"They're known simply as the "blue people" in the hills and hollows around Troublesome and Ball Creeks. Most lived to their 80s and 90s without serious illness associated with the skin discoloration. For some, though, there was a pain not seen in lab tests. That was the pain of being blue in a world that is mostly shades of white to black.
There was always speculation in the hollows about what made the blue people blue: heart disease, a lung disorder, the possibility proposed by one old-timer that "their blood is just a little closer to their skin." But no one knew for sure, and doctors rarely paid visits to the remote creekside settlements where most of the "blue Fugates" lived until well into the 1950s. By the time a young hematologist from the University of Kentucky came down to Troublesome Creek in the 1960s to cure the blue people, Martin Fugate's descendants had multiplied their recessive genes all over the Cumberland Plateau.
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."