Nursing Book Club

What Made Maddy Run: The Secret Struggles and Tragic Death of an All-American Teen by Kate Fagan

It seems like there’s something new every day about athletes struggling with mental health issues: football players with early-onset dementia; baseball players walking away from their careers due to depression; figure skaters and gymnasts with eating disorders.

The drive to excel at sports, the pressure of competition and a little taste of celebrity can all push athletes to the brink.

Maddy Holleran, the subject of What Made Maddy Run,  lived in my county, so this book caught my interest early on. Holleran’s family was much the same as those around me, pushing their kids to achieve at athletics in the hopes of a college scholarship. In her case, it seemed to pay off. She excelled, caught the eye of scouts and was offered a place on the track and field team at her first-choice college.

During her first semester away from home, though, something went very wrong, leading her to take her own life in January 2014. She was only 19.

Holleran was not happy running track for UPenn, but author Kate Fagan suggests that the girl became trapped in a painful bind. Although Maddy thought that giving up track would solve everything, she seemed to find it  hard to abandon a dream she had worked for so many years to achieve.

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We’ll never know exactly what became the breaking point. Maybe she just couldn’t stand the thought of disappointing her parents, her coach and her team by admitting that the combination of college work and hours of daily practice was killing her.

Fagan seems a perfect person to investigate this story, having walked a similar path and ended up leaving a sport that she thought she loved. Fagan punctuates her own insights and theories with interviews with Holleran’s family, her friends and an old boyfriend. Holleran’s family even allowed Fagan access to Maddy’s computer and emails.

A Life on Social Media

In chronicling Holleran’s last days, Fagan suggests that the girl was also a victim of the age of social media. Snapchat, Instagram and Facebook all allow you to present only what you want your friends to see and edit out anything that you might consider too negative.

When your feed always shows you having a perfect day, how many people would think to ask if you’re really okay, especially if you’re an attractive, popular athlete?

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It was obvious to Holleran’s parents that something was wrong, and Maddy herself reached out for help, but an athlete who spends hours each day at practice has little time to actually talk and connect with others. There also wasn’t much emotional support available at this large Ivy League university. Suicide prevention is a difficult subject without clear answers.

Where do you draw the line between respecting privacy and reaching out when you see troubling signs? Even if you recognize that someone is in crisis, what course of action should be taken? This book is a meaningful read for anyone who works with young people.

What we see is not always what we think we see — and what we label success may be perceived very differently by the person we believe to be succeeding. (When screening for depression in a primary care setting, body language can be just as important as what the patient is saying.)

As one of my managers told me years ago, when working with young people, “You need to always keep your antenna up.”  This book is sobering proof.

What Made Maddy Run: The Secret Struggles and Tragic Death of an All-American Teen by Kate Fagan (Little, Brown and Co., 2018)


Christine Contillo, RN, BSN, PHN, is a public health nurse with more than 40 years of experience, ranging from infants to geriatrics. She enjoys volunteering for medical missions.


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