Why I . . . wrote my memoir

When Ike Anya was working his way through medical training in Nigeria his grandmother reassured him, “Everything worthwhile is achieved small by small.”

Some 30 years later, Anya chose that saying as the title of his memoir.

“You become a doctor ‘small by small.’ This Nigerian expression is also a lovely way of paying tribute to my grandmother,” says Anya, a consultant in public health medicine who works as a locum and is based in London.

In his memoir, Anya recalls the achievements and failures of his student days and his first demanding year as a house officer while living in 1990s Nigeria during a time of political unrest, social change, and a worsening economy.

Of the process of creating his memoir he says, “You have to be incredibly honest in your writing. I felt there would be no interest in a memoir that only paints a good picture.” You also have to be “committed and determined, because there are many points when you put your book aside. And while you might be a gifted writer, you still need resilience when publishers say no.”

He says that writing a memoir is like an “extension of the reflection doctors are asked to do as part of their appraisal and daily work.” He says it also gave him “the opportunity to reflect on what being a doctor means, which has made me a better doctor.” Writing has brought him “the joy of hearing from people I may never meet from different parts of the world, talking about how much they have enjoyed the book.”

The process has been cathartic. “When I was writing about some experiences I had as a medical student, such as a military takeover, it was as if I was back there. I feel I’ve recorded a slice of Nigerian history and captured it, both for those who lived through it, and their children.”

He hopes other doctors will consider writing their memoirs. “Everybody has an interesting story. The more stories that are out there, the fuller the picture of our world—and that’s a good thing because it will help us to understand each other better. The more stories we have, the richer we are.”

His book’s publication is the realisation of a childhood dream. “Growing up in Nsukka, a small university town, I loved reading and would make up stories. Medical school was the end of my writing dream—medicine took over everything,” he says.

After qualifying in 1995, Anya worked as a doctor in Nigeria before coming to the London School of Hygiene and Tropical Medicine in 2001 to do a masters in tropical medicine and international health. He then trained in public health medicine in the south west of England and spent several years working in public health in London.

But still he dreamt of writing a book—an ambition reignited in 2012 when his essay “People Don’t Get Depressed in Nigeria” was published in the literary journal Granta (https://granta.com/people-dont-get-depressed-in-nigeria).

His essay generated interest and soon he had an agent and a request for a book proposal. This encouraged him to take six weeks of unpaid leave to write a first draft of his memories of becoming a doctor in Nigeria. He wanted to show how medical training was similar to, but also very different from in the West, and to “give some insight into where doctors who trained in Nigeria are coming from.”

He went back to his agent with a 100 000 word draft. “They liked it, but said it needed lots more work,” he says.

It was to be another 10 years before Small by Small was published. During that time there were work commitments, health problems, and a period spent in Nigeria supporting the public health organisations he has helped to set up.

When Anya was ready to reopen his manuscript in 2017 he took a one year masters in creative writing non-fiction at the University of East Anglia to refine his book. It took three more drafts before it was ready to go to a publisher. The book was published by a small independent in 2023. Six weeks later the publisher went into liquidation. But Anya didn’t give up.

He has spent the last year single handedly promoting and marketing his book, soliciting invitations to readings, festivals, interviews, and reviews. His efforts paid off. Canongate Books who had originally turned the manuscript down, picked it up, and in August released it in paperback and ebook versions in the UK, and now internationally.