Alberto Salazar in 2015.<\/span> Photograph: Christian Petersen\/Getty Images<\/figcaption><\/figure>\nAt Nike, Cain describes a team of people who seem to have been fully aware of Salazar\u2019s tactics but allowed them to flourish.<\/p>\n
She writes scenes in which the performance coach for the Nike Oregon Project, who she was told was a sports psychologist, allegedly ordered Cain to toughen up when she revealed she was cutting herself. Salazar\u2019s boss and the then vice-president of marketing also allegedly told Cain cutting her hair would help her lose weight but he wouldn\u2019t let her, because then she would \u201cnot look good\u201d, and that she needed a different bra because everyone could see how huge her breasts were. The woman who measured her body fat percentage asked Cain to submerge herself in water for at least 30 seconds four different times, because Salazar wanted the most accurate reading possible, and ignored her pleas that she felt panicked under the water.<\/p>\n
Her teammates, she writes, were just as ungenerous. Once, on the way to training, one took a phone call while she sobbed in the backseat of the car on the way to a training run because she was suicidal, another described her depressive episodes as \u201cacting like a child\u201d.<\/p>\n
Cain left the Nike Oregon Project in 2016 while suicidal, self-harming regularly and suffering from a severe eating disorder, but she spent the next three years thinking: \u201cI hope Alberto still loves me \u2026 I am the failure. I was bad. I was fat.\u201d<\/p>\n
From there to here has been a long journey of healing mind and body. She kept running in those first years after leaving Nike, and kept getting injured. \u201cI was still so deeply depressed and confused about my body.\u201d The stress fractures common among women athletes who have experienced disordered eating and underfueling while overtraining (medically known as Relative Energy Deficiency in Sport, or Reds) were one culprit, but there was another, more mysterious ailment, too. Cain\u2019s lower right leg and foot were experiencing numbness that got increasingly worse if she ran for too long, and eventually, even after walking shorter distances.<\/p>\n
The narrative that Cain had been saddled with by the media and her coaches as a phenom was a familiar one for a young woman runner: that her career could end at any moment from injury, puberty, or burnout. \u201cThat really gets in your head and I think it really damaged me more in the years where I was going through this really chaotic physical health issue where I couldn\u2019t feel my leg,\u201d she says. \u201cI was desperate not to fulfill this prophecy.\u201d<\/p>\n
Then, in 2019, the United States Anti-Doping Agency released a 270-page report on Salazar that ultimately banned him from track for doping violations for four years.<\/p>\n
Cain read the entire report in one sitting, and finally realized Salazar had not been honest with her about certain medications she had seen him give other athletes, like L-carnitine infusions in higher than allowed doses. The report also cited him for trafficking testosterone and attempting to tamper with doping results. It made her think about the thyroid medication and diuretics she says he often pushed on her.<\/p>\n
The lightbulb went on: her coach, whom she was desperate to please between the age of 16 to 20, had not been who she thought he was. Weeks later, while texting Alexi Pappas, an Olympian and friend, about processing all of this news, Pappas sends her the contact information for a New York Times editor, who says she could write something up. Within hours, the editor asks Cain to come to the offices, where they shot a video of her describing her experience with Salazar.<\/p>\n Mary Cain walks off the track after competing in the women\u2019s special 1500-meter run at the Drake Relays athletics meet in Des Moines, Iowa. <\/span> Photograph: Charlie Neibergall\/AP<\/figcaption><\/figure>\nWithin days, Cain\u2019s op-ed went live and lit the running world on fire. \u201cThe New York Times <\/em>piece was almost more of a start versus an end,\u201d she says.<\/p>\nThe Nike Oregon Project disbanded shortly after. And, by 2021, Salazar earned a lifetime ban from SafeSport because of sexual and emotional misconduct.<\/p>\n
But Cain emphasizes that Salazar\u2019s ban does not solve the issue of athletes\u2019 abuse in running. In fact, she says, it\u2019s more akin to \u201ccutting off the head of a hydra\u201d.<\/p>\n
For running to change, she says, it will take far more than her speaking out. And she knows her story will ruffle some feathers, as she has no hesitation calling out just how deeply the system\u2019s flaws allow actors like Salazar to flourish \u2013 and names names in doing so.<\/p>\n
\u201cI feel very deeply that if you were unkind to a child, you should work on that \u2026 and if you feel uncomfortable with my perspective, I hope this gives you the opportunity to really sit with some of those things,\u201d she says.<\/p>\n
Shortly after the op-ed came out, the numbness in her leg got bad enough that Cain stopped running for two years. She played rec soccer on Pier 40 in New York City, did pilates, and engaged in intensive talk therapy.<\/p>\n
By fall 2022, Cain decided to take the MCAT \u2013 she\u2019d dreamed of being a doctor since she was a little girl, when she idolized Marie Curie. She felt like a running career was probably off the table by then, but if she was going to be a doctor she\u2019d like to know if she could walk and stand for long periods of time.<\/p>\n
Dismissed time and again by doctors because, she felt, she was a female athlete who had mental health problems on her chart, she\u2019d almost given up seeking a diagnosis. But her mother finally asked her father, an anesthesiologist, to hit Cain\u2019s knee with a reflex hammer and take a look himself.<\/p>\n
When he realized one of her legs looked larger than the other, he surmised the problem could be vascular, so her mom entered the symptoms into Google along with \u201cvascular\u201d and came up with a possibility: popliteal artery entrapment syndrome (PAES).<\/p>\n
The problem \u2013 a muscle that grows too quickly in the back of the calf can start to cut off blood flow to the rest of the leg \u2013 is rare, but can be caused by overtraining in young athletes. She went to two different doctors with the possibility, but they both did an MRI while she was laying down that gave a false negative report. This frustrated her even more. \u201cI\u2019m medically literate,\u201d she says, \u201cand of course an MRI isn\u2019t going to show anything if this is a vascular condition in the way that they had me do it.\u201d<\/p>\n
Cain finally reached out to a well-regarded sports medicine doctor she knew, Trent Stellingwerff, who sent her a list of three specialists who treated PAES, particularly in athletes. Only one was in the US. Cain flew out to see Jason Lee at Stanford in February 2023. \u201cI had trained myself not to cry in front of doctors, because it felt like a death sentence\u201d, she recalls But as soon as she sat in Lee\u2019s office, she crumbled and immediately apologized.<\/p>\nStanford University.<\/span> Photograph: David Madison\/Getty Images<\/figcaption><\/figure>\nHis kindness shocked her. \u201cHe said: \u2018This is so upsetting, you just told me you were a professional athlete and you can\u2019t do the thing you loved to do any more, that\u2019s a normal response.\u2019\u201d<\/p>\n
Her test for PAES came back positive, and Lee called her with the news. \u201cHe said: \u2018I always save a couple surgery openings, I call them my Golden State Warrior openings. You\u2019re a Golden State Warrior to me, do you want to come in?\u2019\u201d<\/p>\n
The way Lee treated her changed her perception of what a doctor could and should be. She was amazed not only that Lee believed her, but that he had been so kind and willing to treat her so quickly, even as a female professional athlete who hadn\u2019t competed in years.<\/p>\n
Two weeks later, Lee operated. Six weeks after that, Cain took the MCATs.<\/p>\n
She applied to and got into Stanford and Harvard, but her experience with Lee \u2013 and her successful surgery \u2013 swayed her fully toward Stanford.<\/p>\n
That summer, she prepared to move to Palo Alto to start medical school. While she still hasn\u2019t ruled out a competitive comeback, Cain is focused on a different physical goal for the time being: rewiring her body.<\/p>\n
That means a lot of intensive PT type exercise, and trying her best to take it easy on runs. \u201cI went for a run this morning and it was nice. You know, the whole time I was like, I\u2019m really thirsty,<\/em> but that was my only complaint.\u201d<\/p>\nAnd she\u2019s seeking that kind of nuance and groundedness in all parts of her life. She doesn\u2019t see medical school, where she lives on campus and gets to enmesh with a small cohort as a do-over of her painful undergrad years.<\/p>\n
\u201cI\u2019ve had a lot of people ask me if I regret things \u2026 I was abused. I can\u2019t regret <\/em>that. The people who did it should regret their actions.\u201d Instead, she is immensely grateful for the people in her med school class. \u201cAfter going through the experience I did, [I thought] \u2018Am I deeply unlikable? Am I being abused because I am a problem?\u2019\u201d<\/p>\nNow, she says, having friends who know her deeply has been healing. Intensive CPT (cognitive processing therapy) helped, too.<\/p>\nMary Cain celebrates as she crosses the finish line to win the Wanamaker Mile in 2014.<\/span> Photograph: Jason DeCrow\/AP<\/figcaption><\/figure>\nThe idea for writing the book in present tense took root in some of the CPT therapy assignments she did that helped her reframe those years. \u201cWhat I developed was such a sense of self-hatred. Ultimately that\u2019s why I self-harmed, why I was suicidal, why I had an eating disorder . At its core I hated myself \u2026 because of the actions of others. But the problem was that I therefore developed a self-hatred.\u201d<\/p>\n
Undoing that self-hatred has been a long process, as has undoing the suppression of her own feelings she learned while working with Salazar.<\/p>\n
\u201cI did not realize until three years ago what hunger felt like. Because I had been convinced by Alberto [Salazar] that that sensation was not hunger and that it was like mittelschmertz (the pain of ovulation), which doesn\u2019t make any sense biologically.\u201d<\/p>\n
She explains this while we eat tofu wraps and sip iced coffees at an outdoor picnic table. \u201cIt was really wild to one day wake up one day and be like, \u2018that\u2019s hunger\u2019.\u201d<\/p>\n
Today, Cain seems hungry for the future. While she has been working with Lee on PAES research \u2013 they hope to publish a paper soon \u2013 she\u2019ll start her clerkships in different specialties this summer. \u201cI\u2019m honestly so curious to see what happens, to find something that I ultimately realize I really want to do.\u201d She laughs. \u201cI\u2019m kind of just happy to be here.\u201d<\/p>\n<\/div>\n
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