I had 20 years of panic attacks about death – but when I found out I was dying, they stopped, says Deborah James in book
DAME Deborah James seemed fearless in the face of incurable cancer.
But for much of her life, the inspirational Sun columnist, who died in June aged 40, actually struggled with crippling anxiety.
Today, in extracts from her posthumously published new book, she reveals how panic attacks almost stopped her from living — until she found out she was dying.
“I’VE lived with anxiety most of my life.
“I’ve been through periods of incredibly frequent, crippling panic attacks — one of which caused me to flee a changing room in the Karen Millen store in Covent Garden, ending up on the busy London street in just my undercrackers.
“I often woke up in the middle of the night already in the grip of an episode, believing my body was dying.
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“The great irony, of course, being that when I was younger and not facing death, my fear of it was so uncontrolled that quite often it stopped me from living.
“I stayed at home when I should have been out enjoying myself, I missed holidays because of my fear of flying. Do you know what finally “cured” me?
“The worst happened and my fear was realised — I was told I had incurable cancer and that I would die.
“I had no choice any more — I had to look my biggest fear straight in the eye. I’m not, of course, suggesting for one second that if you have panic attacks there is nothing to be done unless you receive an incurable cancer diagnosis which will sort you right out.
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“But honestly, for me, that diagnosis did something that nothing else had.
“On paper I could have — and perhaps should have — had an absolute breakdown, the panic attack to end all panic attacks. But instead, my anxiety levels dropped.
“When I was forced to confront what I’d spent 20 years worrying about, something shifted in me. I had no choice but to overcome my fear and anxiety about death.
Absolutely petrified
“I had to face my worst-case scenario. But in having to, I realised I could. I didn’t realise my strength until I had no choice — my fight to live was stronger than my fear of death.
“People often tell me, very kindly, that they think I’m brave. But I don’t think of myself like that. When you find yourself in a horrible situation like mine, you don’t have a lot of choice but to just get on with it.
“I think I’m only doing what any of us would do. It comes down in large part to motivation. You never think, “I’m going to keep going because I’m brave.” You keep going because you’ve got something to keep going for.
“One Friday, I was in hospital and my interventional radiologist had to put in an emergency drain to help clear my bile duct. It was the classic situation just before the weekend in a hospital — everything is rushed, so there was no time for me to be sedated or to receive any of the nice drugs that make it all OK.
“He just had to go ahead and put the drain in, and afterwards he said: “Deborah, you’re more hardcore than any of us give you credit for. You didn’t even flinch.”
“I said: ‘Well, we just had to get the job done’, and he replied, ‘I know, but I have had grown men cry on me!’
“When people tell me I’m brave, my response is usually: “What else can I do? If I don’t let the doctors do what they need to, I will die.”
“When you don’t have a choice, you just close your eyes and grit your teeth and get on with it.
“As anyone who has faced a life-changing diagnosis or who has been called on to confront their fears will know, you can be scared and brave at the same time.
As anyone who has faced a life-changing diagnosis or who has been called on to confront their fears will know, you can be scared and brave at the same time.
Deborah James
“I am still absolutely petrified a lot of the time. Of course I am. But I am also able to endure even the scariest things that happen to me.
“In early 2022 I almost died following a medical emergency related to my cancer. My treatment had been stopped for four months at the end of 2021 because of a bout of colitis.
“Despite this, I’d enjoyed a lovely Christmas with my family and was ready to start chemo again in the new year.
“In the run-up to my appointment at the Royal Marsden on January 6, a blood test showed that my liver function was dangerously out of kilter, and further investigation revealed that the tumour around my bile duct had grown during the gap in treatment and was now blocking it.
“Thankfully, it was operable, and I was booked in for the next day. That evening, I started to feel very unwell. I ran to the bathroom and began to vomit large volumes of fresh blood and clots. It was terrifying.
“I was extremely dizzy and on the verge of passing out, but I managed to call an ambulance.
“I could barely get the words out to the emergency call handler at the other end of the phone. I was simply pleading for help.
“My husband Seb arrived home to find me in this state, and it’s just as well he did. He bundled me in the car and sped me to Chelsea and Westminster Hospital.
“On the way, I was just about holding on to consciousness.
“I couldn’t stop thinking that if the A&E staff didn’t know my complex medical history, they might presume I was beyond saving, so I somehow managed to phone my interventional radiologist, Nicos Fotiadis, who had operated on me multiple times by that point, to tell him where I was headed.
“Thankfully, he was on call and told me he would see me there.
“On arrival, I was bustled into resuscitation, where the amazing staff on the crash team managed to stabilise me after hours of it being touch and go.
Break that cycle
“The liver failure had caused the rupture of my portal vein — the main blood vessel that drains blood from the spleen and gastrointestinal tract to the liver — and swollen veins in my oesophagus, known as varices, were bleeding.
“Both needed to be dealt with if I was to stand any chance of survival.
“The portal vein was operated on that night by Nicos — I was awake throughout the procedure as I was too weak to take a general anaesthetic.
“Then, the following morning, the ruptured varices were repaired.
“Over the following days, I had an allergic reaction to some of my drugs, but they soon managed to find ones that my weakened body could tolerate, and the blocked bile duct — the initial cause of my problems — was also fixed.
“I spent ten days in hospital not knowing if I would ever leave.
“Following the trauma of this event, I was utterly lost again and didn’t know what to do with myself.
“I didn’t trust my body, which is very common when you have been through health trauma or have a serious, life-threatening illness.
“You can second-guess every movement and action, with the result that you are then too scared to step outside your front door.
“You become trapped in a cycle of vicious thoughts and fear.
“For me, the only way to break that cycle is to recognise it and move on — that’s my strategy.
“Following my traumatic experience, I forced myself to go out for a walk — that was the first baby step. It was a new day, and I thought, ‘I’ve got too much going on in my life to die now’.
“I see now that that’s a kind of courage, because sometimes the hardest challenge is learning to live again, especially when everything was telling me that what I was facing was almost insurmountable.
“But if you’ve got a one per cent chance of living, that’s something to hold on to. A one per cent chance is better than nothing.
I hit rock bottom
“However, the challenges kept coming.
“My cancer had advanced to the point that it essentially meant my liver had stopped working, and the next four months or so were mainly spent in hospital.
“I hit rock bottom so many times, and I don’t know how often I said to myself: “I don’t know how to do this. My body is smashed.”
“And then the point came in May 2022 when it was clear that there was nothing more the doctors could do for me.
“My body was too weak to cope with the interventions needed to turn my liver function around, so my family and I came to the heart-rending decision that it was time for me to go home to my mum and dad’s and receive hospice care.
“Despite always knowing that this day would come, it was still completely devastating to realise that my time was coming to an end.
“But even then, I hung on to the fact that I was doing things on my own terms — even at the end of my life.
“There is no magic recipe for bravery, no secret weapon for facing up to something you never could have imagined.
“Being courageous is really hard. When you feel like a ticking time bomb and it’s catching up with you every single day, it is utterly terrifying.
When you feel like a ticking time bomb and it’s catching up with you every single day, it is utterly terrifying.
Deborah James
“I can feel my body breaking down and, particularly recently, it is becoming hard to live every single day. I don’t want people to see me.
“I don’t want people to see my demise, because I find it really heartbreaking myself, let alone what it must be like for them.
“But I’ve found a way to keep going, just like I did when I suffered so badly from anxiety.
“Then when the worst happened and I was moved to hospice care, although I was terrified, I found a way to carry on.
“I thought, ‘OK, I’ll just get through today.’ I’m not sure I’ve really considered that I was being brave.
“It’s just that the alternative was no picnic either, and if I thought too much about the big picture, I’d have been completely overwhelmed.
“To me, bravery in that kind of situation is really just continuing to take small steps in the direction you want to go, even when you’re scared.
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“You don’t feel like you’re doing anything special. You’re just doing what you think you need to at that time.
“It’s only when you look back that you appreciate that each of those small steps took courage. The truth is, we are all braver than we realise. ”
