In the immediate aftermath of Edward's death on 6 July, the navy found itself in what could have been the front line. This was because the King had attempted to decree that his successor should not be his Catholic half-sister Mary, who was the heir both by statute and by their father's will, but rather his Protestant cousin the former Lady Jane Grey, now married to Northumberland's youngest son. Jane apparently had the support of the Council, and was duly proclaimed. Mary made her way to Kenninghall in Norfolk, which was in the heart of her own estates, and in turn proclaimed her right. By 13 July the Council believed that she was in flight for the Low Countries and sent a squadron of half a dozen ships to intercept her [II.1]. Mary, however, had no such intention. Not only was she the lawful heir, she was also the popular choice. First at Kenninghall and then at Framlingham in Suffolk her supporters rallied to her and she soon had a formidable force, led by her committed servants. Meanwhile the naval operation had been frustrated by bad weather; five of the ships sheltered in the Orwell, while the sixth, Greyhound, ended up at Lowestoft [II.2]. There the captain, Gilbert Grice, was arrested, but Mary's Council duly accepted his submission on the 17th, and he was continued in command of his ship [II.3]. Perhaps inspired by Grice's example, or perhaps solicited by Sir Henry Jerningham on Mary's behalf, the other ships followed suit, and some of their guns were transported to the Queen's camp at Framlingham. As a temporary measure, the six ships under the Queen's control were, on 19 July, put under the charge of an experienced shipman, Sir Richard Cavendish. On the 25th he was superseded by William Tirrell, appointed as Vice-Admiral [II.4]. The Lord Admiral, Lord Clinton, made his peace with the new regime, though his actual submission is not recorded. The rapprochement was brief because in November he was dismissed in favour of Lord William Howard [II.5–7]. Then William Winter, the Surveyor, was suspected of involvement in Sir Thomas Wyatt's rebellion of January 1554, which was provoked by the Queen's intended marriage.

Duckworth's ship, Orion (74) was retained at Spithead for two months once the French Revolutionary War began, when Duckworth had nothing to do but a series of administrative tasks, impeded fairly effectively by Admiralty bureaucratic procedures [2, 4–9]. He was a notable mentor to young midshipmen, including the future Admiral William Parker, the nephew of Earl St Vincent [1, 3]. He knew the ship was destined for foreign service, but not until March was the destination clear, with the formal notification from the Admiralty and Admiral Gardner [10, 12]. Once at sea, however, all communication, at least in written form, ceased.

In the Leeward Islands, Admiral Gardner, having failed in an attack on Martinique [14–16], was soon sending Duckworth on independent missions, none of them at first very notable [17, 18], but at the end of July he was sent to assist the Jamaica convoy past the French colony of St Domingue, and then on to a delicate diplomatic mission to Virginia [19]. A fairly ludicrous internal dispute between two of his officers was composed by Duckworth by the simple expedient of isolating the disputants until they had cooled down and had considered the consequences [20–22].

The Admiralty's pernickety behaviour and the nonsensical sensitivity of the officers are both indications that the Navy as a whole was not yet free of the more relaxed procedures of peacetime – though the officers’ behaviour persisted throughout the war, particularly among the senior ranks.

The detachment to Virginia missed the Jamaica convoy he had been told to watch for. He made a good impression as he approached Norfolk, Virginia, by the capture of the French privateer Sans Culotte [23]. Duckworth rapidly established cordial relations with the British consul in Norfolk, John Hamilton, and his presence was evidently regarded with interest and approval by the local gentleman – the capture of the privateer probably helped here [24–32]. He carefully avoided, by sensible research, becoming involved in fighting another French privateer which was not only in American waters but actually in the harbour, despite being urged by the consul to seize it [25], but he carefully gathered information about the French naval presence in American ports, noting that the discipline of the ships was particularly bad [26, 27]. His earlier experience in American waters as a lieutenant was clearly valuable in his estimation of the value of information.

So here's how it went. I’m walking into Harvard Yard on a summer's day, as a rather plump, entirely bald male is walking towards me. I do not recognize him. I cannot, however, help noticing that the person coming towards me exhibits, in very low level and understated form, signs of having recognized me. There is, I intuit, something in his eye movement that expresses greeting. This is always a troubling social predicament. One is caught in a dilemma we have all experienced: either one will be thought rude, if one does not respond to the manifested signs of recognition; or, if one does respond, one runs the risk of being thought slow-witted, on discovering, to one's acute embarrassment, that one had misread those tiny, ambiguous signs of possible recognition – the minuscule eye movements of a complete stranger had not meant “hello” after all.

“After all” is in fact an exaggeration in such circumstances, since encounters of this kind happen in real time, as two creatures approach each other, both walking at brisk pace, from a distance of only two or three yards. With only a couple of seconds available, one's judgment goes into overdrive, but mine wasn't coming up with a decision in time. The apparent stranger, however, released me from this mini-agony.

The dénouement: as we are about to pass beyond each other, the apparent stranger breaks out into a broad smile. Suddenly there is no ambiguity: within a millisecond I stop observing and start recognizing: this is my friend John, who has been absent from campus for many months undergoing chemotherapy.

John had been trim, with plenty of hair, when last I saw him, just before he went in for treatment. “John!” I exclaimed as we warmly shook hands and enjoyed our mutual relief, not to say joy. John was perhaps happy to be back in the land of the living, but I was much more than happy: that sudden flash of my friend's smile transformed everything in an instant – it transformed one quick moment of embarrassment into blissful cognitive certainty; and it transformed months of uncertainty about the fate of my friend into the joy that here he was, fully alive and present. Not least, it transformed observation into recognition.

In the mid-1960s, writer John Berger and photographer Jean Mohr profiled John Sassall, general practitioner in the Forest of Dean, photographing and documenting his everyday practice. The passage above describes the difficulty of providing an accurate medical prognosis to a terminally ill patient. Medical prognosis has always been, at best, an inexact science. There are also a multitude of ethical considerations to take into account when providing a prognosis. If someone is told ‘you have six months to live’ is that likely to make them give up hope and lose the will to carry on, dying sooner? Or will it make them more likely to live their last months to the full, cherishing every last moment? What if you instruct them to make a will, and dealing with the reality of their demise kills them sooner than you predicted? But what if they don't make a will and die, leaving their next of kin to have to sort things out? Is it ever acceptable to lie to a patient, even if you think it is for their own benefit?

These considerations and anxieties around sickness and death are not a consequence of the modern age and biomedicine. Late medieval Europe was intimately concerned with preparing for death. And, despite the difficulties surrounding accurate prediction, medical prognosis was a major branch of medieval medicine, and was one of the physician's main tools in a medical culture where treatment was often ineffective, surgery a dangerous last resort and diagnosis difficult.2 With the rise of university medicine and the emergence of the educated physician in the thirteenth and fourteenth centuries, learned medicine became a commercial enterprise, and a physician's ability to prognosticate successfully demonstrated his skill and secured his status.

Ramsay's Essay originated as a long private letter he wrote when he was a ship's surgeon to an aspiring young officer, a midshipman about to be commissioned in 1760. The same material was given a further airing in 1762 to prepare a petty officer for the life he was hoping for as a commissioned officer. The recipient of this second letter was a seaman whose abilities had attracted the attention of Captain Charles Middleton, who advanced him to the command of a small armed vessel with the local rank of lieutenant. As he was a poorly educated man who might soon be expected to hold his own amongst the more polished lieutenants of the wardroom, Ramsay wanted him to have advice tailored to his situation. He explains he could find no book that gave the kind of advice he felt necessary for any young officer, and he therefore had his original letter of 1760, with the additional material of 1762 as an appendix, published anonymously in book form by a London printer in 1765.

Fifteen years later no comparable work on officer-training had appeared in print, while the need for capable officers had become still more urgent in the face of the dangers threatening Britain from her enemies in arms. Middleton, comptroller of the navy from July 1778, was in anxious correspondence with his friend and former shipmate Richard Kempenfelt, now chief of staff in the Channel fleet, as they considered ways to strengthen the navy materially, tactically and morally. Middleton sounded out Ramsay's availability to help with his paper work in 1779; and, with danger in the background and reform in the offing, the times seemed to call for a reissue of his treatise on the duties of sea officers. An improved and extended second edition appeared in February 1780, followed by a third later the same year, and others in translation. The time for anonymity had passed, and the author was declared to be the Reverend James Ramsay, chaplain in his Majesty's navy.

Despite its success the book was long lost to view and its significance overlooked. For many years the Essay was wrongly attributed to Admiral Sir Charles Knowles since the Bodleian Library's copy of the first anonymous edition bore his name on the cover.