My partner awoke at 4 a.m. on a mid-August day with a massive headache. He dragged himself out of bed and went down to Squid Row for his usual 6 a.m. cup of coffee. He very shortly returned home, and promptly fell into bed.

This is a man who never, ever misses breakfast. When he awoke hours later, his Covid test was negative, but he was much worse: a fluctuating fever and blood oxygen levels that hovered on borderline, intense muscle aches and pain behind his eyes that required cold compresses.

Because he spends many hours a day gardening and mowing, tick-borne diseases are always at the front of our minds. Having had a neighbor die of tularemia several years ago, as well as the father of an acquaintance, helps keep this disease at the top of the list of possibilities.

The next morning, I suggested he ask his doctor to call in a complete tick panel to the hospital lab. She initially refused, as her protocol is to see the patient first. A little background history might help here. My partner spent decades as a pathologist; he spent his later years doing forensic work and only recently retired from consulting. He’s a very good diagnostician and is often frustrated by the current medical practices. When he declined to drive down to the hospital, she finally agreed to call it in. He stressed to her the importance of including a tularemia test.

As he watched his test results come in over the next few days, all of them were negative: Lyme, anaplasma, babesiosis, etc. The blood tests showed signs that his body was battling an infection, but he had no answers. He had more than an inkling that it was either babesiosis or tularemia.

He spent half a day in the emergency room getting poked and X-rayed, and as a precaution they sent him home with a couple of doxycycline pills with a prescription to be filled the next day. At this point he was sleeping 14 to 16 hours a day and was unable to walk a straight line most of the time.

Hours after returning from the hospital, he got markedly worse. His fever began to climb and he was bordering on delirium. He was admitted to the hospital for a brief stay, returning home the next morning.

After waiting four days, with no tularemia results, he called his doctor and asked. Her response was that she had forgotten to add the tularemia test to the order! Back to the lab, for the forgotten tularemia, plus West Nile virus and eastern equine encephalitis.

After two weeks of doxycycline, there was minimal improvement. The headache remained, as did the intense eye pain, now joined by neck pain and a persistent cough, with a still-borderline oxygen level, plus he was still sleeping 12 to 14 hours a day. In two and a half weeks he had gone from fit, vital and vigorous to a man unable to walk 50 feet without taking a three-hour nap.

At the end of the third week, he requested a redo of all the tests. One week later, there it was: tularemia. He called his physician and asked her to call in a prescription for Ciprofloxacin — a drug recommended for this particular infection. (The doxycycline seems to have only kept it at bay). Again she refused without having him see her, even though she had the test results in her hand. He went, she prescribed and now, except for the cough, he’s healing.

My partner had pneumonic tularemia, the most serious form of this disease. How did he get it? During the several hours that it takes him to mow our field, he one day likely ran over the remains of a dead rabbit, inhaling the dispersed results. The neighbor who died is believed to have acquired it the same way. The other gentleman had been working in a brush pile all day, then returned to his off-Island home, where it went undiagnosed. For a brief time after the first death, landscapers everywhere were wearing masks while mowing and then, unsurprisingly, they stopped.

I’ve nagged my partner for years to wear an N95 mask while mowing. I guess this is what it takes sometimes.

Dana Nunes lives in Chilmark.