Running Prodigy Mary Cain Survived a Broken System—and Found Her Voice

Cain became an advocate for mental health in sports and founded Atalanta NYC, a nonprofit that mentors girls in the Bronx through running. Although she’d always been a writer—throughout her teenage years, she kept heartfelt diaries about her experiences—she wasn’t sure she wanted to publish a book about what she’d been through. But Cain kept seeing the power of her words in every room where she shared her story.

Now 29, Cain is a second-year medical student at the Stanford University School of Medicine. Her new book, This Is Not About Running, is a brave, blisteringly honest memoir about a young girl who loved running, and about the systems, policies, and people who placed winning at all costs above her well-being. Fearless on the page, Cain tells hard truths with the hope that her story can help others.

In a conversation over Zoom, she was buoyant, funny, and sharply intelligent; we talked about how writing can be cathartic, how she found joy in running again, and what we as a society and as individuals owe to our girls.

One of the big themes of the book is the silo-ing of self—how the world forced you to choose this obliterating version of a running career over pretty much everything else in your life at such a young age. On some level, this happens to a lot of people, but it’s especially true for those who show promise early. Can you talk about that?

The culture in the U.S. of having to be “all in” to be committed to something—it’s such a fallacy. Truly the only people who can do that are those who have endless means, privilege, and resources. Even though I didn’t have the words back then as a young person, I understood my privilege was that my mom was making my lunch. It is interesting to look back because, as I was going through the system, very few people seemed happy. Very few were people I really wanted to be in the long term. Now that I look back on it, I wonder how many of those people who were “all in” were on drugs, say, or unhappy in their marriages and relationships, for that sport.

Cain racing in the 1500 meters at the USATF Junior Outdoor Championships, June 2011.Courtesy of Mary Cain

When and how did you decide you wanted to write a book?

Writing and publishing are two different things. Writing 100,000 words is not hard for me. My sisters and I, we’ve always worked with one another on our writing. But there’s also the trauma. I always thought it would be a cathartic process. I thought about it during my lawsuit with Nike, when I was doing this intensive therapy. It was only in 2021, when Alberto was banned for life because of sexual abuse, that I began to consider publication. I would never write a book for money; I would write it because I had something to say. I had had therapy to a degree that I was like, OK, I understand to the best of my knowledge my story, and that someone else could benefit from hearing it. I started writing a first draft in January 2024, before medical school. I sold it right before I started my first year.

You tell the story in the present tense, as if you were inhabiting your teenage body right now. My sense is that this immediacy was important to you to convey. How did you decide this was the right way to do it?

For the last few years I’ve been doing active advocacy work to prevent abuse in sports, especially with Athlete Survivors’ Assist, in New York, which does it in a multi-targeted way. I’ve noticed over and over that it’s not until the audience hears a lived experience that they say, “Wow.” It can really change your perspective of what someone’s going through. Putting policies across the table is great, but having someone say, “This is what happened and this is what it felt like”—that makes the biggest difference.

You had your teenage diaries, which I imagine were really painful to revisit. Were there entries that changed how you chose to frame your story as an adult?

There were two types of entries that really stuck with me. The first: I would be so honest with how bad I was doing, and yet there was this undercurrent that was like, But I know I am the problem and I’m failing and I’m so sorry. Those were the hardest to read; it was so twisted. I did not equate those experiences to abuse until much later.

The second: I’m looking in the mirror, I’m seeing what’s happening to my body is a pretty severe eating disorder, but my training logs show that I’m gaslighting myself. Those little moments were so fascinating.

Cain at the 2011 New York State Cross Country Championships.Courtesy of Mary Cain

Was there a part of your story you were most afraid—or most relieved—to share?

Nothing I was scared of. I have the perspective that if you are made uncomfortable by my story, you should be. It’s an uncomfortable way to live. In sports or in life, entering the threshold of discomfort is how you grow. I don’t think any of the chapters specifically gave me relief, but the writing was a catharsis. I do view this book as more for others than for myself. So if there’s a policy I believe in, or a caution about not being a helicopter parent, or how to look for warning signs or fake advocacy, I tried my best to be purposeful about those conversations.

This book is described as “flipping the script” on abuse in youth sports. Adults treated you pretty abominably when you were a young runner. Beyond individual bad actors, what is a policy or structural change or guiding principle that you believe would help protect young female athletes today?

The crux of the story is: What is a systemic problem, and what is an individual problem? At the end of the day, abuse is prevented when systems change. Abusers are individuals who want to do these actions whether or not there are policies in place. But I am very cognizant that policies can help. Athlete Survivors’ Assist has great resources online—we’ve designed one especially for sports, about the power dynamics in play. If an athlete is overly showered with gifts and praise, that can sometimes be problematic; or if there’s an isolation pattern, where a coach is saying, “Don’t tell your parents,” or, “I’m mad because you told the other coach.” There should always be more than one adult.

I also feel very strongly that there should be more rules in place policing parents in youth sports. Harassment of other children on a team is not OK. Recently someone told me that their kid had gotten screamed at by the other coach. This stuff happens all the time, and it’s 2026. Policies help; that’s how you prevent stuff. But adults have to say ‘stop.’ In my head, I was saying ‘stop.’ But because no one said ‘stop’ for so long, it got normalized.

Cain exploring Moscow while at the 2013 World Championships in Russia.Courtesy of Mary Cain

That question: “What happened to Mary Cain?” You first answered it with the 2019 New York Times piece, but you reveal in the book that you now think it might have been too soon to grapple with the trauma of those years so publicly. How does it feel to answer that question for yourself, now, with more time to process and reflect?

Therapy is amazing; it’s why I’m where I am today. In the three years prior to the New York Times piece, it was like, I am a big fat failure. It wasn’t that I was scared to touch the trauma in general—more an internalization that I was at fault. And then, afterwards…you see this a lot in advocacy work and volunteering, when you yourself are not fully well, and you are trying to help someone with the same trauma you had, it’s incredibly re-traumatizing.

You’ve written that your experience with Dr. Jason Lee, who did your 2016 surgery for functional popliteal artery entrapment syndrome, which caused the numbness in your foot, led to you enrolling at the Stanford School of Medicine to study that condition with him. Can you tell us about Dr. Lee and what that experience meant to you?

If it weren’t for my patient experience, I wouldn’t be at Stanford Med. It took me seven years to get this condition diagnosed. They could see it in my chart; there was an illness script. I remember my first appointment with Dr. Lee, I was trying not to cry. But I did, recounting how upsetting this whole process had been. And I immediately started to apologize. Sucking it right back down. And he was like, “Why are you apologizing? You had a career. You don’t know if you will be able to function at a normal ambulatory level, let alone have a career. This is hard stuff.”

When I flew out to have my surgery, my dad—he’s an anesthesiologist—he came with me, and it was so fun to be on campus. We had these incredibly positive experiences with folks working at the hospital. I was so used to being unhappy. But I aspire to happiness! So I applied to the medical school at Stanford, and I was really excited to be accepted. It was all because of that patient experience. I thought, I think I could become a great doctor here.

You write so wonderfully about the freedom you felt running fast at age 12. Have you been able to reclaim that feeling of joy in movement after your surgery?

I have. I’ve gone through different experiences, a mix of getting back into running, respecting the body I have now, figuring out how that works in my life now. How do I fix some of the kinks that developed along the way, the compensations, how do we hit them really hard in PT, so that I really enjoy running as much as I can? And acknowledging that I’m in med school. We’ll see what happens. People want the Cinderella story. But if I start running competitively again, it’s its own thing. The ending for me was really this book.

The title is This Is Not About Running. What’s the biggest thing you hope a non-athlete reader takes away from your journey?

This is about a young girl who had a lot of joy and a lot of hope—and a lot of people who tried to knock that out of her. The idea of being a young person who dreams is a ubiquitous experience. You could want to be a cellist, or a doctor, and systems pigeonhole you into a place where your joy and curiosity are taken away. This is for parents to read even if their kid is not in sports—how to navigate academia, or any passion. Or for med students! In medicine, the culture of sacrificing your life to go all in is widespread. But I don’t think that having someone who is on the edge of their ability and sleeplessness is the surgeon you want. There are things up against doctoring that are beyond the individual doctor, and I hope people do question the system. That they say, This is how I want to be, and this is how I want to do it. How do I talk my colleagues, or how do I respond if I witness this at my kids’ sports event? Sometimes reading uncomfortable things can help us grow.

This interview has been edited and condensed for clarity.

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