Hektoen International

A Journal of Medical Humanities

Discrimination: From Blues to Amazing Grace to sleeves

Lauren E. Hill
Walnut Cove, North Carolina, United States
Jack E. Riggs
Morgantown, West Virginia, United States

Combat support hospital sailors wearing sleeves down (Army way). Three-star admiral (far right) wearing sleeves up (Navy way). Author (far left), hospital commanding officer. In a “sleeves down” world, life may be easier blending in.

“Collective fear stimulates herd instinct, and tends to produce ferocity toward those who are not regarded as members of the herd.” – Bertrand Russell, from “An Outline of Intellectual Rubbish”

“Now I know you’re a Blue, but these old eyes don’t care, nor feels the colors none,” Loretta tells Cussy Mary in Kim Richardson’s novel The Book Woman of Troublesome Creek.1 Cussy Mary was one of the “Blue” people of Kentucky with methemoglobinemia,2 a hereditary disorder that causes affected individuals to appear blue.

“Bluet is going to make you better . . . Ain’t having a colored touch me an’ bring more infection.”1 “Don’t you ever want to be around more of your kind?”1 “I can’t have you breaking the law, offending these folks on their big to-do night . . . He poked his heavily whiskered chin at the NO COLOREDS sign.”1 The language of discrimination is similar, across time and context. Physicians discovered that methylene blue could temporarily reverse the blue of methemoglobinemia.3 “I am the same as them now, Pa. Look at me look at my color,”1 Cussy exclaimed. “And when they see you, they’ll still see a Blue,”1 her dad responded. Physicians noted, “We have not been able to demonstrate that adults with this disease suffer any ill effects other than the social stigma of being ‘blue’. It should be noted that the patients whom we treated with methylene blue all stated that they felt better while taking the drug; however, this might be a psychological effect.”3 Physicians have a knack for understatement.

One might think being “discriminated against” would teach “don’t discriminate.” If only the Golden Rule, do unto others as you would have them do unto you, was so easy. Too often the flip side, do unto others as they do unto you, is the lesson learned. The story of John Newton, who wrote the words to the hymn Amazing Grace in 1772, illustrates that reality.

John Newton, as a young seaman, participated in the African slave trade. Captured in Africa in the late 1740s, Newton himself “for about the space of eighteen months, I was in effect, though without the name, a Captive and a Slave myself.”4 This experience, however, did not alter Newton’s actions. Indeed, Newton later served as a ship “commander, in which capacity I made three voyages to the Windward Coast, for Slaves.”4 In 1788, Newton eventually lamented, “I am bound, in conscience, to take shame to myself by a public confession, which, however sincere, comes too late to prevent, or repair, the misery and mischief to which I have, formerly, been accessory.”4

The lyrics of Amazing Grace are universally appealing:

Amazing grace
How sweet the sound
That saved a wretch like me
I once was lost, but now I’m found
Was blind, but now I see

‘Twas grace that taught my heart to fear
And grace my fears relieved . . .

As suggested by Bertrand Russell, collective fear plays a role in discrimination. Newton was better positioned to eventually recognize the fear that caused him to discriminate against others and others to discriminate against him.

Rules are more strictly enforced upon a minority because they are more “visible.” One of the authors (JR) was commanding officer of a command support hospital staffed by sailors in an Army theater. Many congressional complaints had been made by women and sailors about unfair, unjust, and inappropriate treatment. While “investigations” were conducted, the Navy decided that sailors should demonstrate their Navy pride by rolling up their sleeves. The author decided that his unit would keep their sleeves down (the Army way), much to the consternation of Navy leaders (Figure). Rolling sleeves up would make sailors more “visible”; more easily subjected to rules enforcement. Sure enough, treatment of hospital sailors improved when other sailors rolled up their sleeves. When the command master chief (a retired police officer) took calls concerning sailors breaking camp rules, he would ask one question, “Were the perp’s sleeves up or down?” Almost invariably the response was that the sleeves were up. Hospital sailors had become less visible.

Discrimination, perennial and pervasive, occurs in many shades. Combating fear-induced discrimination is not easy, but rather is difficult and exhausting. Until such time that irrelevant differences are not perceived, discrimination will persist.

“No one is born hating another person . . .
People must learn to hate . . .”
– Nelson Mandela


  1. Ricardson KM. The Book Woman of Troublesome Creek. Naperville IL, Sourcebooks Landmark, 2019.
  2. Trost C. The blue people of Kentucky. Science 1982;82(11): 35-9.
  3. Cawein M, Behlen CH, Cohn JE. Hereditary diaphorase deficiency and methemoglobinemia. Arch Intern Med 1964;113: 578-85.
  4. Newton J. Thoughts upon the African slave trade. London: J Buckland, 1788.

LAUREN E. HILL, M.Ed., is a high school guidance counselor who is currently home schooling her children during the Covid pandemic.

JACK E. RIGGS, M.D., is a professor of neurology at West Virginia University and, more importantly, Lauren Hill’s dad.

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.