Inspired by the true and gentle historical blue-skinned people of Kentucky and the brave and dedicated Kentucky Pack Horse librarians born of Roosevelt’s New Deal Acts, The Book Woman of Troublesome Creek showcases a fascinating and important footnote of history.
In writing the novel, my hope was to humanize and bring understanding to the gracious blue-skinned people of Kentucky, to pay tribute to the fearsome Pack Horse librarians—and to write a human story set in a unique landscape.
Methemoglobinemia is the extremely rare disease that causes skin to be blue. In the United States, it was first found in the Fugates of Troublesome Creek in eastern Kentucky.
In 1820, Martin Fugate, a French orphan, came to Kentucky to claim a land grant on the banks of Troublesome Creek in Kentucky’s isolated wilderness. Martin married a full-blooded, red-headed, white-skinned Kentuckian named Elizabeth Smith. Martin and Elizabeth had no idea what awaited them. They had seven children, and out of those, four were blue.
It was against all odds that, oceans away, Martin would find a bride who carried the same blue-blood recessive gene.
Methemoglobinemia is most commonly acquired from heart disease, or airway obstruction, or taking too much of certain drugs. When acquired, it can be life-threatening.
The Fugates’ methemoglobinemia, however, was congenital. Most of the Fugates lived a very long life, into their eighties and nineties and without serious illnesses related to their blue skin.
Congenital methemoglobinemia is due to an enzyme deficiency, leading to higher-than-normal levels of methemoglobin in the blood—a form of hemoglobin—that overwhelms the normal hemoglobin, which reduces oxygen capacity. Less oxygen in the blood makes it a chocolate-brown color instead of red, causing the skin to appear blue instead of white. Doctors can diagnose congenital methemoglobinemia because the color of the blood provides the clue. The mutation is hereditary and carried in a recessive gene.
I’ve modified one historical date in the story so I could include relevant information about medical aspects and discoveries. Instead of the 1930s, as is the book’s era, it was actually in the 1960s when Madison Cawein, MD, a Kentucky hematologist heard about the blue-skinned people and set out to find them. In the 1940s, a doctor in Ireland made similar discoveries among his people.
Dr. Cawein found the Fugates tucked in isolated hollers, in the thick-treed hills of Appalachia near Ball Creek and Troublesome Creek in Kentucky. The doctor convinced them to let him draw blood, then tested, analyzed, and drew more blood. The Fugates were gracious and kind people, according to Dr. Cawein’s reports. After testing and research, he discovered the Fugates had congenital methemoglobinemia.
Cawein first treated the Fugates with methylene blue injections that instantly turned their skin white. But the drug was only a temporary fix. Methylene blue, first used to treat cyanide and carbon monoxide poisoning, generally is secreted in the urine within twenty-four hours and can cause unpleasant side effects in the interim. The doctor left the Fugates a generous supply of oral methylene blue tablets to be taken daily. Cawein also became a protector of the Fugates, and when news media and Hollywood came to Kentucky to see the rare people, he refused to disclose their whereabouts.
With the help of the elder Fugates, their Bible notations, and their recollections, Dr. Cawein charted the family and traced their ancestry back to Martin Fugate.
In 1943, Kentucky banned first-cousin marriages, and the ban continues there and in most other states today. This prohibition in Kentucky was not only to prevent birth defects; it was sought for other reasons, as well. The Ku Klux Klan lobbied for the ban early and fought vigorously for the bill’s passage to keep white supremacy pure, while others wanted it to keep feuding mountain clans strong, which prevented young lovers from marrying enemy cousins and turning disloyal and increasing a clan’s numbers. Anti-miscegenation laws in Kentucky were in effect from 1866 until 1967. For anyone convicted, the penalty was a fine or imprisonment, or both.
From what we know, the Fugates originated from France and were descendants of French Huguenots. Could the Fugates’ medical anomaly mean they were true “blue bloods” descended from European royals? The Fugates were linked only to inbreeding instead of being embraced for their very uniqueness. Even when first-cousin marriages were legal across the United States, the Fugates were shunned and shamed, suffering in isolation because of their skin color and inherited genes.
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In 1913, the Kentucky Federation of Women’s Clubs convinced a local coal baron, John C. Mayo, to subsidize a mounted library service to reach people in poor and remote areas. But a year later, the program expired when Mayo died. It would be almost twenty years until the service was revived.
The Pack Horse Library Project was established in 1935 and ran until 1943. The service was part of President Franklin D. Roosevelt’s Works Progress Administration (WPA) and an effort to create jobs for women and bring books and reading material into Appalachia, into the poorest and most isolated areas in eastern Kentucky that had few schools, no libraries, and inaccessible roads.
The librarians were known as “book women,” though there were a very small number of men among their ranks. These fearsome Kentucky librarians traveled by horse, mule, and sometimes foot and even rowboat to reach the remotest areas, in creeks and up crags, into coves, disconnected pockets, and black forests, and to towns named Hell-fer-Sartin, Troublesome, and Cut Shin, sometimes traveling as much as one hundred or more miles a week in rain, sleet, or snow.
Pack Horse librarians were paid twenty-eight dollars a month and had to provide their own mounts. Books and reading materials and places for storing and sorting the material were all donated and not supplied by the WPA’s payroll.
With few resources and little financial help, the Pack Horse librarians collected donated books and reading materials from the Boy Scouts, PTAs, women’s clubs, churches, and the state health department. The librarians came up with ingenious ways to provide more reading resources, such as making scrapbooks with collected recipes and housecleaning tips that the mountain people passed on to them in gratitude for their service. The book women colored pictures to make children’s picture books, journals, and more, all the while vigorously seeking donations.
Despite the financial obstacles, the harshness of the land, and the sometimes fierce mistrust of the people during the most violent era of eastern Kentucky’s history, the Pack Horse service was accepted and became dearly embraced. These clever librarians turned their traveling library program into a tremendous success.
In the years of its service, more than one thousand women served in the Pack Horse Library Project, and it was reported that nearly 600,000 residents in thirty eastern Kentucky counties considered “pauper counties” were served by them. During those years, the beloved program left a powerful legacy and enriched countless lives.
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Finally, courting candles. The spiral design of courting candles over a hundred years ago was likely created to keep the melting candle in place and from slipping—a mere practicality, more folklore than fact—though they certainly could have been used later by a patriarch to teach a daughter to respect his judgment and as a way to screen for potential suitors.
Still, I found it a commanding and curious induction of courtship. How powerful that the candle could be the source of someone’s lifelong misery or joy, and passed on in different generations. How wonderful the conversations that must have taken place around and over it.
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A Final Note. Dearest Reader, this is one of the most important books I’ve written to date. Dear in all ways, loved in a million more. I have tried to present the novel with precise historical backdrops, which involved in-depth research; interviews; meetings with hematologists, doctors, firewatchers, and others; studying Roosevelt’s WPA programs; and living in Appalachia. If anything is omitted, or befuddles, it is strictly unintended and the fault of me, the author.