Shipman, dubbed "Dr Death" during his trial, was found hanged in his northern English prison cell on Tuesday, the eve of his 58th birthday.

His death means his victims' families will never know what drove him to kill their loved ones.

If he had been outwardly crazed or violent, driven by sexual perversion, greed, lust or madness, his decades-long killing spree might have been in some way more understandable.

As it was, he became known as one of the world's most mundane serial killers.

The horrific truth was that the respected doctor, who killed up to 215 of his elderly patients with fatal doses of heroin, was a quiet but friendly family physician.
  
He was loved by his wife and children, respected by the community and trusted completely by his patients.

Bearded, bespectacled and softly spoken, Dr Harold Shipman was always known simply by his middle name, Fred, to the people of Hyde, northern England, where he had his practice.

Community support 

When police first began questioning him in 1998 about the suspiciously high number of deaths among his elderly patients, the tight-knit community rushed to support him.

Dame Janet Smith, headed the
public inquiry

One patient remembered him fondly as a lovely man "with twinkly eyes", others defended him as a pillar of the community and a trusted doctor who willingly made home visits.

They did not know then that those visits gave him the perfect opportunity to kill.

It was the ultimate betrayal. The patient killed by the doctor - a man who swore a professional oath to preserve life.

Shipman's murders matched his manner: quiet, calm, even friendly in a twisted way.

He smiled and chatted to his victims as he asked them to roll up a sleeve to give them something to help their pain. Then he ended their lives with a massive injection of diamorphine.

"I have no doubt that each of your victims smiled and thanked you as she submitted to your deadly ministrations," the judge at Shipman's trial, where he was convicted of 15 murders,
told him as he passed sentence in 2000.

Doctor brought death

"None of your victims realised yours was no healing touch. None of them knew that in truth you had brought them death - death which was disguised as their care."

Shipman, the son of a lorry driver, was born on 14 January, 1946 in Nottingham, central England.

He studied medicine at Leeds University, where he did not stand out in any way. "What I remember about Fred was that he was just so ordinary," one fellow student said about him.

But while so many patients trusted him, and so many peers found nothing about him to alert suspicion, Shipman was hiding a dark history of drug abuse and systematic killing.

He was forced to move to a new area after he was convicted in 1976 of drug offences and fraud, to feed an addiction to pethidine.

Prosecutors at Shipman's trial said his drive to kill was fuelled by his need for a God-like power over life and death.

Others said the killer was deeply affected by the experience of watching his own mother die from cancer.

Psychological profilers who studied his case found nothing to suggest the sadism or sexual perversion that drove such notorious British murderers as "House of Horrors" killer Fred West, or "Moors Murderer" Ian Brady.

Shipman did not rob, abuse or mutilate his victims, nor did he make them suffer when he killed them.

And in always refusing to admit to murder or cooperate with authorities, Shipman remained true to form - cold and quiet to the last.