Stephen R. Peters '88, M.D.

“Being Present with People and Journeying with Them Through Their Illness”

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Dr. Stephen R. Peters ’88, P’21, is a cardiologist in Northern California who currently practices at Roseville Cardiology and serves as vice chief of staff at Sutter Roseville Medical Center. He spends a third of his days in the hospital dealing with critical care cardiology, management of heart attacks, heart failure and arrythmias, working in the ICU and on the cardiology wards. The rest of his time is spent at his outpatient consultation practice. He notes some of the changes and complications occurring due to COVID-19.

“All of a sudden in early March patients stopped coming in. They did not want to come in to the hospital. And with shelter in place we immediately transitioned to video and phone business. That has been really interesting for me as a physician, especially as an LMU grad with 13 years of Jesuit education, because I lost suddenly probably the most important aspect of being a physician for me and that was really being present with people and journeying with them through their illness. All of a sudden there was this technology between us,” he said.

Peters’ hospital has a manageable flow of COVID-19 patients at one time. Typically, with COVID-19 cases cardiologists come into the room during the later stages after a patient has been intubated.

“They are very sick and the heart is starting to be impacted by the cytokine storm and the inflammation that’s going on in their bodies. And what we’ve learned from our cardiology colleagues in Seattle is that these patients frequently have heart attacks and strokes from the hypercoagular state induced by COVID-19. The subsequent heart block and arrythmias require really difficult conversations with family. By the way, families that aren’t even in the hospital. That’s the other hard thing, these people are dying alone.

“So frequently when cardiology gets involved it’s like, ‘Here we are, you’re on a ventilator, we’re having a hard time oxygenating you and now you’re having arrythmias.’ This is typically the end of the line. While I have conversations about people dying often because cardiovascular causes are the most common way to die in America, these are particularly hard conversations because during the COVID-19 crisis families are not allowed in the hospital. So, you become really not only a messenger to the family, but then a messenger back to the patient from the family. I became very conscious of that. I was often the link, not only for COVID-19 patients, but all of my hospitalized patients. I became this link and part of my rounding now has been calling the spouse or the child and giving them an update and then going back into the room and telling my patient, ‘I just spoke to your wife, son or daughter, and they’re sending their love.’”

Through his outpatient practice, Peters sees patients that have been with him for years. Often video and phone calls are now substituting routine visits, but for patients with complications, the prospect of coming in to the hospital can be frightening.

“I had a patient that I cared for for years call me, and they were trying to stay out of the hospital, and I said, ‘I don’t think he can make it any longer, he needs to come to the hospital.’ But I said to the wife, ‘You have to realize that when you leave him in the emergency room, you need to say goodbye, you may never see him alive again. I may be the last person to see him. And I promise to communicate with you every day, and share with you and call you, but because of where we are now, that ER door might be the last you see of him.’”

According to Peters one of the problems brought on by this pandemic is that many people wait at home too long before coming in to the ER.

“About two weeks ago I was on call on a weekend, and in 36 hours we had basically four late presenting heart attacks die in the emergency room, which is unheard of. In cardiology, if we can get you in early during a heart attack, we can get the artery open and people have an excellent chance of survival. But these patients died not from COVID-19, but from their fear of COVID-19. It was a reminder to me that I need to be really clear in my messaging to people that we are here to support you, that the medical system is functioning for everyone not just for COVID-19 patients. We’re creating an environment where it is safe to come into the hospital.

“I do think we need to take a broader look at how COVID-19 is impacting everyone — COVID-19 patients and not. Like I told you earlier, patients dying without family members there. That’s traumatic for everybody: the caregiver, the person themselves, the family that is not there. And that is happening in every hospital, every nursing home across this country, across the world. The level of fatigue from the emotional side of this has been surprising to me. And again, I’m a guy that deals with life and death all the time in cardiology, but this has been on a whole other level. I think it is the uncertainty, the fear that has been created. Those of us who practice medicine need to realize that we are the conduit to bring down the fear, to provide some calm and to give people faith that the system can handle them if there is a problem and that they are not alone.”

During this crisis, Peters is grateful for his family and friends, but particularly for his wife, Lucy Peters ’88, and the university they met in.

“I have an amazing wife, who, from LMU days back to the MCATs, has joined me in this journey and been very supportive and that is another blessing from LMU for sure. She understands and supports the long hours that medical practice requires. I also have a deep gratitude for my Ignatian education. I don’t think I would have the reserve and the capacity to be a part of the solution in this crisis not only with the COVID-19 patients, but its impact on all of the patients in the hospital and in my practice. I think the Ignatian message of caring for the whole person and living the Magis, just doing more, going the extra mile, making those family phone calls, finding God in all things, in your fear, in your struggle, in your concern for your own health when caring for patients, in the long hours and the late nights, that is where we need to find God. We talked about that at LMU, but when the rubber meets the road, all of those Ignatian values should come to life and I’m really, really grateful for those. Those teachings that became part of my core through my 13 years of Jesuit education.”

Peters is a member of the LMU Board of Regents.