Medical Writer Laura Schmidt Pizzarello Dies at 51

Laura Schmidt Pizzarello's struggle with cancer became known to millions of people through her appearances on the ABC News show "Nightline." (Ralph Alswang -- Nightline)

Laura Schmidt Pizzarello, 51, a freelance medical writer who for 12 years specialized in end-of-life issues, reached her largest audience three months ago with the story of how she was dealing with her own terminal illness.

Ms. Schmidt, who used her maiden name professionally, died of pancreatic cancer Feb. 25 in her home in Germantown. She wrote for AARP, hospices, newsletters, Web sites and physicians. But when she was featured on a Dec. 11 segment of the ABC television show "Nightline," 4.91 million viewers tuned in, nearly a million more than normal. Viewers continue to request tapes of the show, an ABC official said.

She was found to have pancreatic cancer last summer, just months after a full physical exam seemed to show that she was in good health. But after a massage left her black and blue from the waist down, she went to her doctor and a CAT scan revealed the cause. She told "Nightline" that she went from "the land of the living to the land of the dying in one heartbreaking moment."

But Ms. Schmidt used her knowledge to make decisions that most people have to make without her expertise. She already had a living will, and she and her husband of 15 years had discussed what measures, if any, should be taken at the end of their lives. She also assigned to her husband, Joseph Pizzarello, the power to make decisions about her care if she was incapacitated.

"I heard it said by many elderly people, 'Well, I've had a good life.' So they can justify it more," she said on the television show. "Whereas, for someone of my age, it's a little bit tougher. I mean, to think, you know, all these years I've been paying into Social Security and I'm never going to get it, or I'm not going to be able to do half the things I thought I was going to be able to do."

Control was important to Ms. Schmidt. "Nightline" taped an exchange with her physician, Kenneth Miller, in which they discussed what medical measures she would not want.

"If you had an infection . . . I mean, right now, let's say the catheter became infected or something happened, antibiotics?" Miller asked.

"Yes," she answered.

"Okay. If, for example, you took a downhill turn, but it looked like you really could come back . . . "

"Yes, I'd be willing to give it a try. . . . But if I didn't bounce back, like, with one or two days, then, you know, stop it. And if I go into a coma, that's it."

"But that'll be as long as you didn't require a machine," her husband added. "I mean, you would not want to be put on a respirator for the chance of coming back."

"Yeah. And no feeding tube," she said. "I'm a great believer in just letting God do His work."

Ms. Schmidt began writing a book last summer, but the pain medications she took made her feel too fuzzy to write. She agreed to try a procedure that would have given her a little more time. It didn't work. She decided to stop chemotherapy, a colleague said.

"We believe she had a checklist, and following this one last item on her checklist, she just let go," said Nancy Ochsenreiter, director of community outreach for Hospice Caring Inc. of Gaithersburg. "I think she had control up to the end."

She was a New York native who moved to the Washington area 30 years ago and received a bachelor's degree from Marymount College in Arlington. She completed work on a master's degree in thanatology, the study of death and dying, from Hood College in Frederick and was scheduled this spring to receive the degree. Her academic adviser delivered the degree to her Feb. 22.

"She responded with a huge grin," Ochsenreiter said. "I think that was the second-to-last item on her checklist."

Ms. Schmidt's clients included Americans for Better Care of the Dying, Last Acts and the National Hospice and Palliative Care Organization. She appeared in a video documentary produced by AARP and the DC Coalition of End-of-Life Care, an organization of health professionals.

She volunteered with Hospice Caring as a caregiver, grant writer, newsletter editor and award-winning brochure editor. She also volunteered with the Hospice of Frederick County. She won an award from the Hospice Network of Maryland in November 2003 for her work. The award cited her service as a caregiver, taking on one of the organization's most difficult clients.

"She began an e-mail relationship with her deaf and resistant patient, and progressed to transporting him to treatments. By slowly building the trust of her patient and by quietly persisting, she was able to implement many services that added quality and independence to his life," the network citation said.

Survivors include her husband, of Germantown, and two brothers, William Schmidt of Washington and Camillo Schmidt of Bethesda.