Throughout her time at Washington University School of Medicine, fourth-year medical student Michelle Mendiola Plá has volunteered in disadvantaged neighborhoods, helping residents manage chronic conditions such as diabetes and high blood pressure. Here, she takes the blood pressure of Alberta Mejia at El Torito, a Hispanic grocery store in St. Louis. (Photo: Matt Miller/Washington University)

Advocating to end health disparities

Class Acts-Human Health: Michelle Mendiola Plá s drive, ethics inspired by her native Puerto Rico

For most of her life, Michelle Mendiola Plá’s Puerto Rican heritage has pushed her to do things she never would have otherwise imagined.

The island’s boisterous, bright culture helped Mendiola Plá overpower her shyness and develop confidence and resilience, coaxing her into leadership roles. Exploring Puerto Rico’s coastal beauty, lush forests and underground caves instilled a sense of curiosity and adventure. The island’s depressed economy — with about half of its 3.3 million residents living in poverty — coupled with Puerto Rico’s vulnerability as a far-flung U.S. territory, have motivated her to advocate for the disadvantaged.

In essence, Puerto Rico helped persuade Mendiola Plá to become a physician.

Her training at Washington University School of Medicine in St. Louis will make that happen.

“Puerto Rico has had a significant influence in shaping my professional goals and values,” said Mendiola Plá, who will receive her medical degree May 18 and will begin a general surgery residency at University of Illinois College of Medicine at Chicago/Mount Sinai Hospital this July.

“Washington University reflects my goals and values and has steered me toward success,” she said. “The university emphasizes compassionate care, health advocacy and developing the confidence to take on innovative research and patient care.

“Students here have numerous opportunities that give us the skills needed when we leave but, just as important, the confidence to use our abilities,” Mendiola Plá said.

Such experiences range from the clinical practice of medicine to the philosophical. For instance, during a cardiac surgery, Mendiola Plá held a beating heart inside a person’s chest. “I literally had someone’s life in my hands,” she said.

In a laboratory, she expertly sliced postmortem brain tissue for research involving deep-brain stimulation in people with Parkinson’s disease.

“Michelle moved this project forward with her skills and perseverance,” said the lab’s principal investigator, Joel S. Perlmutter, MD, the Elliot H. Stein Family Professor of Neurology and chief of the Movement Disorders Section. “There were many obstacles to making this work, including tissue preparation and the long hours required slicing brain tissue. Michelle helped to overcome obstacles while also committing many hours to methods development. In the three years since she left the lab, we have continued to use the methods Michelle initially developed.”

Mendiola Plá performs a free health screening April 20 on Rodolfo Castillo at El Torito, a Hispanic grocery store in St. Louis.  (Photo: Matt Miller/Washington University)

‘A person of action’

Altruistic since childhood, Mendiola Plá further connected compassion with medicine during the School of Medicine’s orientation for first-year students. It included an off-campus visit to underprivileged communities marked by crumbling brick buildings, littered lots and a lack of basic services such as grocery stores with healthy food.

“Michelle came into my office at the conclusion of the orientation program and proclaimed she could not sit on the sideline while such health disparities plagued communities of color across the nation,” said Will Ross, MD, the medical school’s associate dean for diversity and creator of the program on health disparities for incoming medical students.

“It was apparent to me that she was a person of action. We should all share her ethic of service and her unwavering belief that all individuals should be provided the opportunity to reach their fullest health potential. Her passion for service and commitment to health equity are part of her DNA.”

Indeed. Mendiola Plá worked closely with Ross on projects such as the St. Louis Health Exchange, where she presented information on management of diabetes, high blood pressure and other chronic conditions to residents in at-risk neighborhoods. She volunteered as a Spanish translator for the Saturday Neighborhood Health Clinic, which Ross founded primarily for the sick and uninsured.

As president of the university’s Latino Medical Student Association chapter, she worked to establish free health screenings in disadvantaged, predominantly Hispanic neighborhoods. She also advocated on a policy level, arranging meetings with politicians while leading student efforts at the Missouri state capital in Jefferson City and at the U.S. Capitol in Washington, D.C. Mendiola Plá also served for one year as a regional student chair on legislation and advocacy for the American Medical Association.

Mendiola Plá traveled to Puerto Rico to help victims in the aftermath of Hurricane Maria. Here she is high above a river in a metal cage on a pulley-and-rope zipline created by residents to reach remote, storm-damaged areas. The device helped volunteers like Mendiola Pláto distribute items such as toilet paper, canned goods, mosquito repellent, sanitary napkins, water and blankets. (Photo: Miriam Plá)

“For many years, I had felt divided between my desire to work toward health equity and my love for hands-on clinical care,” Mendiola Plá said. “Washington University assured me I could do both.”

Her medical interests converged in September, when Hurricane Maria decimated Puerto Rico, destroying highways and bridges and stranding residents in areas with no electricity and little food or clean water. “I and other Washington University students helped collect food and basic necessities to send to Puerto Rico,” Mendiola Plá said. “But I needed to do more, so I reached out to my mom, who was and still is involved in relief efforts, and I volunteered for several weeks.

“As my plane was landing in San Juan, I saw patches of blue tarp covering structures where roofs had blown away,” she recalled. “On the ground, I witnessed a tremendous amount of resilience among people isolated from the main roads because of the destruction. So many families were left without the ability to see their primary care doctors or to access medications to control chronic conditions such as hypertension, asthma and diabetes. This last observation really moved me because I have spent so much time in medical school helping underprivileged people get their medical needs addressed.”

Mendiola Plá got to work right away. She rode in a metal cage on a pulley-and-rope zipline created by the island’s resilient residents to reach remote areas in hilly forests. She swayed in the cage high above a swollen river to distribute items such as toilet paper, canned goods, mosquito repellent, sanitary napkins, water and blankets.

Additionally, Mendiola Plá used her advocacy skills. With help from volunteer groups in Puerto Rico and her mother, Miriam Plá, she helped bring volunteer physicians to the area to provide checkups and prescription refills.

“About 200 people sought help from the six doctors, and the effort was a success,” she said. “The experience helped me to appreciate the personal responsibilities that come with being trained in medicine to identify health problems and offer solutions where we can.”

‘Unafraid to take the lead’

Embracing humanity with medicine “will distinguish Michelle as an exceptional surgeon,” said Adeel Khan, MD, a Washington University assistant professor of surgery who mentored Mendiola Plá last year during her clinical and research rotation in transplant surgery. “She is compassionate, easy to get along with, very hard working and meticulous with details. She is extremely humble, yet unafraid to take the lead.”

Mendiola Plá and her mother, Miriam Plá, celebrated Match Day in March at the Eric P. Newman Education Center on the Medical Campus. After Michelle receives her medical degree, she will begin a general surgery residency at the University of Illinois College of Medicine at Chicago/Mount Sinai Hospital. (Photo: Matt Miller/Washington University)

She learned to take initiative from her mother, Miriam Plá, an engineer who personifies Puerto Rico’s culture and customs. “I used to be mortified speaking with people,” Mendiola Plá recalled. “I would blush, sweat and get palpitations and knots in my stomach.

“But my mom would not have it. As a kid, she enrolled me in a multitude of extracurricular activities such as ballet, gymnastics, tennis, soccer, baseball, ice skating, acting, painting, modeling, playing the violin in orchestras. You name it, and I’ve probably done it,” she said.

Unbeknownst to Mendiola Plá at the time, her mother even nominated her for student council president in the fourth grade. “I was confused when I saw my name on the list of candidates,” she said. “I never would have had the nerve to do it. But my mom was determined to have me run a big campaign. I had large, movie-sized posters plastered in every school hallway. I had bright election pins. I got a lot of attention from students I didn’t know, and it was a strange feeling. But by the time I gave my campaign speech in front of the school, I actually wanted to become president, and I felt pretty comfortable speaking publicly.”

She lost the election but started gaining confidence and assuming leadership roles. “I knew it was necessary if I wanted to go to a top medical school,” Mendiola Plá said. “I’ve wanted to be in medicine since I was 10 years old and watched my grandmother lose her memories and cognitive abilities to Alzheimer’s disease. I imagined that by going to medical school, I’d be able to conduct research on the brain that could contribute to treatments for people with dementia.”

Her father, Rodolfo, who works as an engineer for a large aerospace company in Southern California, recommended she apply to Washington University because of its esteemed reputation, both globally and among his coworkers, some of whom had sent their children to the university.

Mendiola Plá made it her top goal to be accepted into the School of Medicine.

In 2014, Ross called her to see if she would accept the university’s invitation to enroll in medical school. However, his calls went into voicemail because Mendiola Plá was flying home after visiting her father’s extended family in Mexico.

Eventually, Ross reached her mother on the secondary phone number listed. Miriam Plá couldn’t contain her excitement. “I know Michelle better than anyone, and I can tell you she accepts,” she exclaimed to Ross.

Politely, Ross told her it wasn’t official until he heard it from her daughter.

“OK, but I know she will say yes,” she responded.

Once Mendiola Plá herself officially accepted, Ross suggested calling her mother. He told the future medical student that her mother would “be so happy to hear the good news.”

Ultimately, Mendiola Plá wants to return to Puerto Rico to help the people whose culture “pushed my boundaries toward success,” she said.

“I want to use what I’ve learned at Washington University to practice medicine, conduct research, advocate for those in need and mentor students,” she said. “I really developed into the person I am today while growing up in Puerto Rico.”

Read more about the Class Acts of 2018 here.

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