People come in all colors – to an extent. You wouldn’t expect to see a human with naturally blue skin. But that’s the case for the Blue Fugates. Who are the Blue Fugates? The title refers to members of the Fugate family of eastern Kentucky, particularly those who lived in the early- to mid-20th century. And according to firsthand accounts, the title is no exaggeration.
Why did the Fugates turn blue? The short answer has to do with a genetic mutation arising from inbreeding. The longer answer has to do with recessive genes and bizarre happenstance. If the Fugates hadn’t lived in such a rural area, their condition might not have become as pronounced.
Blue skin is often seen as something not quite human: the Scottish Blue Men of the Minch, the Hindu god Krishna, even Smurfs all have it. But the Fugates are mortal, and however wild they may seem, these facts about the Blue Fugates of Kentucky are nothing but the total truth.
They Lived In Isolation
The Fugate family first settled in Kentucky in 1820. Martin Fugate and his wife Elizabeth Smith came to Troublesome Creek, an out-of-the-way region of Appalachia. According to some sources, Fugate was blue himself, though this has been disputed. Whatever his color, his offspring ended up with an unusual appearance: his son Zachariah was born with blue skin, and so were three more of their seven children.
Due to the isolated nature of the community, the Fugate’s neighbors knew about the “blue people,” but few outsiders did.
They Had Unusual Blood
So, where did that blue color come from? The Fugates had a genetic defect that resulted in a condition called methemoglobinemia, which means their blood didn’t carry as much oxygen around the body. This makes the blood darker, which in turn causes the skin of white people to appear blue, and their lips to look purple. In addition, arterial blood looks chocolate brown rather than red.
People with methemoglobinemia have higher levels of methemoglobin in their blood; they may have 10-20 percent, versus the average person’s one percent. The Fugates’ very blood was different from that of their neighbors.
Their Condition Partially Arose From Inbreeding
Martin Fugate and his bride, Elizabeth Smith, both carried the same recessive gene that causes methemoglobinemia. It wouldn’t have affected future generations of Fugates – if they hadn’t married within the family, that is.
In the 1880s, inbreeding wasn’t quite the scandal it is today. The Fugates lived in an isolated area, which limited their options. Zachariah Fugate, one of the first known Blue Fugates, married his aunt; one of their sons married a close cousin. In turn, one of their children married another cousin.
It makes for a confusing family tree marked with plenty of blue individuals. As one of the family members quipped, “I’m kin to myself.”
Luna Fugate Was The Bluest Blue Fugate
At the end of the 19th century, a man named John Stacy attended church one Sunday in eastern Kentucky. He spotted a young woman, and apparently liked what he saw. The two courted, got married, and had 13 children.
The woman was Luna Fugate, and according to lore, she was bluest Blue Fugate of them all. According to a local nurse, “The bluest Fugates I ever saw was Luna and her kin. Luna was bluish all over. Her lips were as dark as a bruise. She was as blue a woman as I ever saw.”
Interestingly enough, Stacy himself refused to say whether or not his beloved wife was blue.
They Were Shunned
The Fugates’ blue skin was more than just startling – it was also a clear sign that the family had practiced intermarriage. As time went on and people began to discover more about the harmful effects of inbreeding, that blue skin became even more of a stigma.
Their neighbors were not always kind to the Fugates, and in response, they had withdrawn even more from their tiny community. By the time Dr. Madison Cawein contacted the family in the 1960s, it was clear they were all too used to being outcasts: “They wouldn’t come into the waiting room. You could tell how much it bothered them to be blue.”
They Lived Long, Healthy Lives
Methemoglobinemia can cause developmental delay and seizures, but despite the intense appearance of their blue skin and purple lips, none of the Fugates suffered poor health or lived in pain. The condition had only a cosmetic effect, though the family endured psychological pain from their outsider status. Each of the Blue Fugates lived to a ripe old age.
They Were Treated With Blue Dye
In the early 1960s, the case of the Blue Fugates was brought to the attention of Dr. Madison Cawein, a hematologist at a University of Kentucky medical clinic. He began “tromping around the hills looking for blue people,” eager to learn more about the Fugates. He ran into a nurse named Ruth Pendergrass, who had firsthand experience with the blue people. She joined him in his hunt, and eventually they met two of the Fugates.
After interviewing the Fugates, Cawein concluded that their blood must be missing a crucial enzyme. To trigger the blood’s natural processes, the doctor decided to inject the affected family members with methylene blue, a dye.
The cosmetic results were nearly instant. Talking about the experience years later, Cawein said that the treated family members were thrilled to see the blue fade from their skin: “For the first time in their lives, they were pink.”
The solution really was that easy. The effects of the dye were temporary, but Cawein supplied the Fugates with methylene blue tablets to take every day.
The Last Known Blue Fugate Was Born In 1975
The Fugates continued to have large families over the years, and some children were always born in varying shades of blue. However, coal mining and the railroads brought new people to Kentucky, and the Fugates began marrying outside of their family. Eventually, that recessive gene receded.
The last known Blue Fugate was born in 1975. Benjy Stacy looked “almost purple” at birth, alarming his doctors. But his grandmother shared the story of her family’s unusual lineage, and the medical staff concluded that he had simply inherited the Fugates’ rare condition. The blue faded from Stacy’s skin over the next few weeks, though his lips and nails continued to turn purple when he got cold or angry.
Could more Blue Fugates be born in the future? Less inbreeding makes it less likely that the recessive gene causing the condition would crop up, though it’s still there. There’s a chance that future generations of the Fugates could have blue skin, but that chance is very small.
The Fugates Today Live Very Private Lives
Although ABC news published a story on the blue Fugates in 2012 and tried to follow up with the surviving family members, they reported being unable to reach anyone. At least two family members still live in the Appalachia area, but the gene pool has significantly dispersed. “You almost never see a patient with [methemoglobinemia],” admits a hematologist from the Mayo Clinic, Dr. Ayalew Tefferi.
The Blue Men Of Lurgan Also Had The Disease
The “blue men of Lurgan” were Irish brothers who, in the 1940s, were treated by a doctor with ascorbic acid and sodium bicarbonate for what the doctor thought was some kind of cardiovascular disease. It didn’t work, but it caught other doctors’ attention and eventually, other doctors used the brothers to identify enzyme deficiencies and unusually high levels of methemoglobin in their skin.
In 2002, DNA was taken from one of the brothers who was still alive as well as two siblings. More than 30 mutations of the genes were found.
Although It Can Be Genetic, You Can Also Acquire Blue Skin Later In Life
Although the Fugates ended up passing down a recessive gene through generations, ensuring the continuation of blue-tinged skin and oxygen-deficient blood for generations, there is also a way to acquire methemoglobinemia without the gene. When protective enzymes that exist in healthy red blood cells are exposed to oxidizing drugs or other nitrates, they can infiltrate the enzymes and increase methemoglobin levels. This leads to physical symptoms like shortness of breath, headache, dizziness, and in extreme cases death, which is why the blue-tinged skin look is often associated with that.