Thursday 18th July 1991   Morning surgery 08:53

“We’ve just seen George Gwilym for you Dr Lewis. He’s not well at all. He’s much weaker.” Dylan and Dilys had come to Dr Lewis’ door. They looked very concerned.
“He is really pale: he’s as white as a sheet.” Dilys said.
“He’s dizzy. He feels faint when he stands up. He was quite wobbly coming in from the waiting room.”
“He’s having awful pain. It’s there all the time, in the top of his tummy and going through to his back.” Dilys rubbed her own tummy and winced.
“He’s got black stools!”
“We think he’s bleeding from the tumour.”
“Obviously!” Dylan frowned reproachfully at Dilys. “He looks very anaemic and he’s got meleana. His pulse is racing and his blood pressure is low. He must be bleeding from somewhere. The tumour is the most likely cause.”
“He’s a warfarin patient which means he’s at high risk of a gastrointestinal bleed.” Dilys added helpfully.
“Dr Lewis knows that! Would you like us to call an ambulance, Dr Lewis? We could put a drip up.”
“Yes, you put the drip up, Dylan, and I’ll ring for the ambulance.”

We think he is bleeding from the tumour.