It’s pretty much gold medal or bust for Cassie Mitchell at the 2021 Paralympics.

The biomedical engineering assistant professor brought home a silver and a bronze medal from Rio in 2016 after a few fourth-place finishes in the 2012 London Games, but you never know when it may be your last chance to compete on the world’s stage. So, on this third trip to the elite Paralympic Games, Mitchell has her eyes on the top of the podium.

“I have World Championships gold medals, world titles, world records, and Paralympic medals. But I don't have the Paralympic gold medal,” Mitchell said. “And it's not just the gold medal, itself. I want to see the American flag raised; I want to hear our national anthem. It's the process and what it means to ‘never, never, never give up’ to reach the top, and to compete with honor for the USA. I'm sentimental and very patriotic when it comes to competing for Team USA.”

Mitchell will compete in two events in Tokyo during the Paralympic Games Aug. 24-Sept. 5, the club throw and the discus throw. Already, she’s having quite a year: she’s No. 1 in the world in both events for her F51 classification, and, in May, she set a new world record in the women’s F51 discus.

Maybe things are shaping up just right for her to hear “The Star-Spangled Banner” in Japan.

“I have to hedge: I'm currently No. 1 in the world this year in club throw, but the F51 club throw world record holder is Zoia Ovsii, and she has thrown 2 meters farther. She hasn't done it in competition this year, but that doesn't mean she won't. It also doesn't mean that I won't go and have a breakout performance in Japan,” Mitchell said. “As an athlete, I've learned that you have to control what you can control. I can control my attitude, my work ethic, my choices.”

Mitchell won a bronze medal in club throw in 2016 and a silver in discus. She suspects her best shot at gold this year will be in F51 club throw.

Paralympic athletes are grouped into classifications according to their disability. Mitchell is classified as a 51 athlete; they are the most severely disabled athletes who have impairments in all four limbs. (The "F" refers to field athletes.) However, unlike F51 club throw, several classifications have been combined for the discus event. That means Mitchell will face other athletes who are less disabled: “It probably will take a F51 world record to get a medal in the combined F51-53 discus event, based on current world ranking performances. I would likely need to throw another F51 world record to get into bronze. But you never know.”

Mitchell is a faculty member in the Wallace H. Coulter Department of Biomedical Engineering at Georgia Tech and Emory University, where her research focuses on harnessing the power of big data and machine learning to forecast disease, identify new therapeutics, and optimize treatments. Her work is at the intersection of engineering, data science, and pathophysiology — she calls herself a “pathology forecaster.”

Mitchell has always been a talented athlete, even before an autoimmune disorder left her paralyzed at age 18. Instead of gymnastics, track, and equestrian events, Mitchell was forced to shift to wheelchair sports — and it turned out, she was very good. Over the years, as her disease progressed and the landscape of Paralympic sports shifted for quadriplegic athletes with Mitchell’s level of disability, she found herself switching from cycling to track events and finally to throwing.

Along the way (just before the Rio Games, in fact), Mitchell was diagnosed with leukemia. Like everything else, though, she hasn’t let that stop her. In fact, competing has helped her quality of life as she fights the cancer, she said.

“Oncologists have said most people in my condition, even now as I do treatment, struggle to get out of bed, much less go and train at an elite level. I think that the act of training and competing — it's not just about the medals, but how it helps you in other ways mentally and physically as well,” Mitchell said.

For many athletes, the coronavirus pandemic disrupted a fairly regimented four-year rhythm of trying to make it to the Olympics or Paralympics. Mitchell said she surely would’ve preferred to skip the pandemic and the havoc it has wreaked on people’s lives and families. But the extra year has given her a chance to reflect on why she competes and stoked her competitive fire.

“I've always been one to push myself, but I find I have a really exceptional desire to push forward this time, even maybe greater than I would have had last year,” Mitchell said. “I think that's [the result] of losing one of the things that you love to do: You remember, I didn't start competing just to get a medal; I started doing it because it was fun.”

The extra year of practice has Mitchell set up well. She mostly was able to continue training since her events are a naturally socially distanced individual sport. She trains outside with the aid of a trusted personal care assistant. It’s also given her a chance to apply her engineer’s mind to her athletic endeavors.

“I am not a research expert in biomechanics, but I do specialize in biomedical data science. I definitely use analytics to tweak my technique,” she said. “I do an engineering analysis on all my throws. I have pages of math and simulation. Sometimes the engineering analysis is spot on, and sometimes what is mathematically optimal is not physiologically possible for me. But, overall, I do think my engineering perspective has made me a better thrower.”

In the meantime, she’ll continue to balance the demanding world of academia with the demanding world of elite international athletics — even when it means teaching bioengineering statistics from her car at the U.S. Paralympic trials. She said sometimes she wishes she could isolate the two worlds — academics and sports — and focus on one at a time. Mostly, though, she finds them to be a synergistic combination.

“The athletic endeavors keep me from getting overly consumed with the often fiercely competitive academic environment, and vice versa. It gives me balance in my life."