The Blue Fugates of Eastern Kentucky

Around the world there are legends of human beings who have skin of a unusual shades, folk whose skin color wasn't some variation on brown or pink. These people, as they are remembered by their neighbor's descendants, were usually of a supernatural ilk - elves or gods or some other genre of sentient being. More often than not, these legends have been explained in our oh-so-enlightened civilization as the product of imaginative storytellers, bad translations, and artistic flourishes. Yet, in the relatively recent past, in the hills of eastern Kentucky, there was a clan of folk who seem to have shared a genetic anomaly that, in effect, rendered them blue.

That's right blue.

Okay, well, maybe not entirely blue - but definitely a blueish tint.

Madison Cawein began hearing rumors about the blue people when he went to work at the University of Kentucky's Lexington medical clinic in 1960. "I'm a hematologist, so something like that perks up my ears," Cawein says, sipping on whiskey sours and letting his mind slip back to the summer he spent "tromping around the hills looking for blue people."
Cawein is no stranger to eccentricities of the body. He helped isolate an antidote for cholera, and he did some of the early work on L-dopa, the drug for Parkinson's disease. But his first love, which he developed as an Army medical technician in World War II, was hematology. "Blood cells always looked so beautiful to me," he says.
Cawein would drive back and forth between Lexington and Hazard an eight-hour ordeal before the tollway was built and scour the hills looking for the blue people he'd heard rumors about. The American Heart Association had a clinic in Hazard, and it was there that Cawein met "a great big nurse" who offered to help.
Her name was Ruth Pendergrass, and she had been trying to stir up medical interest in the blue people ever since a dark blue woman walked into the county health department one bitterly cold afternoon and asked for a blood test.
"She had been out in the cold and she was just blue!" recalls Pendergrass, who is now 69 and retired from nursing. "Her face and her fingernails were almost indigo blue. It like to scared me to death! She looked like she was having a heart attack. I just knew that patient was going to die right there in the health department, but she wasn't a'tall alarmed. She told me that her family was the blue Combses who lived up on Ball Creek. She was a sister to one of the Fugate women." About this same time, another of the blue Combses, named Luke, had taken his sick wife up to the clinic at Lexington. One look at Luke was enough to "get those doctors down here in a hurry," says Pendergrass, who joined Cawein to look for more blue people.
Trudging up and down the hollows, fending off "the two mean dogs that everyone had in their front yard," the doctor and the nurse would spot someone at the top of a hill who looked blue and take off in wild pursuit. By the time they'd get to the top, the person would be gone. Finally, one day when the frustrated doctor was idling inside the Hazard clinic, Patrick and Rachel Ritchie walked in.
"They were bluer'n hell," Cawein says. "Well, as you can imagine, I really examined them. After concluding that there was no evidence of heart disease, I said 'Aha!' I started asking them questions: 'Do you have any relatives who are blue?' then I sat down and we began to chart the family."
Cawein remembers the pain that showed on the Ritchie brother's and sister's faces. "They were really embarrassed about being blue," he said. "Patrick was all hunched down in the hall. Rachel was leaning against the wall. They wouldn't come into the waiting room. You could tell how much it bothered them to be blue."
After ruling out heart and lung diseases, the doctor suspected methemoglobinemia, a rare hereditary blood disorder that results from excess levels of methemoglobin in the blood. Methemoglobin which is blue, is a nonfunctional form of the red hemoglobin that carries oxygen. It is the color of oxygen-depleted blood seen in the blue veins just below the skin.

Okay - that is only a slice of the article - - - you should really read the entire bit, frankly - it'll be well worth your time. When you've reached the end you'll understand why, even with diligent searches of the internet, you're unlikely to find many pictures of blue men or women, Kentuckian or otherwise - because those people affected with this genetic anomaly (I won't call it a defect or even a handicap, because I haven't read of any disabling physiological effects) fear, quite logically, that society would drag them out for public exposition. It is sad, really - a physical trait that could add to someone's uniqueness has had to be hidden out of fear that it will be exploited by the foulest pimps of the entertainment and yellow journalism - both printed and video tabloids. Indeed, I find it interesting that most of those folks interacting with the blue Fugates blame the geography of east Kentucky alone for their genetic inbreeding - I can't remember that any of them make the connection between their hesitancy to leave their family connections and the fact that these people, rational beings all, knew how they would be insulted, feared, abused, and most likely, very, very lonely. Ah well.

If you're interested, I have a few more links for you - not a ton, but enough to keep your eyes moving for a few minutes at least. . . consider:

The Radford University Geography Blog entry on "The Blue People of Kentucky"

The Straight Dope's "Is There Really a Race of Blue People?"

Wikipedia on "Methmoglobinemia"