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LA Times op-ed: Simone Biles delivered a mental health message much of the world wasn’t ready to hear

July 30, 2021 — 

Dr. Jillian Horton from the Rady Faculty of Health Sciences wrote a guest column for the LA Times, which ran on July 29, 2021.


When Simone Biles withdrew from the Olympic women’s gymnastics team final earlier this week because of her mental health, I couldn’t help but think of another Olympian — Canadian sports legend Hayley Wickenheiser — and what happens when culture tries to eat champions for breakfast.

Wickenheiser is a five-time Olympic medalist — four golds, one silver — in women’s hockey. As a trailblazer in a male-dominated sport, she knows something about challenging stereotypes and changing culture. Several years ago, in a career full of surprises, she unleashed the biggest one of all: She went to medical school.

When I interviewed her earlier this year, Wickenheiser had keen observations about the similarities and differences between medicine and Olympic sport … and how odd it is that any pursuit would equate “excellence” with personal self-destruction. One particular story stuck out.

Wickenheiser was describing her first shift on the medical wards. She worked a 20-hour stretch with a single break of 20 minutes, ate one hurried meal, used the washroom once and stumbled through four Code Blues. She described the blur of the next several days, during which she, an Olympic champion, struggled to recover from the physical impact of medical shift. Then she had a sudden insight.

She would never do that to herself again. She couldn’t control the hours she had to work. But she could eat. She could rest periodically. She could take a short walk outside. She had the wisdom to know there wouldn’t be a prize for martyrdom. And she was smart enough not to want it anyway.

Like Biles, Wickenheiser was turning an age-old myth on its head: That to be the best, you have to compromise everything, including your health. You don’t, of course, and being an Olympian with more than 20 years of experience under her belt allowed Wick to see in a few days what it took me more than two decades to really understand.

The closest I’ve come to being a prodigious athlete is taking Peloton instructor Cody Rigsby’s Backstreet Boys and Britney Spears rides in the same day. But as a chronic overachiever, I bought into old, toxic myths about excellence for much of my life. I grew up thinking that rest was a waste of time, and that self-care should be scheduled about as frequently as an oil change.

Later, the unforgiving culture of medicine programmed me to work myself to the bone. It taught me to suppress emotion, to ignore my own health, to work through any conditions, regardless of whether that was necessary or even helpful to patients. It is a culture of so-called “excellence” — until the curtain is peeled back and we see how many of its champions are just barely scraping by.

What defines a champion, anyway? Observers are contrasting Biles’ choice with Kerri Strug’s decision to vault on a badly injured ankle at the 1996 Olympics. Strug was lauded for her heroism — and no one should ever minimize her sheer guts or her resolve. But was it heroism, or were we simply in an era of glorifying one’s ability to smile as the whip, or the bone, cracked?

I’m nearly twice as old as Simone Biles. It’s taken me almost all of those years to be anywhere near as brave as she is, to put up my hand and say “enough!” when my job threatened my physical and mental health. If that’s been hard for me, what’s it been like for her, a woman of color in a notoriously white field who is a survivor of sexual abuse, suffered while training in the very sport in which she excels?

I’ll never forget Wickenheiser telling me that the stress of becoming a doctor was nothing compared with her years as an Olympian, when she felt the weight of an entire country on her shoulders. Yes, medicine and many other high-pressure professions can be grueling, but the sports competitions that entertain us can create a level of stress that many of us will never understand. And changing that culture can only be undertaken by real champions — the precious few who cannot be eaten for breakfast.

What Simone Biles chose to do this week on the Olympic stage is nothing short of revolutionary. She delivered a message much of the world wasn’t ready to hear. She put her health first — and that may be her greatest signature move of all.

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