Putting his life in God’s hands: Lung transplant patient Rick Schmidt moves into palliative care, passes away

 

Starting in 2022, I followed my friend Rick Schmidt in a series of articles about his lung transplant—from his application for the transplant program through acceptance, then through the transplant itself and coming home from the hospital in summer. I also spoke to transplant team members, nurses and surgeons about the transplant surgery, recovery and the importance of organ donation.

 

Unfortunately, the transplant never took. Rick decided to opt for palliative care a week ago. I interviewed him one last time in the hospital last week. Here's my final story in that series. 

Rick died early in the morning on Oct. 3. Requiescat in pace.

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When he started his medical journey, Rick Schmidt knew that one in 10 lung-transplant patients don’t survive the first year.

Rick Schmidt sits surrounded by medications at his kitchen table back in July, after his lung transplant. Last week he made the decision to move into palliative care.

“It turns out I am that one person,” he says, speaking from his hospital bed at Health Sciences Centre.

In consultation with his wife, Sara Jane, and medical staff, Schmidt, 68, made the decision last weekend to cease aggressive medical interventions, including anti-rejection drugs, and start the palliative-care process.

“I’m just not going to get better,” he said, noting his new lung just never connected to his airway. “I could keep on trying, maybe get a few more months, but things are so hard right now. I don’t want to keep living this way.”

Schmidt was diagnosed with idiopathic pulmonary fibrosis in 2018, a terminal condition in which the lungs harden and make breathing difficult. In June 2022, he was accepted into the Manitoba lung-transplant program.

In April, this year, he got the call that a lung was available. He flew to Edmonton for the operation.

The first week after transplant went well, he said. But then things started to crash.

“Everything tanked,” he said as infections and other complications set in. “I would get better, then tank again.”

Instead of coming back to Winnipeg after a few weeks, as expected, Schmidt ended up spending three months in hospital in Edmonton, before returning to Winnipeg in July.

He managed to live at home for a short time before being readmitted to the hospital. After stabilizing, he was sent back home — only to have to return again when breathing became difficult.

He’s been at Health Sciences Centre since the start of September.

The couple made the decision to him to go into palliative care after learning from the medical team that the chance of recovery “was more and more remote,” he says.

“The cascade of complications added up to an insurmountable barrier for him,” Sara Jane says, adding his weight has fallen to about 103 pounds. “There was little prospect of a good life.”

Schmidt, who was an insurance broker before becoming a mediator and university instructor at Menno Simons College, says, “The cost-benefit ratio just wasn’t there. The chances of my long-term survival are minimal. I want to keep living, but it’s just not in the cards. It’s the reasonable choice.”

In place of the anti-rejection drugs and other medications, the goal now is comfort. This includes regular injections of hydromorphone for the anxiety and panic that comes with breathlessness.

One thing the couple appreciated all along the way was how open and honest the medical staff were about the surgery and the chances for recovery.

“There was never a snow job,” Schmidt says. “They never gave me false hope. They were always upfront with us.”

Looking back, he doesn’t regret having the transplant. “I knew I had to give it a try. Besides, my condition was terminal. What did I have to lose?”

And yet, after all the challenges, he isn’t sure he would do it again. “Maybe not, knowing what I know now,” he says. “But I made the best decision based on the information I had at the time.”Sara Jane agrees. “He had already declined a lot before the surgery,” she says. “His life was already limited.”

One thing the couple wondered was how the transplant team felt about his failure to recover.

“They told us they learn something from every transplant operation, even the ones that don’t turn out like they hope,” Schmidt says. “This failure could help them to help someone else succeed.”

While Schmidt is adjusting to his new reality, so is his wife.

“Up until now my role has been to support him toward living,” says Sara Jane, who lived in Edmonton the whole time he was in hospital there and who is now staying with him at Health Sciences Centre in these final days.

“It’s quite a head shift to start thinking from how I could help him have a good recovery to how I can help him to have a good death.”

One thing they both appreciate is the support of their church community and other friends and family. “We get strength from that,” Schmidt says. “People are pouring love on us.”

Adds Sara Jane: “We feel very well looked-after.”

They also have nothing but praise for everyone they met in the medical system.

“The people in the Manitoba Lung Transplant Program, the transplant team in Edmonton, the doctors, the nurses, the aides, the cleaners and everyone else, they’ve all been great and such a support,” Schmidt says. “They have been empathetic, attentive, supportive. It’s clear that, for them, it’s not just a job.”

As for what the future holds, that’s unclear. He could hold on for a week yet, maybe more.

All they know is they are at peace about the decision to begin palliative care. For Schmidt, that includes his faith.

“I’ve put my life and death in God’s hands,” said Schmidt. “The same God who loves me in life will love me after I’m gone.”

God’s love, he added, “is not predicated on me having a certain set of beliefs. God is love, full stop.”

To become an organ donor, visit www.signupforlife.ca.