This was a re-read for KTL Book Club, previously read for BC. All I had remembered was that the heroine was blue, the poverty and the racism. Cussy is Blue and it's 1930's depression in Appalachian eastern Kentucky. Her father is a coal miner dying of lung disease, overworked and underpaid (mostly in Company store Script) He's desperate to get Cussy married but she's not really interested and most men are not interested in a Blue. She's married off to a man who wants her for the promised land from her dad. Her rapes her on their wedding night and immediately dies of a heart attack. She's working for the WPA as a Pack Horse Librarian. She brings old books, newspapers, and magazines to the hollows of the area. Most are very poor and barely literate. There is one, Jackson Lovell, a new one, who has recently returned from working on Hoover Dam and finds here interesting.
The brother of he husband is a minister determined to assault then rid the world of this defective. Her mule chases him off. Later in the book he come to their house but the mule kicks him in the head. While Cussy is fetching the doctor, he dies, probably killed by her father. They know that as Blues, and having 2 brothers die on their watch, their lives are in danger. They convince to doctor to not report the death in exchange for letting the doctor study Cussy.
Taken to Lexington by car to a hospital, Cussy understands nothing so she resists undressing, etc. She's physically restrained by some nuns, is sedated, and examined. In addition to blood a sample of her cervix is taken, so she is essentially assaulted again.
The Doctors identify he blood as lacking red blood cells. Her blood is brown, but this does not really affect her health or length of life. The dr, gives her a treatment that makes he look white, but makes her feel really sick and has to be taken daily. Everyone who knew her as Bluey is just weirded out by her color change and still will not accept her as one of them. At this failure she stops taking the drug.
Cussy arrives at one patrons home hours after the 15 year old wife has given birth to a Blue child. Her husband has evidence of blue and the mother must have been a carrier. The husband has hung himself before C's arrival and the mother dies a little after her arrival. She asks Cussy to take her child. She gets Jackson to bury the parents and takes the child home where Cussy pretends to the world at large that it's the child of her husband.
Jackson proposes and is accepted. The same day C's dad is killed in a mine accident not long before the mine will be closed. They marry a couple of months later. As soon as they are married, the sheriff accuses them of breaking the law against mixed marriages. Jackson gets mad punches the sheriff. Fast forward 4 years, the end is that he goes to prison for a while and is banned from Kentucky for 25 years. They are trying to find a place in Ohio to move to.
In amongst this plot there is a lot about life in the mountains, the hardships, festivals, etc. There's some nasty co-workers when she goes the the library. She was loved and taught by her dead mother. There is a black woman who is also a Pack Horse Librarian. Queenie finds employment in Philadelphia and is continuing her education there. Cussy & her dad argue a lot about her marriage, his union activity, and what he will do when the mine closes but there is love.