The Alexander sisters of Worried Creek, Kentucky, are the last of the Alexander family, a long line of addicts and social pariahs. April, a pregnant prize-fighter, refuses to reveal the identity of her baby’s daddy; May is dead, but narrates their strange tale; and June, the book-smart sister, was born with the "family curse": bright blue skin. June writes daily to a plastic surgeon in Los Angeles she believes can "fix" her.

It’s 1988, and for a while now, it’s seemed like nothing will change. Their days have a repetition so set, it’s almost like a daily dance with highly choreographed steps (and is presented onstage as such). The living sisters care for their comatose mother, feed the animals, fix meals, and clean house, June writes her letters, and they prep for April’s upcoming fights and watch her belly grow. June constantly begs April to tell her who the father of the baby is; April adamantly refuses. The dead sister watches over them and wishes they could hear her.

Each sister wears a hat for the opening show, although they are removed after the opening: June is "BLUE," April is the "FIGHTER," and May is "INVISIBLE."

Then one day, June gets a letter. She was hoping it would be from the surgeon she’d been writing to, but it's almost as unexpected: she had applied to a college, curious if she could get in— and she did. April is thrilled and tells her she has to go; June is so ashamed of her blue skin, she tells April it’s impossible, just a dumb dream, and sends April off to mail another letter to Dr. Green in Los Angeles.

April leaves, and soon after, a visitor arrives.

Dr. Green. Who is, unexpectedly, one-armed… and armed.

He tells June he’s there to kill her.

May, the dead sister, is terrified— but also sickly excited; if June winds up dead, will they finally be together?

Over the course of one of the strangest conversations either of them has ever had, Green reveals to June that she’s not “cursed” with blue skin, nor is her problem correctable by plastic surgery or anything else. It’s a blood condition, methemoglobinemia, entirely genetic. June is devastated, and even more convinced that she’ll never be able to leave Worried Creek because of the color of her skin. Dr. Green— the one-armed, diabetic, veteran Black man— is unable to let her privileged, self-pitying statements go. If that’s really how she thinks, well, then it’s pretty obvious why she doesn’t deserve to live.

April returns, and the desperate unseen ghost of May does everything she can to get April to go into the house and save June from the crazy doctor with the gun. But first, April sits outside with their comatose Mama, talking about guilt and anger and the damned baby in her belly… and almost downing a flask, before deciding there are some cycles she doesn’t want to continue.

Finally, she goes into the house— and finds Dr. Green and her sister, startling them both. She sends June out to check on their mother and confronts Dr. Green. She’s the one who summoned him, but his timing was off. Over the course of their conversation, he tells her about the methemoglobinemia as well and learns that April and June don’t have the same father, which is why April wasn’t at risk of blue skin… but her baby might be, because its father is April’s stepfather… June’s dear departed daddy.

That’s one more reason why April needs June to get the hell out of there. Their lives are hard enough. She doesn’t need her smart little sister to figure out, if the baby is born blue, why that might be— and now that the doctor has explained methemoglobinemia, it will be even more obvious.

Green, who has health issues of his own and might need a caretaker, relents and agrees to ask June to come with him. He tells her he’ll “fix her…” although he means it far more in the psychological sense than the physical sense. The sisters bid each other tearful farewells, afraid of things changing, but more afraid of them saying the same. Green has a brief exchange with Mama… who might not be as comatose as she pretends.

June leaves, donning a new hat: "FIGHTER."

The lights shift, blue light pouring down on May, who puts on the "BLUE" hat… and moves on to the next world.

It is April, the pregnant single mother, staying home to take care of their mother and keep the homestead cared for, who puts on the hat that reads "INVISIBLE." Her emotional labor and her physical labor will go unseen, for now… but as she promises her baby, rubbing her belly as the lights fade on the play, she won’t let them down.