You’ve probably seen the cover. A lone woman on a mule, trekking through the rugged, unforgiving greenery of the Kentucky mountains. It looks like a classic historical drama, but The Book Woman of Troublesome Creek by Kim Michele Richardson is actually a dive into one of the weirdest, most heartbreaking pockets of American history. Honestly, if you told someone today that there used to be people with literally blue skin living in the Appalachians, they’d think you were pitching a sci-fi flick.
But Cussy Mary Carter was real. Well, her character is a vessel for a very real medical phenomenon and a very real, very gutsy group of women.
Richardson didn’t just make up the "Blue People" for a plot device. She tapped into the history of the Fugate family, who carried a rare genetic condition called methemoglobinemia. It’s a mouthful. Basically, it reduces the blood's ability to carry oxygen, leaving the skin a distinct, startling shade of indigo. In the 1930s, being blue in Kentucky wasn't just a medical curiosity; it was a social death sentence.
The Blue Blood of Kentucky
Cussy Mary is the last of her line. She’s a "Blue."
In the book, she faces a brand of prejudice that feels surreal because it’s based on something as arbitrary as a tint. People called them "coloreds," but they weren't Black. They weren't white either. They existed in this strange, lonely limbo. Richardson captures this isolation perfectly. You feel the grit in Cussy’s teeth and the cold in her bones as she rides her mule, Junia, across the treacherous terrain of Troublesome Creek.
The medical side of this is fascinating. The Fugates lived in isolation for over a century, which meant the recessive gene stayed right there in the holler. It wasn't until the 1960s—long after the timeline of the book—that a hematologist named Madison Cawein figured out how to "treat" it with, ironically, methylene blue.
But in the 1930s? Cussy Mary had no cure. She just had her books.
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Roosevelt’s Pack Horse Librarians
If the blue skin is the "hook" of the story, the Pack Horse Library Project is its soul. This was a real program under the Works Progress Administration (WPA). Franklin D. Roosevelt was trying to pull the country out of the Great Depression, and one of the most badass initiatives was sending women on horseback into the deep woods to deliver books.
These weren't easy Sunday rides.
These women were tough. They rode through blizzards, over flooded creeks, and up steep rocky inclines where wagons couldn't go. They were paid about $28 a month—which was decent back then but hardly enough for the risks they took. They weren't just delivering The Great Gatsby. They were bringing scrapbooks, recipes, and news to people who were almost entirely cut off from the world.
Richardson highlights a detail that most history books miss: the librarians often created their own "books." They would sew together clippings, patterns, and tips into handmade volumes to share with families who had nothing. It was the original social media, curated by hand and delivered on a mule.
Why the Controversy with The Giver of Stars?
We have to talk about the elephant in the room. Or rather, the two books in the room.
Shortly after The Book Woman of Troublesome Creek gained traction, Jojo Moyes released The Giver of Stars. Both books feature the Pack Horse Librarians. Both feature a plot point about a library being established in a Kentucky mining town. Both have scenes involving a library being threatened by local authorities.
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Richardson was vocal about the similarities. It sparked a massive debate in the literary world about "book twins" versus plagiarism. While the themes overlap, the vibe of the two books is wildly different. Richardson’s work feels more grounded in the specific, harsh reality of the Appalachian people and the unique "Blue" heritage. It’s grittier. It’s less "romance-novel-in-the-woods" and more "survival-at-all-costs."
Honestly, reading both gives you a weirdly 3D view of the era, but Richardson’s focus on the methemoglobinemia gives her story an edge that’s hard to shake.
The Reality of 1930s Appalachia
The book doesn't shy away from the darkness. We’re talking about a time when mining companies basically owned their employees' souls. The "company store" wasn't just a song lyric; it was a trap.
- Poverty: Many families Cussy visits are literally starving.
- Illiteracy: The librarians didn't just drop off books; they often stayed to read to the families.
- Violence: The tension between the law, the miners, and the "hill people" was always a spark away from a fire.
Cussy Mary’s struggle isn't just about her skin color. It's about the fact that she’s a woman trying to do a job in a place that views her as an omen or a freak. There’s a scene where she tries to "cure" herself by taking medicine that makes her sick, just to look "normal" for a few hours. It’s gut-wrenching because it shows how much she internalized the hate of the people around her.
What Most People Miss About Cussy Mary
People focus on the mule and the books. But the real heart of the story is Cussy’s relationship with her father. He’s a coal miner. He’s dying of black lung. He wants her to marry a man who will "protect" her, but his version of protection involves erasing who she is.
It’s a classic generational clash. Her father sees the world as a place where you hide to survive. Cussy sees the library as a way to finally stand in the light, even if that light shows her blue skin.
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The mule, Junia, is also a character in her own right. Anyone who has ever owned an animal knows that bond. In the book, Junia is often Cussy’s only friend, her only protector, and her only witness. The mule represents the stubbornness required to survive in Kentucky. You can't be soft. You have to be willing to kick when necessary.
Practical Takeaways for Your Next Read
If you’re picking up The Book Woman of Troublesome Creek for a book club or just a personal weekend binge, here’s how to get the most out of it:
Look up the Fugate family photos. Seeing the actual historical photos of the blue-skinned family members makes Cussy Mary’s plight feel much more immediate. It’s not a myth.
Research the WPA posters. The art created during the Great Depression to promote the Pack Horse Library is stunning. It gives you a visual sense of the propaganda and the hope that FDR was trying to instill in a broken nation.
Check out the sequel. Richardson didn’t stop here. She wrote The Book Woman’s Daughter, which follows Cussy’s daughter, Honey Mary. It deals with "female independence" laws and how the state could essentially kidnap children of "unfit" (read: different) parents.
Identify the Semantics. Pay attention to how the "hill talk" is written. Richardson uses specific Appalachian dialects that aren't just for flavor—they represent a culture that was being actively erased by "modernity" and mining interests.
The book is a heavy lift emotionally, but it’s worth it. It’s a reminder that progress isn't just about technology or politics; sometimes, it’s just about a woman on a mule carrying a copy of Robinson Crusoe to someone who has never seen a map.
Next Steps for the Curious Reader
- Read the 1982 article "The Blue People of Troublesome Creek" by Cathy Trost. It’s the definitive piece of journalism that brought this story back to the public eye.
- Visit the Kentucky WPA library sites. If you’re ever in the area, some of the small-town libraries still have archives dedicated to the Pack Horse women.
- Compare the "Blue" genetics. Look into how modern medicine views methemoglobinemia today. It’s still around, though usually caused by reactions to certain medications rather than the Fugate gene.
- Support Rural Literacy. The spirit of the Pack Horse Librarians lives on in mobile book buses and rural literacy programs. Donating a few bucks to a "Bookmobile" project is the best way to honor Cussy Mary’s legacy.