From around 1820 through the mid 1900s there were some very unusual-looking people living in an isolated area of Eastern Kentucky. What made them unusual was the color of their skin – it was blue. They were varying shades of blue: Some were pale blue, others a deeper blue, and still others just had blue tinges to their fingernails and lips.
They were known simply as “the Blues.”
A Mystery in the Hills
While it wasn’t unusual to see Blues, not everyone in this Kentucky hollow was blue. Out of a family with eight children, perhaps four or five of them might be born with this skin condition, while the others had typical Caucasian skin.
For generations, no one understood why. It wasn’t until the 1960s that these people came to the attention of the medical community, and they finally uncovered the cause: a rare blood disorder. But what caused it, and why was it so prevalent in this specific area?
The Blue Fugates
The story of the blue-skinned Kentucky people began in 1820 when Martin Fugate, a French orphan, settled in the wilds of Eastern Kentucky to claim a land grant near Troublesome Creek.
Although there is no mention of his skin color in the earliest records, it’s certain that he carried the gene for a condition now known as methemoglobinemia, a rare blood disorder.
Martin settled near Troublesome Creek and married a red-headed, fair-skinned American woman named Elizabeth Smith. Unbeknownst to both of them, Elizabeth carried the same recessive gene for this rare blue-skin condition.
When both parents carry the gene, there is a chance their children will inherit the condition. Martin and Elizabeth Fugate had seven children, and four of them were born blue.
Isolation and Intermarriage
At the time, this area of Eastern Kentucky was wild and remote. There were no roads and only a few other families lived near the Fugates. In this isolation, the families didn’t have much choice when it came time for their children to marry.
So when one of the Fugate sons married one of the Smith daughters (Elizabeth’s family) it again created the situation where both parents carried the gene and more blue children were born.
The gene for methemoglobinemia spread through the local families living in the cabins dotted along the hollows. They later became known as the Blue Fugates.
Life as a “Blue“
Despite their unusual appearance, the Blue Fugates were generally healthy. Many lived well into their 80s and 90s and rarely went to see doctors. And because they lived in an isolated area, their condition went unnoticed by the outside world for years.
But as roads and railways were built through those wild areas, they became exposed to others. When outsiders would see them for the first time, they were often shocked by their skin color and sometimes frightened. The Blues faced prejudice and persecution because of their appearance.
Cause Revealed
Then in 1960, Madison Cawein, a haematologist working at the University of Kentucky medical clinic in Lexington heard about the blue people. He was immediately intrigued and decided to find out what caused the condition. He teamed up with nurse Ruth Pendergrass, and they began talking to the Blues, taking blood samples, and asking about their family histories.
Dr. Cawein identified the condition as methemoglobinemia — a disorder that reduces the blood’s ability to carry oxygen, giving the skin its blue tint.
He found that treating his patients with methylene blue could temporarily restore normal skin color by improving oxygen flow in the blood. But the effect was short-lived, and the treatment had to be repeated regularly.
A Disappearing Condition
As transportation improved, their world opened up and the Blue Fugates began to marry outside their immediate area. This reduced the likelihood of two carriers having children together — and the condition gradually became rare.
But it does occasionally pop up. The last known person to be born exhibiting the symptoms of this disease was a little boy born in 1975. His skin was blue at birth but was a normal color within a few weeks.
The Book Woman of Troublesome Creek
The story of the Blue Fugates inspires modern historical fiction.
Click the image to see it on Amazon. I’m an Amazon Associate, so if you make a purchase through my site, I’ll earn a small commission. But there’s NO extra charge to you.
I recently read The Book Woman of Troublesome Creek by Kim Michele Richardson. It’s a historical novel about a Blue woman who works as a pack-horse librarian in Eastern Kentucky during the Great Depression. It chronicles the loneliness and dangers of being ‘the last’ of the Blue Fugates. I found this book so interesting and well-written that I couldn’t put it down.
Pack Horse Librarians
Between 1935 and 1943 the US government sponsored the Pack Horse Library Project designed to get books into isolated areas of the Appalachian Mountains.
The librarians were mostly women who rode horses or mules across the often-treacherous terrain to deliver books to the mountain folk. In The Book Woman of Troublesome Creek, Cussy Mary Carter is a pack horse librarian as well as being a Blue, so the author combines two very interesting historical subjects.
Click the image to see it on Amazon. I’m an Amazon Associate, so if you make a purchase through my site, I’ll earn a small commission. But there’s NO extra charge to you.
Another Pack Horse Librarian Book: The Giver of Stars
Another great book about the pack-horse librarians is The Giver of Stars by Jojo Moyes. It shows more of the spirit of these ‘book women’ and how dedicated they were to their mission of distributing books.
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