Elizabeth Boyle

Running is a “spectacular balancing act,” ESPN journalist Kate Fagan writes in What Made Maddy Run. “A runner is always attempting to control everything—time, energy, form, workouts, food intake, hydration.” At the college level, distance athletes often have a team of experts helping them perform this balancing act. As a Big Ten distance runner, for example, I worked often with athletic trainers, sports medicine doctors, nutritionists, strength and conditioning coaches, equipment managers, academic advisors, and compliance officers. Only after I finished my eligibility, though, did I find out our team had access to a mental health professional. Mental health, most athletes learn, is an essential part of the balancing act, but it is also something rarely talked about.    

What Made Maddy Run is Fagan’s response to this lack of conversation about mental health in athletics and on college campuses generally. Specifically, What Made Maddy Run tells the story of Madison Holleran, a University of Pennsylvania varsity distance athlete who committed suicide in 2014. Fagan weaves reflections and anecdotes from her own life into Maddy’s story, too, but the book also covers a range of subject matter beyond the personal. What Made Maddy Run examines general attitudes toward mental health, the pressures college athletes and college students at large continue to encounter, how social media can negatively impact mental health, and how to talk and write about suicide.

Effectively addressing all of these subjects in a single book is a challenging task, and Fagan runs into a few problems attempting to do so, namely issues related to depth and nuance. Despite its weaknesses, however, What Made Maddy Run succeeds in its stated purpose: to serve as a starting point for conversation about athletes and young people struggling with mental health. In particular, Fagan uses the scope of the book well to show how Maddy’s story is not about a singular moment. It is, foremost, about the life that was lost and, most urgently for readers, about the culture in which that life was lost. This is why What Made Maddy Run is important: because mental health misunderstandings and stigma, within athletics and outside of it, are still pervasive.    

I admit, I approached the bookwith some wariness. The book’s full title, What Made Maddy Run: The Secret Struggles and Tragic Death of an All-American Teen, struck me as something akin to clickbait, the subtitle sensationalized, redundant, lacking the restraint appropriate for the subject matter. Chapter titles such as “Shattered” and “The Collapse” led to more wariness. In actuality, none of these titles reflect the care and compassion Fagan employs in her work. Consistently, Fagan writes Maddy’s story with both intentionality and with empathy.

“Hi sweet mother of sweetness I’m doing well thanks!!” Maddy greets her mother in one text message Fagan includes in the book; “i can do this . . . SETBACKS ARE NEEDED TO GET STRONGER,” reads a note from Maddy’s iPhone. “But I just don’t want the team to HATE me. Like completely hate me,” a different text reads. Such communications from Maddy, reproduced throughout the book, show readers a person who is playful and resilient but also insecure. In her own words, too, Fagan portrays Maddy as a capable, multidimensional teenager—one who also struggles with mental health. “When she was with her friends, Madison found it much easier to pretend she was mostly fine,” Fagan writes. “She had always been the axis around which all of them rotated, the one who directed their social calendar, made sure they ended up at the right parties. Maddy was always on her grind, when it came to both work and play.”

If Fagan’s depiction of Maddy provides readers and writers with guidance on how to approach conversations about mental health and suicide, structurally, the book prompts readers to consider where the major entry points into the conversation are located. While the book begins with the retelling of a drive Maddy and her father make to Penn, it frequently steps back from Maddy’s story. In ensuing pages, readers find interviews with mental health advocates, results of academic studies, and data snippets from athletic organizations in addition to reprints of Maddy’s emails, texts, letters, and social media posts—all of which speak to mental health culture in digital, societal, athletic, and college campus contexts. In short, the structure of the book itself responds to the question, Why did Maddy commit suicide? The answer: “there is no one thing.”

The downside of the book essentially embodying the answer to this question is that depth and nuance are sometimes sacrificed for breadth. For a book centered around a Division I distance athlete, for example, little time is spent on the varsity running world. Running culture is not the focus of the book, except that the unique demands of every sport create unique challenges. In women’s distance running, for example, eating disorders are pervasive at every level. In 2002, I ran my first high school cross country race. Fifteen years of involvement with the sport later, I have yet to encounter a women’s high school, collegiate, or professional team unaffected by eating disorders. Fagan gives a nod to eating disorders in Chapter Six, “Size Nothing,” but largely leaves the issue unexamined. Regardless of whether Maddy struggled with one, and we don’t know if she did, the negative impact eating disorders can have on team culture generally is significant. Without an understanding of sport-specific particularities, it can be difficult to distinguish the mental health issues inherent to a sport from the mental health issues inherent to a particular athlete—issues that may have drawn the athlete to the sport in the first place. It can be difficult, in other words, to fully grasp how the different subjects presented in the book overlap and complicate each other.

Consequently, it is worthwhile to note Fagan is a Division I basketball athlete and self-described “fairly mentally healthy” person. In two relevant senses, she approaches Maddy’s story as an “outsider.” If the intended audience is the general public, and arguably it is, then Fagan’s “outsider” perspective is valuable in that she uses it to make the book’s subject matter accessible to a wide range of readers. In other words, Fagan uses the “outsider” perspective as cause for asking many seemingly simple, but important questions. “How can we be more responsible when talking about suicide?” Fagan asks Dese’Rae Stage, photographer and suicide awareness activist, in an interview in Chapter Ten. “It’s about reframing the suicide story to be about the person’s life,” Stage responds.

Still, the “outsider” position also presents significant challenges (the distinction between insider and outsider itself sometimes a false idea). Some of the most interesting lines in the book come from an interview with Megan Armstrong, a journalist who speaks personally to anxiety and depression. “Feeling better actually feels worse sometimes because I feel pressure to never feel bad again, which is inevitable,” Armstrong explains. Such complex realities are impossible to get right for Maddy’s story without Maddy’s own voice. Similar to the social media posts that fill the book’s pages, What Made Maddy Run can only ever be one version of Maddy’s story.

As to relationships with family and friends, the version of Maddy’s story Fagan tells is an overwhelmingly positive one. While avoiding the mistake of equating failure to prevent suicide with blame, What Made Maddy Run never quite delves into the toll mental health issues can have on even the most loving relationships—the toll even the most loving relationships can have on mental health. Assumedly and admirably, this is Fagan being protective of Maddy’s family and friends. Intentionally or not, it is also Fagan asking readers, and especially writers, to consider the value and price of “using” reality to create.

Running is a “spectacular balancing act,” Fagan writes. In fact, the same could be said for What Made Maddy Run. Yes, the book has its weaknesses: the more distant understanding of collegiate running culture is felt throughout, as is Maddy’s missing voice and the resulting lost nuance. Still, the book sheds light on a range of important subjects, and its compassionate tone, ambitious scope, and engagement with tough material provide readers and writers with both guidance and questions for a continued conversation about mental health and suicide. 

What Made Maddy Run: The Secret Struggles and Tragic Death of an All-American Teen
by Kate Fagan
Little, Brown and Company, 2017
$27 Hardcover; ISBN: 978-0-316-35654-1
320 pages

Elizabeth Boyle is an MFA candidate in fiction at Indiana University and graduate of the University of Michigan Law School. Formerly, she was a Division I and professional distance runner and assistant Division I coach.