First and foremost, just like #dqstrong, this goes well beyond football. My thoughts and prayers are with Mrs. Smith and the Smith family.
On the football side, I'm not sure what this means yet. The "extended leave" has not been defined. It could very well be open ended with no defined date of return....but at some point Mrs. Smith's situation will resolve itself (praying for full recovery) and when that happens, what happens to Rick?
I think the Texans have an asst. GM. While the cancer diagnosis is horrible, it does give McNair a very easy way out. He can elevate the Asst GM on an interim basis and essentially kick the can down the road.
He can say (and perhaps rightfully so) that a change like this shouldn't be made under these circumstances and Rick's job is secure upon his return or something like that and meanwhile our Asst GM will be taking over duties in what amounts to an extended trial for the job on a perm basis.
Rick's wife not withstanding, I'd much rather see a bold move and a totally new direction.
History tells me that McNair acts more like the Senate then the House - slow and extremely deliberate. His ownership style is sort of like a sloth playing pictionary.