'I've had very wealthy patients with big families and a large group of friends that all disappeared when things went south'

A doctor has shared some of the biggest revelations he has had since he began working in the field.

David Chan, an MD at UCLA Medical Center and author of Breast Cancer: Real Questions/Real Answers, A Guide for Patients and Families, responded on Quora with four moments in his work with cancer patients that resonated with him:

1) A job is just a job 

"I often get into discussions about life and living with my cancer patients who have a unique outlook because they are face to face with their mortality," Dr Chan wrote. 

"Not one single patient has told me that they wished they had worked more. I've taken it to heart and have made it a point to be there for important events for family and friends and to take vacation days." 

2. I'm reminded daily to have a big picture view of life and to understand what is a real problem 

"It's so easy to be caught up in day to day dramas that we lose sight of what is a real problem," Dr Chan said.

"A real problem is finding a big lump in your neck, getting a scan, then a biopsy, and being told that it's cancer. Virtually every other problem then goes away." 

3. True wealth is measured in family and friends 

"I'm not talking about numbers. What I'm talking about is the small group of people that will really be with you when the s**t hits the fan.

"I've had very wealthy patients with big families and a large group of friends that all disappeared when things went south. Nothing could be sadder to see.

"And I've had other patients who had 2 or 3 people in their lives that made incredible personal sacrifices of time and effort to help them through. I think of it as proof of a life well lived."

4. A corollary to #1 is that we never have as much time as we think 

"I'm reminded of a patient who was a young and very successful executive with pancreas cancer," Dr Chan said. 

"He wasn't curable and it was poorly treatable given his situation. His life expectancy went from 40 years to 6 months within the week of his diagnosis. 

"He'd never taken a vacation with his family; his wife and 3 school-aged kids. We reviewed the pros and cons of treatment and he decided to forego treatment, rented a sailboat and took his family through the Caribbean Islands for about 3 weeks.

"Because of his cancer, he didn't feel physically great but he told me that it was the best 3 weeks of his life." 

Dr Chan concluded by writing that he was "grateful for the lesson he and many other patients have taught me".

His post recalls a story in March 2015 where doctors shared their personal stories of grief on the job, after an image of a medic crying after losing a patient was widely shared on social media.

One doctor wrote: "We are never formally trained to deal with loss and/or with giving the worst news of a family’s life to them."

“It eats at you," another wrote. "Life is very fragile and the pain of losing those we are trying to help becomes a scar that doesn't go away. It has shaped who I am as a person."