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By the time a young hematologist from the 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.

' 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. Methemoglobin which is blue, is a nonfunctional form of the red hemoglobin that carries oxygen.

"They were really embarrassed about being blue," he said. It is the color of oxygen-depleted blood seen in the blue veins just below the skin.

Cawein drew "lots of blood" from the Ritchies and hurried back to his lab.

He tested first for abnormal hemoglobin, but the results were negative.

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It can be brought on by several things: abnormal hemoglobin formation, an enzyme deficiency, and taking too much of certain drugs, including vitamin K, which is essential for blood clotting and is abundant in pork liver and vegetable oil.

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.

Stumped, the doctor turned to the medical literature for a clue.

He found references to methemoglobinemia dating to the turn of the century, but it wasn't until he came across E. Scott's 1960 report in the Journal of Clinical Investigation (vol. Scott was a Public Health Service doctor at the who had discovered hereditary methemoglobinemia among Alaskan Eskimos and Indians.




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