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It’s been two years since Honolulu Marathon founder Jack Scaff, whose radical medical ideas and legendary running exploits inspired generations of Hawaii residents to run farther than they ever had before, has been able to take so much as a step under his own power.
A devastating confluence of medical crises during a 2019 trip to Seattle left Scaff, 86, indefinitely confined to a wheelchair. The COVID-19 pandemic and subsequent shutdown that followed shortly after his return to the islands forced the cancellation of last year’s Honolulu Marathon and temporarily shuttered Scaff’s popular Honolulu Marathon Clinic, which has helped thousands of island runners reach the marathon finish line since its founding in 1974.
The ensuing year of isolation, trauma and adaptation played out on levels personal, societal and global in ways that Scaff and his running acolytes could never have foreseen, prompting some to wonder whether everyday activities sacrificed for the greater community good — including long training runs with friends — might in fact never return.
But on July 11, amid the broader reopening of Honolulu’s civic life and following the Honolulu Marathon Association’s announcement that the race would once again be staged on the second Sunday of December, the marathon clinic reconvened at Kapiolani Park for the first time since the shutdown.
About 80 runners and volunteer coaches turned out for the traditional early morning talk and training run, a strong indication of the group’s desire not just to reconnect but to reclaim a grounding sense of normalcy.
“The clinic represents something of a lifestyle,” Scaff said. “People who run like to run with one another.”
Honolulu Marathon Clinic Board of Directors Chairman Bruce Mullikin said some runners from the clinic had been meeting on their own in small groups during the shutdown but are happy to have the full program available again.
Scaff, a cardiologist, founded the Honolulu Marathon in 1973 to prove what was then a highly controversial theory in the field of cardiology: that exercise could help prevent cardiovascular disease and, wilder still, that long-distance training could help to rehabilitate those who have already suffered a heart attack.
Scaff and fellow cardiologist John Wagner, with whom Scaff had founded the Cardiac Rehabilitation Program at the Central YMCA, initially set out to explore the cardiovascular benefits of exercise, an idea rooted in Dr. Kenneth Cooper’s 1968 best-seller “Aerobics,” by taking their patients on short runs around Kapiolani Park and Diamond Head.
Scaff’s ultimate goal was to train his patients to complete a full 26.2-mile marathon. As part of his due diligence, Scaff himself entered the 1973 Boston Marathon to see what the experience was like. While in Boston, Scaff attended the American Medical Joggers Association Conference, where he met Canadian cardiologist Dr. Kenneth Kavanaugh, who was also interested in using marathon training to help his cardiac patients return to health.
Kavanaugh suggested to Scaff that rather than fly his patients to races on the mainland, he establish his own race in Honolulu — a Honolulu Marathon, as it were.
Training in moderation
Marathon-distance races had been staged in Hawaii since at least 1909 but few were open to recreational runners. The Hawaiian AAU Marathon had moved from Honolulu to Maui two years prior Scaff’s Boston trip.
In short order, Scaff enlisted the help of the Mid- Pacific Road Runners Club and, with then-Mayor Frank Fasi’s enthusiastic backing, gained the planning and manpower support of the Department of Parks and Recreation.
The 1973 race, then called the Rim of the Pacific Run, attracted 162 people, 151 of whom completed the entire distance. Duncan McDonald won the race in a state record time of 2 hours, 27 minutes and 34.8 seconds. The last finisher was Val Nolasco, one of Scaff’s heart patients.
The following year, Scaff partnered with Department of Parks and Recreation fitness specialist and former Olympic weightlifting champion Tommy Kono to found the Honolulu Marathon Clinic, which he considers his most meaningful legacy.
The free clinic was founded on a set of basic principles that have stood the test of some five decades of operation. Participants are told to train continuously for at least one hour at least three times a week — but no more than four times — and to establish a base of endurance.
To maintain proper long- distance pacing, they are advised to run slow enough that they can talk normally without losing breath — hence the benefit of training partners.
And to stay properly hydrated, they are told to stop for water every 20 minutes.
Each year, a mix of experienced runners and aspirational athletes who have never run a mile in their life come to the clinic for instruction, support and camaraderie. Not every clinic participant elects to run the marathon but the completion rate for those who avoid injury and faithfully follow the tenets of the program is close to perfect, according to longtime coaches.
A medical crisis
For most of the clinic’s existence, Scaff himself gave the brief weekly lesson that opens each session. But worsening spinal stenosis, a condition he has suffered since he was a teen, made standing in one place difficult. He had years ago already stopped running in favor of long walks with his wife, Donna.
In fact, Scaff was still walking regularly when he and Donna departed Honolulu in July 2019 to visit their son Kawika in Seattle two years ago. Shortly after the flight, however, Scaff suffered debilitating pain that necessitated a trip to Harbor View Medical Center via ambulance.
As doctors worked to relieve his worsening pain, Scaff became short of breath and his fever spiked to 104. In short order, a blood clot, which did not originate in his legs as is most typical, was discovered in his lungs. On the third day, Scaff became septic, and a subsequent test found that a bacterial infection had damaged his heart.
Essentially, Scaff entered the hospital for treatment of a serious spinal condition and while there suffered a stroke that damaged his heart. Great misfortune wrapped in great luck. Or perhaps the other way around. Either way, Scaff said, he survived.
Scaff was intubated for four days and remained in the intensive care unit for a total of 21 days. He was later transferred to a local nursing home for rehabilitation. Donna Scaff rented a nearby apartment and made daily trips to assist her husband.
The Scaffs were eager to return to Hawaii but could not get clearance from their insurance to book transport. Eventually, they swallowed hard and paid $58,000 for a private jet to bring them back to Honolulu.
Scaff spent an additional three weeks at Rehabilitation Hospital of the Pacific and most of the next three months after that at Maunalani Nursing and Rehabilitation Center before finally returning to his Round Top residence on Dec. 23, 2019.
While he was in rehab, Donna Scaff arranged for the installation of a wheelchair lift from their parking deck to the bottom floor of their home, where Jack’s new room was located. There, for the next year and a half, the couple lived in virtual isolation necessitated by Jack Scaff’s diminished physical condition, Donna Scaff’s beyond-full-time care duties and the pandemic raging outside.
“The whole experience was shocking,” Donna Scaff said. “We went from being very active to all of a sudden not mobile. We just did our best to try to adapt.”
Jack Scaff’s spinal condition has left him unable to walk. The stroke also paralyzed his right arm and affected his left. He says he also experiences difficulty with his speech when he is tired and sometimes has to wait for his mind to retrieve names and other words for which he is casting.
Beyond that, however, Scaff retains much of his old self. He’s full of ideas. He can deliver an insightful review of the latest medical literature. He laughs easily and often.
He’s also eager to travel, although most likely via cruise ship due to his bad back.
Most of all, he’s happy for the re-start of the marathon clinic. Scaff plans on speaking at the clinic once a month, sharing lessons on distance training that will be recorded and posted on the Honolulu Marathon Clinic website.
“You do what you can,” he said with a resigned chuckle.
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Honolulu Marathon Clinic
>> What: Brief lesson and group training runs
>> Where: Kapiolani Park, near the bathrooms at 3833 Paki Ave.
>> When: 7:30 a.m. Sundays
>> Cost: Free
>> Info: honolulumarathonclinic.org
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