How TikTok doctor Julie Smith had to rewrite her own rules on coping in a crisis after she was diagnosed with breast cancer
I meet clinical psychologist Dr Julie Smith in a busy London café. Small, slim and pretty, she looks younger than her 40 years. Although she is surrounded by people, nobody pays any attention to her, which is strange because Smith is an internet phenomenon. Her videos are watched by more than eight million people via TikTok, Instagram and YouTube. They range from ‘how to know if you’re burnt out’ to ‘are your friends really your friends?’.
Not only that, her first book, Why Has Nobody Told Me This Before?, published in 2022, has sold more than a million copies in the UK and was on The Sunday Times nonfiction bestseller list for 42 weeks, 23 of them in the number one slot. It was also translated into more than 40 languages.
Yet there was a moment, in March this year, when she thought she might not survive. ‘Everything in my life was going so well and then one day I found a lump in my breast.’
‘I’m usually clear-headed but I felt muddled. I didn’t want to tell anyone’
At first Smith wasn’t worried; she’d had biopsies for lumps before. (I ask her if there’s a history of breast cancer in her family – hence the biopsies – but she says there isn’t.) She usually gets everything checked quickly but, because she was finishing her second book, Open When…, and on a six-week deadline, she almost didn’t get the lump looked at.
‘I was so close to finishing the book and I think I was pressuring myself to do it. The first one had been so successful, there was a sense of momentum and I was enjoying writing it. The idea that I had to stop and go and do something, when I didn’t know what the outcome might be, made me not want to do it. A part of me thought it probably wasn’t anything and did I really need to go? But another part of me took over and I told myself I had to go.’
She stopped writing the book and, two weeks after finding the lump, she went to her doctor for tests. ‘A week or so later he rang and said he had the results and could I come into the clinic. When I arrived, there was also an oncologist there and that’s when I knew.’
Was it frightening? ‘It was terrifying, yes. It’s hard to put into words when you know you’re about to hear something you don’t want to hear, that is potentially life-threatening. Everything goes into some sort of slow motion.’
Smith had early onset breast cancer.
Dr Julie Smith has almost eight million online followers
‘I hadn’t expected that,’ she says. ‘I was in shock. I’m usually clear-headed, but I felt muddled. I didn’t want to tell anyone, but I knew I had to tell my publishers and they were supportive.’ She says it’s difficult knowing who to tell and who not to, because by doing that you’re making it real – and there was part of her that didn’t want that.
‘You go into this sort of alternative universe whereby you feel alone, even though you’re not alone and lots of women have been through what you’re about to go through.’
Did she feel scared? ‘Absolutely. I’d already written a chapter [in the second book] on fear, but I realised I needed to rewrite it because I hadn’t fully experienced this sort of fear where you actually think you could die. I deleted the entire chapter and started again.’
She was only 39, with three children under 11. ‘My husband Matthew and I decided not to tell the children at first because, until we had a treatment plan, there wasn’t anything concrete to say and I didn’t want them to feel worried.’
What did she discover about herself?
‘That it is easy to fall into a pit of despair and inaction. It’s an overwhelming feeling. It’s also unlike me. For a couple of weeks I couldn’t do anything much. I wasn’t even sure if I was ever going to do anything much.
‘I woke up one morning and almost had to shake myself. I was ceasing to recognise who I was. I realised that the only thing I could do was to force myself to get active. I got practical about my cancer. I got second opinions. I did research. I poured myself into understanding what was going on. I rewrote the chapter on fear from the place of someone who realised that sometimes you’ve got to give yourself a hard talking to.’
Smith usually keeps herself private on social media, but she decided to share her diagnosis. ‘I want to encourage women not to ignore early signs of breast cancer.’
She had two operations to remove the lump in July and was told she didn’t need chemotherapy or radiotherapy, for which she is grateful. ‘The key to the fact that I am now cancer free is that I took action early. This is what I want women to know.’
I’m not surprised by this, because as a doctor she is focused and proactive. Her videos on mental health may be short, but they’re concentrated and science-based.
She wrote her first book so that people could find help and support. But when they write to her saying it has saved their lives, that they carry their copy around with them and use it every time they feel upset, depressed or anxious, it worries her. ‘It feels like a huge responsibility. I didn’t expect it to be used as a replacement for other things that I feel are important.’ What, does she believe, are those other things? ‘Therapy, medical diagnosis, friends and family, the community.’
Smith lives outside Ringwood in Hampshire, where she grew up with her parents and two sisters. She met Matthew at school when she was 12. It took him ten years to ask her out, but once he did that was it.
It’s this base of family and community that keeps her grounded. ‘I’ve got my ego in check,’ she says. ‘I’ve worked hard on not being affected by what other people think of me.’
When she started posting Instagram videos in 2019, she was one of the first people to do bite-size therapy online. Was she concerned that other therapists wouldn’t take them seriously?
‘Yes, I was concerned,’ she says. ‘The therapy world is full of rivalries and opinions, but I’ve learnt to do my thing and be good with that.’ She still sees some patients but they’re ones she’s had for a long time and she doesn’t accept referrals. ‘Taking on patients is awkward when you are getting well-known. I’m no longer a blank slate.’
Her success hasn’t changed her. ‘In many ways I’m still the introverted child I was when I was growing up.’ Neither does she venture into musings about the universe. In fact, she actively worries that people have got hooked on affirmations and manifestations.
‘The problem with that,’ she says, ‘is that looking into the mirror and telling yourself that you are lovable may not change the fact that you don’t believe it. So then you go into shame and guilt and that is not healthy.’ What she does advocate is becoming the best champion of ourselves that we can be.
This commitment to helping people help themselves is central to Smith as a person. I don’t imagine she ‘does’ drama.
‘I would have agreed with that until I had my cancer diagnosis,’ she says. ‘My sense of self was challenged because it’s scary. But I pulled myself out of that place and realised how important that is when you are facing fear. You need to find the strategies that help.’
Then she says she has to leave, and off she goes. And not a single person in the café bats an eyelid as this internet sensation slips off into the night.
Open When… A Companion for Life’s Twists and Turns by Dr Julie Smith is out now (Michael Joseph, £20). To order a copy for £17 until 12 January go to mailshop.co.uk/books or call 020 3176 2937. Free UK delivery on orders over £25.
