It’s no accident that the century’s most significant innovation in mitral valve surgery is taking place in eastern North Carolina. That accomplishment and many others spring from the devoted efforts of those committed to creating a thriving medical center in Greenville, a dream once scoffed at by nearly everyone to the west. Despite strong opposition, leaders like the late Leo W. Jenkins, former chancellor of ECU, strove to establish a medical center that would help improve the lives of the farmers, fishermen and small business owners of this isolated part of the state.

Once approved, they gave the school a three-part mission: Teach and train more minority physicians, train doctors to provide primary, or basic health care, and raise the overall health of people in the region.

Early studies from that time revealed heart disease as one of the top threats to health here and in 1984, the medical school hired a new surgeon, W. Randolph Chitwood Jr., just out of an exacting 10-year residency at Duke University. He performed the first open-heart surgery in Greenville that year.

Over the years, he developed a passionate interest in heart valve repair and replacement, with a special focus on the mitral valve. In February 1999, Chitwood became the first American to perform a mitral valve repair using da Vinci, while in Germany. That followed by only months the first-ever robotically assisted heart procedure in Paris, which took place in May 1998.

Common interests
“Surgeons like doing things with their hands,” Nifong said. “We like the immediate gratification of doing something and immediately seeing a result.”

From a young age, Chitwood enjoyed tinkering with mechanical things and today is an avid photographer. For Nifong, it was an interest in building that led to cardiac surgery.

“A lot of times in general surgery, you are removing something. But in heart surgery, we’re interested in reconstructing, repairing. I loved general surgery, but I was drawn to intense situations, with patients who are sicker,” Nifong said.

Nifong is used to competition and has excelled at every turn. Offered admission to medical schools at Duke, Chapel Hill and Wake Forest, he chose the ECU medical school. He is a member of Alpha Omega Alpha, the medical honor society, which invites only the highest achieving doctors as members. At his 1990 graduation, he received the Frank Longino Award from the Department of Surgery.

He chose ECU for its emphasis on personal involvement that applies to the teaching relationship, as well as to relationships with other doctors and patients.

“In medical school here, you really learn to communicate with the patients and the referring physicians,” Nifong said.

His responsibilities are even greater now that he is training others. But he stays realistic about his abilities and limitations. He has to.

“You should always be humble,” he said. “As soon as you lose that, something will happen. As soon as you think, ‘I can do anything,’ or if something appears too simple, then suddenly it will become terribly complex. I’ve seen it happen. That brings you back to the importance of what you are doing.”

Nifong also maintains his intense focus by imagining how he would feel if one of his family members needed surgery. He remembers the lessons he learned at the School of Medicine, where primary care — and respectful, compassionate communication with patients — is paramount. “It becomes a very hands-on experience,” he said.

After receiving his medical degree at ECU, Nifong completed a general surgery residency at the University of Rochester in New York and a three-year cardiothoracic surgery fellowship at Wake Forest University.

“I got to see the old-timey, conventional operations, so I could see the ways people benefited from laparoscopic,” he said. “That’s how I became interested in it. When I was looking for a job, we just meshed,” Nifong said of Chitwood. “We built our relationship over the next couple of years.”