Inspired by rehab

‘Physios picked me up and put me back together’ 

Ella Cottle was a healthy teenager, good enough at sport to represent her county. The first indication something was wrong came when she was 14. On holiday with her family, she dived backwards off a boat and was left in ‘absolute agony’.

In the weeks that followed the pain was so bad she was unable to sleep. ‘I couldn’t do anything that didn’t aggravate it one way or another,’ Ella says.

The diagnosis, when it eventually came, was devastating: ewing sarcoma – a large tumour on her pelvis and spine. 

It took 14 rounds of chemotherapy over the course of a year to kill off the tumour, with each three-to five-day treatment followed by three weeks of side effects. For just a single day in between, she would ‘feel human’, she says. Then it was back into hospital to begin the cycle all over again. And after treatment came intensive study, trying to catch up with all the schooling she’d missed.

If anything good can be said to have come from her ordeal it is that Ella’s long rehabilitation fired a desire to build a career in physiotherapy. The tumour’s position left her with nerve damage affecting her right leg but the rehab brought significant improvement. The nerve damage continues to affect her – she is ‘wonky’ when she runs – but while she acknowledges that it was medical and nursing teams that saved her, it was physios who restored her quality of life. 

‘I thought, that’s powerful – to transform someone’s life after they’ve gone through something like I went through, for them to pick me up and put me back together and allow me to do all the things I wanted to do. The only reason I could do all of that is because of a lot of physio input.’ 

Another major influence was her mother, also a physio. ‘She’s always enjoyed work and talks so passionately about it,’ Ella says. ‘She’s still so enthusiastic after being in the job for 30 years.’ 

Recent graduates also have an especially strong understanding of the value of collaboration, Ella suggests. Fellow students at Worcester worked very closely with others in the multidisciplinary team – occupational therapists (OTs), in particular.

‘We did a lot of work with the OTs so we understood their role very clearly – what they could bring that we couldn’t. We worked out our strengths and weaknesses as a therapy team and I think that’s something that’s been especially valuable during the pandemic, making sure everything is as efficient as it can be and that you’re supporting each other appropriately.’

Graduating in a pandemic 

A decade on from her cancer diagnosis, Ella’s ambition is well on track. Earlier this year she graduated from the University of Worcester with a first-class honours degree in physiotherapy and is now on rotation at the Royal United Hospital (RUH) in Bath. To survive cancer only to begin your dream job in the midst of a pandemic seems especially unjust. But Ella, who admits to a dark sense of humour forged in the bleakest of moments, seems unfazed. 

‘Tricky’ is the understated way she describes the experience of graduating as coronavirus was peaking. ‘It’s been the craziest way to start a career,’ she adds.

Has cancer endowed her with qualities and insights that help in her role? Her answer is unequivocal. ‘It has absolutely made me a better physio. Every placement I went on, the feedback was always “You are so empathetic with patients”.’

Other qualities emerged as a result of her long hospital stays. She’s a strong advocate on behalf of those she cares for – and extremely patient too.

I’ve been in the position where the world has been against me and I’ve felt like death warmed up but have had to keep plodding on.

Her compassion comes at a price, though. Working recently with a 16-year-old girl who had a tumour provided Ella with a stern test. So many little things about the girl reminded her of her own time in hospital – her mother being a constant presence, the duvet brought in from home to provide some personal comfort, the sense of missing out on friendships.

‘She was also quite similar in that she’d have a giggle about it all and I thought, that’s just like me. We got on really well but I did have a wobble afterwards. I had to try and put all of my history behind me to deal with that patient so that I didn’t cry.’

Fresh opinion 

Among the attributes that students and newly qualified physios bring to established teams, Ella identifies one that feels especially relevant as the pandemic continues to test health services.

‘We have a lot of fuel in the tank,’ she says. ‘I can imagine that if you’ve been in the NHS for a really long time, and you’ve seen the things you’ve seen, it must have been more tiring.’

Students and new recruits also bring a fresh pair of eyes, she says. ‘We’re happy to ask questions because I think we accept that we’re not supposed to know it all. And when we ask those questions, it’s thought-provoking for other people. There’s no bad that can come out of that.’

Although ‘surviving’ cancer suggests the job is done, that the tumorous cells have been defeated, the reality for many is that their cancer retreats only to recur later. And Ella has had her own scares along the way, including one when even her consultant was certain the cancer had returned. 

There was more worry last August, mid-pandemic, in the week she started at the RUH. She had to undergo an emergency biopsy and before she knew the results, a patient she was working with, upset at something, shouted at her, saying she didn’t know how hard life could be. 

‘I was thinking, you have no idea,’ she says, laughing.

Thankfully, each scare has proved a false alarm. ‘Everything’s always been fine. But I can’t say how much it takes me back to that 14-year-old girl finding out that her whole world was about to change.’ 

‘In that sense, it doesn’t end,’ she says. ‘And I think that’s what people don’t realise. Your hair grows back, you look well and you live life to the full because you’ve been so poorly. You’re now free of the tumour but not the cancer effect and that’s what I live with every day.’ 

Charity champion 

As for the future, she’ll continue with rotations, developing her core skills, and then perhaps look at neurological physiotherapy as a specialism. 

‘I’ve always enjoyed neuro and I think that’s to do with my whole experience. I’ve had so much intense physio and I know how challenging it can be to reteach the brain – and how frustrating.’

As an ambassador for Stand Up To Cancer, helping to raise awareness and funds for research, Ella takes the role seriously and says she loves being able to help. ‘The more I do with them, the better it makes me feel.’