US Secretary of State Hillary Clinton’s last public appearance was in Dublin, en route to Belfast, on 6 December 2012.
It was part of a unrelenting workload which was cut short by a stomach virus and the medical complications that followed.
Her latest packed European tour was in December and she has averaged two such trips somewhere in the world each month for four years, travelling around 1.5 million kilometres – more than any other US Secretary of State. She has visited 112 countries.
The fact that Barack Obama gave her that key job was a surprise, particularly after the bruising primary battle between the two Democratic presidential candidates.
Starting work in January 2009, Hillary Clinton had an ambitious agenda.
Top of the list was getting strained diplomatic relations between Washington and Moscow back on track, presenting her counterpart, Sergei Lavrov with a symbolic red “reset” button.
She said: “We want to reset our relationship and so we will do it together.”
Unfortunately the word “reset” on the button was mistranslated into the Russian for “overcharge”. Both sides laughed it off.
Another focus for the top US diplomat was the Israeli-Palestinian peace process, which has been virtually ignored during George W Bush’s administration.
But the region also quickly spawned new conflicts and crises, with the Arab Spring uprisings in Tunisia, Egypt, Libya and Syria.
Changes at the top in countries important to Washington, including Egypt with a president from the ranks of the Muslim Brotherhood, forced a profound rethink of the State Department’s strategy for the Middle East and north Africa.
A memorable moment during Clinton’s four years as Secretary of State was the operation against Osama bin Laden in Pakistan. Pictures taken in the operations room at the time revealed the tension in her face.
But there were reasons to smile as well, as when, in Washington, she met the finally freed Burmese opposition leader Aung San Suu Kyi.
Her final months at the State Department were overshadowed by the attack on the American consulate in the Libyan city of Benghazi in September 2012, the first since 1979 to have claimed the life of a US ambassador. Clinton publicly took responsibility.
So is she about to finally leave the political stage? Asked if she would run for president in 2016, Hillary Clinton said she doesn’t “believe” she will, which did not entirely shut the door to that idea.