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Less than two months have passed since Crown Princess Mette-Marit underwent a month's pulmonary rehabilitation at Cathinka Guldberg Hospital in Jessheim.

But the development is discouraging. [Her health state] has deteriorated significantly during the autumn.

- I have spent much of this half year at Jessheim or at Rikshospitalet taking new tests, and we have had several conversations this autumn about lung transplantation. That is what is new, that we are beginning to approach that step. It has been…

Crown Princess Mette-Marit pauses for a moment before continuing:

- It has been a long process for me to get there in terms of thinking.

- I have always hoped that we would be able to keep the disease in check with medication, and the development has actually been quite slow until now. Whereas now the development has gone faster than both I and the doctors had hoped for, says the Crown Princess to NRK's «Året med kongefamilien».

The Crown Princess: - Just the thought is quite demanding

We meet her and Crown Prince Haakon at [their] home in Skaugum.

Seven years have passed since they sat in the same room and announced that the Crown Princess had been diagnosed with the chronic disease pulmonary fibrosis.

Pulmonary fibrosis causes scar tissue to form on the lungs, so they become stiff and less elastic and shrink.

This makes it harder and harder to breathe as the disease progresses.

Now the situation for Crown Princess Mette-Marit has become so serious that the need for a lung transplant is approaching, the Crown Prince couple say.

- We are not yet there for you to be put on the list, but these tests show that the disease has progressed [one step further]. So it's more actualised now – we're starting to approach [that point], so it's something we're talking about, says Crown Prince Haakon.

- But it is moving towards a lung transplant, that is the way forward for the Crown Princess?

- Yes, we have known all along with this disease that this is [where it's heading]. But I think it probably came a little faster than at least I had imagined and hoped for, says Crown Princess Mette-Marit.

- But now I've had quite a few such experiences... I think that with all such processes, it takes time. It is a process for me as a patient, and it is a process for my family, says the Crown Princess while the Crown Prince nods.

- Just thinking the thought at all that this is the next step is quite demanding, because it is an operation with a lot of risk associated with it, she says.

Foto: Christian Breidlid / NRK

- Unable to carry out the things I was able to do before

A box of paper handkerchiefs is set out. It remains untouched. The Crown Princess is composed when she talks about the development.

The disease has affected her work capacity for a long time. In March this year, the Royal House announced that the lung disease had worsened.

«The Crown Princess has daily symptoms and troubles that affect her ability to carry out her daily work. The Crown Princess needs more rest, and the daily schedule changes more quickly than before,» the press release from the Palace stated at that point.

Since then, the disease has further developed in a negative direction.

In the last couple of weeks, the Crown Princess has taken part in public reading at a Leseklubben event, was present during the Peace Award ceremony, and the Crown Prince couple were invited to «Jul i Slottskapellet» with Princess Ingrid Alexandra and Prince Sverre Magnus.

Just two days ago, just before the serious development of the disease was to become known to the whole country, she was on a pre-Christmas visit to a nursing home in Oslo with her children and husband.

Nevertheless; now the disease [restricts her] even more than before.

- The biggest difference for me is actually that I can't do the things I was able to do before. There are [simply put] too many things I can't do, says Crown Princess Mette-Marit now to «Året med kongefamilien».

The Crown Prince Family visited Langerudhjemmet just two days ago. Foto: Ismail Burak Akkan / NRK

She stops and looks into the air. Takes a slow breath and describes how she has noticed a clear deterioration in a short time.

- I think it is very sad that I am not able to carry out things at work as I would like. It is something that is not only important to me, but also being allowed to contribute. I really don't think I'll be able to do what I managed to do earlier this autumn. So it's... There's something painful about it.

She looks [towards] the Crown Prince, he nods carefully.

- But that's how life is, we just have to take it as it is, she adds.

The Crown Prince: - A mourning process

She says that the development has also been difficult for the children and the rest of the family, and that it has been a process for them to come to terms with the situation as well.

The Crown Prince describes it as a mourning process.

- [Obviously,] for those of us who are very fond of Mette and want her to be well, it hurts that [it's becoming] more difficult, he says.

- And it's a little difficult to understand, perhaps, [just how] ill you are, he says and turns to her on the bright sofa.

- Because she looks very good, he adds and smiles.

- And when we sit quietly, it can seem like she's perfectly fine. But we can see that she struggles more with her breathing. [Bear less] and have less surplus and energy, get sick more often - and it can come on a bit suddenly. So all those things are easy to notice for us who are [close by], says the Crown Prince.

He looks at her. Describes things they enjoyed doing together before, like hiking and skiing, that are no longer possible.

- So we have the big picture, that it is a serious situation, and then there are the smaller things that you also have to adjust to, which are really sad. That you can't do it anymore. So there is a bit of a grieving process along the way, says the Crown Prince.

- And we have to be allowed to be a little sorry and take it to heart every once in a while too. Then you have to adapt and find as good solutions as possible along the way. But life is a bit brutal, he says.

Christmas lights hung on the gate to Skaugum illuminate the winter darkness. Foto: Christian Breidlid / NRK

Become clearer that it is moving towards transplantation

When asked what it is like to accept that things are moving towards transplantation and surgery, Crown Princess Mette-Marit says that she is more ready for things to go in that direction now than she has been before.

- Especially after the summer, I kind of felt that it was necessary. And it is something new. I think I've been very much like: «No, I will make it work. This will go well, the medication will work.» But now I feel that... In many ways, it's probably the case that I've become more ready for it, says Crown Princess Mette-Marit.

- And fortunately it is not up to me to make the decision about when I am put on the list. I am very happy that that decision rests with someone else, with good professionals who have done this many times before. It is a great [comfort] for me.

The doctor: - It's terrifying

The decision as to when the Crown Princess will be put on the list of people who need and are ready for a transplant will be made by the doctors at Rikshospitalet.

Chief physician Are Martin Holm, head of the lung department at Rikshospitalet, is the Crown Princess's doctor and has followed her development for a long time.

He has been given permission to talk to NRK about the situation.

Holm shows with his hand how pulmonary fibrosis often worsens step by step downwards, like a staircase going down.

- The Crown Princess has had some such deteriorations during 2025. Some clear deteriorations. [They are not so noticeable] when you're standing still, but we can measure it, and we see it. And it has been quite noticeable.

- As of today, the disease is so serious that we are beginning to prepare how to deal with further deterioration. And then the only thing [that] can help is a transplant, says Holm.

Chief physician Are Martin Holm describes the Crown Princess's situation as serious and says they are beginning to prepare for a possible transplant. Foto: Håvard Greger Hagen / NRK

In a press release from the Royal House, Holm states that «we are approaching the time when a lung transplant must be carried out, and we are making the necessary preparations so that it will be possible when that time comes.»

- We must start thinking about transplantation when we see that things are going [in that direction]. And that is when life prospects are limited. Transplantation is done to save lives. That is the reason for the transplant, says Holm to NRK.

- When will the Crown Princess be [put] on the waiting list?

– The time to get on the waiting list is when we believe that the life prospects are poor, Holm answers.

– Is it now?

– It's not yet. But we know that this is a deadly disease, so we have to be prepared. We closely monitor people who have this type of disease. The sum of various tests gives us an indication that the life prospects are now...that now it's alarming, now transplantation is the best solution. And then it's time to get on the waiting list, says Holm.

– We are not there today, but there has been a deterioration during 2025 that means we have to start thinking about this, and we have to follow it a little more closely, he says of the Crown Princess.

Holm describes lung transplantation as a major operation.

– It's not trivial. It's a major operation. It's scary too. And if people don't understand that it's scary, I have to explain it to them. Because it is. It should be. But at the same time, it is also a rescue and a solution. And there is hope in that.

A large crowd had turned up when Crown Princess Mette-Marit visited Stavanger in June in connection with the city's 900th anniversary. Foto: Øystein Otterdal / NRK

Rejects royal [privilege]

Holm describes tests they take to monitor when a patient is at the critical point that they should be put on the waiting list for a transplant, and tests they take to check if the person can tolerate the major surgery.

After a person has been placed on the waiting list, they must in practice always be available to come at short notice.

– Because it is completely unpredictable when a suitable organ will become available. It could happen in one day – or never, says Holm.

Chief physician Are Martin Holm says that the Crown Princess's public role will require additional protection in connection with the operation, but denies that she will be prioritised over other patients because of her royal role. Foto: Håvard Greger Hagen / NRK

– Will the Crown Princess be prioritised over others?

– No, she won't. When an organ arrives, it has a specific size and a specific blood type. Based on that, we need to look at the list to see who [it] fits. Of those who are suitable, we always take the one who is the sickest, the one who has the worst time [prospect] and [therefore] least ability to wait, Holm answers.

– What is the alternative to transplantation for the Crown Princess if the development continues as it has this autumn?

– I can say what the alternative is in general for all the patients we are considering for transplantation and investigating for transplantation. That alternative is heavy and difficult to think about, Holm answers.

– But it is necessary for those patients to actually consider what the alternative to a transplant is, when a transplant is the only form of life-saving treatment.

A guard at the entrance to Skaugum. Foto: Christian Breidlid / NRK

Article written by Vilde Helljesen and Kristi Marie Skrede for NRK, published Dec. 19, 2025, at 09:06 and updated the same day at 10:35. Translation and slight editing for clarity by me.

Note #1 from Saga: Since it's such a serious topic and such a long article, I've been more careful with my editing this time around. Usually, I sometimes rewrite or restructure entire sentences just to make sure that the message gets across. So it's not technically word-for-word what they're saying, but it's the message/point that they're trying to get across. However, with this one I've been more careful & that's why you'll see so many [word] & [phrases] compared to other translated articles from me, because I wanted to be as close, as word-for-word, as possible.