U.S. national team swimmer Ella Eastin woke from a nap in early January 2020 and fainted in her apartment in California. She hasn’t been the same since.
Eastin, a 24-year-old who won 12 NCAA titles at Stanford and made the 2019 World Championships, announced last month that she will not compete at the U.S. Olympic Trials, which are ongoing in Omaha.
Eastin, the third-fastest American in the 400m individual medley in 2019, was a contender to make her first Olympic team. The top two at Trials per individual event qualify.
She spent years training six days a week at Stanford, pursuing an Olympic dream as part of a three-woman post-grad group with Olympic champions Katie Ledecky and Simone Manuel.
But after that nap and that fall, Eastin’s life turned into something she could not have imagined, what she called “a medical mystery journey.”
“Over the past year and a half, I have been battling a seemingly undiagnosable illness that incapacitated me,” Eastin posted on Instagram on May 18. “I couldn’t live a normal life, much less one of a professional athlete.”
Eastin, who graduated from Stanford in 2019 with a human biology degree, all of a sudden struggled to remember appointments. Her mom did her laundry and cooked for her because she was unable to manage those kinds of tasks. Going to the grocery store and not needing to nap upon returning home marked a successful day.
“I was unable to get my heart rate up and had extreme muscle fatigue and weakness even when I would try to exert more energy,” Eastin said. “It felt like I could only move in slow motion, but was exhausted after any exercise at all.”
It took eight months to learn what was going on. She first heard the word “dysautonomia” last summer. It’s an umbrella term for several medical conditions.
Specifically, Eastin had orthostatic intolerance and chronic fatigue. Symptoms included brain fog, dizziness, low blood pressure and an inability to stand for long periods. She combatted it by increasing salt intake, changing her diet and drinking lots of electrolyte-filled water to increase blood volume and blood pressure.
“There is no single treatment that is effective for everyone with dysautonomia, but symptoms usually can be managed, and many people can return to normal lives,” said Dr. Peter Rowe, the director of the children’s center chronic fatigue clinic at Johns Hopkins University, who diagnosed Eastin.
Eastin improved over the last 10 months, but not to the point to resume training at an Olympic level. She might again one day.
“I’m definitely not at my 100 percent best, but I also haven’t really tried to push myself into anything super intense because my life hasn’t required it yet,” she said last month. “The more time I’ve given myself, the better I’ve felt. I have enough energy to exercise every day. I’m feeling good enough to be in the water. I swim once or twice a week to keep my toes in, and it’s something that’s really refreshing and enjoyable.”
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Eastin’s mom, Liz, swears her younger daughter was born an amphibian.
“The minute we got Ella into the water, she was just a little fish,” Liz said.
Eastin joined her first swim team at 6 and, right off the blocks, began setting local records in Southern California.
“Friends and neighbors and teachers would all be like, So you’re going to go to the Olympics one day? You want to go to the Olympics one day?” Liz said.
Eastin wanted to. She wrote about the dream in journals, drawings and in a school project (that Liz saved).
“As she got a little older, that turned into this pressure,” Liz said. “You didn’t hear it come out of her mouth because I think she was scared to put it out there as a goal because if she didn’t achieve it, what did that mean?”
Liz said that Eastin learned from all of her swimming coaches that the sport is something you do, but it’s not who you are.
“She’s an athlete for sure, but she’s also an academic, an advocate, a sister and a friend,” Liz said. “Even though she knows she’s a talented swimmer, she doesn’t want her success in the pool or her ability or inability to make the Olympic team what defines her in this world.”
One of Eastin’s dreams outside the pool: attend Stanford.
Todd Larsen, her first swim coach, helped her get there. Larsen was a college runner who became a music teacher, sang in a seven-man a cappella group and performed as “The Hunchback of Notre Dame” at Tokyo Disneyland.
When Eastin was 12, Larsen was diagnosed with acute lymphoblastic leukemia. He died 13 months later from complications following a bone marrow transplant at age 44. Eastin remembered Larsen’s positive outlook throughout his cancer fight.
“Todd was probably the most influential person in my swimming career,” said Eastin, who detailed Larsen’s impact in her Stanford application essay. “He has been a constant reminder to live your life doing the things that you’re passionate about and you love and you enjoy.”
Eastin enrolled at Stanford in 2015 and became an immediate star. There are 23 bullets under “career accolades” on her bio, plus 20 more sub-bullets. She’s the only woman to win the NCAA title in the 400-yard individual medley -- considered the decathlon of swimming -- four times.
She traded the American record in that event with Ledecky, ultimately taking it for good at the 2018 NCAA Championships (Ledecky’s most recent defeat to an American in a championship-level final). Eastin trounced Ledecky by 3.69 seconds among five total titles at the 2018 NCAAs -- three individual and two relays. She was Swimmer of the Meet.
Stanford coach Greg Meehan called it “the greatest performance in an NCAA Championships in the history of our sport.”
That triumph was sandwiched between adversity-filled summers. In 2017, Eastin appeared to make her first world championships team, touching second in the 400m IM at nationals. But she was disqualified moments later for an illegal turn, remaining on her back too long on the change from breaststroke to freestyle.
In 2018, Eastin contracted mono and withdrew from all but her final event of the U.S. Championships. She found a way onto the national team by placing third in the 200m IM on the last day of the meet in her hometown of Irvine. She finished fourth at the Pan Pacific Championships later that summer, then made the semifinals of the 2019 World Championships.
In late December 2019, Eastin joined other swimmers at the U.S. Olympic and Paralympic Training Center in Colorado Springs for an often-held altitude camp.
She felt fantastic -- completing every single practice set for the first time at a Colorado Springs camp -- and flew back to California. A few days later, Eastin felt off while struggling through a two-hour morning practice with Manuel and Ledecky at Stanford.
She took a nap before her scheduled afternoon practice, but when she woke and stood up, she felt extreme leg weakness and fell down. She tried practicing the next two days, but still didn’t feel well.
So Eastin began taking breaks from training to visit doctors, then returning to the pool, struggling, and seeing more doctors. She repeated this process for two months until Stanford’s facilities closed due to the pandemic.
Early on, none of the medical professionals found the root of the problem. It could have been overtraining, they said. Or problems with her diet.
In a Stanford press release last month, Eastin was announced as a recipient of a post-graduate scholarship. In the first public mention of her diagnosis, the release stated dysautonomia was “possibly from long-haul COVID-19.”
“Some doctors speculated that there’s a chance that I got COVID and am now dealing with long-term complications,” Eastin said, adding that other athletes had “severe flu-like illnesses” while at the Colorado Springs training center during the swim camp, though she did not. USA Swimming and the USOPC did not comment, citing medical privacy.
The first confirmed COVID-19 case in the U.S. was Jan. 21, 2020, two weeks after Eastin fainted.
Rowe said it’s possible that Eastin’s case was a result of COVID, but it’s impossible to know for sure.
Many forms of dysautonomia and chronic fatigue syndrome are triggered by an acute illness, he said.
Eastin was told that there were multiple possible explanations for the development of the dysautonomia, including her bout with mono in 2018. She also struggled with chronic sinus infections throughout her life. Around the same time she became sick in 2020, Eastin said she had major hormonal imbalances from overtraining and a prescribed diet that led to underfueling and female health challenges.
“I improved a lot with [Stanford coaches] Greg [Meehan] and Tracy [Slusser] and the group at Stanford,” Eastin said. “I think that the structure of the training was amazing, and I usually could perform throughout the week. I think towards the end of my time there, the increased volume and intensity got to me and pushed my body to its limits.”
After California shut down in March 2020, Ledecky and Manuel found a two-lane backyard pool in which to train for three months. Eastin chose to drive seven hours south to Irvine, where she had family and friends to help her through the chronic fatigue. She’s been there ever since.
“I struggled just as much with my mental health as I did my physical health,” said Eastin, citing consistent depressive feelings and anxiety. At one point last year, she worked with three mental health professionals.
She went back to training locally with her teenage swim club coach, Steve Pickell, a 1976 Olympic medley relay silver medalist for Canada.
When Pickell coached Eastin before she went to Stanford, he could tell her to move her left pinkie a quarter of an inch to the left in her stroke, and she could do it. When teenage Eastin was sick and Pickell sent her home, she trained in the neighborhood pool instead. She refused to take Saturdays off.
When Eastin returned last spring, she at first looked like that stubbornly determined swimmer again.
“We would do two or three practices in a row, and she would be outstanding,” Pickell said. “Then she would call me and say, ‘I can’t get out of bed for the next practice.’ Then she couldn’t swim for two or three days. That cycle lasted for weeks.”
Eastin took a long break in July, but the up and down continued from August to Thanksgiving, when she took a break to visit her sister’s boyfriend’s family in North Carolina. There was no pool access. Eastin chose not to exercise for the whole trip.
“My energy level was great. I was in a really good mood,” she said.
She sat on the porch one morning, drinking coffee alone. She felt at peace.
When she arrived back in California, her mom asked how the trip went. Eastin broke into tears. She decided that she could no longer train and continue to improve at the same time. Around Christmas, she told her family she was not going to try for the Olympic Trials in 2021.
“Every time I’ve taken a rest is when I feel my best,” she said. “I can’t continue to beat myself up emotionally and physically over trying to reach this goal I’ve had for such a long time.”
Eastin benefited from scaling back. She now has the energy to exercise daily, though not as strenuously as before, and pursue her long-held, post-swimming goal: a healthcare career.
Her grandmother Ellen Lewis founded two nursing schools. Some of Eastin’s oldest memories are of visiting her office at UC Irvine’s medical school, interacting with nurses and doctors and dissecting brains.
“I’ve often related the nursing profession to swimming,” Eastin said. “I think of Simone Manuel and Katie Ledecky and [two-time Olympian and Stanford teammate] Lia Neal and all the people that are going to be on the Olympic team this summer that I know really well and have really great relationships with. A lot of the time, those athletes aren’t necessarily as appreciated as the ones that are making millions and millions of dollars, but that doesn’t mean their efforts are any less valuable.”
Eastin could return to competitive swimming if she continues to improve.
“I still love swimming outside in the sun as my body allows me and plan to keep it as a restorative activity in my life,” she wrote. “You may just see me again behind the blocks one day.”
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