I went in to see Isobel at a quarter past four. Isobel had eaten none of her breakfast or lunch but had taken half a pot of balanced supplement in the late morning. She had drunk several small amounts.

I started to give her some thickened blackcurrant squash. This was desperately difficult work, as once again her teeth were clenched shut most of the time. Over the course of an hour she drank half a beaker. Isobel only ate two teaspoonfuls of the main course of her tea. A further hour was spent getting Isobel to drink half a glass of high energy drink.

It has been very difficult to get Isobel to take her medication orally over the past few days. If difficulties recur tomorrow, after discussion with Dawn Dark the Ellenor Trust supervisor, a syringe driver will be used. Dawn will come to see Isobel on Monday.

Isobel is not taking sufficient nutrition at the moment to preserve her body mass, but this is not a critical problem. More worrying is the struggle to get her to take sufficient fluid. She is more or less permanently on a knife edge.

The trembling of the left leg and arm were less today. The nurses are concerned that she is suffering "silent fits". It is clear that further problems are occurring within the brain. These are probably partly due to the destruction of healthy brain tissue by tumour growth and partly to pressure build up as a result of the increase of total tissue volume within the brain as a result of the increase in tumour volume.

Isobel's right arm was again rather swollen today, I manipulated and massaged it. Both the left and right hands were locked into a claw position. It can be uncomfortable for Isobel if the hands are opened, so I did not attempt this.

Isobel's conjunctivitis was rather better today.

After I had washed Isobel's face I left the Centre at a quarter past seven.