Cussy’s blue skin is the novel’s central symbol, representing visible otherness and the arbitrary, cruel logic of prejudice. The protagonist establishes that methemoglobinemia is an inherited genetic condition and, in her case, has no bearing on her health. Neither is the condition contagious, yet it is the primary justification for the social ostracism and legal persecution she endures. This visible difference becomes the focal point for the theme of The Cost of Systemic Prejudice, marking her as subhuman in the eyes of an intolerant society. 

Early in her imprisonment, Cussy reflects on how others perceive her condition as a damning verdict: “There was no undoing the crime of my pertinacious heredity. I remained a Blue” (4). This internal monologue reveals her learned self-perception, where her very existence is framed as a criminal offense. Ignorance leads others, including doctors, to fear she is contagious. Furthermore, she describes her skin as a “telltale sign that would betray the slightest emotion” (4), changing from “soft robin’s-egg-blue” to “cobalt” when she feels fear, anger, or happiness (4). This visible indicator of her internal state makes her emotions a public spectacle, robbing her of privacy and rendering her perpetually vulnerable.

Cussy’s body becomes a site of Institutional Dehumanization and Abuse, as doctors subject her to brutal examinations and the warden plans a forced sterilization based on the eugenicist belief that her “kind” is unfit to reproduce. Ultimately, Cussy’s only path to freedom relies on the methylene blue drug, which temporarily erases her color, allowing her to escape the hospital. The fleeting and superficial nature of this “cure” suggests that survival in a prejudiced world requires the erasure of the very trait that defines one’s otherness. Her skin symbolizes the reality that societal bias, not inherent biology, is the true affliction.

The recurring motif of angel crowns grounds the narrative in Appalachian folk tradition and symbolizes the characters’ relationship with fate, superstition, and mortality. These wreaths of feathers, discovered in pillows, are interpreted as omens, either confirming a soul’s passage to heaven or foretelling an impending death. For Cussy, the crowns are a source of deep anxiety, externalizing her constant fear for the survival of herself and her loved ones. The novel opens on the day of her arrest, as she is interrupted while trying to bury a pillow containing one such crown. This failed ritual becomes a powerful portent of her captured fate: “The task still lingered, its prophecy now a riddle” (3). Her inability to complete the burial leaves her future uncertain, suspended between the promise of an angel and the threat of earthly demise.

This motif reappears at moments of high emotional stress, tracking Cussy’s internal struggle against what feels like a predetermined, tragic destiny. When Cussy sees the crowns displayed in Mrs. Claxton’s home, she is reminded of her own fears, and later, at the boardinghouse, she replaces a lumpy feather pillow with one stuffed with rags. This persistent fear reflects her precarious position as a fugitive and a mother trying to protect her unborn child. The angel crowns serve as a tangible link to her cultural roots while also embodying the fatalism she must overcome. Cussy’s final recognition that the angel crowns she encounters represent “A rebirth from a troubled past” underscores her change of perspective (304). The objects transform from an omen of doom into a marker of her survival against the odds.