Medical Writing

Deborah Liao, PharmD

From Seed to Fruition

When I talk about location-independence, I think it's easy to gloss over how long it's actually take to make it happen, from the first time I thought about traveling for more than 2 weeks at a time, to where I am today with a raggedy-looking passport that has seen better days but plenty of adventures.

But first, I have to say that it's part luck, part timing, plenty of planning, and LOT of hard work. When I look at the sequence of events that have culminated in recent events, everything started over a decade ago.


After working at the bench in R&D at the NIAID, NIDCR, Regeneron Pharmaceuticals, and Progenics Pharmaceuticals, I decided to go back to school for a PharmD.

I had considered a PhD in molecular virology or something infectious diseases-related, but every PhD I met said it wasn't worth it. I had thought about medical school and had even taken it as far as the MCATs and getting wait-listed for the program at the Uniformed Services University of the Health Science, but I felt ambivalent about it, never mind the don't ask, don't tell policy in the military at the time.


I landed my first agency job. I had no clue what medical communications was about. I had no idea what medical writing was. But there I was, thrown into the fray on a big blockbuster brand at the end of its lifecycle. A great way to learn, but definitely a bit of trial by fire, which I think is the best way to go about it. If you come out of it okay, you've been tempered like steel. Hopefully more resilient and stronger than you were before. If it wasn't a good trial by fire, I'd probably liken it it to being thrown in front of a bus. I think if you've been in the industry long enough, you get to experience both ends of the spectrum. 


I ended up leaving the first agency. Part of it was the appeal of better pay (of course, who doesn't like that), more responsibility (a double-edged sword), and exposure to different therapeutic areas.

Another part of my resignation conversation with the boss focused on salary in relation to student loans because I had left school with $72,000 in loans. By 2010, I think the balance was $65,000. The other part of the conversation was about the possibility of taking a sabbatical from work to travel but their policy was a resounding NO. Which helped push me out the door.

After that, I bounced around at a few agencies, kept on paying down my student loans, and then went freelance in 2014.


Going freelance in 2014 was probably one of the scariest decisions I've ever made.

When you're on staff, even if the company can up and fire you, your day-to-day is generally more stable or has a greater semblance of stability than that of a freelancer. As a freelancer, I've had days where I woke up thinking that I would have a full day of work only to find emails telling me to hold off on a job and by noon I'd be slammed again with work from other clients. 

As a freelancer, too, even if you've got a good commitment from one or two agencies to do work, there is a deep-seated and unshakeable paranoia that makes you say yes to more work than you need. Part of it is fueled by the need to cover your bases. JUST IN CASE. So you think 2 or 3 clients is a good number. But then the work is sporadic for 1 or 2 clients. So then you say yes to 1 or 2 more. And then one delay on one project means all your deadlines for all your clients fall around the same time and you end up swamped. But you're also grateful because you're busy and busy is better than NEVER WORKING AGAIN. Which is a deep seated and irrational and persistent fear that I butt my head against yet find myself strangely reassured to hear from other freelance friends. Because they know the fear whereas when I was on staff, I was completely oblivious to it.

While my clients may not love it when I'm slammed and can't commit more time to them, I am grateful that they accommodate my schedule (and travel). And I accordingly prioritize my clients based on the relationships we've built. I jokingly say that my main client relationship is like the perfect relationship that I don't have in my personal life. A great science team (especially appreciated when I have spent too much time by myself and I think I don't make sense and need other people to bounce ideas off of), nice and smart people that I enjoy working with,  interesting and challenging projects, the kind of integration and responsibilities that you don't get with most other clients (ie, business pitches, working on RFPs, live meetings, responsibility for content, etc vs being the anonymous fingers on the keyboard). Oh, and the freedom to travel for me (and them) and to work for them at the same time. So they get most of my time and they are literally the only compelling reason I have for coming back to the US for more than a few days at a time. I also think it's essential to have some face time (workload permitting) every so often.

Some days, though, I feel like I'm the equivalent of the office feral cat that disappears for a while and then comes back a little bedraggled (after 361 days of travel, I came back maybe 15-20 lbs lighter, minus a tooth, and had experienced a terrible food poisoning episode, rabies PEP, dengue, a broken toe, a successful mountain climbing summit, and the collapse of a 4.5 year relationship).

I also have two other long-standing relationships that are awesome in different ways and I'm happy to be working with them again! Thank you, everyone. I can't tell you how much I appreciate the relationships we've built over the years.

Anyway....tangent aside, 2014 was a very busy year. Too busy, but again, as a freelancer, it's nice to be busy. And I was able to take advantage of being busy to earn more than I would have as a staff employee. With that in mind, I was able to pursue my two primary goals: pay off my student loans (approximately $55,000 in 2014) and save for extended travels. 


2015 was another busy year. Too busy again. I hadn't worked out consistently in 2014 let alone 2015. BUT, by May 25, 2015, I had paid off the remaining $30,000 of my student loans. It was one of the best decisions I ever made. The insane work hours I put in were worth it even if it sort of sucked for a while and I was bursting blood vessels in my eyes on a regular basis.

At that point, the only thing left to do before embarking on extended travels was making sure my finances were in order. But the sheer amount of work I was doing at that point was more tolerable because I didn't have to juggle two financial goals at once. I also had a departure date and could look forward to doing some volunteer work and taking a much needed sabbatical from work-induced burnout. 

And so I set off on November 15, 2015, for a 19-country, 361-day trip around the world. 


At some point during my travels, I had updated my LinkedIn to say that I was looking for a 100% remote position. I totally forgot about it until my previous and current main agency squeeze (as I like to say) saw my profile update and asked me if I would take on work, even though I was in Bangkok at the time. So after 8 months of not working, I started working sporadic part-time hours. I worked from Bangkok (hotel and Wolf coworking space), Myanmar (the Novotel at Inle was decent to work from and Hintha coworking space in Yangon), Malaysia, Nepal, Fort Kochi, Greece, Rome, and Barcelona (at Transforma BCN coworking space). And as the time neared to return to the US in November, I started emailing old clients and sent out my CV to numerous other agencies (most didn't bother responding, but that's fine). 


Which brings me to today, 2 days away from flying to Morocco for a 4-month stint after a month in the US following 3 months in Latin America. Then I'll be back at the office in October. 

I think the most challenging thing is the perception that my availability will be more limited. I reiterate here that at this point in time, my priority is full-time work. If you have work to throw at me, I'll take it if I have capacity. Yes, I also want to do tourist activities, but I already had a year of doing whatever I wanted every day. At this point, I prefer structure to my days and the mental stimulation of work. The weekends are for sightseeing whenever possible, but I enjoy the weekday routine I establish wherever I go, which typically looks like the following:

  • Wake up at 5:00 am
  • Drink coffee
  • 6:00 am workout
  • Breakfast/shower get ready for work
  • 7:30-8:00 am, start working until dinnertime
  • Dinnertime at a local place if possible
  • Relax until my 9:00-10;00 pm bedtime

I'm not as exciting as people think. In between the fun things, there are a lot of hours spent working.  I think the main differences are that I like my freedom more than most people, I'm not particularly close to my family, I have no relationship/children/pets, and I have a really high tolerance for change. Let's face it, living out of 2 bags for 18 months is not most people's idea of fun. Some days I'd really like a hot shower or a bath tub to soak in but even those things are hard to come by in some places.  

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