The brevity and beauty of each day

Dame Deborah James received much attention and praise for her tireless campaigning on bowel cancer, particularly in the last months of her life. Her blog 'BowelBabe' which I, along with thousands of others followed on Instagram, documented her journey with incurable cancer – detailing the realities of being a patient, but also demonstrating Deborah's infectious positivity. Her book, How to live when you could be dead, was completed towards the end of her life and captures what I imagined Deborah to be like as a person. Littered with anecdotes, evidence-based approaches to support living through adversity, and her lived experience, the reader goes on an incredible journey with her.

Early on, Deborah acknowledges that her approach to adversity is her 'greatest weapon'. When we consider the factors that facilitate resilience, we can see that Deborah's rebellious hope, passion for life and drive to make the world a better place enabled her to make sense of, and even be positive about, possibly the hardest thing a human must endure: living every day with their mortality thrust in their face.

We learn more about Deborah before cancer too; her struggles with anxiety, her career, beloved family, and passions including fashion and makeup. I really enjoyed these parts of the book, as I was able to imagine who she was, and relate to her as a young, passionate woman. When people are given a diagnosis such as incurable cancer, often others can lose sight of the entire person, instead focusing on the illness and its impact on the person and their family. What Deborah does really well in her book is ensure that the reader holds on to who she was: flawless lipstick, fabulous dance moves and floral dresses, with and without cancer.

A key concept through the book is hope, which for many Deborah embodied. Hope can be infectious, and as I read on, I noticed the hope mindset becoming more ingrained in my own mind. Deborah helps us to understand how our mindset can have an impact on our mood and overall wellbeing. She gently embeds psychological concepts and explanations in an accessible way, including principles from Cognitive Behavioural Therapy, Compassion Focused Therapy and Acceptance and Commitment Therapy. In doing so, this book becomes a useful toolkit for living, which I believe makes this a valuable read for all.

Deborah recognises that we often don't stop, pause, and reflect. We live on a treadmill of constant deadlines and life moves quickly. As a result, it is often when one is floored due to a life-changing event, that we stop to take stock. She urges us to stop and reflect on what's important before then, so that when life gets difficult we can look back and feel that we made the most of our circumstances.

Working at the Royal Marsden cancer hospital during my final year of clinical training, I recognised how much hope and optimism people living with cancer can possess, and how much effort they make to live every day. Seeing this first-hand prompted me to reframe my understanding of what cancer or any incurable condition must mean. Stepping away from the prescribed social narrative, I became aware of the brevity and thus beauty of each day, the 86,400 seconds we each have every day, as Deborah puts it. As a society, we tend to shy away from discussions around illness and death. These topics can evoke a range of difficult emotions, understandably. Deborah has created a space in our society to address topics such as cancer and death, without the familiar doom and gloom being attached to it.

This is a book written by someone who had incurable cancer, yes, but it is so much more than what happened to Deborah after her diagnosis. It is a lifetime of her personal learning and growth, and a gift to us. Whilst Deborah is tragically no longer with us, her spirit and wisdom shine on in this book and her BowelBabe legacy. She may never see the impact she has had, but you as a reader can have a little slice of her rebellious hope through her writing. I laughed, smiled, and cried whilst devouring this brilliant book and I hope you may take the time to feel those emotions and more as you read Deborah's brilliant closing thoughts.

Reviewed by Dr Talia Drew, Clinical Psychologist