By BRENT HALLENBECK, The Burlington Free Press

BURLINGTON, Vt. (AP) — Julia Crane and Courtney Billings became friends in seventh grade, while on a field trip with their fellow Colchester Middle School students.

"We were hiking Mount Mansfield," Crane said.

"Not very well," Billings said. She was lagging behind, and Crane stayed back to keep her company.

The students were scattered across the top of Mount Mansfield when Billings told Crane her secret: She was diagnosed at 7 months old with cystic fibrosis, a disease that causes persistent lung infections and over time reduces lung capacity. She hid her ailment from her classmates.

"I wanted to be as normal as I could," Billings said.

She found a sympathetic ear in Crane. Crane was familiar with cystic fibrosis, as her mother knew someone with the ailment and supported a cystic-fibrosis foundation. Crane and Billings formed an instant bond that has only grown stronger as they followed separate but parallel paths through life - Crane as a competitor in the Miss Vermont pageant and Billings as a young woman hoping for a double-lung transplant.

Crane gave Billings support as she battled cystic fibrosis. Billings gave Crane purpose and a new outlook as she ran for Miss Vermont on the platform of advocating for organ donations like the one Billings needed to save her life.

Last year, both women reached their dreams after five years of striving. In May, Crane won the Miss Vermont title (her reign ends June 1) and competed in September in the Miss America pageant. In October, Billings underwent a successful double-lung transplant at a Boston hospital, beginning an accelerated trip on the road to recovery.

Their connection has changed Billings, 24, and Crane, 23, in ways they recognize now and can only imagine in the future.

"Not everybody," Crane said, "has a friendship like this."

A 'horrible sweet spot'

Billings' condition only grew more severe after that hike up Mount Mansfield. By the time she got to high school she was spending so much time in the hospital that her classmates wondered what was wrong. In her absence, Crane helped explain to them the struggle Billings faced.

Billings spent much of her time at the University of Vermont Medical Center in Burlington, receiving treatments to clear mucus from her lungs. She was frequently attached to a 20-pound oxygen compressor she dubbed Mildred and dragged around nearly everywhere she went.

She knew she needed a double-lung transplant. At only 4-feet, 10-inches and under 90 pounds, Billings had to wait for lungs that fit her tiny frame. One hospital turned her down for a transplant because she had harmful bacteria that made the surgery too risky.

To receive a double-lung transplant, Crane noted, the patient needs to be sick enough to warrant the surgery but strong enough to handle it, with a good prognosis for survival.

"You have to be in this horrible sweet spot," Crane said.

A platform for Miss Vermont

While Billings waited to qualify for a double-lung transplant, Crane adjusted her life. She felt helpless watching her best friend struggle with cystic fibrosis.

"When you love somebody, you want to take away their pain," Crane said. The best way she could help, she found, was by campaigning for Miss Vermont, and using that as a platform to encourage organ donation.

"Mentally it helped me process everything that was going on," she said.

Billings, who herself had competed for Miss Vermont in 2010 and 2011, attended each pageant as Crane continually finished in the top five but fell short of winning. Crane was discouraged by her near misses but told herself that if her advocacy through the pageant for organ donation helped one person, it was worth continuing.

Crane won on her fifth try last May. Billings was too sick to attend that pageant. Crane came to her hospital room right after to celebrate.

It had taken Crane five years to win Miss Vermont. Now it was Billings' turn to realize a dream she had been striving to make come true for the past five years - to receive new lungs.

Miss America, and a new set of lungs

Massachusetts General Hospital in Boston declared Billings eligible for a lung transplant in February 2018, the day before National Donor Day. In September, Crane competed in the Miss America pageant, where she won the Miss Congeniality award. On Oct. 15, Billings received the call that a pair of lungs was available.

She went into surgery in Boston at 4 a.m. Oct. 16. She'd been told to expect the surgery to last 12 hours. She was out of surgery by noon.

Crane visited her at 4 p.m. Doctors took Billings' breathing tube out at 7 p.m., and she drew her first independent breath with her new lungs.

"She was like, 'Julia, on my first breath I could tell I was breathing so much better,'" Crane said.

Less than seven months later, Billings and Crane told their story over breakfast at The Skinny Pancake in Burlington. Billings ate a plate of well-cooked eggs; raw eggs and other uncooked foods are among the no-nos for her diet.

"I still cry if I see cake batter around me, because I can't have cake batter," Billings said.

She's on a host of anti-rejection drugs. Otherwise, her quality of life - and that of Crane, her best friend - has improved in seemingly infinite ways.

"My path," Crane said, "has changed for the better."

Changed by a friendship

Crane is a University of Vermont graduate and seventh-generation Vermonter; her great-grandfather, Edward F. Crane, was executive editor of the Burlington Free Press in the mid-20th century. Crane is a crisis clinician for the Howard Center and thought she'd become a transplant surgeon.

Her time as Miss Vermont, and especially her time with Billings, put her on a new course. She has visited every county in Vermont, 12 states and two countries as Miss Vermont, appearing at numerous organ-donation drives urging people to "be a hero, be an organ donor."

Crane has heard from many people who donated a kidney or received a heart or the gift of sight. A staff member at Central Vermont Medical Center told her that, after Crane's appearance at an organ-donation drive there in February, the family of a young person who died donated the youth's organs.

Her tenure as Miss Vermont has shown Crane that she could change lives as a surgeon but can maybe touch even more lives as an advocate. She's thinking of going to law school and getting into public-health policy, where she could continue to campaign for organ donations. She's contemplating politics.

"Courtney has helped me realize I'm destined to make a bigger difference," Crane said. "Just take action to make a difference. One voice can impact the lives of many."

Billings, Crane said, has dealt with her lifetime of health problems with good cheer and optimism. "It takes a very particular type of person to not only face what Courtney has faced, but to face it with a smile," Crane said. Their friendship, according to Crane, "literally has changed me. I would be a very different person without her."

New lungs, for Shawn Mendes

Many of the changes in Crane's life are yet to come. Billings has already seen dramatic change in her life since her surgery last October.

"Without my organ transplant," she said, "I probably wouldn't be here."

A year ago, Billings was raising money online to defray her family's costs for lodging, travel and other expenses related to her hospitalization and declining health; if all else failed, she figured, the money would cover her funeral costs. She didn't have candles on her birthday cake last Sept. 7 because she probably wouldn't be able to blow them out. She thought that birthday might be her last.

Now, with the support of her family and best friend, Billings is enjoying the present. Her lung capacity had dwindled to 21 percent function; now it's at 72 percent - well below the average person's 90 to 100 percent, but greatly improved. Billings still has cystic fibrosis and the doctors haven't given her a long term prognosis, other than to keep doing what she's doing.

She plans to blow out birthday candles this Sept. 7. She's not ready for Mount Mansfield, but she is hiking again. She's even learning to run.

"I have to be cautious," Billings said, "but I can do so many more things." She only had two sleepovers at Crane's family's house in Colchester before her surgery but has had seven since.

"When you have a life with this invisible disease you have to find the bright spots," said Billings, who now lives with her mother and two dogs in St. George. "I find so much more meaning in the small things."

Billings has tickets to see singer Shawn Mendes in Boston this August, just before her birthday. Crane said her friend told her "The only reason I'm getting lungs is to see Shawn Mendes in concert." Billings plans to hold up a sign at the show telling the singer, "I got lungs for you."

She's dreaming of a future now. She can go to college. She can get a job. She wants to work with animals. She might become a veterinary technician.

"I'm not really sure," Billings said of her future. "There's so many possibilities."

Online: https://bit.ly/2WfRuC7

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Information from: The Burlington Free Press, http://www.burlingtonfreepress.com