Mac Holliday, pioneer in kidney treatment, dies at 90

04/10/2014

Malcolm “Mac” Holliday, Jr., a doctor who pioneered kidney treatments for children and retired in Inverness, died on March 26. He was 90.

Mac was born on January 12, 1924, in Staunton, Virginia, a low-lying city in a valley between the Blue Ridge Mountains to the east and the Appalachians to the west. At age 3 he was hospitalized with a kidney infection. A year before the discovery of penicillin, doctors had a choice between removing the kidney—an unprecedented step for a child—or watching the infection kill him. For the rest of his life, Mac would maintain he was living proof that one kidney is enough. 

The experience sparked a lifelong interest. “I wanted to become a doctor and get even!” he said in a 2005 interview. “So from that inauspicious beginning, I went to medical school.” 

A quick study, Mac enrolled at the University of Virginia as an undergraduate at 16 and was in the medical school by 19. With many students fast-tracked for training as medics on the front lines of World War II, Mac qualified as a doctor by the time he was 22. (He avoided the draft because having one kidney was a liability.) 

Halfway through his medical studies, his sister Jean introduced him to a woman named Millie, a Charlottesville native. The two met at a party on Valentine’s Day in 1944 and soon began dating.

Mac and Millie married on March 20, 1946, a day he would never forget. In the morning, he received his university diploma and in the evening he married Millie in the school’s chapel. In between, in an early sign of the absent-mindedness that afflicts university professors, Mac realized he forgot the ring at home. A member of the wedding party had to break a window to grab it and make it back in time for the ceremony. The couple shared 63 years together until Millie’s passing in 2009.

Mac studied under various doctors at the Children’s Hospital in Boston and at Yale. “Having lived in a segregated Virginia and ultimately repulsed by legalized degradation I was glad to leave the day I graduated and married to a slightly better community—Boston, where sick children were not segregated but treated without regard to race,” he wrote to friends in 2008. 

Mac said he was drawn to pediatrics because children’s cases were so exciting: the threats could be more acute, but young bodies also seemed more flexible and resilient. His academic career began in earnest with his first faculty appointment at the University of Indiana. But his time was cut short by a change in Army regulations, and he was drafted during the Korean War. After, Mac became a professor of pediatrics at the University of Pittsburgh. 

In 1963, he moved his wife and five children—Suzanne, Sander, Rob, Rick and Randy—to California, stacking luggage on the roof of a new Ford Fairlane for a weeks-long road trip across the northern half of the country. Always forward-thinking, Mac had optional seatbelts installed. The family fell in love with the Bay Area, making regular excursions to the countryside. 

Mac became physician-in-chief at the Children’s Hospital in Oakland, but he only kept the job a few years. He had ambitions to start a robust pediatric program, but as Ronald Reagan was elected governor with a promise “to send the welfare bums back to work,” securing public funding seemed unlikely. He found new work in 1966 at the University of California, San Francisco, where he headed the pediatric nephrology division, studying children’s kidneys. He pioneered home dialysis and kidney transplants, procedures that were scoffed at as unfeasible, even ridiculous. 

The work changed his outlook on children’s medicine as he observed the impacts of disease and prescribed treatments, like special diets, on patients and their families. He remembered one child who dreamed of steaks and watermelons—two forbidden foods—raining down on him. Especially with children, he found that cures needed to be collaborative. 

Even as Mac developed the field of pediatric nephrology—he helped write the first board exams—raising a family of five on his salary could be difficult. Sometimes when Millie pressed him on the challenge, he made it clear his passion was advancing pediatrics. The culture of medicine was slowly shifting from “a service organization to a business organization,” a change he said he lamented.

By 1967, a small program was training two children at a time for home dialysis, and children were signed up for donations from relatives at U.C.S.F. In one case, a grandmother donated a kidney to a grandchild, and when the sibling encountered the same problems, the other grandmother donated hers. “Four people sharing four kidneys!” Mac exclaimed. Medicare began paying for dialysis and transplants in 1972, prompted in part by Mac’s contributions as chair of the Committee of the National Kidney Foundation on Dialysis and Transplant.

“He dedicated his life to his job,” his son Randy said. “He wasn’t a doctor to make money; he was a doctor to make positive change. That’s the only way I can put it.”

When he retired, Mac and Millie moved to Inverness in 1991. They had purchased a small, three-room cottage for weekend stays, but now they wanted to live in the area full-time. It was the place he fell in love with, and maybe defined him, friends and family said. He continued to be involved.

“If you spend your whole life working with children, I think it must change who you are,” his friend Richard Kirschman observed. “I expect that it keeps you in touch with what younger people are thinking and doing and hoping for, what the problems are for them and their families, as opposed to just surrounding yourself with health problems of aging and gray hair.”

Mac continued to work on medical issues: he became president of the board of directors for the Coastal Health Alliance and helped broker a deal to allow Kaiser Permanente patients to use the local clinics. He also edited the textbook on pediatric nephrology.

“Inverness was all kinds of people who had interesting ideas, who were thoughtful, intellectually engaged and politically active,” his daughter Suzanne Calpestri said. “All this other stuff was available, when he was no longer trapped by the day-to-day of going to the hospital. Fortunately, he had a lot more to give to the community than just being a doctor.”

Mac and Millie kept a pied-a-terre in the city to spend the night after seeing a play or symphony, but spent most of their time in West Marin. He was an active member of the Dance Palace, and Millie was president of the Inverness Garden Club. With a bit of Southern hospitality, they both enjoyed having friends over for dinner: she cooked Dungeness crab while he entertained.

One of his favorite aspects of life in West Marin was being a founding member of the decades-old Thursday lunch club at the Station House Café: the ROMEOS, a tongue-in-cheek acronym for “Retired Old Men Eating Out.” The group consisted of seasoned luminaries that shared discussion and debate over meals.

Mac was considered one of the best-read, particularly in American history, and his medical advice was always handy for the group. With a slight drawl, Mac often advocated progressive politics in a group that included an important member in the American Communist Party and a former speechwriter for cabinet members in the Kennedy, Johnson and Nixon administrations.

Mac also enjoyed hiking trails in the seashore, his favorite being Abbotts Lagoon. The trail used to cross through muck and swampy areas, but Mac donated money for a boardwalk. As rigorous hikes became more difficult, he still walked the Bear Valley and the Earthquake Trails, always commenting on whether the dogwood—a reminder of Charlottesville—was in bloom. 

“Even within the medical field, all of his friends knew Point Reyes was where his heart was,” Suzanne said. “He went back every week to hike and have lunch. Even when he couldn’t drive, we had somebody drive him out there. That’s really where all of the dimensions of his personality and all of his diverse interests were very well cared for. 

“We never saw him happier than when he was in Inverness,” she continued. “They had the best of their lives up there, and we’re really grateful to know that life could be so rich.”

 

This article was corrected on April 16. Mac Holliday's men's lunch group included one member who, as a member of the Department of State, wrote speeches for cabinet members in the Kennedy, Johnson and Nixon administrations, but not for President Nixon as previously reported.