The moment an NHS doctor was moved to tears by a thank you note from a 10-year-old patient has been captured on video.
Consultant paediatrician Dr Ravi Jayaram wipes away tears after reading the letter from his patient Elle Grace Morris who suffers from cystic fibrosis (CF).
The youngster, who appears in the Cystic Fibrosis Trust's moving Christmas campaign message, is in desperate need of a double lung transplant.
The video features the youngster reading the note to her doctor saying "without your help I don't know if I'd be here today".
Dr Jayaram, who has been treating Elle since she was diagnosed aged 15 months, admits that he is a "big softie" before saying he will "write to Santa for those new lungs for you".
Last Christmas, Elle, from Nantwich, Cheshire, was told she may not live for another year.
But the CF Trust said that thanks to the work of her dedicated medical team, she is still alive.
When she found out that she needed to go on the transplant list, the youngster created a list of 10 things she wanted to do before she reached the age of 10.
She has fulfilled most – including meeting Rita Ora and Olly Murs, making her own music video and being a princess for a day.
One of the wishes was raising awareness for the work of the CF Trust - something she has achieved through making the video.
Her mother Becky Whitfield, 29, told the Press Association: "One her wishes was to promote organ donation and the CF Trust so it's what she has asked for.
"She is just such a strong and independent person.
"She's just amazing. I know I'm biased because I'm her mum but she just gets on with it."
Elle has recently been reviewed at Great Ormond Street Hospital – where it is hoped her lung transplant will take place.
"They said: 'from what we see on paper to the girl we are looking at, you wouldn't think it is the same person'," the stay-at-home mum said.
"They were expecting her to be in a wheelchair.
"She has got weaker as the months have gone on but they said they just can't believe how she is pushing herself and getting by every day and going to school.
"They said she shouldn't even be in full time school by looking at the state of her lungs because she is only on 30% lung function."
On Dr Jayaram, Ms Whitfield added: "Dr Ravi is amazing. His comical character always keeps Elle's spirits up.
"He goes beyond his duties as Elle's consultant to make sure she is comfortable and as healthy as she can be when having her treatments and medication.
"He is a huge credit to the NHS."
Dr Jayaram, consultant paediatrician at the Countess of Chester Hospital: "I've watch Elle and her family deal with the burden of cystic fibrosis since she was a diagnosed with the condition at 15 months-old.
"Elle has already had to devote too much of her short life to the daily medications and treatment that keep her alive.
"Every day she must take dozens of tablets, do two hours of physiotherapy and carry an oxygen cylinder around with her wherever she goes.
"Since her health has deteriorated she also has to spend two weeks in hospital every two months and is in desperate need of new lungs.
"Despite all this, Elle remains one of the toughest, bravest and most positive little girls I know and I'm proud to appear in this film with her and help raise awareness of the Cystic Fibrosis Trust's work to beat this disease."
Cystic fibrosis is a life-shortening genetic condition that causes lungs to become clogged with mucus, making it hard to breathe.
There are over 10,500 people with cystic fibrosis living in the UK.
Half of those who die from cystic fibrosis are aged 28 or younger.
Figures from NHS Blood and Transplant show there are currently 6,451 people in the UK in need of an organ – including 153 children.
James Barrow, head of external affairs at the Cystic Fibrosis Trust said: "This time last year Elle was told she may not live for another year, but thanks to the incredible support of her CF team, she has the chance to spend another Christmas with her family.
"Sadly Elle is just one example of how cruel this condition can be – there is almost 11,000 people living with CF in the UK, and millions carrying the gene.
"We need to raise awareness and with support we can beat cystic fibrosis for good."
:: Text ELLE to 70500 to donate £5 to the Cystic Fibrosis Trust.