need for food or survival.

7. Being an adopted child, or forced either to live with relatives or in a foster home, or to live in a different culture: a. Causes feelings of abandonment as well as rejection and fear of rejection b. Allows an opening for the spirits of orphan, abandonment, fatherlessness, vagabond, rejection, and confusion to enter

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2. In almost every case, adoptees will have feelings of rejection, lack of self-worth, anger, and abandonment issues.

3. They have absorbed all the elements of their environment (fear, tension, anxiety, guilt, shame, confusion, hatred, anger, and the pain of their mother).

4. They will lack security, not being adequately nurtured and supported.

5. They will have a loss of identity and question their right to live or to belong.

6. They think something is wrong with them.

7. They are bound by lies (for example, "I am ugly, crud, a mistakeâ&#x20AC;Ś").

8. They respond to life with either aggressive anger and rebellion or withdrawing in fear and isolation.

9. Prayers for the adopted should include a breaking of bonds and soul ties with the biological mother and father.

8. Factors that cause rejection during early childhood: a. A child who is criticized, over-disciplined, victimized, ignored, or who us treated as a favorite (or who shares a family with a sister or brother who is the favorite) b. A stern, legalistic or over-disciplinarian father c. An alcoholic father or mother d. Hearing comments that hurt (for example, "I never wanted you in the first place" or "You are stupid.") e. Physical, mental, verbal, or sexual abuse occurring through parents, friends, or others who frequent the home environment f. The absence of the parents from the child's school or extra-curricular activities 9. Problems in school caused by teachers or schoolmates (that cause rejection): a. Physical disabilities which keep a child from being chosen for team events or from playing in sports b. Speech impediments, birth defects, lisps c. Educational disabilities d. Bullying, being treated unfairly, being sexually harassed e. School expulsion f. Not being believed by a teacher g. Teacher picking on the child

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10. Multiple causes of rejection later in life: a. Poverty in the family home b. Unhealthy early sexual experiences c. Abortions (planned or forced) d. Rejection of self (occurring through embarrassment over undesirable physical features, obesity, etc.) e. Rejection from a relationship or a broken engagement f. Being sick or bedridden g. Unexpected pressure beyond one's ability to cope h. Self-condemnation after a moral failureâ&#x20AC;Ś Compounding or Multi-layering of Causes Rarely is there a single cause for rejection within the area of woundedness. Most people are wounded in many different ways, each new way adding to the pain and hurt which already exists. Thus, the person has multi-layered rejection, compounding the resultant problems. However, there usually is a core or main root that must first be identified before the offering of healing prayer. While many who come for prayer will have a generational pre-disposition toward rejection (because of the influences of darkness discussed earlier), there usually will be another core factor which occurred before, during, or shortly after birth.

Multi-faceted Spirit of Rejection Seldom is only the curse of the spirit of rejection identified, as it is almost always accompanied by one or more of the spirits of self-rejection, fear of rejection, fear of abandonment, fear, and perceived rejection. In many cases, the seeker has rejected his or her parents, or others (as well as themselves and God), for not doing something to protect them from the hurt and pain they earlier experienced. The wounded seeker constructs emotional walls around their heart and typically makes vows, such as "no one will ever hurt me again" (vows are dealt with in more detail in the section entitled, "Healing from Vows and Death Wishes"). Those who suffer the worst types of rejection at times develop multiple-personalities or alter-egos as a form of emotional protection.

The outward expressions or symptoms of rejection (and related spirits) result in one of two major areas of response: (1) an aggressive response (which exhibits rebelliousness, sexual promiscuity, self-sufficiency, anger, rejection of others, deception, and/or defiance) or (2) a passive response (which exhibits an approvalseeking nature, submissiveness, loneliness, and/or depression).

Healing of Rejection There are numerous examples of rejection exposed in the Bible. And Jesus was the most rejected person who ever lived. He was born in a stable 70 miles from home. He was born to a betrothed but unmarried virgin. At an early age, his parents moved to

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The religious and political Jewish leaders rejected him. The Jewish population at large rejected him. The Roman overseers also rejected him, and even most of his own disciples rejected and abandoned him. Isaiah 53:3 says, "He was despised and rejected of Men." Other scriptures speak of Jesus' rejection as well (Mat. 21:42, Ps. 118:22-23, Luke 9:22, Mark 8:31, Luke 17:25). Even while upon the cross, Jesus is stated by some to have questioned rejection by the Father, as in His statement, "… My God, my God, why hast thou forsaken me?" (Mat. 27:46). He was born amongst cattle, crucified between criminals, and surrounded by a murderous mob. Yet Jesus, the Son of Man, made it possible for the "sons of men" to become the "sons of God" by the Atonement He made for our sins, our sick-nesses, our sorrows, our suffering, and our being despised and rejected by men. "Surely he hath borne our grief's, and carried our sorrows: yet we did esteem him stricken, smitten of God, and afflicted. But he was wounded for our transgressions, he was bruised for our iniquities: the chastisement of our peace was upon him; and with his stripes we are healed" (Is. 53:4-5).

"By his stripes" we are healed, also, of rejection. It is a gift made possible by His death on the cross equal to the forgiveness of our sins, the healing of our sicknesses, and our being given power over the adversary. It is appropriated by faith, as are all of His promises.

The opposite of "to reject" is "to accept." "He hath made us accepted in the beloved" (Eph. 1:6). In the Greek, the word 'accepted' (as used here) means "highly favored one." When we come to God through Jesus, we are accepted and as highly favored as is our brother Jesus…ccxxii

I have a problem with the way that most people see rejection. Most people see rejection as what others have done or are doing to me presently. Here is the reality about rejection.

Rejection is not what people did or are doing to me but it is how I respond or react to their rejection. I choose how I will respond and react with my HEART (Mind, Will, Emotions and Personality/Character) to how and what I perceive people are doing to me. So then the pain of rejection triggers in my mind that no one loves me, I then choose to allow myself to 'feel' negative thoughts about myself and from this I start to show inward character traits of being rejected and outward personality traits of rebellion.

I have noticed that people tend to cope with rejection in one of two ways: inwardly or outwardly. Let me explain. Those who respond (INWARDLY as part of their CHARACTER) to the hurts of rejection in their lives tend to live behind walls and masks, hiding from others and themselves. Since they don't know how to just 'be themselves,' they're always trying to be what others want them to be. Having been hurt and rejected in the early, formidable years, they tend to live life behind facades and fronts, going to great lengths to hide their true feelings.

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Then on the other hand, we have those who respond (OUTWARDLY as part of their PERSONALITY) to the hurts of rejection and they tend to live life with a defiant or even a rebellious type attitude. They tend to have angry or manipulative type personalities. In effect, they're daring anybody to reject them. These types of folks are generally easier to get along with than the others, as long as you don't threaten their turf. Interestingly, underneath, these two personality types are fairly similar. In both cases, the root problem underlying their responses to the things of life is the same: offence, rejection and being wounded.ccxxiii So then what really is the solution to rejection? Adam Pulaski in his Biblical Counseling Manual, gives you and I the solution as he sees it.

The answer is to know the unconditional love of God. I am acceptable and significant and worthy in His eyes. God is my mate, I seek my identity in God, not by how people view me, treat me or whatever. My worth, my security and significance can only come from God. He is the one who made me and destined me to be conformed to the image of His Son. Do not look to a human being, position or power for value. God is my true identity; I am made in His image. His love makes me whole. I work accordingly being conformed to His image by obeying His commandments. When rejected or hurt, mourn the loss, turn it over to God, and go on living. God is our glory. He is the lifter of our head. Forgive all those who hurt me, be free of revenge. Pray for mercy, become and be complete in Him who forgave all those who rejected and abandoned Him on the cross.

Identities (Gen. 1:26-28) We are either a container or an expressor of God or of our diseased attitudes and perceptions. At the fall, man, a creature united to God, lost his identity. This identity to God is the true meaning of life, that is, to reveal God and to express His love to the world. Otherwise, man becomes dysfunctional. Fallen man tries to find his identity, and the only thing he has to work with is his body, senses, and his head. He focuses now on his created self. His identity becomes his performance to another plus a rating of his performance by another (co-dependency).

Now fallen man 'does' in order 'to be' 'for God' instead of 'being' and 'doing' 'from God'.

Man was made initially accountable to God but God is gone now. Man needs another to find out who he is. Man was supposed to 'be' in his relationship to God and out of his 'being', he was 'to do'.

Redemption (Luke 4:1-13) Jesus in the wilderness is a test of the 'independent spirit'.

Here is the supreme test and example in determining who and what we are, and how we are to live.

Regardless of the circumstances, we respond within by the word, to that which is without.

(John 5:30) Jesus identified with His Father; His will was His Father's will. Likewise, redeemed man lives by and from the Father to give glory to God by acting on His commandments regardless of and in spite of circumstances, people, things or

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Spirit of rejection reveals one is earthbound, living horizontally, and influenced by the circumstances of life. Thus, being redeemed, one's identity is now in God and from God man is empowered by prayer, power and provisions to accomplish God's purposes on earth: to convey God's love to others, so that they, in turn, may also become identified in Christ.

Significance (Col. 2:11-13; Phil. 2:12-18) Thus, the sense of rejection reveals a diseased attitude, waiting to be accepted and approved and fulfilled by others. Put this off and put-on that you are already accepted and approved by God Who made you significant in Christ. From significance already obtained via the cross, you work out your salvation, giving glory to God by being concerned for the widow and the orphan, being the salt and light, thus fulfilling God's purpose for your life. By these means the sense of rejection will gradually fade. (2 Cor. 3:16-18) Rejection is one of the many barriers that keeps one from becoming…ccxxiv

Mr. Pulaski goes on to say, "All of the veils of the fallen life have been removed in Christ.

We move from grace to grace to glory to glory, and as we allow the Holy Spirit to complete His work in us."

I find this statement very interesting and even fascinating let me show you why. Let's first read the following verse together. 2 Corinthians 3:14 But the people's minds were hardened, and to this day whenever the old covenant is being read, the same veil covers their minds so they cannot understand the truth. And this veil can be removed only by believing in Christ.

(NLT) The fascinating part to me is that when Adam sinned a veil (covering) came over his head and his life. This veil was and is a cloud of darkness and because of this veil Adam lost his headship under God his father. This meant that Adam lost and was cut off from the revelation of God. Meaning that Adam lost out on God showing and telling him (Adam) who he was…..

Adam no longer had open communication walks with God in the cool of the night in the Garden so he was Cut Off. Cut Off! Adams mind was now veiled with a Cloud of darkness that also covered his life making him and all like him to come ignorant of the Fathers love. Because of this cloud the Father can not reveal His plans for his life… Who he was… Who he is… What he is to do…

How he is to live… so how does he live now?

Adam and all of mankind now live through our senses, what we see, hear, taste, smell and by what we can touch. We live our lives by what we can feel, what we stumble into… We live through and by our emotions this is because we through Adam lost our revelation through God the Father, because only the Father can reveal who and what we are truly to be.

2 Corinthians 3:14 tells us that because of unbelief the people's minds were hardened, and to this day whenever we are living as and for the old man (Non-Believer) under the old

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covenant, that the same veil covers their minds so they cannot understand the truth. And this veil can be removed only by believing in Christ and becoming a Christian.

Adam also lost God as his Father (Relationship With and his Connection to) because of his sin.

This trend has continued even into today as we find an increasing numbers of missing fathers. Wither these fathers are really absent or just silent and are no entering into Godly Fatherhood. You see it is the FATHER who is to tell his sons and daughters who their really ARE. When fathers don't take time to talk with and tell their children who they are they leave their children's HEART wide open for everyone else to tell them who they are or should be.

This allows anybody to lead them. And as we all know that is not good.

Because of his sin Adam also lost God's Headship over him. Try this sometime take a towel or a dark pillow case and place it over your head (make sure you cannot see through it) and try to walk through your home without stumping a toe or knock something over. You cannot do it on your own, now have your spouse, your kids or a friend to lead you and walk you around the house. This towel or pillow case represents the veil that is covering our heads and our lives. What is covered by this towel or pillow case?

It is our (2) Eyes, (2) Ears, (2) Nostrils and our (1) Mouth that is covered. What is covered is the 7 openings we have in our heads and these 7 opening are the ways we communicated with God. By Adam's sin we lost our ways to talk to God, to hear from God, see or smell God and His presents. If we as men do not do our job we fail our kids and our calling. As men of God we are to be the Head for our children and the Headship or covering for our families and allow them to see, to hear, to smell, to taste and talk to God.ccxxv As an EMT or a Paramedic we can handle something being Cut Off in the physical. We control the scene; we control the bleeding we don't get distracted by the distracting injuries.

We do our job and if the patient is missing an extremity we find it and transport it to a trauma center for them to attempt to reattach it if possible. The problem here is that Adam's mind was cut off and veiled not an extremity. So the only way to reattach his and our minds is to return to God. In our returning to God we can learn to use "His ways which are not our ways."

Isaiah 55:8 We can even learn to overcome the rejection in our lives as Jesus did in His own life. Let's look into how Jesus overcame the rejection in His life?

1. He found his identity in his heavenly Father. "And lo a voice from heaven, saying, This is my beloved Son, in whom I am well pleased" (Matthew 3:17). "I and my Father are one" (John 10:30).

2. He didn't take offense. "Great peace have they which love thy law: and nothing shall offend them" (Psalm 119:165). "Then answered Jesus and said unto them, Verily, verily, I say unto you, The Son can do nothing of himself, but what he seeth the Father do: for what things soever he doeth, these also doeth the Son likewise" (John 5:19).

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3. He forgave those who bruised and rejected him. "Then said Jesus, Father, forgive them; for they know not what they do. And they parted his raiment, and cast lots" (Luke 23:34).

4. He loved and blessed those who rejected him. "But I say unto you, Love your enemies, bless them that curse you, do good to them that hate you, and pray for them which despitefully use you, and persecute you" (Matthew 5:44). "But I say unto you which hear, Love your enemies, do good to them which hate you" (Luke 6:27). "But love ye your enemies, and do good, and lend, hoping for nothing again; and your reward shall be great, and ye shall be the children of the Highest: for he is kind unto the unthankful and to the evil" (Luke 6:35).

5. He looked forward to the victory in the end.

"Looking unto Jesus the author and finisher of our faith; who for the joy that was set before him endured the cross, despising the shame, and is set down at the right hand of the throne of God" (Hebrews 12:2).ccxxvi By learning to overcome rejection as Jesus did we will be learning to break what is known as the Rejection Cycle! This can be done by meditating on and living out these statements and by memorizing these Scriptures.

Rejection: Just because someone rejects me doesn't mean that everyone rejects me. Jesus loves me no matter what others choose to do. John 15:9-10 "I've loved you the way my Father has loved me. Make yourselves at home in my love. If you keep my commands, you'll remain intimately at home in my love. That's what I've done—kept my Father's commands and made myself at home in his love. (MSG) Worthlessness: Just because someone may think that I am worthless doesn't mean everyone thinks I'm worthless. God has already established my worth, and because of Him I will always have worth. Luke 12:6-7 "What's the price of two or three pet canaries? Some loose change, right? But God never overlooks a single one. And he pays even greater attention to you, down to the last detail—even numbering the hairs on your head! So don't be intimidated by all this bully talk. You're worth more than a million canaries. (MSG) Self-Hate: Just because someone has rejected me doesn't mean I should hate myself God has always loved me, and I can rely on His love. 1 John 4:13-16 This is how we know we're living steadily and deeply in him, and he in us: He's given us life from his life, from his very own Spirit. Also, we've seen for ourselves and continue to state openly that the Father sent his Son as Savior of the world. Everyone who confesses that Jesus is God's Son participates continuously in an intimate relationship with God. We know it so well, we've embraced it heart and soul, this love that comes from God. (MSG) Negative Behavior: Just because someone has rejected me doesn't give me license to do what is wrong. God has given me the power to do what is right. Sin will not be my master!"

Genesis 4:6-7 GOD spoke to Cain: "Why this tantrum? Why the sulking? If you do well, won't you be accepted? And if you don't do well, sin is lying in wait for you, ready to pounce; it's out to get you, you've got to master it." (MSG)ccxxvii

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Admit the Rejection of the past and acknowledge its pain: Lamentations 3:19-23 I'll never forget the trouble, the utter lostness, the taste of ashes, the poison I've swallowed. I remember it all oh, how well I remember the feeling of hitting the bottom. But there's one other thing I remember, and remembering, I keep a grip on hope: 22-24 GOD's loyal love couldn't have run out, his merciful love couldn't have dried up. They're created new every morning. How great your faithfulness! I'm sticking with GOD (I say it over and over). He's all I've got left. (MSG) Claim God's acceptance and unconditional love: Isaiah 54:10 This exile is just like the days of Noah for me: I promised then that the waters of Noah would never again flood the earth. I'm promising now no more anger, no more dressing you down. For even if the mountains walk away and the hills fall to pieces, My love won't walk away from you, my covenant commitment of peace won't fall apart. The GOD who has compassion on you says so. (MSG) Choose to forgive those who rejected you: Colossians 3:12-14 So, chosen by God for this new life of love, dress in the wardrobe God picked out for you: compassion, kindness, humility, quiet strength, discipline. Be even-tempered, content with second place, quick to forgive an offense. Forgive as quickly and completely as the Master forgave you. And regardless of what else you put on, wear love. It's your basic, all-purpose garment. Never be without it. (MSG) Expect future rejection as natural in a fallen world: 1 Peter 4:12-14 Beloved, do not be amazed and bewildered at the fiery ordeal which is taking place to test your quality, as though something strange (unusual and alien to you and your position) were befalling you.

13 But insofar as you are sharing Christ's sufferings, rejoice, so that when His glory [full of radiance and splendor] is revealed, you may also rejoice with triumph [exultantly]. 14 If you are censured and suffer abuse [because you bear] the name of Christ, blessed [are you—happy, fortunate, to be envied, with life-joy, and satisfaction in God's favor and salvation, regardless of your outward condition], because the Spirit of glory, the Spirit of God, is resting upon you.

On their part He is blasphemed, but on your part He is glorified. (AMP) Plant Scripture in your mind to produce new thought patterns: Romans 12:1-2 So here's what I want you to do, God helping you: Take your everyday, ordinary life—your sleeping, eating, going-to-work, and walking-around life—and place it before God as an offering.

Embracing what God does for you is the best thing you can do for him. Don't become so welladjusted to your culture that you fit into it without even thinking. Instead, fix your attention on God. You'll be changed from the inside out. Readily recognize what he wants from you, and quickly respond to it. Unlike the culture around you, always dragging you down to its level of immaturity, God brings the best out of you, develops well-formed maturity in you. (MSG) Thank God for what you've learned through your rejection: Psalm 119:71 It is good for me that I have been afflicted, that I might learn Your statutes. (AMP) Encourage others as an expression of Christ's love: Hebrews 3:13 But instead warn (admonish, urge, and encourage) one another every day, as long as it is called Today, that none of you may be hardened [into settled rebellion] by the deceitfulness of sin [by the

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fraudulence, the stratagem, the trickery which the delusive glamor of his sin may play on him]. (AMP) Draw on the power of Christ's life within you: Philippians 4:13 I have strength for all things in Christ Who empowers me [I am ready for anything and equal to anything through Him Who infuses inner strength into me; I am self-sufficient in Christ's sufficiency]. (AMP)ccxxviii If you still need other verses to help you overcome and walk through and away from rejection please take the time to read the following scriptures. I pray that they will bless you as much as they have me.

Psalm 69:20 Insults and reproach have broken my heart; I am full of heaviness and I am distressingly sick. I looked for pity, but there was none, and for comforters, but I found none.

(AMP) Psalm 142 I cry to the Lord with my voice; with my voice to the Lord do I make supplication.

2 I pour out my complaint before Him; I tell before Him my trouble. 3 When my spirit was overwhelmed and fainted [throwing all its weight] upon me, then You knew my path. In the way where I walk they have hidden a snare for me. 4 Look on the right hand [the point of attack] and see; for there is no man who knows me [to appear for me]. Refuge has failed me and I have no way to flee; no man cares for my life or my welfare. 5 I cried to You, O Lord; I said, You are my refuge, my portion in the land of the living. 6 Attend to my loud cry, for I am brought very low; deliver me from my persecutors, for they are stronger than I. 7 Bring my life out of prison, that I may confess, praise, and give thanks to Your name; the righteous will surround me and crown themselves because of me, for You will deal bountifully with me.

(AMP) Psalm 31 In You, O Lord, do I put my trust and seek refuge; let me never be put to shame or [have my hope in You] disappointed; deliver me in Your righteousness! 2 Bow down Your ear to me, deliver me speedily! Be my Rock of refuge, a strong Fortress to save me! 3 Yes, You are my Rock and my Fortress; therefore for Your name's sake lead me and guide me. 4 Draw me out of the net that they have laid secretly for me, for You are my Strength and my Stronghold. 5 Into Your hands I commit my spirit; You have redeemed me, O Lord, the God of truth and faithfulness. 6 [You and] I abhor those who pay regard to vain idols; but I trust in, rely on, and confidently lean on the Lord. 7 I will be glad and rejoice in Your mercy and steadfast love, because You have seen my affliction, You have taken note of my life's distresses, 8 And You have not given me into the hand of the enemy; You have set my feet in a broad place. 9 Have mercy and be gracious unto me, O Lord, for I am in trouble; with grief my eye is weakened, also my inner self and my body. 10 For my life is spent with sorrow and my years with sighing; my strength has failed because of my iniquity, and even my bones have wasted away. 11 To all my enemies I have become a reproach, but especially to my neighbors, and a dread to my acquaintances, who flee from me on the street. 12 I am forgotten like a dead man, and out of mind; like a broken vessel am I. 13 For I have heard the slander of many; terror is on every side! While they schemed together against me, they plotted to take my life. 14 But I trusted in, relied on, and was confident in You, O Lord; I said, You are my God. 15 My times are in Your hands; deliver me from the hands of my foes and those who pursue me and persecute me. 16 Let Your face shine on Your servant; save me for Your mercy's sake and in Your loving-kindness. 17 Let me not be put to shame, O Lord, or

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disappointed, for I am calling upon You; let the wicked be put to shame, let them be silent in Sheol (the place of the dead). 18 Let the lying lips be silenced, which speak insolently against the [consistently] righteous with pride and contempt. 19 Oh, how great is Your goodness, which You have laid up for those who fear, revere, and worship You, goodness which You have wrought for those who trust and take refuge in You before the sons of men! 20 In the secret place of Your presence You hide them from the plots of men; You keep them secretly in Your pavilion from the strife of tongues. 21 Blessed be the Lord! For He has shown me His marvelous loving favor when I was beset as in a besieged city. 22 As for me, I said in my haste and alarm, I am cut off from before Your eyes. But You heard the voice of my supplications when I cried to You for aid. 23 O love the Lord, all you His saints! The Lord preserves the faithful, and plentifully pays back him who deals haughtily. 24 Be strong and let your heart take courage, all you who wait for and hope for and expect the Lord! (AMP) Psalm 55 Listen to my prayer, O God, and hide not Yourself from my supplication! 2 Attend to me and answer me; I am restless and distraught in my complaint and must moan 3 [And I am distracted] at the noise of the enemy, because of the oppression and threats of the wicked; for they would cast trouble upon me, and in wrath they persecute me. 4 My heart is grievously pained within me, and the terrors of death have fallen upon me. 5 Fear and trembling have come upon me; horror and fright have overwhelmed me. 6 And I say, Oh, that I had wings like a dove! I would fly away and be at rest. 7 Yes, I would wander far away, I would lodge in the wilderness. Selah [pause, and calmly think of that]! 8 I would hasten to escape and to find a shelter from the stormy wind and tempest. 9 Destroy [their schemes], O Lord, confuse their tongues, for I have seen violence and strife in the city. 10 Day and night they go about on its walls; iniquity and mischief are in its midst. 11 Violence and ruin are within it; fraud and guile do not depart from its streets and marketplaces. 12 For it is not an enemy who reproaches and taunts me—then I might bear it; nor is it one who has hated me who insolently vaunts himself against me—then I might hide from him. 13 But it was you, a man my equal, my companion and my familiar friend. 14 We had sweet fellowship together and used to walk to the house of God in company. 15 Let desolations and death come suddenly upon them; let them go down alive to Sheol (the place of the dead), for evils are in their habitations, in their hearts, and their inmost part. 16 As for me, I will call upon God, and the Lord will save me. 17 Evening and morning and at noon will I utter my complaint and moan and sigh, and He will hear my voice.

18 He has redeemed my life in peace from the battle that was against me [so that none came near me], for they were many who strove with me. 19 God will hear and humble them, even He Who abides of old—Selah [pause, and calmly think of that]!—because in them there has been no change [of heart], and they do not fear, revere, and worship God. 20 [My companion] has put forth his hands against those who were at peace with him; he has broken and profaned his agreement [of friendship and loyalty]. 21 The words of his mouth were smoother than cream or butter, but war was in his heart; his words were softer than oil, yet they were drawn swords. 22 Cast your burden on the Lord [releasing the weight of it] and He will sustain you; He will never allow the [consistently] righteous to be moved (made to slip, fall, or fail).

23 But You, O God, will bring down the wicked into the pit of destruction; men of blood and treachery shall not live out half their days. But I will trust in, lean on, and confidently rely on You. (AMP)

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TORSADE DE POINTES The QRS reverses polarity and the strip shows a spindle effect. This rhythm is an unusual variant of polymorphic VT with long QT intervals. In French the term means twisting of points.

Figure 14.5 ccxxix Criteria for Classification Rhythm: Irregular Rate: 200-250 bpm P Waves: None PR Interval: None QRS: Wide (0.10 sec), bizarre appearance What's Unique about this Rhythm?

Ventricular tachycardia has a classic "twisting" appearance and a rate in excess of 100 beats per minute, with, no P wave.

Clinical Significance The patient will have a decrease in cardiac output due to the decrease in ventricular filling time and the loss of the atrial kick. Some patients can tolerate the dysrhythmia for a short time and will have a pulse and remain conscious, whereas other patients will be unresponsive immediately. About 50% of the patients will become unconscious immediately, with no pulse or respiration.

As soon as you recognize ventricular tachycardia on the monitor or EKG equipment, you should check the patient for unresponsive. A Code is called and CPR is initiated. Emergency equipment such as a defibrillator, medications, and intubation equipment are necessary. If the patient is responsive, initiate a treatment plan of medications and electrical treatments.

What does this mean to the Christian heart?

The Christian that is found to be in Torsade De Pointes on the Christian EKG is the Christian that has been wounded to the point that they are allowing the wounds to cause spiritual

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multisystem trauma. And as in any case where a person has multisystem trauma the need to get to the most appreciate Level I Trauma Center to receive the appreciate level of care.

Spiritual speaking this Christian has to have Spiritual Trauma Surgery. They are in need of getting to the most appreciate Christian Level I Trauma Center and need to by operated on by the number 1 trauma surgeon in the universe and that is God Himself.

In more than 20 years as a Paramedic, and almost 28 years involved in the EMS I can say that I have ran many call and have seen and bandaged many physical wounds first hand, some unfortunately fatal. Yet there is a certain satisfaction in starting that person and their wounds on the road to recovery. It is amazing to see seriously injured people go on to recover and regain useful productive lives. However wound healing can be complex and can cause permanent scars, sometimes these wounds will get infected and if allowed to fester they will fail to completely heal, leaving ongoing weeping wounds.

People can also suffer other types of wounding; including wounds to their deep inner being (which we call the human spirit) I like to call the Spiritual Wounds. Let's consider what can cause wounds in your spirit and then how to have them healed. Spiritual wounds do not heal by time alone and will continue for many years until brought before Christ for active healing.

Proverbs 4:23 Above all else, guard your heart [your spirit] for it is the wellspring of life. (NIV) Proverbs 17:22 A cheerful heart is good medicine, but a broken spirit saps a persons strength. (NLT) [dries up the bones NIV] Hebrews 4:12-13 God means what he says. What he says goes. His powerful Word is sharp as a surgeon's scalpel, cutting through everything, whether doubt or defense, laying us open to listen and obey. Nothing and no one is impervious to God's Word. We can't get away from it no matter what. (MSG) I want to start this section off with following scripture verse it is found in Zechariah 13:6 And if someone asks, 'Then what about those wounds on your chest?' he will say, 'I was wounded at my friends' house!' (NLT) WOW, I mean WOW 'I was wounded at my friends' house!' (NLT) In EMS we see this all the time, friends assaulting friends over stupid stuff. A lot of the time there is some other factors involved like alcohol or other drugs or just fighting to be fighting, and then you have the daily meetings of the gun and knife lubs. All of us know what a wound is but I am still going to define the word anyway.

A Wound: Is an injury, usually involving division of tissue or rupture of the integument or mucous membrane, due to external violence or some mechanical agency rather than disease. An injury or hurt to feelings, sensibilities, reputation, etc. To inflict a wound upon someone or thing; injure; hurt. Most of us are likely to sustain different types of wounds throughout life as we participate in daily activities.

As we all know many minor wounds result in damaged skin cells that lose their function and need time and simple treatment to heal. Most common wounds are superficial, limited to the outer skin layers. Some are deeper, reaching the underlying tissues and organs. Depending on the cause, site and depth, a wound can range from simple to life threatening.

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Just as in the physical realm you can have and do find the same types of wounds in the Spiritual realm. As I have done throughout this book I will start off with the physical wounds and will swing to the Spiritual wounds associated with the physical ones.

Causes and Types of Wounds Depending on the healing time of a wound, it can be classified as Acute or Chronic. Those classified as acute wounds heal uneventfully (with no complications) in the predicted amount of time. Those classified as chronic wounds take a longer time to heal and might have some complications.

An Acute Spiritual Wounds heal uneventfully (with no complications) in the predicted amount of time. This is like when you and someone you love get into a heated discussion and one or in most cases both parties feelings get hurt. The two of you have some time apart to cool off and the Holy Spirit lovingly and tenderly requests that you go and ask for forgiveness of each other and the two of you respond accordingly to the Holy Spirits request. In this case the wounds were fast onset healed without complications in the relationship.

The Spiritual Wounds that are classified as Chronic in nature will take a longer time to heal and will have some relationship complications if left unchecked and not over seen by the Holy Spirits leading. Case in point would be the same as listed above with the exception that this time one or both parties refuse the Holy Spirits leads to go make things right. This causes a Spiritual Hematoma, also called a contusion or a bruise. If this type of wound continues to happen without resolve and a healing take place it will lead to an Abrasion known as an open wound.

Wounds can be Open or Closed. Open wounds are wounds with exposed underlying tissue and/or organs that are open to the outside environment (like penetrating wounds). Closed wounds have damage that occurs without exposing the underlying tissue and organs (nonpenetrating wounds).

In the Spiritual realm a Closed Wound would be like the healing of the Acute Spiritual Wound if all parties involved in the wounding ask for forgiveness and make amends when and where required then the wound usually heals without even leaving a scare.

The Spiritually Opened Wound would be like Spiritual Chronic Wounds that has been left unattended and continued to receive more and more wounds (spiritual back stabbings, cuts, laceration, bites, burns and pressure soars etc.). These wounds have gone past the abrasion which is superficial and have now become something that is becoming deeper in nature consistent with that of a laceration. These wounds even if properly healed leave physical and spiritual scares that only the unconditional Love of God and the daily interaction with the Holy Spirit can and will if allowed heal and sometime He will remove the scares but not always.

We need to always remember even when we see Jesus face to face we will be able to see, touch the scares that His body has from paying the sin penalty for you, me and all of humanity. John 20:24-29 But Thomas, one of the Twelve, called the Twin, was not with them when Jesus came. 25 So the other disciples kept telling him, We have seen the Lord! But he

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said to them, Unless I see in His hands the marks made by the nails and put my finger into the nail prints, and put my hand into His side, I will never believe [it]. 26 Eight days later His disciples were again in the house, and Thomas was with them. Jesus came, though they were behind closed doors, and stood among them and said, Peace to you! 27 Then He said to Thomas, Reach out your finger here, and see My hands; and put out your hand and place [it] in My side. Do not be faithless and incredulous, but [stop your unbelief and] believe!

28 Thomas answered Him, My Lord and my God! 29 Jesus said to him, Because you have seen Me, Thomas, do you now believe (trust, have faith)? Blessed and happy and to be envied are those who have never seen Me and yet have believed and adhered to and trusted and relied on Me. (AMP) This Christian that now has a spiritually open wound is not allowing the Blood of Jesus or the guiding of the Holy Spirit to assist in the healing process of these wounds and this is making the wounds themselves to stay open. If this continues to happen without a Spiritual Healing taking place then this once clean wound will become a contaminated wound.

Another way to classify wounds is to determine if the wound is Clean or Contaminated.

Clean wounds have no foreign materials or debris inside, whereas contaminated wounds or infected wounds might have dirt, fragments of the causative agent, bacteria or other foreign materials.ccxxx In the Spiritual realm a Clean Wound could be a spiritually Acute Open Wound but as before if all parties involved in the wounding ask for forgiveness and make amends when and where required then the wounds usually heal without complications.

Then there is the Christian that has allowed their spiritual wounds to stay open and fester and are now infected. These wounds require medical and spiritual attention before they cause the Christian to become septic and even more spiritually sick from the wounds and they now requires more intensive care. At this point the Christian's wounds are very deep and are down to the bone open and are contaminated by every thought and remembrance of all past hurts.

This wound will require debridement and as the Bible states in Hebrews 4:12-13 ... His powerful Word is sharp as a surgeon's scalpel, cutting through everything, whether doubt or defense, laying us open to listen and obey. Nothing and no one is impervious to God's Word.

We can't get away from it no matter what. (MSG) This Christian needs to go under the knife and allow God to perform a spiritual wound debridement and then send this Christian to His spiritual Hyperbaric Chambers as seen in Song of Solomon 1:4 Draw me, we will run after thee: the king hath brought me into his chambers: we will be glad and rejoice in thee, we will remember thy love more than wine: the upright love thee. (KJV) In God's chambers the Christian will undergo treatments of God's unconditional and unwavering Love for His children. And I pray that as you read the next few verses that you the reader will allow the Holy Spirit to bring out His scalpel and cut away the hardness and wounds on your heart and place you on a spiritual wound vac and heal you from the INside OUT.

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Romans 8:26-39 Meanwhile, the moment we get tired in the waiting, God's Spirit is right alongside helping us along. If we don't know how or what to pray, it doesn't matter. He does our praying in and for us, making prayer out of our wordless sighs, our aching groans. He knows us far better than we know ourselves, knows our pregnant condition, and keeps us present before God. That's why we can be so sure that every detail in our lives of love for God is worked into something good. 29-30 God knew what he was doing from the very beginning. He decided from the outset to shape the lives of those who love him along the same lines as the life of his Son. The Son stands first in the line of humanity he restored. We see the original and intended shape of our lives there in him. After God made that decision of what his children should be like, he followed it up by calling people by name. After he called them by name, he set them on a solid basis with himself. And then, after getting them established, he stayed with them to the end, gloriously completing what he had begun.

31-39 So, what do you think? With God on our side like this, how can we lose? If God didn't hesitate to put everything on the line for us, embracing our condition and exposing himself to the worst by sending his own Son, is there anything else he wouldn't gladly and freely do for us? And who would dare tangle with God by messing with one of God's chosen? Who would dare even to point a finger? The One who died for usâ&#x20AC;&#x201D;who was raised to life for us!â&#x20AC;&#x201D;is in the presence of God at this very moment sticking up for us. Do you think anyone is going to be able to drive a wedge between us and Christ's love for us? There is no way! Not trouble, not hard times, not hatred, not hunger, not homelessness, not bullying threats, not backstabbing, not even the worst sins listed in Scripture: They kill us in cold blood because they hate you. We're sitting ducks; they pick us off one by one. None of this fazes us because Jesus loves us. I'm absolutely convinced that nothing --nothing living or dead, angelic or demonic, today or tomorrow, high or low, thinkable or unthinkable absolutely nothing can get between us and God's love because of the way that Jesus our Master has embraced us.

(MSG) I want to share with you a few words on wounded Christians from a fellow YWAMer (Youth With A Mission). Gareth Evans in his book The Key in My Hand a Guide to mending broken relationships, In Chapter 6, The Wounded Soul he had the following to say.

Bruises of the soul Many people have been subject for most of their lives to continuous criticism and verbal abuse. This might come from a parent or older siblings. Their retiring personality invites others to continue this abuse at school or at work and they come into adulthood with great bruises on their soul. They are often accused of being too sensitive and indeed they are, as a result of the abuse. They function well enough until criticized again when they find themselves unable to handle the pain. New bruises are formed and each new criticism, real or imagined, is like a punch on the bruise.

Peter had been raised in a somber, though Christian home. He was the only child and had few friends. He was not allowed to bring friends home from school as they were "worldly" and there were no others his age in the small church his family attended. He never quite met his father's expectations or demands of him and was unable to hold a job for very long. He was never made to feel good enough to be accepted. In his midthirties he left home and went to work for a Christian mission, where he was befriended by three other men. He began to enjoy his work and friends and became a

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well accepted part of that ministry - until, one month, three years later, each of his three friends announced that he would soon be leaving to work elsewhere. Instead of the usual sorrow one would expect, Peter began to act in a strange way. He deliberately set out to make himself disliked by his departing friends. For example, he borrowed something from one of them, deliberately broke it and said it was an accident. Each of the friends left the mission offended by Peter.

Why did he act like this? He told me that it had started just after he had returned from holidays - at home. That had not been a good time and he had been glad to return to the mission. When I suggested that his experience of more criticism at home had produced renewed bruising on his soul, and that the departure of his friends had been like punches on the bruising, Peter broke down and cried. "That's exactly how I feel," he declared, "their leaving just added to my feelings of being unworthy of love and acceptance." Today, Peter is walking in a new freedom, knowing his worthiness in Christ.

Stab wounds For others, the wound may have been created by a single act - a wound just like a stabbing. The classic example, of course, is the child who is sexually abused by a trusted, loved one. The child does not understand that he or she is the victim and not the guilty one. They are afraid to speak about the incident, choosing rather, to bury it in their memory. Some time afterwards, the wound is covered over and not easily brought to the surface to be faced, even in adulthood. The bandage with which the wound was covered has become a bondage affecting other areas of the adult's personality. Such a soul needs healing!

When I asked Alec why he couldn't read or write, he told me a sad story. For four years his mother had doted on him, her only child, after his father had walked out on them. Then another father came on the scene - one who did not like, or want Alec around him. He soon knew the deep pain of rejection. At the age of five, Alec started primary school, where he would sit in the back of the room, day dreaming. He well remembers the occasion when an unthinking teacher shouted at him. "Alec, you're nothing but a dumbo!" The hurting, little soul said to himself, "If that's what you think I am, that's what I'll be!" He resolved, as a young child, never to study to please that teacher . . . and so grew into a teenage illiterate!

Was Alec bright enough to have learned? Just one month after we talked, Alec was reading all the sports news in the daily newspaper! He had an interest in a young lady and was motivated to walk out a healing. I used his knowledge of sports personalities and their photographs in the newspapers, to encourage him in reading the words explaining the pictures. Soon, he needed no pictures and I watched his self esteem grow as he began to read with understanding. So many teachers - and parents - and others, will never know the negative significance of the stabbing wounds their unthinking words have had on so many young souls. And many adults today are still carrying the scabs and scars from those wounds on their souls!

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Then there's the grazing kinds of wounds. They usually leave no scar or permanent bondage, but can bleed profusely at the time of injury. If not treated correctly, however, they can fester and then produce far worse injury. I see such wounds of the soul occurring when one experiences a put-down or some great disappointment. It is accompanied by feelings of inadequacy and loneliness. Spiritual defenses are down.

This is the time when we need to come around in tender support for the hurting one. It is the time for empathy, and understanding.

Mary had become ill with Epstein Barr or Yuppie Flu, called the disease of the nineties.

It was hard not knowing how long she was likely to be ill, for the doctors had no ready cure. The members of her church were praying for her but she wished someone would come to visit her. No one came, giving their reason that they were unsure if such a disease was contagious. That was hard to accept but Mary did so, with grace. Then one day, a telephone call caused much bleeding of the soul. Her closest friend called to tell her that the church had stopped praying for Mary as it was obvious she was not exercising faith. If she had been so doing, she would have now been well!

Fractures Let us continue with our metaphors. Are there such wounds as fractures in the soul?

Yes, there are many believers who are limping through life because of some traumatic experience. It may be the death of a loved one, a broken engagement, some accident of life. They were crippled by the experience and have never learned to walk again.

Melinda had an argument with her mother, during which she had pushed her away with some force. Some months later, mother was diagnosed as having developed breast cancer and within a year, she had died. No amount of argument could convince Melinda that her push had not created the cancer in her mother. She would not forgive herself, and could not accept the Lord's forgiveness. She was a broken woman when I met her, and remains crippled.

"He restores my soul" I am convinced that very many believers today, have wounded souls. I am also convinced that the Lord wants to heal those wounds - to restore the soul. The psalmist David was guilty of adultery and murder. He carried terrible soul wounds but he could say, "The Lord is my shepherd . . . He restores my soul." (Psalm 23:3).

There are also wounds created by our own doings. It seems to me that when we deliberately act contrary to the explicit Word of God, we create our own wounds. Sex outside of marriage, and divorce, will always create wounded souls that need healing through the grace of God. Be very sure, that it is His desire to bring such healing.

Indeed, I see this as the true work of sanctification - the second part of salvation.

Justification - set free from the penalty of sin - salvation (wholeness) for the spirit.

The past work of the Spirit.

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Sanctification - set free from the power of sin - salvation (wholeness) for the soul.

The present work of the Spirit.

Glorification - set free from the presence of sin - salvation (wholeness) for the body.

The future work of the Spirit.

That's why we call Him Savior!ccxxxi As I stated above Spiritual wounds do not heal by time alone and will continue for many years until brought before Christ for active healing. So please do yourself and your families a favor seek help. Get yourself to a Spiritual Level I Trauma Center, sign the consents for medical care and allow the Great Physician to call the shots and get wounds healed.

Time to move on to our next rhythm and that will be the Agonal rhythm.

AGONAL RHYTHM Agonal rhythms occur when essentially all of the pacemakers in the heart have failed. This is the last semblance of ordered electrical activity in the heart. The heart is dying. The impulses showing on the monitor are ventricular but firing at a rate of less than 20 beats per minute.

This dysrhythmia presents with "wide-bizarre" QRS (0.12 second or greater) complexes and an absence of P waves.

Figure 14.6 ccxxxii Criteria for Classification Rhythm: P-P interval cannot be determined. R-R interval may or may not be regular.

Rate: Atrial rate cannot be determined due to the absence of atrial depolarization. The ventricular rate is less than 20 beats per minute.

P wave configuration: The P wave is absent; therefore, no analysis of the P wave can be done.

PR interval: The PR interval cannot be measured because the P wave cannot be identified.

QRS duration and configuration: The QRS duration and configuration measures 0.12 second or greater and will have a "wide-bizarre" appearance.

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What's Unique about this Rhythm?

The accelerated idioventricular rhythm has an absence of P waves, a ventricular rate of less than 20 beats per minute, and wide-bizarre QRS complexes.

Clinical Significance The patient has a profound loss of cardiac output due to the loss of atrial kick and the slow ventricular rate. The patient will be unconscious. This is a medical emergency that will likely require both basic life support and advanced cardiac life support interventions.

What does this mean to the Christian heart?

The Christian that is found to be in an Agonal rhythm to me is a Christian that has allowed Satan to devour their whole HEART. He fought and won the war in the Christians MIND devouring with and by telling lies. He then had the Christian believing the lies that he was telling them and the Christian does not even have the WILL to fight like that seen in Stockholm syndrome and also known as capture-bonding.

Before we get into how I think this is like a Christian with Stockholm syndrome I want to read what Dr. Paul W. Carlin had to say on the subject of the Christian allow Satan to devour them.

Satan can Devour A Christian The Apostle Peter, writing to Christians (1 Peter 5.8) warns, "Be sober, be vigilant; because your adversary the devil, as a roaring lion, walketh about, seeking whom he may devour."

You are a target! You are vulnerable! You are the object of Satan's interest! This is a serious warning from the Father. Do not take it lightly. You are a tasty morsel for a hungry adversary. Therefore, first, "Be sober." The expression connotes a cool head and a balanced mind enabling one to exercise self control or moderation.

Then, "be vigilant." It means to be alert, wide awake and cautions at all times.

Confidence in God must not lead to slackness or indifference. The spiritual warfare requires us to be always alert.

There are two terms used to describe Satan in this text. The first, "adversary," means an opponent in a legal matter. The second, "devil," denotes an enemy in general or, in effect, a slanderer. Satan, therefore, is the general enemy of all believers, but at the same time he is your particular and personal enemy. He is not merely an abstract personality.

And he continually roars like a lion as he walks about, prowling openly, looking for Christians who are neither sober nor alert. And when he locates a spiritually anesthetized or sluggish believer, he "devours" him. Literally the expression means "to swallow down" or "eat up."

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Traditionally the word has been used to describe an animal swallowing its prey. It could have been used to describe the horrors of the Christian martyrdoms of Nero's time, when lions mauled and devoured Christians in the Roman Coliseum. Some believers actually spend their days trapped between the jaws of this devouring monster. If they have any personal testimony left, attesting to the power of Christ, it is only some historical account of their old victories. Their spirituality is little more than the residue from earlier times, or perhaps the spillover from other Christians. They presently have no miracle-working power of God in their lives.

Many pastors, evangelists and music ministers have actually told me, "Paul, I just want out." Others preach to live rather than live to preach. Still others have fallen into the alternative trap of continually promoting Christian or semi-Christian causes. Still others are being ground between the teeth of spiritual "burnout." However, in the background, the discerning Christian can still hear the roar of a lion.

Symptoms of A Devoured Christian Here are the distinguishing characteristics of a devoured Christian: 1. He (or she) lacks powers of self-control and moderation.

2. He leads a compromised lifestyle.

3. He has a sense of being permanently trapped.

4. He feels worthless, washed up or burned out 5. He tends to be unnaturally aggressive.

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It was stated above that in an Agonal rhythm we see the last semblance of ordered electrical activity in the heart. To me this is the Holy Spirit trying to get the Christian to respond before it is too late. If the Christian willing decides to continue to walk away then as in the physical an Agonal rhythm leads to the heart dying so will the Christian's Spiritual HEART. Once the Christian has allowed Satan to take them captive as seen in 2 Timothy 2:26 And that they may recover themselves out of the snare of the devil, who are taken captive by him at his will. (KJV) To the point where this Christian is now having empathy and even sympathy for the old live before they were Christians and are starting to defend their desire to return to the worldly life that is how I see this a Christian with Stockholm syndrome.

As Satan won the battle in the Christian MIND he was then able to get them to willingly give up their WILL. Satan then went on to drawn the Christian away from relationship with God and then the Christian in turn willingly decided to walk away for the relationship known as being drawn away. This can be seen and was referenced in James 1:14-16: But every person is tempted when he is drawn away, enticed and baited by his own evil desire (lust, passions). 15 Then the evil desire, when it has conceived, gives birth to sin, and sin, when it is fully matured, brings forth death. 16 Do not be misled, my beloved brethren. (AMP) This then gives way to a form of traumatic bonding of sorts and Satan then has a right to build strong EMOTIONAL ties with the person that is walking away from their Christian life and heritage.

At this point this Christian is in a very bad place in their spiritual life and is at the door step of

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Apostasy, and IF and only IF they take the next step and start their abandonment of God and His will for their lives we will see changes in their CHARACTER and PERSONALITY. It is at this point spiritually that Christian's entire HEART is quivering similar to a bowl of Jell-OTM when shaken. This brings us to the rhythm of Ventricular fibrillation.

VENTRICULAR FIBRILLATION Ventricular fibrillation (VF) is an immediately life-threatening arrhythmia that requires immediate medical intervention. During VF, many small waves propagate throughout the ventricles most likely caused by meandering reentrant waves, spiral or scroll wave breakup, fibrillatory conduction, or some combination of these. As a result, electrical waves in the ventricles are uncoordinated and cannot produce an effective contraction. Blood cannot be pumped properly, and blood pressure drops to zero.

The ventricle walls are quivering, preventing any movement of blood out of the ventricles, which results in no cardiac output (see Figure 14.7 below). The entire myocardium is quivering similar to a bowl of Jell-OTM when shaken. The amplitude and frequency of the fibrillatory activity can be used to define the type of fibrillation as coarse, medium or fine.

Small baseline undulations are considered fine; large ones are coarse.

The only effective therapy is electrical defibrillation delivered either from external defibrillators or from internally positioned devices implanted into patients diagnosed as at risk for severe cardiac arrhythmias. Defibrillators attempt to reset the heart's electrical activity by delivering a high-energy electrical shock, following which sinus rhythm resumes. Because the heart's inability to pump blood deprives body tissues of oxygen, defibrillation must be performed within minutes for the body to recover.ccxxxiv

Figure 14.7 ccxxxv Criteria for Classification Rhythm: Both the P-P and R-R intervals cannot be determined because only chaotic waveforms are recorded on the rhythm strips. If an R-R interval is determined, it will be irregular.

Rate: The atrial rate cannot be determined or identified. The ventricular rate, if identifiable, is greater than 300 beats per minute.

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P wave configuration: The P wave configuration is not identifiable.

PR interval: The PR interval cannot be identified.

QRS duration and configuration: The QRS duration and configuration cannot be determined because only fibrillatory waves are present without any uniform depolarization of the ventricle occurring.

What's Unique about this Rhythm?

Ventricular fibrillation is the absence of organized electrical activity. The tracing is chaotic in appearance.

Clinical Significance If the patient is conscious and talking but the EKG tracing is showing ventricular fibrillation, the patient's electrodes have become loose or detached. In true ventricular defibrillation, patients will be unresponsive when the ventricles are quivering without contracting. This will always be a Code situation, in which immediate intervention is necessary to prevent biological death. Every patient experiencing ventricular fibrillation will be unconscious, apneic (apnea means not breathing), and pulseless. CPR and emergency measures should begin immediately. It is recommended that appropriate advanced cardiac life support (ACLS) care is given to regain normal cardiac function.

What does this mean to the Christian heart?

As I stated earlier in this chapter this Christian has allowed Satan to win the battle in their MIND. Satan was then able to get the Christian to willingly give up their WILL. Satan did not stop there but he then went on to drawn the Christian away from their relationship with God. It was at that point that the Christian willingly allowed Satan to drawn them away from God. Now that Satan has done this he has been able to from EMOTIONAL ties with the Christian and their desire for their formal life in the natural world. The Christian now more than ever does not just want to walk away from their Christian life and heritage but RUN as fast as they can back to the worldly life and the life they had before Christ.

It is at this point that the Christian has willingly steps through the door to Apostasy, and they have started to follow the desires of their sinful nature, and continue to walk in abandonment of God and His will. We have now come to the Christian having and showing CHARACTER and PERSONALITY changes as seen in the following verse. Galatians 5:19-21 It is obvious what kind of life develops out of trying to get your own way all the time: repetitive, loveless, cheap sex; a stinking accumulation of mental and emotional garbage; frenzied and joyless grabs for happiness; trinket gods; magic-show religion; paranoid loneliness; cutthroat competition; all-consuming-yet-never-satisfied wants; a brutal temper; an impotence to love or be loved; divided homes and divided lives; small-minded and lopsided pursuits; the vicious habit of depersonalizing everyone into a rival; uncontrolled and uncontrollable addictions; ugly parodies of community. I could go on. This isn't the first time I have warned you, you know. If you use your freedom this way, you will not inherit God's kingdom. (MSG) It is at this junction that the Christian has allowed Satan to bring them to the point of them destroying themselves and Dyeing before their time.

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Here again I want to read what Dr. Paul W. Carlin had to say on the subject of the Christian that would destroy himself.

DESTROY HIMSELF I conclude with this awesome, sobering thought because I have seen this very thing happen so many times. Not only have I witnessed the destruction of self, but I have seen the devastation, destruction and/or near destruction of other people coming as fallout from self-destruction.

It is really not a pretty picture. Let me lift a couple of locations from the Old Testament.

First, from Ecclesiastes 7:16-17 we read, "Be not righteous over much; neither make thyself over wise; why should thou destroy thyself? Be not over much wicked, neither be thou foolish; why shouldest thou die before thy time?" Secondly, there is Hosea 13:9 which says, "O Israel, thou hast destroyed thyself; but in Me is thine help."

The entirety of Ecclesiastes 7 is loaded with wisdom for the living. But those two phrases, "destroy thyself" and "die before thy time," intrigue me. With such an obvious condition of pride existing in many Christians, churches, denominations and ministries, I really do not think Satan believes he has a whole lot to worry about. He does not have to destroy them, for many will do a fairly adequate job of destroying themselves.

The word of God would suggest here that it is not so much our human or supernatural enemies we should be so concerned about, but rather ourselves. I fear that selfdestruction is perhaps more prevalent than we wish to admit. At the heart of the problem appears to be pride. Ezekiel 16:49-50 says: "Behold, this was the iniquity of thy sister Sodom, pride, fullness of bread, and abundance of idleness was in her and in her daughters, neither did she strengthen the hand of the poor and needy. And they were haughty, and committed abominations before Me; therefore, I took them away as I saw good."

A grotesque list of sins indeed. However, heading the list was "pride," and at the close was "haughty."

In Proverbs 8:13 God says, "Pride and arrogance I hate." In Proverbs 11:2 we have, "when pride cometh, then cometh shame." In Proverbs 13:10 we learn that "by pride cometh contention." In Proverbs 10:18 we have, "Pride goeth before destruction and a haughty spirit before a fall." And in Proverbs 29:23 the writer says, ". . . man's pride shall bring him low."

Pride is the condition that guarantees you will bring yourself down. You will not need any outside help. And the ironic thing about it is that when the inevitable downfall happens, the prideful person never has a clue as to why it happened. The truth is that the longsuffering God had taken about all of an individual's pride and arrogance that He could stand.

Have you ever seen a minister, or a church, or ministry "die before their time"? I am aware that it happens physically more often than we would like to admit. But I am not talking about physical death. I mean, for example, a denomination or a ministry that

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once reached millions of people but now affects only thousands. Once it was sitting on top of the world, but now scarcely a trace of it can be found.

No invading army crushed its adherents. No demon from hell brought them down. It was simply or perhaps I should say not so simply pride! Are you destroying yourself?

Have you destroyed yourself?

I want you to grasp in this teaching is the necessity of assuming responsibility for your actions. You must quit blaming other people for a great portion of your failures to which God says, "Thou art the man."

The dying before their time is at first spiritual in nature but as their lives start to spin, quivering and fibrillate out of control this spiritual death could also lead them to an early physical death as well. This brings us to our last rhythm that we will be discussing and that is Asystole.

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Chapter 15 Asystole EQUALS Apostasy ASYSTOLE Asystole is absence of ventricular activity and depolarization. Often this is called "the straight, flat line or TV Death" of rhythms. No electrical activity is present in the myocardium.

Figure 15.1 ccxxxvi Criteria for Classification Rhythm: Since no waveforms are present, there are no P-P or R-R intervals.

Rate: No atrial or ventricular rates are present.

P wave configuration: No P waves are present.

PR interval: The PR interval is unable to be measured because no waveforms are being recorded.

QRS duration and configuration: The QRS duration and configuration is not measurable because no QRS waveform is observed.

What's Unique about this Rhythm?

This rhythm is associated with life-threatening conditions. The patient will display no pulse and no cardiac output as evidenced by unconsciousness and apnea. The patient is in cardiac arrest, and emergency procedures must be initiated immediately.ccxxxvii Clinical Significance Confirm asystole in two leads to make sure it is not Fine V-Fib! Pace them immediately!

What does this mean to the Christian heart?

The Christian found to be in a spiritual asystole; like that of physical asystole, is the endstage rhythm that follows prolonged VT, VF or PEA, (Spiritual H's and T's / Sins / the Backslidden Christian) and all of these rhythms, if not reversed prior to this point will lead to spiritual death which could also lead to physical death. Asystole, is the most deadly of rhythms, actually it is the lack of any rhythm; it's also a cardinal sign of death!

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This is the Christian that willingly choose to walk away from God and their spiritual life and they have committed spiritual suicide. They willingly opened door and stepped through the door leading to the sin unto death. We find this stated in 1 John 5:16-17 If any man see his brother sin a sin which is not unto death, he shall ask, and he shall give him life for them that sin not unto death. There is a sin unto death: I do not say that he shall pray for it. 17 All unrighteousness is sin: and there is a sin not unto death. (KJV) I need to summarize this Christian's Actions to get to this point of what I see as the Christian that has chosen to commit spiritual suicide known as Apostasy. This Christian has gone through cycles of different MIND SETS that has led them to backsliding and then to repenting as many of us have (it is more normal than any of us would care to admit). This Christian has moved for that of the Spiritual man and mind set back into being that of a Carnal man with a carnal mind and has finally continued to backslide until their heart is so hardened through sin that repentance becomes impossible and has become as they were before they were Christian. Eventually, the engrafted nature will be smothered out and they will become a Reprobate and this person is doomed because the New (CHRIST) Nature is now dead and the reprobate person and mind set has returned to their Old Nature.

You find this frightening mind set in Romans 1:28, which says, "And even as they did not like to retain God in their knowledge, God gave them over to a reprobate mind, to do those things which are not convenient. (KJV) From the perspective of The Bible, a reprobate and the reprobate mind set is someone who refuses to make good use of the understanding of the Word of God provided to them, 2 Timothy 3:8 states it as the following: Now just as Jannes and Jambres were hostile to and resisted Moses, so these men also are hostile to and oppose the Truth. They have depraved and distorted minds, and are reprobate and counterfeit and to be rejected as far as the faith is concerned. (AMP) Reprobate is also used to translate the originate Greek word of the New Testament, pronounced, ad-ock-ee-mos, meaning rejected i.e. those who reject the Word of God will be rejected by God's Word in due time, this is clearly seen in John 12:48 Anyone who rejects Me and persistently sets Me at naught, refusing to accept My teachings, has his judge [however]; for the [very] message that I have spoken will itself judge and convict him at the last day.

(AMP)ccxxxviii I see the Reprobate as someone who knows better, but they chose not to do better, as seen in Romans 1:18 For the wrath of God is revealed from heaven against all ungodliness and unrighteousness of men, who hold the Truth in unrighteousness; (KJV) The reprobate man and mind set is an addictive-compulsive mind which leads the man to be the same. This person is capable of every possible evil and the consequences of this mind set are disastrous.

To bring this point home I want us to read Romans 1:18-32 But God's angry displeasure erupts as acts of human mistrust and wrongdoing and lying accumulate, as people try to put a shroud over truth. But the basic reality of God is plain enough. Open your eyes and there it is! By taking a long and thoughtful look at what God has created, people have always been able to see what their eyes as such can't see: eternal power, for instance, and the mystery of

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his divine being. So nobody has a good excuse. What happened was this: People knew God perfectly well, but when they didn't treat him like God, refusing to worship him, they trivialized themselves into silliness and confusion so that there was neither sense nor direction left in their lives. They pretended to know it all, but were illiterate regarding life. They traded the glory of God who holds the whole world in his hands for cheap figurines you can buy at any roadside stand. 24-25 So God said, in effect, "If that's what you want, that's what you get." It wasn't long before they were living in a pigpen, smeared with filth, filthy inside and out. And all this because they traded the true God for a fake god, and worshiped the god they made instead of the God who made them—the God we bless, the God who blesses us. Oh, yes! 2627 Worse followed. Refusing to know God, they soon didn't know how to be human either— women didn't know how to be women, men didn't know how to be men. Sexually confused, they abused and defiled one another, women with women, men with men—all lust, no love.

And then they paid for it, oh, how they paid for it—emptied of God and love, godless and loveless wretches. 28-32 Since they didn't bother to acknowledge God, God quit bothering them and let them run loose. And then all hell broke loose: rampant evil, grabbing and grasping, vicious backstabbing. They made life hell on earth with their envy, wanton killing, bickering, and cheating. Look at them: mean-spirited, venomous, fork-tongued God-bashers.

Bullies, swaggerers, insufferable windbags! They keep inventing new ways of wrecking lives.

They ditch their parents when they get in the way. Stupid, slimy, cruel, cold-blooded. And it's not as if they don't know better. They know perfectly well they're spitting in God's face. And they don't care—worse, they hand out prizes to those who do the worst things best! (MSG) This person has returned to being that of a Natural man and most of them go to the extremes against God. As I stated in Chapter 3, this person is now a Dead man walking a zombie. I hope none of you ever watched any of those zombie movies as kids but I did. The funny thing now is that all that I can remember now is that the zombies are dead and want everybody else to be dead like them.

As you read in the title of this chapter the Christian that is found to be in asystole equals the Christian that has committed apostasy (spiritual suicide) to me. Holman Bible Dictionary states that, Apostasy is the act of rebelling against, forsaking, abandoning, or falling away from what one has believed. Such apostasy in the latter times will involve doctrinal deception, moral insensitivity, and ethical departures from God's truth… Still others argue that the biblical warnings against apostasy are real and that believers maintain the freedom, at least potentially, to reject God's salvation.ccxxxix Apostasy requires a series of deliberate acts, willful choices not to follow the Lord, a turning away from God, a continued refusal of repentance. Apostasy begins with backsliding.

Apostasy is not something one may unknowingly commit. It takes a deliberate walking away from God, a refusal to allow the discipline of the Lord to have its purifying effect, a continual turning from the grace of God-until one crosses the line. At that point his or her heart is so hardened it is impossible to return to God. Where is that line?

The Bible does not say, but over and over, it is indicated as a possibility. Once the line is crossed, "no sacrifice for sin is left" as seen in Hebrews 10:26b. I want us to see the BIG pitcher here so I think we all need to read Hebrews 10: 26-31 and I want to do so in both The Amplified Bible and then in The Message.

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Hebrews 10:26-31 For if we go on deliberately and willingly sinning after once acquiring the knowledge of the Truth, there is no longer any sacrifice left to atone for [our] sins [no further offering to which to look forward]. 27 [There is nothing left for us then] but a kind of awful and fearful prospect and expectation of divine judgment and the fury of burning wrath and indignation which will consume those who put themselves in opposition [to God]. 28 Any person who has violated and [thus] rejected and set at naught the Law of Moses is put to death without pity or mercy on the evidence of two or three witnesses. 29 How much worse (sterner and heavier) punishment do you suppose he will be judged to deserve who has spurned and [thus] trampled underfoot the Son of God, and who has considered the covenant blood by which he was consecrated common and unhallowed, thus profaning it and insulting and outraging the [Holy] Spirit [Who imparts] grace (the unmerited favor and blessing of God)? 30 For we know Him Who said, Vengeance is Mine [retribution and the meting out of full justice rest with Me]; I will repay [I will exact the compensation], says the Lord. And again, The Lord will judge and determine and solve and settle the cause and the cases of His people. 31 It is a fearful (formidable and terrible) thing to incur the divine penalties and be cast into the hands of the living God! (AMP) Hebrews 10:26-31 If we give up and turn our backs on all we've learned, all we've been given, all the truth we now know, we repudiate Christ's sacrifice and are left on our own to face the Judgmentâ&#x20AC;&#x201D;and a mighty fierce judgment it will be! If the penalty for breaking the law of Moses is physical death, what do you think will happen if you turn on God's Son, spit on the sacrifice that made you whole, and insult this most gracious Spirit? This is no light matter.

God has warned us that he'll hold us to account and make us pay. He was quite explicit: "Vengeance is mine, and I won't overlook a thing" and "God will judge his people." Nobody's getting by with anything, believe me. (MSG) Here is a question for you. If apostasy were not a possibility for the believer, then why the great number of passages warning believers against drifting, turning away, hardening of one's heart through the deceitfulness of sin? God isn't playing here, He is warning of a real and perilous possibility. We will find this teaching in 2 Peter 2:20-22. Here again we have to read it for ourselves so we are again going to read the verse from both The Amplified Bible and then in The Message.

2 Peter 2:20-22 For if, after they have escaped the pollutions of the world through [the full, personal] knowledge of our Lord and Savior Jesus Christ, they again become entangled in them and are overcome, their last condition is worse [for them] than the first. 21 For never to have obtained a [full, personal] knowledge of the way of righteousness would have been better for them than, having obtained [such knowledge], to turn back from the holy commandment which was [verbally] delivered to them. 22 There has befallen them the thing spoken of in the true proverb, The dog turns back to his own vomit, and, The sow is washed only to wallow again in the mire. (AMP) 2 Peter 2: 20-22 If they've escaped from the slum of sin by experiencing our Master and Savior, Jesus Christ, and then slid back into that same old life again, they're worse than if they had never left. Better not to have started out on the straight road to God than to start out and then turn back, repudiating the experience and the holy command. They prove the point of the proverbs, "A dog goes back to its own vomit" and "A scrubbed-up pig heads for the mud." (MSG)

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Now that we have just read the above I have a second question for you the reader. What do you think could be worse than not knowing Christ, and then having to face eternity in hell? My answer has to be the fore knowledge that one faces hell after having known God and His love but chose to turn from the Lord. Those people know it is coming and are choosing to die and go to hell anyway.

But as I will share in the next scripture, those that have committed apostasy have neither the capacity nor inclination toward repentance and it is absolutely impossible as seen through Hebrews 6:4-8. For it is impossible [to restore and bring again to repentance] those who have been once for all enlightened, who have consciously tasted the heavenly gift and have become sharers of the Holy Spirit, 5 And have felt how good the Word of God is and the mighty powers of the age and world to come, 6 If they then deviate from the faith and turn away from their allegianceâ&#x20AC;&#x201D;[it is impossible] to bring them back to repentance, for (because, while, as long as) they nail upon the cross the Son of God afresh [as far as they are concerned] and are holding [Him] up to contempt and shame and public disgrace. 7 For the soil which has drunk the rain that repeatedly falls upon it and produces vegetation useful to those for whose benefit it is cultivated partakes of a blessing from God. 8 But if [that same soil] persistently bears thorns and thistles, it is considered worthless and near to being cursed, whose end is to be burned. (AMP) Sin is serious business. One is playing with fire presuming upon God while indulging known sin. The believer is secure. Absolutely nothing can remove the believer from the Love of Godnothing but willful disobedience that has the potential to harden one beyond the point of return (a seared conscience). Seemingly conflicting passages do not conflict, but present facets of truth which serve to refine and define the Bible's teaching on salvation.

Falling away takes place by degrees. One does not apostatize in one day. Rather it is the "small" things that take one away from God, the gradual erosion of the things of God in the life of a believer, step by step until the line of apostasy has been crossed. If you're toying with sin, repent! Don't presume upon God's grace!

We find biblical lists of things that can't remove us from God's love-but in none of those lists does one find self, because self-will (the freedom to choose or reject God) is the only thing that can remove one from God's care.ccxl Next I want to give you a Biblical example of the Christian in asystole that has committed apostasy which is spiritual suicide to me. This person knew God intimately and then chose to walk away from that relationship. I am referring to King Saul and too me I would call him the text book example of a person that has a compulsive-addictive HEART (his Mind, his Will, his Emotions and his Character and Personality). King Saul at this point in his life he has committed apostasy and has been handed over to a reprobate mind which leads to King Saul ultimately committing physical suicide on top of Mount Gilboa.

This is recorded at the close of the book of I Samuel and to me it is one of the saddest stories in the history of the nation of Israel. I Samuel 31:1-6 The Philistines made war on Israel. The men of Israel were in full retreat from the Philistines, falling left and right, wounded on Mount Gilboa. The Philistines caught up with Saul and his sons. They killed Jonathan, Abinadab, and Malki-Shua, Saul's sons. 3-4 The battle was hot and heavy around Saul. The archers got

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his range and wounded him badly. Saul said to his weapon bearer, "Draw your sword and put me out of my misery, lest these pagan pigs come and make a game out of killing me." 4-6 But his weapon bearer wouldn't do it. He was terrified. So Saul took the sword himself and fell on it. When the weapon bearer saw that Saul was dead, he too fell on his sword and died with him. So Saul, his three sons, and his weapon bearer the men closest to him died together that day. (MSG) I want to take a quick look back over the life of King Saul; he was the king that was called by God to lead His people, but he chose to sin by his acts of self-will, disobeying the Lord, and finally Saul rejected God's Word! 

King Saul was anointed of God: I Samuel 10:1 Then Samuel took a flask of olive oil and poured it over Saul's head. He kissed Saul and said, "I am doing this because the LORD has appointed you to be the ruler over Israel, his special possession.(NLT)

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King Saul was given another heart by God: I Samuel 10:9 And when [Saul] had turned his back to leave Samuel, God gave him another heart, and all these signs came to pass that day. (AMP)

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King Saul was used by the Spirit of God: I Samuel 10:10 When they came to the hill [Gibeah], behold, a band of prophets met him; and the Spirit of God came mightily upon him, and he spoke under divine inspiration among them. (AMP)

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King Saul was humble in the beginning: I Samuel 9:21 Saul answered, "But I'm only a Benjaminite, from the smallest of Israel's tribes, and from the most insignificant clan in the tribe at that. Why are you talking to me like this?" (AMP)

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King Saul's slide down the path of sin began when his own self-will caused him to intrude into the Priest's office, directly violating the commandment of the Lord: I Samuel 13:8-14 He waited seven days, the time set by Samuel. Samuel failed to show up at Gilgal, and the soldiers were slipping away, right and left. 9-10 So Saul took charge: "Bring me the burnt offering and the peace offerings!" He went ahead and sacrificed the burnt offering. No sooner had he done it than Samuel showed up! Saul greeted him. 11-12 Samuel said, "What on earth are you doing?" Saul answered, "When I saw I was losing my army from under me, and that you hadn't come when you said you would, and that the Philistines were poised at Micmash, I said, 'The Philistines are about to come down on me in Gilgal, and I haven't yet come before GOD asking for his help.' So I took things into my own hands, and sacrificed the burnt offering." 13-14 "That was a fool thing to do," Samuel said to Saul. "If you had kept the appointment that your GOD commanded, by now GOD would have set a firm and lasting foundation under your kingly rule over Israel. As it is, your kingly rule is already falling to pieces. GOD is out looking for your replacement right now. This time he'll do the choosing. When he finds him, he'll appoint him leader of his people. And all because you didn't keep your appointment with GOD!" (MSG)

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King Saul lost his reasoning ability, making a rash oath: I Samuel 14:44 Yes, Jonathan," Saul said, "you must die! May God strike me and even kill me if you do not die for this." (NLT)

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King Saul directly disobeyed the voice of the Lord by not eliminating Amelek, instead sparing him and "the chief things which should have been utterly

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A Paramedic’s view of Christianity destroyed." This open disobedience by the king caused Samuel to utter those now famous words: I Samuel 15:22-23 Samuel said, Has the Lord as great a delight in burnt offerings and sacrifices as in obeying the voice of the Lord? Behold, to obey is better than sacrifice, and to hearken than the fat of rams. 23 For rebellion is as the sin of witchcraft, and stubbornness is as idolatry and teraphim (household good luck images). Because you have rejected the word of the Lord, He also has rejected you from being king. (AMP)

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King Saul's jealousy led him to try to kill David, falsely considering him an enemy: I Samuel Chapters 18-19 you can read them for yourselves

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King Saul's anger caused him to try to kill his own son Jonathan: I Samuel 20:33 Then Saul hurled his spear at Jonathan, intending to kill him. So at last Jonathan realized that his father was really determined to kill David. (NLT)

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King Saul later brutally commanded the slaughter of 85 Priests and all the inhabitants of their city: I Samuel 22:17-19 And he ordered his bodyguards, "Kill these priests of the LORD, for they are allies and conspirators with David! They knew he was running away from me, but they didn't tell me!" But Saul's men refused to kill the LORD's priests. 18 Then the king said to Doeg, "You do it." So Doeg the Edomite turned on them and killed them that day, eighty-five priests in all, still wearing their priestly garments. 19 Then he went to Nob, the town of the priests, and killed the priests' families men and women, children and babies and all the cattle, donkeys, sheep, and goats. (NLT)

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King Saul's last irrational act prior to his suicide was consulting the witch of Endor. Recognizing that the Lord no longer was with him, he turned to Satan's counterpart to give him counsel. But even through this unlikely source he hears from the departed spirit of Samuel who soundly condemned him and prophesied doom to Saul. Saul reacts by falling down and "was sore afraid": I Samuel 28:820 So Saul disguised himself by wearing ordinary clothing instead of his royal robes.

Then he went to the woman's home at night, accompanied by two of his men. "I have to talk to a man who has died," he said. "Will you call up his spirit for me?" 9 "Are you trying to get me killed?" the woman demanded. "You know that Saul has outlawed all the mediums and all who consult the spirits of the dead. Why are you setting a trap for me?" 10 But Saul took an oath in the name of the LORD and promised, "As surely as the LORD lives, nothing bad will happen to you for doing this." 11 Finally, the woman said, "Well, whose spirit do you want me to call up?" "Call up Samuel," Saul replied. 12 When the woman saw Samuel, she screamed, "You've deceived me! You are Saul!" 13 "Don't be afraid!" the king told her. "What do you see?" "I see a god coming up out of the earth," she said. 14 "What does he look like?" Saul asked. "He is an old man wrapped in a robe," she replied. Saul realized it was Samuel, and he fell to the ground before him. 15 "Why have you disturbed me by calling me back?" Samuel asked Saul.

"Because I am in deep trouble," Saul replied. "The Philistines are at war with me, and God has left me and won't reply by prophets or dreams. So I have called for you to tell me what to do." 16 But Samuel replied, "Why ask me, since the LORD has left you and has become your enemy? 17 The LORD has done just as he said he would. He has torn the kingdom from you and given it to your rival, David. 18 The LORD has done this to you today because you refused to carry out his fierce anger against the Amalekites.

19 What's more, the LORD will hand you and the army of Israel over to the Philistines

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tomorrow, and you and your sons will be here with me. The LORD will bring down the entire army of Israel in defeat." 20 Saul fell full length on the ground, paralyzed with fright because of Samuel's words. He was also faint with hunger, for he had eaten nothing all day and all night. (NLT) It was the above; bizarre encounters which lead King Saul into the final chapter of his life that ended with him in battle and badly wounded on the top of Mount Gilboa, where he decides to commit physical suicide.

It is obvious to me that Saul's physical suicide began by his acts of willfully, disobeying the Lord, and finally rejecting His Word! So then as I have shown spiritual suicide always takes place first, before anyone is found committing physical suicide! I don't know about you but in my years in EMS I have seen my share of self-inflected wounds and my share of suicides.

As I see it, Saul, is a Biblical example of the person that comes to have a personal relationship with God and receiving eternal life from God. This is obviously seen in I Samuel 10:9 when "God gave him a new heart" and the Spirit of God then repeatedly used Saul.

Here again as I see it, these two acts of God prove that Saul like the Christian found to be asystole; both truly were children of God. But, as I stated above Saul's spiritual suicide began by his acts of willfully, disobeying the Lord, and finally rejecting His Word! It was these actions that opened up an opportunity for the devil to direct his thoughts and actions leading him down the treacherous road of rebellion and witchcraft ending ultimately in his satanically motivated self-destruction!

No man in the Bible had so many opportunities thrust upon him to make a success of life, and no man ever so missed them and deliberately abused them as this man Saul. The down-slide of Saul is the old familiar story of pride, egotism and abuse of power leading to moral degradation and ruin.ccxli I want to end this chapter by reading what Dr. Paul W. Carlin in his outstanding work Satan and the Saint: A Look into The Dark Side Of Christian Behavior, in the section entitled "A Christian can lose his life" had to say about the Christian that chooses to lose their life, which I belief to be Satan's ultimate goal for all Christians.

1 John 5:17 says, "There is a sin unto death." The verse is addressing believers only.

It literally says that a believer can sin to the point where physical death will result as a judgment from God. However, do not be misled. This verse does not mean that there is one particular sin that will cause the premature death of a believer.

It is not a sin which directly brings on death, but a lifestyle of rebellion against God. It is the believer who is in a backslidden condition that is in danger of committing this fatal sin.

Ananias and Sapphira (Acts 5:1-11) committed this sin and "fell down, and gave up the ghost." God killed this married couple, who were wealthy members of the Jerusalem church, because they lied to the Holy Spirit.

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A Paramedicâ&#x20AC;&#x2122;s view of Christianity Because of the sinful lifestyle of some of the members of the Corinthian church, we find this in the Word of God (1 Cor. 11:30-32); "for this cause many are weak and sickly among you, and many sleep (have died). For if we would judge ourselves, we should not be judged. But when we are judged, we are chastened of the Lord, that we should not be condemned with the world." A sobering verse lies at the close of 1 Corinthians (16:22); "If any man love not the Lord Jesus Christ, let him be Anathema Maranatha." The phrase Anathema Maranatha means "marked for destruction."

A male member of the church in Corinth had had sexual intercourse with his stepmother. Paul says concerning this man (1 Cor. 5:5), "To deliver such a one unto Satan for the destruction of the flesh, that the spirit may be saved in the day of the Lord Jesus."

I fear that millions of the unexplained, premature deaths that occur in our churches can be explained in the context of the "sin unto death." The tragic truth is that many Christians, backslidden in heart, corrupt in lifestyle, are living on death row. Some day God will sign their death warrant and they will suddenly die.

Have you lost something? Have you lost your first love? Have you lost your fellowship with God? Have you lost the joy of salvation? Have you lost your testimony for Christ?

Have you lost your courage? Have you lost heart? Will you lose your rewards? Are you living on death row in a cold, backslidden condition?

Christian, you could lose your life! Examine yourself! Take inventory! Get real! Get honest with God and with yourself! Do you not see that you might very well be "marked for destruction?" According to 1 Timothy 6:9, it is possible for a Christian to "fall into temptation and a snare, and into many foolish and hurtful lusts, which drown men in destruction and perdition."

The spiritual condition of a believer can erode to an irretrievable loss. Have your actions become spiritually irrational and harmful? If such is the condition of your Christian life, the verse says literally that you will be dragged to the bottom, submerged and drowned! And the horrifying thought is that you will drown in your own "foolish and hurtful lusts."

The good news is that there is a way out! 1 John 1:9 says, in the form of a promise to sinning saints, "If we confess our sins, He is faithful and just to forgive us our sins, and to cleanse us from all unrighteousness."

Christian confession of sins to God the Father initiates forgiveness and cleansing in the life of the believer. You can recover your losses!ccxlii

In the next chapter we will be discussing that just as in the physical we need to have our personal physicians do a complete check-up. Then I think that it is about time for you and I to go and have the Great Physician do a complete Spiritual Check-UP also.

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Chapter 16 Now is the Time to Have Your HEART Examined If you have been reading this from the beginning or have just picked it up and started reading then something about it caught your eye. Maybe you have already been having times of personal heart examination.

Well there is now better time than now. If you have been a Christian for any amount of time then you know that daily quiet times and church services are time of examination. But here is the problem with that line of thinking.

How often are called out to someone's house that is deathly sick, and we walk in the house with all our bags only to hear why are you here I didn't call you? It is at that point from the back of the room or house that we hear another voice that states Daddy you are sick so I called (Rescue Squad, the Ambulance Drivers, and EMS) to come and get you to the hospital. We then hear things that I cannot and will not repeat.

It is just that scenario above that brings me to what I want to share with you from I Corinthians 14:24-25 But if all of you are prophesying, and unbelievers or people who don't understand these things come into your meeting, they will be convicted of sin and judged by what you say. 25 As they listen, their secret thoughts will be exposed, and they will fall to their knees and worship God, declaring, "God is truly here among you." (NLT) Could it be that some people will not go to church for the same reason they won't go to see a physician; they are afraid they might find out that something is wrong.

As seen in the verse above they are afraid that they or someone else might find that the "their secret thoughts will be exposed." And then we will know that they are not the person on the inside that they portray to be on the outside.

I want to read Hebrews 4:12 in the following three versions to be able to see the big pitcher of what this verse is teaching us.

Hebrews 4:12 For the Word that God speaks is alive and full of power [making it active, operative, energizing, and effective]; it is sharper than any two-edged sword, penetrating to the dividing line of the breath of life (soul) and [the immortal] spirit, and of joints and marrow [of the deepest parts of our nature], exposing and sifting and analyzing and judging the very thoughts and purposes of the heart. (AMP) Hebrews 4:12-13 God means what he says. What he says goes. His powerful Word is sharp as a surgeon's scalpel, cutting through everything, whether doubt or defense, laying us open to listen and obey. Nothing and no one is impervious to God's Word. We can't get away from it no matter what. (MSG) Hebrews 4:12 For the word of God is quick, and powerful, and sharper than any twoedged sword, piercing even to the dividing asunder of soul and spirit, and of the joints and marrow, and is a discerner of the thoughts and intents of the heart. (KJV)

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As we read the verses above we see that the human HEART (Mind, Will, Emotions and Character / Personality) are all to be examined by the Word of God. The verse talks about five things that the Word is. Let's review them shall we: 1. The Word of God is alive: quick (KJV) 2. The Word of God is powerful: making it active, operative, energizing, and effective 3. The Word of God is sharp 4. The Word of God pierces: penetrating 5. The Word of God discerns: exposing and sifting and analyzing and judging the very thoughts and purposes of the heart This whole book has been about the Word doing those five things in the Christians HEART has it not? When we got to number five that was and is still one of the hardest for me it states that the Word of God discerns. So then it being the Word is constantly exposing and sifting and analyzing and judging every thought and purpose of mine and your HEARTS (Mind, Will, Emotions and Character / Personality).

My prayer through this whole book has been that we all will allow God and His Word to perform Open HEART surgery on us daily as He did on Lydia in Act 16:14-15 One of those who listened to us was a woman named Lydia, from the city of Thyatira, a dealer in fabrics dyed in purple. She was [already] a worshiper of God, and the Lord opened her heart to pay attention to what was said by Paul. 15 And when she was baptized along with her household, she earnestly entreated us, saying, If in your opinion I am one really convinced [that Jesus is the Messiah and the Author of salvation] and that I will be faithful to the Lord, come to my house and stay. And she induced us [to do it]. (AMP) As we allow God to open our hearts and if we are in need of a new heart He will provide one for us. God has wanted to bring about these changes and exchanges that He has seen for us since the beginning of time but He has had to wait on us to turn to Him. This fact is seen in the following two verses.

Ezekiel 36:24-28 "'For here's what I'm going to do: I'm going to take you out of these countries, gather you from all over, and bring you back to your own land. I'll pour pure water over you and scrub you clean. I'll give you a new heart, put a new spirit in you. I'll remove the stone heart from your body and replace it with a heart that's God-willed, not self-willed. I'll put my Spirit in you and make it possible for you to do what I tell you and live by my commands.

You'll once again live in the land I gave your ancestors. You'll be my people! I'll be your God! (MSG) 2 Corinthians 5:16-20 Because of this decision we don't evaluate people by what they have or how they look. We looked at the Messiah that way once and got it all wrong, as you know.

We certainly don't look at him that way anymore. Now we look inside, and what we see is that anyone united with the Messiah gets a fresh start, is created new. The old life is gone; a new life burgeons! Look at it! All this comes from the God who settled the relationship between us and him, and then called us to settle our relationships with each other. God put the world square with himself through the Messiah, giving the world a fresh start by offering forgiveness

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of sins. God has given us the task of telling everyone what he is doing. We're Christ's representatives. God uses us to persuade men and women to drop their differences and enter into God's work of making things right between them. We're speaking for Christ himself now: Become friends with God; he's already a friend with you. (MSG) The Bible Reveals Blockages in our HEARTS Just as in AV Blocks. We Christians sometime seem to have the same problem in the spiritual that people develop in the physical blockages in the heart. The Bible speaks of hardness of heart. Zechariah 7:12 Yes, they made their hearts as an adamant stone or diamond point, lest they should hear the law and the words which the Lord of hosts had sent

by His Spirit through the former prophets. Therefore there came great wrath from the Lord of hosts. (AMP) This verse tells us that Israel "made their hearts as an adamant stone." The adamant stone is thought to be the same as the corundum, the second hardest of all minerals. God told his preacher in Ezekiel 3:9 Like an adamant harder than flint or a diamond point have I made your forehead; fear them not, neither be dismayed at their looks, for they are a rebellious house. (AMP) This is God speaking and doing the hardening of His prophets "adamant harder than flint or a diamond point have I made your forehead."

As I first read this verse I saw a lot of EMS personal fitting this description and I have Biblical proof that it is apparently alright to be "hardheaded" about important things, but it is wrong to be "hardhearted."

A SPIRITUALLY HARD HEART SADDENS THE LORD! Jesus encountered this hardness of heart. Mark 3:5 And He glanced around at them with vexation and anger, grieved at the hardening of their hearts, and said to the man, Hold out your hand. He held it out, and his hand was [completely] restored. (AMP) As you can read and see it when we have spiritually hard hearts caused Jesus to grieve and be sad then what about now when and where we have the Holy Spirit living inside us but we still allow our hearts to become harden.

It is at the time that we allow our hearts to become harden that we start having problems and also start to see the changes on the Spiritual EKG's that we talked about in the previous chapters.

As it is true in the physical; it is also true in the spiritual. Proverbs 28:14 warns us that "he that hardeneth his heart shall fall into mischief." (KJV) A hardened heart keeps you from enjoying God's blessings. Mark 6:52 says, "they considered not the miracle of the loaves, for their heart was hardened." (KJV) Jesus rebuked HIS (Christians) disciples in Mark 16:14 for their unbelief and hardness of heart. Let's read it Mark 16:14 Afterward He appeared to the Eleven [apostles themselves] as they reclined at table; and He reproved and reproached them for their unbelief (their lack of faith) and their hardness of heart, because they had refused to believe those who had seen Him and looked at Him attentively after He had risen [from death]. (AMP)

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Now to the good part for the Christian we need to examine our HEARTs at all times it was at a time in Job life that he had a spiritual doctor's appointment and he had a spiritual physical or exam when he stated in Job 23:16 For God has made my heart faint, timid, and broken, and the Almighty has terrified me, (AMP) Something must be done about the Christian and their heart of unbelief. Unbelief is the blockage keeping Christ outside. He loves you and desires to enter in and take care of your heart problem.

Psalms 51:7-15 Soak me in your laundry and I'll come out clean, scrub me and I'll have a snow-white life. Tune me in to foot-tapping songs, set these once-broken bones to dancing.

Don't look too close for blemishes; give me a clean bill of health. God, make a fresh start in me, shape a Genesis week from the chaos of my life. Don't throw me out with the trash, or fail to breathe holiness in me. Bring me back from gray exile; put a fresh wind in my sails! Give me a job teaching rebels your ways so the lost can find their way home. Commute my death sentence, God, my salvation God, and I'll sing anthems to your life-giving ways. Unbutton my lips, dear God; I'll let loose with your praise. (MSG) Over the years I have really enjoyed reading anything from Winkie Pratney and I wanted to share with you the reader one of his papers on you and I the Christian getting a Spiritual check-UP. A Spiritual Check-UP Ready?

To take this spiritual check-up you will need only pencil, paper, some time - and complete honesty. Deep breath Take A Seat CASE HISTORY - For the next hour or so, let the Holy Spirit turn His searchlight on your spiritual life. Let Him probe, X-ray and test your soul! And let Him start by opening the closets of your memory.

Memory is highly efficient at remembering wrong. Although it easily forgets merely unpleasant or worthless things, it NEVER forgets unrighted SIN. Much mental illness today can be traced to GUILT never wiped from the mind by the twin tools of confession and restoring -- and receiving forgiveness. Shock, drugs and other medical and psychiatric treatment may try to take guilt memories from the mind, but God's method is the only fully effective one - FACE each wrong with its full load of guilt, admit it to God and others who are involved AS wrong, then ask and receive healing forgiveness. (Ps 32:1-5; I Jn. 1:5-9) Use the following three lists as check-up charts to examine your life before the Lord.

Take each one slowly and carefully. Check each area that is a "sore spot" and on your own paper write out what you will have to do to get it right. Confess them to the Lord one by one as He shows you them. When you have finished, RE-READ your list again,

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and add any others that come to mind. Don't give in to the temptation to pass quickly over any area that hurts. Take your courage in your bare hands; FACE your sin. This first part will be painful. Let God furrow your heart and break up all the hardness that has formed from unconfessed sin. If tears begin to come, let them. "Godly sorrow works repentance" and tears may soften your heart for God to work with it. (2 Cor. 2:4; Ps. 38:18; 34:6, 18: 51:17; Eccles. 7:3; Ps. 147:3; Ezek. 34:16; Luke 4:18) Memory Test 1. Stealing - Can you remember taking money for property that was not yours? Did you steal from neighbors, relatives, shops or stores, school or home? (Ex. 20:15; Eph. 4:28) 2. Cheating - Did you get anything from anyone unfairly? Does someone know or suspect that you cheated to pass an important test? did you rob someone of their fair share of praise or pay for a job? (Jas. 5:1-4; Mal. 3:5; Deut. 24:14-15; Jer. 22:13; Job 31:13) 3. Lying - "Any designed form of deception for selfish reasons". If you design to make an impression contrary to the naked truth, you have lied. Have you been deceitful?

(Rev. 21:8) 4. Slander - Speaking evil of someone. You do not have to lie to slander. Have you talked about someone behind their back in a way you would not be willing to before their face? Malicious gossip - telling the truth with intent to hurt or injure is slander. Are you guilty of backbiting or criticism? (Matt. 7:1-5; I Cor. 5:12; Col. 3:8; Matt. 5:21-24) 5. Immorality - Are you guilty of stirring up desires that you could not righteously feed?

In outings with the opposite sex have you failed to keep your body and mind clean and pure, and bartered your integrity for pleasure? (Matt. 5:28; Job 31:1; 2 Pet. 2:14; I Cor. 6;18) 6. Censoriousness - Have you spoken about others without love? Did you judge, think or say the worst thing about a person in a situation you knew? (Jn. 7:24; I Cor. 4:1-7; Gal. 6:1) Action Test 1. Envy - Behind talk of other's failures and faults usually lurks envy. did you gossip and boast to exalt yourself at another's expense? does it hurt to hear certain people praised? If you have nursed this spirit of Hell, repent DEEPLY. (Job 5:2; Prov. 14:30; 27:4; Gal 5:25) 2. Pride - Pretending in thought or life to be more or less than you really ARE. Do you pay more attention to your looks than your soul? Is there a trouble-stirring spirit in your life? These are the signs of pride. (Prov. 16:5; 12, 18: 21:4; 29:23; Tit. 3:9; I Cor. 1:2631; 1 Pt. 5:1) 3. Ingratitude - How many times have others gone out of their way for you, perhaps really sacrificed to help you - and you took this all for granted? (2 Tim. 3:2; Mal. 3:811) 4. Anger - Have you been bad-tampered? Did you shrug off self-control and lose patience or gentleness with someone? (Prov. 14:29; 15:8; 21:9; 22:24; Eccl. 7:9; Eph. 4:26; Col. 3:8)

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5. Cursing - Have you used gutter language? Swearing has no place in the life of a child of God. Never use exclamations beginning with "G", "J", or "C"; they are usually substitutes for curses against God. Have you failed to guard your speech? (Deut. 5:11; Matt. 5:33-37) 6. Levity - "Needless frivolity, silly talk - talking and acting like a moron". Jests that tend to undermine the sacred and precious standards of life; "Bible" jokes that make light of the Holy Word of God; unprofitable, empty and often stupid foolishness achieves nothing but a dangerous devaluation of the Christian's word. Real humor is a gift of God, and will always edify or prepare the way for the Holy Spirit; foolish levity is sin.

(Ecc. 5:3; Prov. 24:19; Eph. 5:4) Inner Inspection 1. Hardness - Did you fight back, murmur or return evil for evil? Was your response to trial un-Christlike when you were wronged or hurt by someone? (Phil 2:14; I Cor. 10:10) 2. Habits - Have you continually over-indulged natural appetites until they have grown far beyond normal? Are you a slave to food, drink or stimulants? (Phil. 3:19; Prov. 23:21; I Cor. 6:19) 3. Half-heartedness - Can you remember times when you deliberately shirked your full share of responsibility? Did you skip times of secret or public prayer to please yourself when you should have been meeting with God? Have you been flippant and light with Him? (Prov. 19:15; 21:5; 24:11-12; Matt 25:1-13; 25:14-30; I Thess. 5:6; Jas. 4:13-17) 4. Hindrance - Have you destroyed another's confidence in you by needlessly taking up their time? Have you prevented them from doing God's work for yourself? (Eph. 5:16) 5. Hypocrisy- Did the life you lived before some people make all you said of Christ and His gospel a lie? Have you said one thing and done another? Were others turned from God by your life that declared to them your hypocrisy? (Matt. 6:5-6; 7:3-5; 23:28; Rev. 3:15-16) 6. Broken Vows - Is there a vow you made to God that you have not kept? Did you promise Him something that you have since forgotten or gone back upon? If it was unwise, you had better ask forgiveness and release; He expects you to KEEP voluntary vows! (Eccl. 5:1-6) Surgery Needed?

If the Holy Spirit shows us sin, we must go back to the place where the Lord first met us. It is the cross again. We see the Lord Jesus once crucified - for that sin - bearing our penalty.

A line of blood trickles down from its splintered base. The sight should shock and grieve us; we see the awfulness of God's judgment. This is not the law, representing God armed with holy wrath and determined to punish the sinner without hope or help, but LOVE demonstrated in the infinite cost and sacrifice God is willing to go to in order to save us from sin. It is the most terribly beautiful picture of the Gospel, showing God's hatred for sin and heartbreak over mans' selfishness. Our sin nails Him to the cross all over again. We tear open His wounds and make His redemption a mockery. Well might "heaven put on

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the robes of mourning and Hell hold a jubilee." All God's care and love - and DARE we still sin?

Walk out into the light of reality. Drop your self-deceit and face this sin for what it really is.

Turn from it, from your heart. Take sides with God against it- purpose in your heart NEVER to go back into that sin again.

"Oh God, You know my foolishness, and my sin is not hid from You...for Your Name's said, pardon my iniquity, for it is great...If you, Lord, would mark iniquities, who shall stand? But there is forgiveness with You, that You may be feared." (Ps. 69:5; 25:11; 130:3-4) Will you do this now? Will you go to your gracious and loving Father as a little child and humbly ask His forgiveness?

"If we confess our sins, He is FAITHFUL and just to forgive us our sins, and to cleanse us from all unrighteousness." (I Jn. 1:9) The LORD is merciful and gracious...He has not dealt with us after our sins, nor rewarded us according to our iniquities; For as the heaven is above the earth, so great is His mercy towards them that fear Him; as far as the east is from the west, so far hath He removed our transgressions from us." (Ps. 103:12) Confession Confession is humbling yourself and admitting your wrong. Restitution is the willingness to pay back or restore wherever possible. If you are now forgiven before the Lord, are you ready to ask Him for the courage to confess and restore to others you have wronged?

Your conscience must be clean before both God AND man if you want to know true freedom. You cannot stand for God with a dirty past in others eyes; memories of failure in their eyes will drive you deeper into bondage each time you remember them; when you have not asked their forgiveness, your guilt will kill your faith and rob you of direction and purpose. You will not, of course, have to confess every sin to everyone; just the sins committed against the ones you know you have wronged. The RULE: The circle of CONFESSION should only go as far as the circle of COMMITTAL. Those sins against God alone you have left with His loving forgetfulness (Ps. 103:8-13; Is. 43:25; Jer. 31:34) those against God and man must be put right with BOTH God and the person(s) wronged.

Restitution should only go as far as the person can humanly repay. You will NEVER be able to undo all your wrong, but God expects you to do all in your power to restore what which you have taken from others; no more and certainly no less. God asks of you the WILLINGNESS, if need be, to go to a hundred people to restore a relationship. True, total repentance is to do that which is right up to the full limit of our ability. It concerns only that which is KNOWN and RECOGNIZED to be sin by the repentant one. Often those who see your sincerity may make exceptions to any claims they have to restitution, but you will have to trust your case to the hands of God Who does all things well.

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Getting Right With Others NAME the BASIC SIN! You can never really right the RESULTS of your sin; no-one can really forgive you for these. However you can always (and MUST!) right the sin ITSELF,

by NAMING IT and asking forgiveness for it. Confess the sin that caused your words or actions; God will show you what it is. What was your REAL wrong? Write it down so you can see it. Are you sure that was what it was?

Make sure the WAY you ask is right. Such half-hearted "confessions" as these show false or incomplete repentance and are usually worse than useless: 1. "I'm sorry - but it wasn't all my fault!"

2. Forgive me - IF I have wronged you..."

3. "I was wrong - but SO WERE YOU!" 4. "Alright - I'm sorry" or "I apologize...

Full blame must be taken; the sin must be NAMED; pride must be crucified.

5. Do you know the basic sin you must get right?

6. Have you thought through what you are to say?

7. Is the time convenient for the other person?

8. Can you be alone when you see this person? ď&#x201A;ˇ

Do you have a truly repentant attitude? If you have trouble getting the proper feelings, think of all the hurt and loss your sin has caused. What did your sin cost Christ? (read Lk. 22:39-44; Jn. 15:8-14). the Holy spirit convicts by recalling from your memory in DETAIL all the results of your wrong. Go over your sin in detail, never in general. As you think deeply about the effect of your sin, feelings will come equal to your guilt.

ď&#x201A;ˇ

Are They in a good mood to forgive? If they get angry when you arrive, wait quietly in a repentant manner until their temper is under control. Then acknowledge your sin and ask forgiveness. Pray before you go for help. (Prov. 22:24; Matt. 5:43-48) Don't use words taking the blame off yourself; don't involve others who may have also sinned; don't try to witness as well, unless specifically asked why you are getting this thing right; don't underestimate your guilt or their hurt and don't wait too long to go and get it right!

The elements of these three sentences MUST be in any truly effective confession: 1. God has convicted me of something I did (have been doing) against you..."

2. "I've been wrong in....(NAME the basic sin - being envious, proud, stubborn etc.)* 3. "I know I've wronged you in this, and I want to ask you - will you forgive me?" *(The only exception to this is a moral offense; use "not setting you a decent standard")

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EXCUSES from pride: When it comes to getting right with others, our minds supply many "reason" why we need not do what we know we MUST do. Be BRUTALLY HONEST with yourself. Deal with each AS AN EXCUSE. Determine to do what is right. It's your life!

When you have gone through your list as thoroughly as if you were about to meet God before the throne of Judgment and determined to get right everything you can, you may burn your list and leave your sins forgiven and forgotten for good! Wrongs may not be wiped out completely from your mind, but they can be exchanged for memories of the joy of forgiveness! Should Satan try to recall a dark past shadow, you will be able to think instead of the bright memory of confession and forgiveness. The word of pardon from those who accept our confession will put wings on our hearts and move us mightily to praise God for His forgiveness.

Many millions are jailed in their own guilt this very day in your world, not knowing what to do or who to turn to. To some, the last road of suicide seems the only possible escape.

Minds are snapping from the terrible load of guilt of a filthy past. It is up to you now to put into practice what you know must be done. Your testimony will be a ray of hope to any you come in contact with. Don't just READ this; in HIS Name, go and DO IT!ccxliii As we end this chapter and move on to the last chapter in this book I just want to say thank you to you the reader. I also want to share with you my daily prayer for you and it is that you will allow the Holy Spirit to open up your hearts and do the works that he needs to do to complete you in Him. And always remember that I am convinced and sure of this very thing, that He Who began a good work in you will continue until the day of Jesus Christ [right up to the time of His return], developing [that good work] and perfecting and bringing it to full completion in you. (AMP) as seen in Philippians 1:6.

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Chapter 17 The CONCLUSION We have come to the end of this section of the journey into the study of the electrocardiogram of a Christian. I feel that we have truly looked into the heart of the matter of what we all face in our own day to day lives. I want to take this time and review a few topics that we have spoken about at length throughout this book.

As I still spend time daily studying the physical and spiritual sides of the heart of a Christian, I know that there is so much more that we could have talked about. As we all know this has not been a study in the realm of science but into what I think is bigger than science and that is the spirit.

As I have stated before and we all know that the EKG is an important tool used for the diagnosis and treatment of various cardiac and other related diseases. The recorded tracing of the EKG waveforms produced by the heart's electrical system can tell you basic information about your patient's condition. The same would be true if we could really place the Christian on an EKG of their spiritual hearts.

We all know that in order to evaluate a rhythm, you must first understand each component and its normal appearance. When these components differ from the expected norm, a dysrhythmia (or arrhythmia) is indicated. Remember, an abnormal EKG tracing may only be the result of artifact. The tracing must be evaluated for artifact prior to the evaluation of the heart rhythm.ccxliv I want to review how I see the electrical current that flows in the Christian's heart and what it shows us on the Christian EKG. The EKG seen in Table 17.1 below represents the Christian's thought process. As the Christian is listen to the leadings of The Holy Spirit and respond appropriately to His leadings or not.

This thought process is traced from the conception of the thought in our beliefs to the execution of our wills seen through our inward or outward behaviors or both; to staying stuck on the previous thought or starting the next thought, then to a coming back to the baseline of our thought process to start it all over again.

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Table 17.1ccxlv P Wave: I believe that the P Wave of the Christian heart shows us our Minds reaction to our own personal belief system. Your beliefs that are either founded on TRUTH or a Lie produce Thoughts. Your thought life will always request that you act on these thoughts. As we know this will in turn lead us to our Will.

The PR Interval and or Segment: I believe that the PR Segment of the Christian heart shows us a physical tracing of the spiritual journey that our thought life goes through while waiting for a response from the request that was placed in to our wills from our minds. This response will show up in the form of an emotional response as seen in the QRS Complex of the Christian EKG. The QRS Complex: I believe that the QRS complex of the Christian heart shows us a physical tracing of the emotional response that has occurred as a direct result of our thoughts wanting our wills to act. This emotional response will occur no matter what we are thinking on, or wanting to do or not do, it is how God created us. Having the right or wrong emotional response will be determined by our actions that will occur after the meeting held in our minds along with our wills. The different emotional response that we have will either produce an inward or an outward behavior or both as seen in the Christian EKG as the ST segment.

The ST Segment: I believe that the ST segment of the Christian heart shows us a physical tracing of the inward or of the outward behaviors or both. These behaviors follow the emotional response that we have had from the meeting held in our heads with our wills.

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I like to think that our Personality, is acting outwardly with our behaviors and our Character, is us acting inwardly where only God Himself can see.

The T Wave: I believe that the T wave of the Christian heart seen or not on the EKG represents the Christian finishing one complete thought process from conception in our beliefs to the execution of our wills seen through our inward or outward behaviors or both; to staying stuck on the previous thought or starting the next thought a coming back to the baseline of our thought process.

Two Hearts but not Double Minded The Christian heart is to be viewed as being two hearts - a right and a left heart. The fact is; that the Right Heart (Mind and Will) are dealing with the part of the human heart that only God himself can see. Jeremiah 17:9-10 The heart is hopelessly dark and deceitful, a puzzle that no one can figure out. But I, God, search the heart examine the mind {and motives behind the human Will (added by this author)}. I get to the heart of the human. I get to the root of things. I treat them as they really are, not as they pretend to be." (MSG) Whereas the Left Heart (Emotions and the Personality) is outward man that is seen by everyone and it is our individual patterns of human behavior. Here we are dealing with the outward part of the human heart that is open for all to see. I Timothy 3:15 That thou ought to know how to behave thyself.

The Bible identifies behavioral problems as being rooted in a heart problem. I hope that I have been able to prove to you the reader that this is true and that all behavioral problems, unless there is a diagnosed physical disorder, are always a spiritual problem.

The Bible also makes a strong connection between what we believe and what we think.

Your heart is the home of your belief system. Belief (from within your Mind) <produces> Thought (requesting that you act on these leads us to your Will) <produces> Feelings (which trigger our Emotions) <produce> Behavior (Personality in action for the good or bad) Matthew 15:16-20 states it this way: Jesus replied, "You, too? Are you being willfully stupid?

Don't you know that anything that is swallowed works its way through the intestines and is finally defecated? But what comes out of the mouth gets its start in the heart. It's from the heart that we vomit up evil arguments, murders, adulteries, fornications, thefts, lies, and cussing. That's what pollutes. Eating or not eating certain foods, washing or not washing your hands that's neither here nor there." (MSG) Notice they begin in the heart (our belief system), move to the mind (the cognitive part of man where we think), which triggers the emotions (our feelings) and finally are manifested in our behavior (actions).

I want to revisit the Christian H's and T's To the Christian, the H's and T's is a mnemonic used to remind each of us to look for any and all of the HINDRANCES and TEMPTATIONS we have allowed in our lives to go unchecked. Leaving these H's and T's to go unchecked leads to spiritual arrhythmias which I

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see as a breakdown in our daily prayer life, spiritual growth and our personal relationships with God the Father, Jesus or the Holy Spirit.

The Christian H's include: (There are many more Hindrances to our personal Spiritual growth then I have listed here, we will talk about these listed and more in a later chapter in detail.)

From WITHIN yourself: Spiritual Fatigue, Forgetfulness, Neglect, Dullness of Hearing, Lack of Endurance, Pride, Selfishness, Self-reliance, Sinfulness, Frustration, Shame, Lies (from Satan) that we believe, Distorted View of God and Distorted View of Self and NOT taking personal responsibility for your action.

From things OUTSIDE yourself: Prevalence of Lawlessness, Commands & Doctrines of Men, Stumbling blocks Laid by Others, Cultural Pressure, Materialism/Consumerism, Abuse (physical, sexual, spiritual, verbal) Satanic hindrances and Childhood wounds. Personal DISTRACTIONS: Busyness, Laziness and Addictions.

The Christian T's include: (Temptations you and I all face) We all have our own temptations we must face. The only people that don't have temptations are the ones that are physically dead. We all have personal desires, which mean that we can all be tempted. Let me share some examples: Sexual Desire not kept within the bonds of a Godly marriage. Then there is cheating others out of something to get ahead in this life. Lying to others to make yourself seem better than what you really are. Stealing something that is not your own and the list goes on and onâ&#x20AC;Ś Temptations will always be a part of this life and they will always start first as a desire in your heart. We all remember that your heart is the home of your belief system. So the Temptation starts off as a belief within your Mind. This produces a Thought that requests that you act on this Temptation which leads us to your Will. At this point you have not sinned but this produces you're feelings. Now that your feelings are involved they will trigger our Emotions to response. At this point you still have not sinned with this temptation. Your emotions will produce a Behavior and this behavior will either be pleasing to God or you and I will chose to Willfully SIN against God with this temptation. This action of turning to or from God starts to produce our personalities for or against God. You might ask what SIN is, for now. I like what John Wesley's mother once wrote to him. She said: "Take this rule: whatever weakens your reason, impairs the tenderness of your conscience, obscures your sense of God, or takes off your relish of spiritual things; in short, whatever increases the strength and authority of your body over your mind, that thing is sin to you, however innocent it may be in itself." Susanna Wesley (Letter, June 8, 1725)ccxlvi Rev. R. A. Torrey says: "There are many things which are not sinful in the ordinary understanding of the word sin, but which HINDER spiritualityâ&#x20AC;Ś The gratification of the flesh and the fullness of the Spirit do not go hand in hand. "The flesh lusteth against the Spirit, and the Spirit against the flesh: and these two are contrary the one to the other." Galatians 5:17.

We live in a day when the TEMPTATION of the indulgence of the flesh is very great."ccxlvii

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Are You into Religion or Relationship?

Religion to me is like when I write down the address for a call in a specified subdivision and I drive the ambulance to that subdivision but stop at the entrance. Am I at the call? NO!!

Relationship to me is, Intimacy. Intimacy means, in-to-me-see! Jesus asks me to see into Him and I am to ask Him to see into me. This is not achieved until I have turned into the subdivision and have driven the ambulance to the actual physical address of the call; call out on scene (10-23). I am then to get out of my ambulance grab the needed medical or trauma equipment, airway kit and cardiac monitor and walk into the residents and take over patient care.

Who would you rather to answer the call to help you or your family member in a time of need, those that have religion and stop at the subdivision or those that have an intimate and personal relationship and come all the way to the house? Christianity is not about religion at all but it is all about right relationships and being rightly related to others. God's relationship with Jesus and the Holy Spirit, God's relationship with Man. True Christianity then turns to look at a man's (woman's) relationship with others and to see if they are rightly or wrongly related. The following is a short list of the major areas that we as maturing Christians are to actively work on and maintain Rightly Related Relationships.

Cardiac Rhythms as Seen on the Christian EKG As we move on I want to review a few of the rhythms that we discussed throughout this book.

If you remember back in Chapter 2, I stated that we all know in normal sinus rhythm the P wave starts in the right atrium; as well the tracing of the Christian EKG will start in the right atrium. In the Christian heart, the right atrium is the Mind, which is where we have our own belief system. Your Belief starts from within your Mind (P Wave) and your beliefs are either founded on the TRUTH of God's word the Bible or a Lie. Your beliefs will produce Thoughts.

Your thoughts will always request that you act on these thoughts, which in turn lead us to your Will (PR Segment). At this point it is up to YOU and it is your CHOICE to start Acting on or not acting on your thoughts by your will, your decision to or not to act on your thought will then start to produces Feelings. This triggers our Emotions (QRS Complex), this emotional response; produces inward and outward behaviors. I like to think that our Personality (ST Segment), is acting outwardly with our behaviors and our Character (ST Segment), is us acting inwardly with our behaviors.

NORMAL SINUS RHYTHM: As I first stated in Chapter 3, Normal Sinus Rhythm is the standard that we use to look at all other cardiac rhythms'. So then the Christian that is in a Normal Sinus Rhythm is the Christian that God wants us all to be.

This Christian is actively growing in their personal relationship with God. They are allowing the Holy Spirit to lead and guide them through their daily lives as they grow from the Carnal (babes in Christ) into the Spiritual (mature) Christians that Gods wants us to become. This Christian is thinking on the right things, choosing to act on the right things, they have their emotions in check and they are actively walking out their salvation with the fear of the Lord.

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What is the normal Christian life? The apostle Paul gives us his own definition of the normal Christian life in Galatians 2:20. It is "no longer I, but Christ." Here he is not stating something special or peculiar but only presenting God's normal for a Christian, who can be summarized in the words: I live no longer, but Christ lives his life in me.

The next four rhythms that I want to review will follow the path through the Christian HEART starting in the Christian's MIND, which leads to their WILL, then on to their EMOTIONS and we will end up looking at the Christian's CHARACTER / PERSONALITY. ATRIAL FLUTTER: Now that we have the usage of EP studies it has been discovered that Atrial Flutter is often, though not always, found to originate in the right atrium, whereas Atrial Fibrillation usually comes from the left atrium. This Christian's MIND is in a crisis and is causing them a lot of what I term as Stinking Thinking and this is causing them some problems.

This Christian's thinking has become darkened and this will lead them to start also having darkened emotions' (as in Atrial Fibrillation). They have become spiritually dark by a lack of and being deprived of the Light of God. This Christian has been rendered dim and has been deprived of Godly vision. This Christian has allowed Satan to cloud, or perplex; their thinking and judgments. This is found in Romans 1:21 Because when they knew and recognized Him as God, they did not honor and glorify Him as God or give Him thanks. But instead they became futile and godless in their thinking [with vain imaginings, foolish reasoning, and stupid speculations] and their senseless minds were darkened. (AMP) UNIFOCAL PVC's: This Christian is having trouble with their WILL. All of our decisions in this life are determined by us through our will. Paul writes of believers becoming 'obedient from the heart' in Romans 6:17 and then we find the following in Ephesians 6:6 Not with eyeservice, as menpleasers; but as the servants of Christ, doing the will of God from the heart; (KJV). And it is a function of the will to choose to "let the peace of God rule in your heart" Colossians 3:15. The book of Proverbs tells us that 'many are the plans of a man's heart' (19:21) and 'in his heart a man plans his course, but the Lord determines his steps' (16:9).

There are three spheres of WILL on the earth: The Human Will, Satan's Will and God's Will.

The Human (Self) Will: This is the will of man, the basic selfish nature which desires to walk its own way. When you guide your life by self-will, you make choices on the basis of your will apart from God. Sin, suffering, and trouble in the world today are all results of man living in disobedience to the will of God. David speaks of self-will operating in the lives of wicked men: Psalms 27:12 Deliver me not over unto the will of mine enemies: for false witnesses are risen up against me, and such as breathe out cruelty. (KJV) Satan's Will: Yes Satan himself has a will. His will has stood in opposition to God's will since eternity past. The Bible actually records five "I wills" of Satan found in the book of Isaiah.

Let's read Satan's "I wills" together found in Isaiah 14:12-15 How art thou fallen from heaven, O Lucifer, son of the morning! how art thou cut down to the ground, which didst weaken the nations! 13 For thou hast said in thine heart, I will ascend into heaven, I will exalt my throne

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above the stars of God: I will sit also upon the mount of the congregation, in the sides of the north: 14 I will ascend above the heights of the clouds; I will be like the most High. 15 Yet thou shalt be brought down to hell, to the sides of the pit. (KJV) God's Will: Romans 12:1-2 I beseech you therefore, brethren, by the mercies of God, that ye present your bodies a living sacrifice, holy, acceptable unto God which is your reasonable service. And be not conformed to this world: but be ye transformed by the renewing of your mind, that ye may prove what is that good, and acceptable, and perfect will of God. (KJV)ccxlviii God Himself must love that number three because as you read above Romans 12:2 shows us that there is three levels to His will, that ye may prove what is that good, and acceptable, and perfect will of God. (KJV) This is known as the GAP. The GAP is an acronym for the good, acceptable and perfect will of God. G - Good: Agathos - good in character and beneficial in its effect A - Acceptable: Euarestos - eu (well) arestos (pleasing) P - Perfect: Teleios - the end accomplished as the effect of progress ccxlix ATRIAL FIBRILLATION: This Christian is having some sort of emotional crisis and is causing them a lot of mental and problematic feelings. If these feelings are left unchecked will led the Christian to wrong actions. It is a known fact that you are going to go where your Thoughts take you! In Psalm 139:23-24, David cried out to God, Search me, O God, and know my heart; test me and know my anxious thoughts. 24 Point out anything in me that offends you, and lead me along the path of everlasting life. (NLT) Let's read this same verse from the New Living Translation and take a closer look into this verses: "heart" = belief system / " anxious thoughts" = cognition / "anything in me that offends you" = darkened emotions / "lead me along the path of everlasting life" = behavior.

Heart >> Anxious Thoughts >> Anything in me that offends you >> Lead me along the Path (Belief) >> (Cognition) >> (Negative Emotions) >> (Behavior) The Bible identifies behavioral problems as being rooted in a heart problem. I believe that all Behavioral problems, unless there is a diagnosed physical disorder, are always a spiritual problem. The Bible also makes a strong connection between what we believe and what we think.

Your heart is the home of your belief system. Belief (From within your Mind) <produces> Thought (Cognition that is requesting that you act on whatever leads us to your Will) <produces> Feelings (Which trigger our Emotions positive or negative) <produce> Behavior (Personality in action for the Good or Bad) MULTIFOCAL PVC's: This brings us to the Christian that is having multifocal PVC's and we know that this Christian's Will problem, has now lead to troubles with this Christian's

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Character and Personality. The heart, or inner moral choice of man, determines his moral character and personality before God. It is the supreme choice of a man's life, and can be fixed on serving either God or self. Our supreme choice determines our ultimate motive, for good or bad.

Man's act of choice can only function in one direction at a time. The will cannot choose partially to decide and partially not to decide at the same time. To me the will is like an on-off switch. Man cannot choose in a half-right and half-wrong manner at the same time. The Bible shows moral cannot be mixed: Ephesians 4:18 Their moral understanding is darkened and their reasoning is beclouded. [They are] alienated (estranged, self-banished) from the life of God [with no share in it; this is] because of the ignorance (the want of knowledge and perception, the willful blindness) that is deep-seated in them, due to their hardness of heart [to the insensitiveness of their moral nature]. (AMP) It is the work of the Holy Spirit in the life of the Christian, to begin the life long process of producing a change of character and personality in the child of God. This is seen in Philippians 1:6 And I am convinced and sure of this very thing, that He Who began a good work in you will continue until the day of Jesus Christ [right up to the time of His return], developing [that good work] and perfecting and bringing it to full completion in you. (AMP) and I John 3:2-3 2 Beloved, we are [even here and] now God's children; it is not yet disclosed (made clear) what we shall be [hereafter], but we know that when He comes and is manifested, we shall [as God's children] resemble and be like Him, for we shall see Him just as He [really] is. 3 And everyone who has this hope [resting] on Him cleanses (purifies) himself just as He is pure (chaste, undefiled, guiltless).

(AMP) This is guaranteed to us by the resurrection of Christ found in 1 Corinthians 15:2023 But the fact is that Christ (the Messiah) has been raised from the dead, and He became the firstfruits of those who have fallen asleep [in death]. 21 For since [it was] through a man that death [came into the world, it is] also through a Man that the resurrection of the dead [has come]. 22 For just as [because of their union of nature] in Adam all people die, so also [by virtue of their union of nature] shall all in Christ be made alive. 23 But each in his own rank and turn: Christ (the Messiah) [is] the firstfruits, then those who are Christ's [own will be resurrected] at His coming. (AMP) As I stated before every believer has to know the Word of God to do the Will of God in order to complete the Work of God. His will for us is always good, acceptable, and perfect, and customized for each person by the Holy Spirit.

There are two ways by which any Christian is able to generally discern the will of God for one's life.

The first is the Internal (Character) Principle: Submission of one's will to the control of the Holy Spirit, then allows Him to change the thoughts and intents of the mind and heart, to bring one's internal ideas into conformity to the principles of God's Word this is the Christians Will and their Character. One's desires are now in the process of change, as guided and controlled by the Holy Spirit.

1Timothy 1:4, 19 4 Nor to give importance to or occupy themselves with legends (fables, myths) and endless genealogies, which foster and promote useless speculations and questionings rather than acceptance in faith of God's administration and the divine training

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that is in faith (in that leaning of the entire human {Character} personality on God in absolute trust and confidence) 19 Holding fast to faith (that leaning of the entire human personality on God in absolute trust and confidence) and having a good (clear) conscience. By rejecting and thrusting from them [their conscience], some individuals have made shipwreck of their faith. (AMP) The {Character} was added by this author.

Then we come to the second which is the External (Personality) Principle: Conditions outside of one's life, over which there may be little or no control, are then controlled by the Holy Spirit, to bring both the internal desires, and the external conditions into conformity to God's will for His child. All this is for our good and maturation.

2 Timothy 1:5 and 22 I am calling up memories of your sincere and unqualified faith (the leaning of your entire {Character} personality on God in Christ in absolute trust and confidence in His power, wisdom, and goodness), [a faith] that first lived permanently in [the heart of] your grandmother Lois and your mother Eunice and now, I am [fully] persuaded, [dwells] in you also. 22 Shun youthful lusts and flee from them, and aim at and pursue righteousness (all that is virtuous and good, right living, conformity to the will of God in thought, word, and deed); [and aim at and pursue] faith, love, [and] peace (harmony and concord with others) in fellowship with all [Christians], who call upon the Lord out of a pure heart. (AMP) The {Character} was added by this author.

There are two other rhythms that I want to review here Ventricular Tachycardia and Asystole.

VENTRICULAR TACHYCARDIAS (VT): We will be looking into the Christians life that can be described as monomorphic which is the Christian that is dealing with being offended. The Christian described as polymorphic, we find that Christian is having problems with rejection.

Then in the case of Torsades de Pointes we will find the Christian that is dealing with being wounded.

MONOMORPHIC (VT): I see the Christian that is in a monomorphic VT as the Christian that is dealing with being offended and boy does that start to build up scar tissue in our hearts. An Offense as defined in Vine's Greek (skandalon) as the name of the part of the trap on which the bait hung that lured the animal into the trap or a hindrance or a stumbling block. So then Satan uses offenses as bait to lure you and I into a life-time of bitterness, resentment, unforgiveness, and even hatred. If we allow the spirit of offense to come in, and take hold in our lives then it becomes a hindrance and a stumbling block to us. It causes us to stumble in our walk with God. As Christians we are to determine not to be offended, and we are to seek to keep offense out of our lives. This is seen in the following three verses: Proverbs 4:23 Keep and guard your heart with all vigilance and above all that you guard, for out of it flow the springs of life. (AMP) Philippians 1:9-10 And this I pray, that your love may abound still more and more in knowledge and all discernment, that you may approve the things that are excellent, that you may be sincere and without offense till the day of Christ . . . (NKJV) Psalm 119:165 Great peace have they who love Your law; nothing shall offend them or make them stumble. (AMP)

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I believe that there are two elements to an offense: (1) the injury—the act of being hurt and then (2) the debt or IOU the offended person feels they are owed something as a result of the injury. As a victim or as the recipient of an offense, we want the offending person to apologize, to say they are sorry, to take back the words they said or the things they did, and to accept responsibility for making restitution or for amending the offense.

POLYMORPHIC (VT): This Christian is dealing with Rejection. The dictionary defines rejection as "an act of throwing away or discarding someone or something," which implies a lack of value in the person or thing thrown away. Being rejected, then, makes us feel valueless or worthless.

Rejection is rooted the feelings of the Christian being denied love. It is this feelings of rejection (whether active or passive, real or imaginary) that robs Jesus Christ of His rightful position as Lord in the lives of His children and keeps the Christian from the life only He can give.

Rejection results in wounding of the heart sometimes so painful that the mind refuses to deal with it, so we bury it in our subconscious. Later, it surfaces in other ways to cause us problems. Rejection is the greatest undiagnosed and most untreated malady within the Body of Christ today. Regrettably, a large majority of those coming for prayer suffer from feelings of rejection.

There are numerous examples of rejection exposed in the Bible. And Jesus was the most rejected person who ever lived. Isaiah 53:3 says, "He was despised and rejected of Men."…

The opposite of "to reject" is "to accept." "He hath made us accepted in the beloved" (Eph. 1:6). In the Greek, the word accepted (as used here) means "highly favored one."

When we come to God through Jesus, we are accepted and as highly favored as is our brother Jesus…ccl Just because someone rejects me doesn't mean that everyone rejects me. Jesus loves me no matter what others choose to do. John 15:9-10 "I've loved you the way my Father has loved me. Make yourselves at home in my love. If you keep my commands, you'll remain intimately at home in my love. That's what I've done—kept my Father's commands and made myself at home in his love. (MSG) TORSADE DE POINTES (VT): This Christian has been wounded to the point that they are allowing the wounds to cause spiritual multisystem trauma. And as in any case where a person has multisystem trauma the need to get to the most appreciate Level I Trauma Center to receive the appreciate level of care.

The Bible in the book of Zechariah 13:6, shows us all that a lot of the wounds that we all carry around have been inflicted on us by those closets to us like our friends and loved ones.

Zechariah 13:6 And if someone asks, 'Then what about those wounds on your chest?' he will say, 'I was wounded at my friends' house!'(NLT) Just as in the physical realm you can have and do find the same types of wounds in the Spiritual realm...

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We need to always remember even when we see Jesus face to face we will be able to see, touch the scars that His body has from paying the sin penalty for you, me and all of humanity.

John 20:24-29 But Thomas, one of the Twelve, called the Twin, was not with them when Jesus came. 25 So the other disciples kept telling him, We have seen the Lord! But he said to them, Unless I see in His hands the marks made by the nails and put my finger into the nail prints, and put my hand into His side, I will never believe [it]. 26 Eight days later His disciples were again in the house, and Thomas was with them. Jesus came, though they were behind closed doors, and stood among them and said, Peace to you! 27 Then He said to Thomas, Reach out your finger here, and see My hands; and put out your hand and place [it] in My side. Do not be faithless and incredulous, but [stop your unbelief and] believe! 28 Thomas answered Him, My Lord and my God! 29 Jesus said to him, Because you have seen Me, Thomas, do you now believe (trust, have faith)? Blessed and happy and to be envied are those who have never seen Me and yet have believed and adhered to and trusted and relied on Me. (AMP) There are those spiritual wounds that will require debridement and as the Bible states in Hebrews 4:12-13 ... His powerful Word is sharp as a surgeon's scalpel, cutting through everything, whether doubt or defense, laying us open to listen and obey. Nothing and no one is impervious to God's Word. We can't get away from it no matter what. (MSG) This Christian needs to go under the knife and allow God to perform a spiritual wound debridement and then send this Christian to His spiritual Hyperbaric Chambers. It is in God's chambers that the Christian will undergo treatments of God's unconditional and unwavering Love for His children.

But the Greatest scripture we have to hold onto about wounding is found in Isaiah 53:5 But He was wounded for our transgressions, He was bruised for our guilt and iniquities; the chastisement [needful to obtain] peace and well-being for us was upon Him, and with the stripes [that wounded] Him we are healed and made whole. (AMP) And it is His desire to heal us all of all of our offences, our rejections and our wounds.

ASYSTOLE: This is the Christian that willingly choose to walk away from God and their spiritual life and they have committed spiritual suicide (known as Apostasy). They willingly opened door and stepped through the door leading to the sin unto death. We find this stated in 1 John 5:16-17 If any man see his brother sin a sin which is not unto death, he shall ask, and he shall give him life for them that sin not unto death. There is a sin unto death: I do not say that he shall pray for it. 17 All unrighteousness is sin: and there is a sin not unto death. (KJV) This Christian has gone through cycles of different MIND SETS that has led them to backsliding and then to repenting as many of us have (it is more normal than any of us would care to admit). This Christian has moved for that of the Spiritual man and mind set back into being that of a Carnal man with a carnal mind and has finally continued to backslide until their heart is so hardened through sin that repentance becomes impossible and has become as they were before they were Christian. Eventually, the engrafted nature will be smothered out and they will become a Reprobate and this person is doomed because the New (CHRIST) Nature is now dead and the reprobate person and mind set has returned to their Old Nature.

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From the perspective of The Bible, a reprobate and the reprobate mind set is someone who refuses to make good use of the understanding of the Word of God provided to them, 2 Timothy 3:8 states it as the following: Now just as Jannes and Jambres were hostile to and resisted Moses, so these men also are hostile to and oppose the Truth. They have depraved and distorted minds, and are reprobate and counterfeit and to be rejected as far as the faith is concerned. (AMP) As I closeout this last chapter I want to discuss the topic known as "Burn-OUT". As EMS providers, I know that we see things that human eyes were never created to see. This fallen world is full of pain, sickness, death and, other carnages that we have to see and deal with day-in and day-out, while on duty. Struggles, with life and death, do not place us at risk on every call, though certainly dangers often come our way.

Now, on the other hand, as Christians that have chosen to work in this awesome profession, our souls are in harm's way, with every call also; and, that is a danger graver than any bullet, fire or being hit on the road, while working a motor vehicle accident, could ever be.

Burn Out in Biblical terms is known as "Losing Heart" also known as "Spiritual Burn-OUT".

The term Lose Heart is seen Galatians 6:9 And let us not lose heart and grow weary and faint in acting nobly and doing right, for in time and at the appointed season we shall reap, if we do not loosen or relax our courage and faint. (AMP) It is true that this loss is most commonly experienced in the clergy or the full-time ministry worker. But you see here is how I see this: ALL Christians are to be in full time ministry, the Bible teaches us in Matthew 28:18-20 Jesus, undeterred, went right ahead and gave his charge: "God authorized and commanded me to commission you: Go out and train everyone you meet, far and near, in this way of life, marking them by baptism in the threefold name: Father, Son, and Holy Spirit. Then instruct them in the practice of all I have commanded you.

I'll be with you as you do this, day after day after day, right up to the end of the age." (MSG) and then we read in Mark 16:14-15 Still later, as the Eleven were eating supper, he appeared and took them to task most severely for their stubborn unbelief, refusing to believe those who had seen him raised up. Then he said, "Go into the world. Go everywhere and announce the Message of God's good news to one and all. Whoever believes and is baptized is saved; whoever refuses to believe is damned. (MSG) Those verses were talking to you and I as Christian, we are commissioned by God Himself to be ministers of His Gospel as seen in Acts 1:7-8 He told them, "You don't get to know the time. Timing is the Father's business. What you'll get is the Holy Spirit. And when the Holy Spirit comes on you, you will be able to be my witnesses in Jerusalem [Your Family and Friends], all over Judea [On your JOB] and Samaria [Your Community], even to the ends of the world [To everybody you come into contact with]." (MSG) [Emphasis added by this author]. So then it would not be uncommon for you and me as Christians experience a loss of heart.

Let's read once more from Dr. Paul W. Carlin and his work Satan and the Saint: A Look into The Dark Side Of Christian Behavior, in the section entitled "A Christian can Lose Heart" had to say about how the Christian can and does lose heart from time to time.

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Have you ever taught a Bible class, preached a sermon, sung a song, attended a committee meeting, or gone to church when your heart was just not in it? But you grin and bear it, put on a happy face, bite the bullet, "suck in" and do it anyway. You are eminently aware that you have done nothing more than give a performance.

The Bible uses the word "faint," as does the King James Version in Galatians 6:9, a word translated "lose heart" in the Amplified Version, it is referring to discouragement.

Often a Christian may become discouraged in his labors because the harvest or the visible fruit is slow coming. And over a period of time, this depleted spiritual condition can overwhelm a person to the point of giving up . . . he faints, loses heart.

Save for only a few close, discerning friends, no one knows that condition exists except the one suffering the loss of heart. The cover-up is possible because the subject is an experienced professional and so can counterfeit a Divine anointing and freshness.

I am talking about a spiritual heart condition. Proverbs 14:14 talks about those who are the backslidden "in heart." Every form of spiritual deficiency, whether expressed in spirit or performance, begins in the heart. Relinquishing Christian responsibilities for worldly involvements is only a symptom of a condition that exists in the heart.

Of the seven losses a Christian can experience, this one can be the most dangerous.

It can cause a person to go down quicker, stay down longer, and come up dryer, than anything else can. It can be more easily concealed, or dismissed as a physical or emotional problem, hence justified, more conveniently than other conditions can. And the longer it is permitted to exist, the more acute the problem becomes.

Loss of heart is an unhealthy spiritual condition for a Christian. It is unlike a "pure heart," (1 Peter 1:22; 2 Tim. 2:22; 1 Tim. 1:5) a "true heart," (Heb. 4:12) a "single heart," (Col. 3:22; Eph. 6:5) a "melodious heart," (Eph. 5:19) a "purposeful heart," (2 Cor. 9:7) and a "steadfast heart," (1 Cor. 7:37) which are all indications of a spiritually healthy heart.

An important mark of spiritual maturity is not how much it takes to keep you going, but how little it takes to get you to quit, i.e., "lose heart," become discouraged.

The danger of dangers is that a loss of heart can result in "an evil heart of unbelief."

(Heb. 3:12) Have you lost heart?ccli It is my sincerest prayer that as you have been reading this book that you have allowed the Holy Spirit to change your HEART. I pray that we stop our MINDs from having stinking thinking and that we only think on those things as taught in Philippians 4:8 For the rest, brethren, whatever is true, whatever is worthy of reverence and is honorable and seemly, whatever is just, whatever is pure, whatever is lovely and lovable, whatever is kind and winsome and gracious, if there is any virtue and excellence, if there is anything worthy of praise, think on and weigh and take account of these things [fix your minds on them]. (AMP)

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I pray that we will always choose to complete the WILL of God for your lives as seen in Ephesians 6:6 Not with eyeservice, as menpleasers; but as the servants of Christ, doing the will of God from the heart; (KJV). I pray that the peace that passes all understanding will always be with you. Philippians 4:7 And God's peace [shall be yours, that tranquil state of a soul assured of its salvation through Christ, and so fearing nothing from God and being content with its earthly lot of whatever sort that is, that peace] which transcends all understanding shall garrison and mount guard over your hearts and minds in Christ Jesus.

(AMP) May you always chose to RUN away from the sins that so easily makes you stumble.

Romans 8:5-6 Those who are dominated by the sinful nature think about sinful things, but those who are controlled by the Holy Spirit think about things that please the Spirit. 6 So letting your sinful nature control your mind leads to death. But letting the Spirit control your mind leads to life and peace. (NLT) May you allow God to calm and stop all anxious thoughts.

Psalm 139:23-24, David cried out to God, Search me, O God, and know my heart; test me and know my anxious thoughts. 24 Point out anything in me that offends you, and lead me along the path of everlasting life. (NLT) May we have EMOTIONAL health in Him. May we walk out freedom in Christ from all past, present and further offences, feelings of rejection and wounds of kinds. May we all walk out our own salvation before God and man as God would have us to walk. Philippians 2:12 Therefore, my dear ones, as you have always obeyed [my suggestions], so now, not only [with the enthusiasm you would show] in my presence but much more because I am absent, work out (cultivate, carry out to the goal, and fully complete) your own salvation with reverence and awe and trembling (self-distrust, with serious caution, tenderness of conscience, watchfulness against temptation, timidly shrinking from whatever might offend God and discredit the name of Christ). (AMP) May we allow God through His Holy Spirit to make changes to our CHARACTER and PERSONALITY. Ephesians 4:13 [That it might develop] until we all attain oneness in the faith and in the comprehension of the [full and accurate] knowledge of the Son of God, that [we might arrive] at really mature manhood (the completeness of personality which is nothing less than the standard height of Christ's own perfection), the measure of the stature of the fullness of the Christ and the completeness found in Him. (AMP) Amen.

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Stars of Life (Someone, in the medical field, that carries the gospel with them, as they work) The very first STAR of LIFE is GOD Himself. He created everything, by the spoken word.

Then, He decided to create man, in His image, out of the dust of the earth. Once the first man, named Adam, was formed, GOD breathed the breath of life into him, and, Adam became a living being. Adam sinned, landing us in the dilemma we're in first sin, then sickness and death, and, no one is exempt from either sin or death. Even those who didn't sin, precisely as Adam did, by disobeying a specific command of God, still had to experience this termination of life, this separation from God. The verdict on that one sin was the death sentence.

But, God Himself sent His one and only son, Jesus Christ, to the earth, to die on a wooden cross, for our sins. It is through His blood sacrifice, which gives you and me remission from our sin. Then, Jesus himself went up to heaven, to sit at the right hand of God, the Father, making intercession on our behalf. Jesus also gave us, here on this earth, the power of the Holy Spirit, to walk out what He has asked us, as individuals, to do for Him and His kingdom.

Benjamin Rush (1744-1813) Dr. Rush a signer of the Declaration of Independence was an outspoken Christian, statesman, and pioneering medical doctor. He was a prolific author, publishing the first

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American chemistry textbook and textbook on mental illness. In 1797, President John Adams appointed Rush as Treasurer of the U.S. Mint, a position he held until 1813.

As a physician he had no equal and was called the "Father of American Medicine" because of his numerous medical discoveries. He was also called the "Father of American Psychiatry", a statement found on his grave to this day.

In 1777 he was appointed Surgeon General and then Physician General of the Continental Army but these fancy titles did not keep him from caring for the sick and dying often without any payment at the risk of his own life.

He hated to see his patients suffer and he agonized over them every time one passed away.

Of this internal pain, he recorded, "Upon my complaining of my inability to save life where I was most anxious to do it, he [a minister friend] said, "Oh, Doctor, there is an awful decree against the certainty of your profession,… It is appointed for all men to die once.

(Hebrews 9:27)."

During his career, he educated over 3000 medical students, and several of these established Rush Medical College (Chicago) in his honor after his death.

Dr. Rush was also called the "Father of Public Schools Under the Constitution" because he was the first to advance the idea of free public schools, and also a pioneer in the opportunity for women's education. He helped Abigal Adam's (John Adam's wife) dream become a reality by establishing the Young Ladies Academy of Philadelphia, one of America's first educational institutions for women.

He wrote textbooks, formed curriculum plans, crafted educational policies, and helped establish five universities and colleges. As the founder of public education in America, listen to his definition of what education should contain: "The only foundation for a useful education in a republic is to be laid in religion. Without this there can be no virtue, and without virtue there can be no liberty…"

On March 28, 1787 when Dr. Benjamin Rush proposed his plan for public education in America he wrote: "Let the children who are sent to those schools be taught to read and write… (and a)bove all, let both sexes be carefully instructed in the principles and obligations of the Christian religion. This is the most essential part of education… " In 1791 Dr. Rush wrote a lengthy pamphlet entitled 'A Defense of the Use of the Bible as a Schoolbook'. Here is how that writing began: "It is now several months since I promised to give you my reasons for preferring the Bible as a schoolbook to all other compositions.

Before I state my arguments, I shall assume the five following propositions: 1. That Christianity is the only true and perfect religion; and that in proportion as mankind adopts its principles and obeys its precepts they will be wise and happy.

2. That a better knowledge of this religion is to be acquired by reading the Bible than in any other way.

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3. That the Bible contains more knowledge necessary to man in his present state than any other book in the world.

4. That knowledge is most durable, and religious instruction most useful, when imparted in early life.

5. That the Bible, when not read in schools, is seldom read in any subsequent period of life.

My arguments in favor of the use of the Bible as a schoolbook are foundedâ&#x20AC;Ś" Benjamin Rush was another of the majority of the Founding Fathers who would be enraged at being called an atheist, agnostic, or deist! His stand as a Christian was undeniable.

Dr. Rush felt that the United States was the work of God: "I do not believe that the Constitution was the offspring of inspiration, but I am as perfect ly satisfied that the Union of the United States in its form and adoption is as much the work of a Divine

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Appendix A: As a Christian in the field of EMS As a Christian in EMS, I believe that Jesus Christ is "The Great Physician". Jesus was greatly concerned for the sick he went about healing the sick wherever he went. Not only was healing a preoccupation with Jesus but as Christian we are commanded to make healing our duty as seen in Matthew 10:8 "Heal the sick, raise the dead, cleanse the lepers, cast out demons."

As a Christian in EMS, I believe that hospitals are an explicitly Christian institution and the idea of Pre-hospital medical care and the job of EMS are ordained by God Him self. AS seen in the following: The first ever recorded Heart Attack (1 Samuel 25: 37) The first ever recorded rescue breathing (Gen 2:7) The first ever recorded CPR (1 Kings 17:17-24) The first ever recorded (EMS system see EMT-B book for more info) First responder through definitive care at his level of training, Transported patient to the closest appropriate facility, and even took care of his paper work and billing. (Luke 10:29-35) Known as the Good Samaritan or the Good Samaritan Law. As a Christian in EMS, I cannot separate my faith in Jesus Christ from my everyday life, conduct, and speech.

As a Christian in EMS, I cannot justify the rendering of medical care for only those who love me, aiding only my friends, and praying only for fellow Christians. But I must up hold to God's Standard of Care in the healing of the whole man Body, Soul, Mind and Spirit As a Christian in EMS, I have no desire to carry the name of the Son of God to the level of my own base intentions.

As a Christian in EMS, I aspire to be like Him, to live on unseen resources by faith, to tap the unlimited supply of His love through the life of His indwelling Holy Spirit, to emerge from my moral conflicts "more than a conqueror" through His power, and to rise above all earthly standards to the completeness of His perfection.

As a Christian in EMS, I acknowledge that this is an impossible quest, but accept the challenge of its impossibility in the knowledge that its pursuit will force me to rest on Him. As a Christian in EMS, I desire no little challenges, expect no unrippled seas, and abandon all personal "rights" for the ultimate goal of ministering (Physical and Spiritual healing) to all patients that I come in contact with and their families - to the best of my abilities.

As a Christian in EMS, I consider it not God's will for my life to have a quality of life that is indistinguishable from unbelieving men and common Christians.

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As a Christian in EMS, my present failure to fulfill these intentions merely proves that God isn't finished reshaping my raw materials.

(Adapted By Rev. Chris Credle EMT-P Founder of the SoulMedic Ministries From Chaplain Dr. James Devine National Academy of Fire Service Chaplains "Mastering the ABC's of Fire Service Chaplaincy")

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Appendix B: The Emergency Medical Services Chaplain What a Rush!

According to the majority of men & women who are involved in the pre-hospital field of EMS, the real "Rush" in this life is not found fighting a huge house fire, nor is it in a police car on a high speed pursuit. The greatest Rush in the entire world is fighting the fight, and betting the Grim Reaper at his on game. Bring someone back from his grasp of death, and seeing that person make a full recovery and then leave the hospital returning to a normal life. Now that is a rush!

Ask any one in this field, who are you and you will more than likely hear the following: "Being in the EMS is not just a job to me . . . it is my life! Being an EMT-Basic, an EMT-Intermediate, or an EMT-Paramedic is my identity; it is who I am."

What is happening in our world of EMS? If you are in management, you face the problem every week and the challenge does not seem to go away: How do I address the personal needs of my staff and help them become better EMS professionals?

If you are an EMT, EMT-I, EMT-Paramedic, then you may be asking: "Whom can I talk to when I feel my life is coming apart at the seams?"

"Who really knows the answers for what I am feeling and thinking?

"Is there someone who can give me some help with my family?"

What Does It Take?

"Pep talks" don't last too long. Strong exhortation is too risky and offering bribes is out of the question. Sometimes a counselor may help, but what you really need is a professional resource that is especially oriented to the unique needs, demands, stresses and spiritual issues faced by EMS personnel. You and your department will profit from the assistance given by an EMS chaplain.

The EMS chaplain will be dealing with many men and women whose attitude is just like the following statement: "EMS is not just a job to me . . . it is my life! Being an EMT, EMT-I, or EMT-Paramedic is my identity; it is who I am." The effectiveness of the EMS chaplain must be fleshed out and made real through his/her life in relationship with all those involved in EMS, their families and people out in their community.

What will it take? How are you answering this question? Let me offer an encouraging alternative: Have you considered using an EMS Chaplain to personally assist your personnel in doing their jobs better and meeting the needs of community victims and their families?

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Who is an EMS Chaplain?

Let me offer a brief working definition of who a Christian EMS chaplain is and what he/she does: A Christian EMS CHAPLAIN is a minister of Jesus Christ who seeks to meet the life needs of all EMS personnel and their families, who honors all faiths, and who is also available to care for community victims impacted by any emergency situation that affects them or assisted by EMS personnel and/or the local department.

The EMS chaplaincy is the intentional process (actions, behaviors and attitudes) involved in serving and meeting the life needs of EMS personal and their families in the name of Jesus Christ, as an ambassador of the Lord and His Church, with the ultimate purpose of making disciples in obedience to the great commission.

Helping a Shivering Beggar We need to understand the answer to this question: "When and where did the terms chaplain and chapel originate?" This question leads us to consider the story of St. Martin of Tours, a compassionate fourth century soldier who encountered a shivering beggar on a cold winter night. Having no money in his purse, he took off his cloak and slashed it with his sword to give half to the beggar.

Later that night he had a vision in which he saw Christ wearing the half-cloak. As a result of this experience he was baptized as a Christian. Ultimately he left the army to devote his life to the church. In time he became the patron saint of the French kings of the Middle Ages. St. Martin's cloak (cappella) was carried into battle by the kings as an signifying the presence of God. But since the cappella was a sacred relic of the church, a priest went along as custodian.

This keeper of the cloak, or cappellanus, also tended the king's religious needs, and from his office was derived that of "chaplain." The depository for the cloak became the "chapel," the place of worship.

The story is more than a quaint bit of etymology explaining the origin of the terms "chaplain" and "chapel." It is also a clue, which points to the essential nature of the chaplaincy. The cappellanus was a member of one institution - a priest of the church - serving in another institution - the king's army.

The EMS Chaplain's Dual Identity Definitions of the chaplaincy seldom take sufficient account of this fact of institutional duality.

Chaplains are unique in that their primary identification is with a non-departmental institution.

But they are also unique in the church, as the only large group of the clergy whose vocational identification is with a non-church social institution. An EMS chaplain has "one foot in

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heaven" and the other out in the field doing patient care. (Talking with the patient and his/her family members, taking vital signs, blood sugar readings, placing patients on oxygen or the cardiac monitor, starting IV's, controlling bleeding, administering medications used to save the patients life, and all the many other thing that are done while running EMS calls) (Adapted from The Churches and the Chaplaincy by Richard G. Hutcheson, Jr.; p. 17. John Knox Press, 1975) Summary: Who is an EMS Chaplain?

When we finally boil down our answer to the question - "Who is a EMS Chaplain?" - we encounter the truth that can also be applied to all those that work in the field of EMS: who the person is, is dynamically defined by what he/she does.

The work of the EMS chaplain flows out of and, to a significant degree, defines the individual.

Similarly, the EMT, EMT-I, EMT-Paramedic, in large measure is defined by the work he/she engages in and is committed to doing.

WHAT DOES AN EMS CHAPLAIN DO? C

Called & Commissioned

H

Helper & Healer

A

Ambassador & Affirmer

P

Proclaimer / Priest & Pastor

L

Leader / Liaison & Listener

A

Available & Assistant

I

Instructor & Initiator

N

Nurturer & Nourisher

Serving the Needs of EMS Personnel The EMS chaplain is first called of God to ministry and then commissioned to work in a context outside of the local church. The EMS chaplain engages in a ministry of helps and is also on the lookout for opportunities to offer a listening ear and heart or to give a healing word of counsel or encouragement.

The EMS chaplain is first an ambassador of the Lord and His church. The EMS chaplain is not there to sell anyone his/her religion or particular church group, but to give comfort, counsel and affirmation, which lead to wholeness and in some cases restoration.

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Yes, the EMS chaplain is a proclaimer of hope, a spiritual priest, and in a real sense the EMS worker's "pastor-on-the-job." The EMS chaplain is a leader, liaison & listener. The chaplain is especially attuned to departmental morale and motivational issues as well as personal integrity and growth.

Thus the EMS chaplain assists the employee to become a better professional by helping the individual become a better person, both inside & outside. This process takes time, a supportive relationship, and consistent instruction. The EMS chaplain needs to keep on initiating goodwill and being available as a personal confidential resource.

The EMS Chaplain's CARE & SHARE Ministry Every EMS chaplain engages in many activities in carrying out this unique, specialized ministry to EMS personnel. If I were to sum up the EMS chaplain's key areas of duty it would certainly be characterized by the term CAREgiver. (What we do ever day in the back of our unit while doing patient care enroute to the hospital) The EMS chaplain's role is truly basic and fundamental - nurturing and nourishing men and women toward personal maturity, integrity and spiritual wholeness.

CAREing Before SHAREing Here is the essence of what a Christian EMS chaplain does. The aspects of this type of ministry may be summarized with the words CARE & SHARE. Helping EMS Personnel Outside the Church Basically, an EMS chaplain is an ambassador of the Lord who is usually sent out by the local church to minister to people in a non-church context and who is readily available to serve others and meet needs. Every Christian minister is under mandate to make disciples of Jesus Christ.

The EMS chaplain is not a pastor or a minister in a traditional sense. The EMS chaplain ministers or serves EMS personnel outside of the traditional boundaries of the local church and addresses human needs in specialized contexts - in the department, out in the community or even at the scene of a medical call or traumatic event (motor vehicle crash, fire, etc.) The chaplain is available to come where EMS people live, work and even play.

What is the "bottom line?" An EMS chaplain is called by God and sent out by a local church to serve the personal & professional needs of EMS service people and their families and to share the word of hope - the good news of Christ's love and forgiveness.

Serving in Two Arenas The EMS chaplain often must serve the needs of people in two different arenas. First, he/she has a primary duty to help EMS personnel - to attend to needs, problems, morale issues,

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family and marital concerns as well as spiritual questions. Thus, the EMS chaplain keeps his/her focus in-house, within the ranks of EMS worker's and their families.

Second, the chaplain widens the scope of service to another arena of people - the community at large - those families and individuals who are served and protected by the EMS professionals. The EMS chaplain may often be called out to handle painful situations, crises and emergencies - at any time, day or night - for a family or individual in the community.

Whatever the arena of personal concern, one of the essential qualities that an EMS chaplain must possess is the ability to readily adapt to various stressful situations and the fluctuating moods of different people.

The EMS Chaplain May provide any or more than the Following Services: 

Provides 24-hour emergency services and intervention when called upon; chaplain is always "on call" for the needs of EMS personnel



Provides short term, confidential counseling for departmental personnel and family members & their children



Conducts weddings & funerals for EMS personnel and family members



Prays at department meetings and ceremonies



Visits stations and crews



Coordinates employee assistance programs



Coordinates community assistance programs (i.e. Red Cross, Salvation Army, community food bank, community church programs)



Assists department bereaved



Visits the sick and/or injured



Coordinates pastoral care of fire and EMS victims



Refers department personnel and victims to appropriate church or religious location



Conducts Bible study group for seekers and/or discipleship training for Christian EMS workers



Participates and/or leads in department Traumatic Incident Team



Participates in state association of Fire and Emergency Chaplains



Engages in continuing self-education, training and upgrading of skills and knowledge

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Assists and/or teaches EMS personnel with training in crisis intervention and stress management.

15 EXCELLENT REASONS FOR THE POSITION OF CHAPLAIN (I am uncertain of the original source of this list.)

1. Counsel with men/women on job to retain active job proficiency.

2. Chaplain does lend itself to a special type of dignity at public and social meetings.

3. Chaplain attending staff and organizational meetings acts as a stabilizing force in reminding those present of the brotherhood of men/women and the need for a cooperative spirit.

4. Assists EMS workers and their families in times of crisis.

5. Assists employees in using their abilities to carry out their duties.

6. Assists employees in dealing with situations that could distract them from their work.

7. Assists in death and injury in which somebody in the official capacity for the city/county should perform.

8. Aids employee by informing him/her of the type of care that is entitled.

9. Assists the city in carrying out the responsibility it has to the employee and assures the employee that the responsibility is being carried out.

10. Sees to it that the employee carries his responsibility out to the city and uses every resource available to see the employee realizes this.

11. Assists with those emotional problems that are expressed in conflicts in the family or marriage that are related to the profession.

12. As Chaplain, he/she has some advantages that insure his acceptance others serving in the same capacity would not have. Much of the work is confidential and it is an accepted fact that legal, medical and pastoral counseling have the right of privileged information, more so ministerial than any other. This is extremely important to many types of counseling or referrals.

13. The point should be made that the primary duty of the Chaplain is to personally seek to meet the emotional, spiritual and morale needs of EMS workers and their families.

14. Confidence in both sides, whether it is in a marriage, business relationship, work problem, internal action, or other with neither side being betrayed is of utmost

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15. The main advantage of the Department Chaplain is availability. Somebody must do these things for the betterment of all personnel in the department who are serving the community and providing critical public safety customer service.

Appendix C: SOAP Method of Personal Bible Study

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Appendix C: SOAP Method of Personal Bible Study SOAP is short for Scripture, Observation, Application and Prayer and is a simple way to approach your personal devotion time with God. Here's what you need: BIBLE - Be sure to get a Bible translation you can understand. The New Living Version (NLV) Study Bible is a great start. It contains footnotes, definitions, a concordance, and other tools to help you understand the Scriptures.

JOURNAL - This is your Spiritual DVR. It helps you capture and record all of the good stuff God wants to speak into your life.

PEN - Obviously, so you can write stuff down.

READING PLAN - You can follow one of our great reading plans offered.

SCRATCH PAD - This is to write down all those little annoying things that creep in while you're trying to focus on God's voice. Make a "To Do" list of things for later.

Here's what you do: Very simply, carve out a quiet time each day. During this time, go through your daily reading this way:  "S" for Scripture: Take time reading and allow God to speak to you. Highlight, underline or place a mark in the margin of your bible next to the scriptures that stand out. When you are done, reread the verses you marked, look for one that particularly spoke to you that day, and write it in your journal. 

"O" for Observation: What do you think God is saying to you in the scripture? Ask the Holy Spirit to teach you and reveal Jesus to you. Paraphrase and write this scripture down in your own words in your journal.



"A" for Application: Personalize what you have read by asking yourself how it applies to your life right now. Perhaps it is instruction, encouragement, revelation of a new promise or corrections for a particular area of your life. Write how this scripture can apply to you today.



"P" for Prayer: This can be as simple as asking God to help you use this scripture, or it may be a greater insight on what He may be revealing to you. Remember, prayer is a two-way conversation, so be sure to listen to what God has to say!

That's it!! SOAP It's as simple or deep as you want it to be.

Additional great elements for your time of Personal Devotion: Worship: Have an iPod or guitar handy.

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Prayer List: Create a prayer list in back of your journal. Write down specific, answerable prayer requests. Date each one. Read through them regularly, and remind God what you are believing for. When God answers each prayer, record the date and celebrate!

Scripture Memorization: Pick a few Scriptures from our reading that you want to commit to memory. Write them in the back of your journal. Review them regularly, until they become automatic!cclii

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Chaplain Christopher A. Credle, EMT-Paramedic, CICP, BCBT, LBT, PhD Chris has had a personal one-on-one relationship with Jesus Christ since Easter 1979. Chris knew from an early age that GOD had a calling for him for the ministry, and, his fascination, with the medical field and EMS, started during a Boy Scout Fall Camporee, while getting his First Aid skill award.

The local county EMS system taught the First Aid class that Chris attended, when he was eleven years old. To add to the visual aid and hands-on experience, the local EMS brought their Ambulance. After that First Aid class, Chris knew that EMS was what he wanted to do: help people and drive that big ambulance with the lights and sirens; what a great way to minister to people.

Chris became involved with EMS in 1985 in a Rescue/EMS Explorer Post. Chris earned his Basic EMT in the spring of 1988. In the fall of 1988, Chris attended a Discipleship Training School (DTS), at Pacific and Asia Christian University now known as the University of the Nations. U of N is the university for Youth With A Mission (YWAM).

Chris became an ordained minister in 1991, with the Jameson Evangelistic Association. Chris has been in ministry for over twenty-two years, all the while maintaining a full-time job in EMS. While in ministry, Chris has worked as an EMS Chaplain, missionary, college & career pastor, and, along with his wife, as singles' ministers and youths' pastors.

Chris earned his EMT-Paramedic in the spring of 1992. While in EMS, Chris has worked in and for both large cities EMS services and the rural EMS systems. He has worked as a line Medic, QRV Medic, Critical Care Paramedic, Crew Chief, Preceptor, Assistant Operations Manager, Training Director and is an adjunct facility at one of the local community colleges with the EMT and Paramedic courses. He currently works as a CTE-EMT Instructor at a local high school in his community.

Chris holds multiple Christian degrees in Religious Arts, Theology, and Biblical Counseling from the following Christian schools: Logos Christian College, from Christian Life School of Theology, and Therapon University. Chris is a Licensed Belief Therapist (LBT), Board Certified Belief Therapist (BCBT), Certified Reentry Crisis Counselor (CRCC) and a Certified Youth Behavioral Advisor (CYBA) through the Therapon Institute in Marrero, Louisiana.

In 2003, Chris and Amy Credle started SoulMedic Ministries, a multi-faceted ministry to reach out to men and women of Emergency Medical Services (EMS), with the Gospel. The goal is to bring Chaplains into a working role in Emergency Medical Services, and, to provide those in EMS with Bible study tools, relevant to Emergency Medical Service Providers.

In 2006 Chris authored Christian Paramedical Review Š Copyright 2006 - SOULMEDIC Ministries. Rev. Christopher A. Credle, EMT-Paramedic, CBT with Aardvark Global Publishing Company, LLC 9587 So. Grandview Dr. Salt Lake City, UT 84092 USA / ISBN 978-1-4276-0157-5 Chris and Amy live in Garner, North Carolina. They have two sons Jacob and Jesse living at home and one daughter Kelsey who is married.

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Figure 1.5: Normal blood flow of heart and lungs Photo from a UK website known as Patient.co.uk. http://www.patient.co.uk/diagram/Heart/lung-circulation.htm xix

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www.stfrancismagazine.info/ja/TheChristianMind.pdf: The Christian Mind by Rev. Bassam M. Madany clviii

http://reiterations.wordpress.com/category/harry-blamires/: From: The Christian Mind by Harry Blamires clix

http://reiterations.wordpress.com/category/harry-blamires/ The Christian Mind: How Should a Christian Think? by Harry Blamires clx

http://www.tfusa.org/Uploaded%20files/conditions.pdf : Conditions of The Mind by Dr. Paul Carlin 10 Unhealthy Conditions of The Mind, Used with Permission. clxi

The Spiritual Dynamics of a Healthy Mind by Dr. Paul Carlin found within the Reentry Crisis Counseling Manuel. Used with Permission. clxii

www.joycemeyer.org/content/articles/ea/scriptures_for_a_sound_mind/ScripturesforSoundMind.pdf : © 2008 Joyce Meyer Ministries, Inc. clxiii

Satan and the Saint: A Look into The Dark Side Of Christian Behavior, by Dr. Paul W. Carlin used with Permission. clxiv

www.gospeltruth.net/1861OE/610327_harden_not_heart.htm: The Gospel Truth: The Oberlin Evangelist March 27, 1861HARDEN NOT YOUR HEART By PRES. FINNEY. clxv

Dr. Paul Carlin Change Your Beliefs… Change Your Life: Used with permission

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www.biblicaleq.com, Biblical EQ: A Christian Handbook for Emotional Transformation by John Edmiston, Used with Written Permission clxvii

www.biblicaleq.com, Biblical EQ: A Christian Handbook for Emotional Transformation by John Edmiston, Used with Written Permission clxviii clxix

http://www.dotjenna.com/power-of-words/

http://won-by-one.blogspot.com/2011/02/words-thoughts-emotions-decisions.html

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http://www.swartzentrover.com/cotor/bible/Doctrines/Angels%20&%20Demons/The%20Continuu m%20of%20Sin.htm clxxiii

Character Deficiency Syndrome by Garry D. Nation, Copyright (C) 1996-2012 Probe Ministries http://www.leaderu.com/orgs/probe/docs/char-def.html clxxiv

EKG Interpretation WWW.RN.ORG® Reviewed February, 2011, Expires February, 2013 Provider Information and Specifics available on our Website Used with Written Permission. ©2011 RN.ORG®, S.A., RN.ORG®, LLC Developed by Melissa K. Slate, RN, BA, MA clxxv

http://www.randylarson.com/acls/cycle.html, used with Permission.

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Chapter 5 ECG Interpretation and Clinical Significance highered.mcgrawhill.com/sites/dl/free/007351098x/451682/sample_ch05.pdf clxxvii

Character Deficiency Syndrome by Garry D. Nation, Copyright (C) 1996-2012 Probe Ministries http://www.leaderu.com/orgs/probe/docs/char-def.html clxxviii

Chapter 5 ECG Interpretation and Clinical Significance highered.mcgrawhill.com/sites/dl/free/007351098x/451682/sample_ch05.pdf clxxix

EKG Interpretation WWW.RN.ORG® Reviewed February, 2011, Expires February, 2013 Provider Information and Specifics available on our Website Used with Written Permission. ©2011 RN.ORG®, S.A., RN.ORG®, LLC Developed by Melissa K. Slate, RN, BA, MA clxxx

Chapter 5 ECG Interpretation and Clinical Significance highered.mcgrawhill.com/sites/dl/free/007351098x/451682/sample_ch05.pdf clxxxi

Character Deficiency Syndrome by Garry D. Nation, Copyright (C) 1996-2012 Probe Ministries http://www.leaderu.com/orgs/probe/docs/char-def.html clxxxii

http://www.randylarson.com/acls/cycle.html, used with Permission.

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EKG Interpretation WWW.RN.ORG® Reviewed February, 2011, Expires February, 2013 Provider Information and Specifics available on our Website Used with Written Permission. ©2011 RN.ORG®, S.A., RN.ORG®, LLC Developed by Melissa K. Slate, RN, BA, MA clxxxiv

Character Deficiency Syndrome by Garry D. Nation, Copyright (C) 1996-2012 Probe Ministries http://www.leaderu.com/orgs/probe/docs/char-def.html clxxxv

Chapter 5 ECG Interpretation and Clinical Significance highered.mcgrawhill.com/sites/dl/free/007351098x/451682/sample_ch05.pdf

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A Paramedic’s view of Christianity

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EKG Interpretation WWW.RN.ORG® Reviewed February, 2011, Expires February, 2013 Provider Information and Specifics available on our Website Used with Written Permission. ©2011 RN.ORG®, S.A., RN.ORG®, LLC Developed by Melissa K. Slate, RN, BA, MA clxxxvii

http://www.randylarson.com/acls/cycle.html, used with Permission.

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Chapter 5 ECG Interpretation and Clinical Significance highered.mcgrawhill.com/sites/dl/free/007351098x/451682/sample_ch05.pdf clxxxix

Character Deficiency Syndrome by Garry D. Nation, Copyright (C) 1996-2012 Probe Ministries http://www.leaderu.com/orgs/probe/docs/char-def.html cxc

http://en.wikipedia.org/wiki/Apostasy_in_Christianity

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Apostasy–Falling from Grace by Thomas R. Fletcher http://www.proseandphotos.com/apostasy.htm cxcii

Paul W. Carlin, Sr, Th.D., LBT. Mastering Life Through Belief Therapy® Why We Do What We Do When We Do It: Used with Permission cxciii

EKG Interpretation WWW.RN.ORG® Reviewed February, 2011, Expires February, 2013 Provider Information and Specifics available on our Website Used with Written Permission. ©2011 RN.ORG®, S.A., RN.ORG®, LLC Developed by Melissa K. Slate, RN, BA, MA cxciv

Chapter 5 EKG Interpretation and Clinical Significance highered.mcgrawhill.com/sites/dl/free/007351098x/451682/sample_ch05.pdf cxcv

EKG Interpretation WWW.RN.ORG® Reviewed February, 2011, Expires February, 2013 Provider Information and Specifics available on our Website Used with Written Permission. ©2011 RN.ORG®, S.A., RN.ORG®, LLC Developed by Melissa K. Slate, RN, BA, MA cxcvi

EKG Interpretation WWW.RN.ORG® Reviewed February, 2011, Expires February, 2013 Provider Information and Specifics available on our Website Used with Written Permission. ©2011 RN.ORG®, S.A., RN.ORG®, LLC Developed by Melissa K. Slate, RN, BA, MA cxcvii

EKG Interpretation WWW.RN.ORG® Reviewed February, 2011, Expires February, 2013 Provider Information and Specifics available on our Website Used with Written Permission. ©2011 RN.ORG®, S.A., RN.ORG®, LLC Developed by Melissa K. Slate, RN, BA, MA cxcviii

EKG Interpretation WWW.RN.ORG® Reviewed February, 2011, Expires February, 2013 Provider Information and Specifics available on our Website Used with Written Permission. ©2011 RN.ORG®, S.A., RN.ORG®, LLC Developed by Melissa K. Slate, RN, BA, MA cxcix

EKG Interpretation WWW.RN.ORG® Reviewed February, 2011, Expires February, 2013 Provider Information and Specifics available on our Website Used with Written Permission. ©2011 RN.ORG®, S.A., RN.ORG®, LLC Developed by Melissa K. Slate, RN, BA, MA

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EKG Interpretation WWW.RN.ORG® Reviewed February, 2011, Expires February, 2013 Provider Information and Specifics available on our Website Used with Written Permission. ©2011 RN.ORG®, S.A., RN.ORG®, LLC Developed by Melissa K. Slate, RN, BA, MA cci

EKG Interpretation WWW.RN.ORG® Reviewed February, 2011, Expires February, 2013 Provider Information and Specifics available on our Website Used with Written Permission. ©2011 RN.ORG®, S.A., RN.ORG®, LLC Developed by Melissa K. Slate, RN, BA, MA ccii

http://1828.mshaffer.com/d/search/word,will : Noah Webster on-line copy of The First Dictionary of the American Language, 1828 cciii

Winkie Pratney from his paper entitled, Man and the Origin of Evil, 1998 Used with written permission cciv

http://harvestime.org/EnglishCourses/KnowingGodsVoice.pdf: Knowing G o d ' s Voice, Harvestime International Instisute by Patricia Hulsey, Used with Written Permission ccv

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Dr. Paul Carlin Mastering Life Through Belief Therapy©: Used with permission

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http://harvestime.org/EnglishCourses/KnowingGodsVoice.pdf: Knowing G o d ' s Voice, Harvestime International Instisute by Patricia Hulsey, Used with Written Permission ccviii

http://1828.mshaffer.com/d/search/word,will : Noah Webster on-line copy of The First Dictionary of the American Language, 1828 ccix

http://1828.mshaffer.com/d/search/word,will : Noah Webster on-line copy of The First Dictionary of the American Language, 1828 ccx

Winkie Pratney from his paper entitled, Man and the Origin of Evil, 1998 Used with written permission ccxi http://www.leaderu.com/offices/stoll/maturity/chap12.html: Chapter 12 - God's Will and Man's Character © Copyright 1996 by John H. Stoll. ccxii

EKG Interpretation WWW.RN.ORG® Reviewed February, 2011, Expires February, 2013 Provider Information and Specifics available on our Website Used with Written Permission. ©2011 RN.ORG®, S.A., RN.ORG®, LLC Developed by Melissa K. Slate, RN, BA, MA ccxiii

Satan and the Saint: A Look into The Dark Side Of Christian Behavior, by Dr. Paul W. Carlin used with Permission. ccxiv

EKG Interpretation WWW.RN.ORG® Reviewed February, 2011, Expires February, 2013 Provider Information and Specifics available on our Website Used with Written Permission. ©2011 RN.ORG®, S.A., RN.ORG®, LLC Developed by Melissa K. Slate, RN, BA, MA

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http://www.scholarpedia.org/w/index.php?title=Cardiac_arrhythmia&prin...

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EKG Interpretation WWW.RN.ORG® Reviewed February, 2011, Expires February, 2013 Provider Information and Specifics available on our Website Used with Written Permission. ©2011 RN.ORG®, S.A., RN.ORG®, LLC Developed by Melissa K. Slate, RN, BA, MA ccxviii

http://www.jmmindia.org/JMMSITE/jmm/ministries/Teaching%20Notes/TN148%20%20DEALING%20WITH%20OFFENSE.pdf : Dealing with Offence by Joyce Meyer ccxix

www.healingofthespirit.org: HEALING OF THE SPIRIT by Dr. Arlin Epperson

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www.healingofthespirit.org: HEALING OF THE SPIRIT by Dr. Arlin Epperson

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EKG Interpretation WWW.RN.ORG® Reviewed February, 2011, Expires February, 2013 Provider Information and Specifics available on our Website Used with Written Permission. ©2011 RN.ORG®, S.A., RN.ORG®, LLC Developed by Melissa K. Slate, RN, BA, MA ccxxii

www.healingofthespirit.org: HEALING OF THE SPIRIT by Dr. Arlin Epperson

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http://www.newwineonline.com/files/pdf/publications/newwineFDH.pdf : Freedom From the Deep Hurts of Rejection © 1991-2004 by Chris N. Simpson: Presented by http://www.newwineonline.com ccxxiv

http://www.ntslibrary.com/PDF%20Books/Biblical%20Counseling%20Manual.pdf : Biblical Counseling Manual by Adam Pulaski ccxxv

www.fireonthealtar.com/compilations/index.html: Notes taken from Do you know what's missing? Speakers: Carl Richeal / Background Music: Various ccxxvi

http://www.wholeperson-counseling.org/id/jesus_bruised&rejected.html

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http://www.hopefortheheart.org/pdfs/OLQR-pr-Rejection.pdf

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http://www.hopefortheheart.org/pdfs/OLQR-pr-Rejection.pdf

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EKG Interpretation WWW.RN.ORG® Reviewed February, 2011, Expires February, 2013 Provider Information and Specifics available on our Website Used with Written Permission. ©2011 RN.ORG®, S.A., RN.ORG®, LLC Developed by Melissa K. Slate, RN, BA, MA ccxxx

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http://www.emedicinehealth.com/wound_care/page3_em.htm

http://www.garethevansministries.org/media/KeyCH06.pdf : CHAPTER SIX types of wounds slashing, stabbing, Grazes, Fractures THE WOUNDED SOUL by Gareth Evans

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Satan and the Saint: A Look into The Dark Side Of Christian Behavior, by Dr. Paul W. Carlin used with Permission. ccxxxiv

http://www.scholarpedia.org/w/index.php?title=Cardiac_arrhythmia&prin...

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EKG Interpretation WWW.RN.ORG® Reviewed February, 2011, Expires February, 2013 Provider Information and Specifics available on our Website Used with Written Permission. ©2011 RN.ORG®, S.A., RN.ORG®, LLC Developed by Melissa K. Slate, RN, BA, MA ccxxxvi

EKG Interpretation WWW.RN.ORG® Reviewed February, 2011, Expires February, 2013 Provider Information and Specifics available on our Website Used with Written Permission. ©2011 RN.ORG®, S.A., RN.ORG®, LLC Developed by Melissa K. Slate, RN, BA, MA ccxxxvii

Chapter 5 ECG Interpretation and Clinical Significance highered.mcgrawhill.com/sites/dl/free/007351098x/451682/sample_ch05.pdf ccxxxviii

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http://www.keyway.ca/htm2003/20030723.htm: Reprobate by Wayne Blank

http://www.studylight.org/dic/hbd/view.cgi?n=384 : By Michael Fink

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http://www.proseandphotos.com/apostasy.htm: Apostasy–Falling from Grace by Thomas R. Fletcher ccxli

http://www.btmi.org/messages/suicide.html: "SPIRITUAL SUICIDE" by Rev. Larry Wolfe-Evangelist ccxlii

Satan and the Saint: A Look into The Dark Side Of Christian Behavior, by Dr. Paul W. Carlin used with Permission. ccxliii

http://www.liftupusa.com/pratneychkup.html: A Spiritual Check-UP by Winkie Pratney ©1995 Contact at Box 876 Lindale TX 75771 or winkprat@aol.com: Used with Written Permission ccxliv

Chapter 5 ECG Interpretation and Clinical Significance highered.mcgrawhill.com/sites/dl/free/007351098x/451682/sample_ch05.pdf ccxlv

The ECG records the electrical activity that results when the heart muscle cells in the atria and ventricles contract. http://electro-medicals.com/2011/01/electrocardiogram-ecg-or-ekg/ Changed by SoulMedic Ministries to show the Christian Hearts EKG 2012. ccxlvi

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How do we decide what is sin? http://home.snu.edu/~hculbert/sin.htm

Heart Talks to Ministers and Christian Workers (Chapter 10) Spiritual Power and How Lost: by E. E. Shelhamer and Others

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http://harvestime.org/EnglishCourses/KnowingGodsVoice.pdf: Knowing G o d ' s Voice, Harvestime International Instisute by Patricia Hulsey, Used with Written Permission ccxlix

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Dr. Paul Carlin Mastering Life Through Belief Therapy©: Used with permission

www.healingofthespirit.org: HEALING OF THE SPIRIT by Dr. Arlin Epperson

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Satan and the Saint: A Look into The Dark Side Of Christian Behavior, by Dr. Paul W. Carlin used with Permission. cclii

http://soapstudy.com/