Queen Elizabeth crying during Prince Philip memorial service. Photo / BBC
OPINION:
Of all the Queen's confidants, aides, advisers, secretaries, ladies-in-waiting, family members, childhood friends (well, the remaining few) and horses, there is only one individual, aside from Her Majesty, who undisputedly knows what is currently ailing the 96-year-old.
His name is Sir Huw Thomas and you should not know who he is or what he does – if he's doing his job properly, that is.
Since 2014, Sir Huw has held the ancient title of The Physician to the Queen, a position that dates back to 1557 and the reign of King Henry VIII. (Imagine all the curious rashes and odd nether-region itches that the libidinous monarch had …)
In practice, Sir Huw's job means that he runs the Queen's Medical Household and oversees the team of doctors and nurses on 24/7 call for the royal family. (It has been reported that a home hospital exists inside Buckingham Palace, with another rumoured to have been established at Windsor Castle where Her Majesty and Prince Philip isolated during the pandemic.)
The medic is possibly one of the few people in the world right now who fully apprised of what malady or illness has hobbled the once full-pelt Queen over the last year, which has seen her dramatically scale back her public appearances.
Over the past 12 months, the nonagenarian has pulled out of a trip to Northern Ireland, the Cop26 climate conference, Remembrance Day, the General Synod, Maundy Thursday, the Commonwealth Day service, the State Opening of Parliament and even the service of thanksgiving for her reign at St Paul's after numerous concessions and tweaks had been made for her comfort.
Then came the most worrying cancellation of them all: In June, Her Majesty missed Royal Ascot for the first time in her 70-year reign.
There can be no hiding it, no polite obfuscation or glossing over: Something is very clearly wrong with the Queen but what exactly is that something?
Anyone who asks Buckingham Palace seems to come away with the same line about "episodic mobility problems" which sounds a lot like the sort of benign condition that a smart PR person would roll out if they didn't want to worry the public.
(Though the Queen has previously had knee problems including surgery and late last year sprained her hip.)
However, the "mobility problems" line is one that has worn increasingly thin and insiders have started to hear whispers of much more serious issues.
In the Daily Beast, Tom Sykes this week became the first royal correspondent to even lightly mention the 'c' word – cancer – in conjunction with Her Majesty.
Sykes wrote that he had "been told by sources that it is everything from the catastrophic (bone cancer) to the more minor mundanities of old age (a bad hip that really should be replaced)."
Previously Sykes reported in May that "the most convincing rumours" about the Queen's health "are the ones that suggest she has problems with her heart, and say that the reason she had to go into hospital for tests last year was because she had to have an MRI".
Now, let's get one thing straight here: Given the total information blackout that seems to surround the highly sensitive issue of the great-grandmother's wellbeing, there is absolutely no way of genuinely knowing where the truth lies.
However, we are in some seriously murky, complicated territory here and the Palace seems to be stumbling around without a map, compass, head torch, hiking boots or any vague sense of direction.
Clearly their experience with Philip didn't teach them much.
In 2008, also during the Queen's annual Balmoral jaunt, the Evening Standard set off quite the hullabaloo when ran a story entitled "Prince Philip Defies Cancer Scare." At the time, a spokeswoman for Buckingham Palace would only say "We do not comment on private health matters", a taciturn refusal to engage that hardly tamped down speculation. Immediately, the story was picked up by news outlets both in the UK and internationally.
All signs pointed to a minor crisis brewing, at which point the Palace changed tack and put out a highly unusual statement the very same day, denying the "damaging story" and arguing that "Members of the Royal Family have a right to privacy, particularly in relation to their personal health" which was why they had "always refused to confirm or deny the persistent rumours.
Which is, of course, entirely understandable. HRHs are human and deserve the dignity and space to privately deal with whatever ails them, just like the rest of us. The problem is, you and I are not the Head of State with a church and military of our very own, to boot.
While the planning for the Queen's passing and funeral, Operation London Bridge, has been meticulously set out and plotted down to the minute for years now, what seems to have gotten forgotten in all that preparatory fluster is how to manage the prospect of a 97-year-old sovereign in obviously declining health.
There cannot be a person on the planet who is so close to 100 years old and is also in tip-top, perfect condition; of course Her Majesty just is experiencing some form of bodily complaints or aches and pains. However the Palace seems adrift and lost when it comes to managing the information flow here.
The issue lies in the dual identity the nonagenarian occupies. Elizabeth Windsor, horse-lover, great-grandmother and Marmite fan should be able to face the vicissitudes of age with as much poise as possible.
But, Elizabeth the Second, by the Grace of God, of the United Kingdom of Great Britain and Northern Ireland and of Her other Realms and Territories Queen, Head of the Commonwealth, Defender of the Faith? That's another thing entirely.
If the Palace continues to remain rigidly tight-lipped, this way only danger lies. Rumour, conjecture and downright Trumpian levels of misinformation will only thrive if the public is kept entirely in the dark too.
In recent years, and in recent months especially, we have seen the monarchy wheel out future Kings William V and George VII with increasing regularity, the purpose being to drive home a message of continuity and to amp up public faith in the stability of the monarchy.
Smart move.
However, that canny approach is going to be undermined by the whispers and insinuation that will only swirl with greater velocity and force if the situation is allowed to remain unchecked.
It is this nearly impossible tight rope that the Palace now has to walk.
We only have to look at the handling of Queen's father, George VI's illness in the early '50s to see how badly this can all go wrong. When he had a lung removed in 1951, the public was told it was because of "structural changes" in the organ. We now know he in fact had lung cancer and he never fully recovered from that operation. When the king died less than six months later, vaulting his young daughter precipitously onto the throne, the UK and the world were left reeling and stunned.
What courtiers will have to do is to find some way of preparing the public without sparking panic; of helping one woman see out her final years with decency and delicacy while also balancing her vast responsibility as a head of state. It's an unenviable, herculean task and the Palace has its once-in-a-lifetime work cut out for it. Time waits for no man, woman or history-making monarch.
- Daniela Elser is a royal expert and a writer with more than 15 years' experience working with a number of Australia's leading media titles.