Patient Justin Hills is every nurse's worst nightmare
Justin Hills is way more comfortable standing over the stretcher than laying on it, but that's exactly the position he's found himself in after being diagnosed this fall with Hodgkin's lymphoma.
Hodgkin's lymphoma is a cancer of lymph tissue found in the lymph nodes, spleen, liver, and bone marrow, among other sites.
In Hills' case, his lymphoma was found in his neck.
"I had a bump on my neck for almost a year, and it kept getting bigger and after enough prodding by Julia and Samantha, I had it checked," said Hills.
"Julia" is Camden First Aid Association EMS Chief Julia Libby, also known as Hills' boss. "Samantha" is Samantha Quinn, Hills' girlfriend of about 12 years.
Hills is unabashedly stubborn when it comes to his own health. As far as he — and the growing bump — was concerned, he could breath and swallow fine, so he was fine.
For emergency responders like Hills, ABC is their mantra. A = airway; B = breathing; and C = circulation. The priorities of first aid are airway, breathing and circulation (also bleeding), and only after checking those vitals are they supposed to move on to look for burns, broken bones and other possible sources of injury.
Hills is 39 and was born and raised in Union. Now he lives in Lincolnville with girlfriend Quinn and son Alexander, 14-1/2, who Hills said has called him Dad since the age of 2. They also have a pair of Labrador retrievers, 7-year-old Opie (yellow) and 9-year-old Griffin (chocolate).
Many in the communities of Camden, Hope, Lincolnville and Rockport, among other towns, know Hills as the really "big guy" who works for Camden First Aid Association. For those wondering, he stands 6 feet, 7 inches tall and weighs about 300 pounds. When there's a combative patient in the wings, it's a good thing to have Hills around.
He has been with CFAA for a dozen years, having left Camden and Rockland police departments at 26 to embark on a different kind of emergency responder career.
"After being a cop for a couple of years, I wanted to give back to my community," said Hills.
Growing up, his father was a firefighter and he fondly remembers riding with him in the big red truck, lights flashing and sirens wailing. It was a big adrenalin rush for him, he said.
"Wait, I'm still like that," he said. "I enjoy the big trucks, the lights flashing and the sirens, too. And the adrenalin rush I still get."
He learned cardio pulmonary resuscitation and started out at CFAA as a volunteer driver, and then joined full time, back in the days when EMS personnel lived at the old Camden fire house five to seven days and nights a week, each shift.
"Laurens Adams from Islesboro and I lived and worked there to offset the cost of rent," said Hills.
His education and training was inhouse and on the job. Each new skill he learned in classes held at CFAA through Kennebec Valley Community College. As all paramedics do, he first earned the Emergency Medical Technician-Basic designation, then EMT-Intermediate, and finally EMT-Paramedic.
It took approximately 18 months to complete the training to become paramedic-certified.
"2013 will be my sixth year as a paramedic," said Hills.
He said his most memorable call was in August 2005, when Ron Dupler of Rockport was found slumped behind the wheel of his car on the side of High Street in Camden.
"Here was my former instructor, my former teammate, and here he was, coded behind the wheel," said Hills. "He taught all the classes and taught me personally and here I am pulling up and seeing him there. We ended up saving him. He walked out of the place [hospital], even though he wasn't in a good way and had so many issues afterward."
Everyone working to save Dupler that afternoon knew him. He had either taught the EMS providers how to perform CPR or trained them on the newest device to start a stopped heart, called an automated external defibrillator.
Dupler died March 10, 2007, from complications of a massive heart attack he suffered Aug. 3, 2005. The heart attack happened just nine minutes after he had driven off the ferry from Islesboro, where he had spent the day teaching first aid to emergency responders on the island. He had been an emergency medical instructor since the 1980s and in addition to regular gigs through the Midcoast, had taught on just about every island in Penobscot Bay.
Hills loves to teach, like Dupler. He also likes to be in charge when a call comes in.
"My first call as a licensed EMT on duty was a two-car, head-on crash on Route 17 by Grassy Pond," he said. "There was one person dead when I got there, another taking a last breath and a third person trapped behind the wheel on his cell phone, calling his family. Wow, it was a lot to take in, but my training kicked in and I assessed real-quick what to do and who to tend to first."
Hills said the public's expectations have changed over the time he has served on the job, adding that people just don't understand the difference license levels.
"Everyone wants the paramedic, not the basic level EMT," he said. "You're either a driver or a paramedic, nothing in between. But being able to render aid falls back on what you learned as a basic EMT. Compressions and breaths are always first. Is there a shock-able rhythm? We all ask those questions first, basics and paramedics. The difference is that a paramedic can do more procedures if you're more hurt, and can administer more drugs, that's all. Heck, the layperson can do the basics with minimal training, it's that basic."
Back to teaching, Hills said he loves being in front of a room full of people, with everyone listening to him.
He commands attention, yes, with his sheer presence and a deep resonating voice. But he's childlike and friendly too, in his ready willingness to get down on the ground and help someone learn exactly how to do something right, something that can save a life.
Of all the classes he's taught, the memories of teaching CPR classes, which he has taught for nine years, linger longest, he said.
"I realize I have reached people in a different way than I ever could as a cop," he said. "As a cop, people shied away from me. As an EMT and teacher, people come up and tell me great stories about how I helped save their uncle or how they were able to save their family member using CPR I taught them. Oh my god, what I go out and teach made a difference. And it's all the people I get to meet, too. I love it."
But put him on a gurney and make him stay in a hospital bed, with an IV flowing fluid into his arm and he's a different person.
"Noncompliant," said Hills, straight-faced, deadpan, when asked how he is as a patient at Pen Bay Medical Center since beginning chemotherapy treatment in September.
"I have new respect for what patients go through on the receiving end," said Hills. But it still doesn't change his attitude about his own health.
"I'm not bedridden when I'm there for treatment or for a complication," he said. "I'll walk down the hall, me and my IV pole, I'll go outside for a walk, and I'll invite the nurses to go with me if they give me the look. My attitude is I'm perfectly healthy, I made my hospital bed today, I cleaned up my food tray, don't try and stop me. I do those things to keep busy, I don't like being confined. That's why I love this job, it's the best of both worlds. I am able to teach and learn administrative work and I still get to go on the ambulance with the lights and sirens and be a kid again."
Hills' lymphoma is a Stage 2, meaning that the infected area stayed above his diaphragm and that it is "very curable." He had a biopsy of the lump to determine it was positive for Hodgkin's. He also had a positron emission tomography scan of his neck, and it showed numerous smaller internal lumps, which are being treated with the chemotherapy.
The therapy treatment is administered every two weeks and began Sept. 24. Hills knows this because he noted the date on his computer. He notes everything on his computer, or his smartphone, these days.
"The computer is my brain now," said Hills. "I forget if I don't write it down or put it in the computer, I didn't know about chemo-brain until now, but I have it."
Hills, who said earlier that he likes to be in charge, said his oncologist is now in charge, and he likes it.
"She tells me when and where and how things will be," said Hills. "She told me, 'You called me because you can't deal with this problem, and I'm now in control.' I like that, because I can identify. It's how I am in the back of the ambulance when people try to turn it around on me. I tell them, you called me because you have a problem, and I'm here to help you with that, so you need to let me do my job."
Treatments are a five-hour "ordeal" that involve blood draws, administering of the chemotherapy and other drugs he has to have to counter what the chemo drugs do to his body. Every two weeks now signals the end of a good week, because even on the good days following chemotherapy, Hills said he tires easily. As the buildup of chemo in his body increases, so too does the aftereffects.
"It affects everybody different," he said. "At my size, I'm used to being in control, bowling through whatever I need and want to. It's hard to fathom that the stuff in the bag going into me can take me down so much, but it does, like David and Goliath."
The original plan included four treatments, two sessions per treatment, then another PET scan to see if the spots in his neck are gone. If they aren't, then he'll have to move to radiation treatments.
"Whatever happens, happens. Whatever it is, I'll deal with it. It's like a flu bug to me. But I like to take a positive spin on everything. I keep my routines normal, I try to continue to attend meetings, I just may not last through till the end of them. I live for my good weeks now," said Hills. "I asked to have my chemo on Tuesdays, so I could still play basketball with the guys on Monday nights."
These days, his work at CFAA means tending to more of the administrative work and attending meetings in his boss' stead. But Hills likes it, and said he's fortunate the organization is working with him, telling him to come in and do what he can.
"It's therapy for me to still come in, to spend time with the people at Camden First Aid and at the fire station in Lincolnville," said Hills. "But it's hard not being in control. I can't tell my body what to do anymore, it's telling me, and that's hard."
Knowing that his family and friends were urging him to have the bump on his neck checked for nearly a year, the obvious question to ask Hills is "would he do anything different, knowing what he knows now?"
He paused every so briefly, and then said: "No, I would do the same thing, I would contend that I don't have to deal with it if I keep blowing it off. But that's made it harder for those closer to me to deal with this than for me. Part of the reason I deal this way is because I'm invincible. What's going get me? When everyone else is running away, I am going in. It's hard for me to step back and look at it any other way."
But then he says, he has come to realize that he needs to not overdo things in either place, home and work, so he can still have "both worlds."
"I need to have normal in both places, which is me always trying to do for others," said Hills.
Five years from now, Hills sees himself, hopefully, at least one office closer to the chief's office at the other end of the hall.
"My desk used to be in the bay with the trucks, now my office has a wall with windows overlooking the bay, and I also have a window now that looks out on the yard," said Hills. "I want to still go out on calls, pull people out of Quarry Hill, ride with the Coast Guard to Matinicus and climb Mt. Battie to help injured hikers, but I also want to work on protocols and policies, and teach, as well."
"I don't want to lose patient contact as I hope to move up. For 12 years I have been first out the door and on the truck, I don't want that to change," said Hills.
Editorial Director Holly S. Edwards can be reached by email at email@example.com or by calling 207-706-6655.