When I was a ward sister in a cardiac/chest ward I went round and said goodnight to patients at the end of the shift. This one man, who I can still see, was a homeless man with TB. He was fully mobile but in for supervision of medication.  He looked me in the eye and said, “you won’t see me “sis”, thank you for everything.” I wondered if he was planning to self-discharge. Next morning I came in the the news that he died in the night, quite peacefully and in his sleep. Did he know? I have pondered this regularly. I am convinced he did, and convinced most people do know, and more importantly are not distressed by knowing.