Lyme disease has been on my radar for many years. My husband was treating patients with tick-borne illness long before anyone knew much about the course of these diseases. Back in the late 90’s many physicians didn’t believe Lyme disease was a real illness. The medical field was split between doctors who followed the guidelines of the Infectious Disease Society of America and doctors who belonged to The International Lyme and Associated Diseases Society. The consequences were disastrous for many people who had been bitten by a tiny tick.

I wanted Fragment of Doubt to be an enjoyable, suspenseful mystery—but also one that would inform readers of the real-life struggles of so many people bitten by ticks. Many are pathologized by physicians who don’t understand the course and progression of these infections. They don’t understand the unreliability of the available tests for tick-borne illness, or the need to diagnose and treat based on signs and symptoms, or the importance of testing for co-infections. They don’t understand the toll tick- borne illness takes on emotional health, financial stability, and the physical capacity of those who suffer from them—and their families.

Long COVID has brought attention to the suffering of people with debilitating ongoing symptoms long after an initial infection. Finally, collaboration is occurring in the medical and scientific fields to explore how viruses and bacteria persist despite treatment and how they alter the immune system and lead to chronic inflammation. There is new hope for effective therapies and collaboration among specialists.