How My Books Came to Being by Kwan Kew Lai
I have published four books; my fourth book, Finding Independence in America: An International Student’s Journey from Malaysia to Medical School, was released on October 8, 2026. It is wonderful that it is published on the semiquincentennial of America.
I have often admired reading stories that transport me into another world.
In secondary school, I kept a notebook transcribing poems and passages I liked from books I couldn’t afford to buy and keep. After my secondary school teacher introduced me to the free United States Information Service library, I began to read avidly. I marveled at the authors’ ability to craft intriguing characters in complicated plots. The writing I did then was essays my English teacher assigned in class.
As a doctor, I wrote reams of notes about my patients’ history, physical findings, assessments, and treatment plans, culminating in countless words every day. I was too busy to think about being a writer; writing was part of work.
Twenty years ago, I left academia and plunged into humanitarian volunteer work worldwide. In rural Africa, there was no radio, TV, or WIFI. The single, naked light bulb in my room was too dim; I had to complement it with a headlamp to read. Books kept me company, and I used a computer or a notebook to write about my experiences. With ample free time in the evening, I started writing about the first two decades of my life, intending to leave it for my children, not for publication.
For a decade and a half, I was in and out of Africa and fell in love with it. It was natural that I wrote about my time there; Into Africa, Out of Academia: A Doctor’s Memoir was the result. I signed with an agent while I was volunteering in the Ebola outbreak in West Africa.
The US Army set up an Ebola lab next to where I lived and provided internet access. To Assuage my family’s concern for my well-being in the Ebola Treatment Unit, I blogged. Deeply moved by how many people were willing to risk their lives and the intense experience with life and death, I needed to write about this period of my life. An NPR reporter who interviewed me after I returned from Liberia concurred. Lest We Forget: A Doctor’s Experience with Life and Death During the Ebola Outbreak was born.
My agent did not get anywhere with Into Africa, so I suggested she pitch Lest We Forget while the Ebola outbreak was still ongoing. But she disagreed and waited almost a year; by then, the publishers she approached concluded that the public interest in the outbreak had waned. In the end, Viva Editions accepted Lest We Forget. It is my first published book.
Author Publish periodically publishes a book of publishers where unagented authors can submit. My agent and I agreed I could seek publication without her. McFarland, an academic press for non-fiction, accepted Into Africa.
I turned my attention to my memoir and queried publishers for unagented authors. It found a home in Vine Leaves Press, a small press interested in memoirs. It underwent a few title changes, but one day the title, The Girl Who Taught Herself to Fly, which reflected the spirit of the book, floated into my mind. Developmental editing taught me to organize, improve the story arc, and pare down my writing.
My latest book, Finding Independence in America: An International Student’s Journey from Malaysia to Medical School, also started slowly; I first called it My College Years. Early in 2025, when international students came under intense attack, the US administration threatened to stop issuing student visas, even if they were accepted into a university; it would be devastating for many who had worked hard to get to that stage. I felt an urgency to finish writing this book and get it published. I added parts IV and V, which deal with citizenship and assimilation into American culture. In May 2025 through mid-June, I queried agents and submitted to unagented publishers. Less than a week after I submitted a proposal entitled The Sojourner: Americanization of an International Student, McFarland offered me a contract.
Acceptance of my manuscript disrupted my writing life. I funneled my time and energy into developmental editing, title change, cover design, searching for authors to write a blurb; a task as difficult as writing regularly. McFarland does not require blurbs, but I looked for authors to blurb. When a big press invites an author to write a blurb, might he be more willing to agree than when an unknown author asks for one? So, I am always appreciative of authors who give their time to support me. With the all-consuming process of refining the manuscript, writing chapter notes, bibliography, indexes, copy-editing, and proofreading, it is almost impossible to keep a regular writing schedule.
Do I have a writing schedule? Yes and No. Distractions during the day demand my attention. Once upon a time, I kept a strict schedule of writing 2,000 words a day. Currently, that has gone by the wayside. A few years ago, I joined NaNoWriMo and wrote a 60,000-word novel in 30 days. The flow of creativity issuing from me was truly amazing. That novel is now sitting on the back burner. Perhaps someday it will see the light of day.
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Kwan Kew Lai, a former Harvard Medical faculty physician, volunteers with various humanitarian organizations worldwide during wars and natural disasters, including the Ebola outbreak, the Syrian and Rohingya refugee crises, Libya, Yemen, Sudan, and the COVID-19 pandemic in New York and the Navajo Nation. Her work has appeared in The New England Journal of Medicine, JAMA, The Infectious Diseases Society of America Science Speaks, MedPage Today, Balloon Literary Journal, Literally Stories, Vine Leave Press, Synapses, and others. She is the author of Lest We Forget: A Doctor’s Experience with Life and Death During the Ebola Outbreak, Into Africa, Out of Academia: A Doctor’s Memoir, The Girl Who Taught Herself to Fly, a finalist for the Wishing Shelf non-fiction book award, and Finding Independence in America: An International Student’s Journey from Malaysia to Medical School.
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Finding Independence in America
An International Student’s Journey from Malaysia to Medical School
Kwan Kew Lai arrived in the U.S. from Malaysia on an F-1 student visa, supported by a full college scholarship, to find a society in social upheaval following the Vietnam War. Raised in a politically restrictive, sheltered, and impoverished environment, her introduction to American life was marked by freedoms and complexities that were vastly different from the world she had previously known.
Spanning 17 years, this memoir follows Lai’s transformation from international student to American citizen. Without sustained support from her family, she relied on scholarships, loans, and ingenuity to complete her education and pursue medical training, all while navigating a cultural landscape of racism, sexism, and unfamiliar social cultures. She secured permanent residency and later used her medical expertise in her global humanitarian work. Lai presents a nuanced account of immigration, identity, and the pursuit of acceptance in a country that is full of both opportunities and challenges.
Buy link: McFarland
Category: On Writing
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