The novel elaborates ever so slightly more about this, and it seems that it took....literally...every ounce of Hutch's strength to tell the nurse what he did.
That he collapses right after the last word.
As to why it wasn't written in the book before Hutch went into the coma, he was likely afraid it would land in the wrong hands before Ro could read it.
He knew they were watching, and that Guy monitored everything and wore the 'pants'.
So he gave her a *puzzle* (the anagram) hoping that she would figure it out.
My impression was that Hutch intended to tell Ro all that in person, and was (understandably) paranoid about revealing it all on the phone or in the book a letter.
I'd say this cloud is Cumulo Nimbus.
Didn't he discover America?
Penfold, shush.
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