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On December 11, 1912, at Portland, Oregon, Dr. Alexander married Dr. Harry R. McKellar. The two doctors had met when they were both interning at Philadelphia General. Dr. McKellar was an officer in the U.S. Army Medical Corps, and he and his wife were in the Philippines prior to coming to Hawaii in 1915 when Dr. McKellar was stationed at Ft. Shafter.
Dr. Ruth was granted a license to practice in the Territory in June, 1916. Two years later (August, 1918) she was appointed director of the Tuberculosis Bureau of the Territorial Board of Health at a salary of $250 a month. She was selected for this position to replace Dr. Lawrence L. Patterson who was serving with the Army. On his return to his former position, friction developed between the two, and the Board then made it clear that Dr. Patterson was to head the Bureau and that Dr. Ruth was to serve as his assistant. Continuing trouble and tension resulted ultimately in Dr. Patterson's dismissal and Dr. Ruth's transfer to head the Government School Inspection program. On May 13, 1920, Dr. Ruth resigned her position with the Board of Health. Named by Governor Charles J. McCarthy to the commission to manage the affairs of the home for the feeble minded in 1919, she was the only physician on the commission.
Dr. Ruth filed for divorce in February, 1919. As Major McKellar was then stationed on the Mainland, the suit dragged on for over a year with a cross complaint being filed by the Major. The suit was finally settled in July, 1920, in Dr. Ruth's favor, and she resumed her maiden name.
In October, 1920, Dr. Alexander left Honolulu to take a postgraduate course at the Manhattan Eye, Ear, and Throat Hospital in New York City. Returning to Honolulu in November, 1921, she opened an office and specialized in diseases of the eye, ear, nose, and throat. A letter, dated January, 1930, from Queen's Hospital files, shows that Dr. Alexander accepted a position as physiotherapy specialist at the hospital for a year. Sometime between 1931 and 1934 she went back to the East Coast and, presumably, was in practice for a time or affiliated with some institution for further study, since she became a member of the Massachusetts State Medical Society. By 1934, she was back in Honolulu where she was in practice until her retirement in 1939.
On January 18, 1941, Dr. Alexander died in Honolulu at the age of 51.
She was a former member of the Medical Society of Pennsylvania, the Honolulu Medical Society, the Hawaii Territorial Medical Association, the American Medical Association, and on the staff at Queen's Hospital. She was one of the founders of the Honolulu Zonta Club in 1923 and served as its president in 1924.
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