Ruth was admitted on an emergency basis to the Castle Hill Hospital in Cottingham, Hull, 2 weeks ago with suspected cancer of the ovaries and/or multiple fibroids for an immediate hysterectomy operation, delayed only by her Consultant - Mr Van Geen's - holiday. A problem which had been developing over many months had suddenly mushroomed across the previous 10 days to the point that Natania looked many months pregnant, and was suffering considerable pain together with an inability to keep food down.

The operation revealed both that the ovaries appeared clear under a microscope + multiple tumours upon the peritoneal wall - a metastasis. Whilst the secondary tumours were clear to his surgeon's eye Mr Van Geen was uncertain of the site of the primary tumour. All his colleagues accept him as an excellent surgeon & expert on gynaecological cancers, but the primary source was (literally) out of his field. His best guess was the pancreas. He took various samples for histological analysis, and the results will be known by the end of next week. No further surgery was performed, apart from draining 3½ litres of fluid + taking the tissue samples.

Ruth is extremely weak. The operation was last Monday 17 June & it took 3 days before the nurses removed a saline drip. Even when a good friend brought her favourite food - grapes - she could only manage 3 before the nausea took hold, and even water is difficult. Her bowels are now joining in a symphony of pain due to prolonged absence of food & water.

Ruth wants to live. I put the question to her directly last Friday, and would have accepted a desire to die - who could not have accepted it, her arms blossoming with purple bruises from desperate attempts by the anaethetist to find a shrunken vein capable of accepting his morpheus drip? and every natural function a concourse of pain? - but she wants to see her great-grand-daughter grow up. At the same time she knows her position is of no hope. God bless Mr Van Geen, he was straight with people that need him to be straight - Ruth is going to die, within a year at the most.