In Conversation

Last week we spoke to Ike Anya about his new memoir, Small by Small, and how he balanced his writing with a demanding medical career.

Interviewed by Nancy Adimora

NA: As always, I’d love to start by throwing it back to where it all started. Can you tell us about your childhood in Nsukka and walk us through your journey to writing?

IA: So I grew up in Nsukka, which is a small university town in south-eastern Nigeria, and it was a magical place. People often ask whether we’re ascribing too much to it with the hindsight of nostalgia and rose-tinted glasses, but Nsukka was genuinely magical - so many things made it unique.  There was the fact that, when we were growing up, most of our parents had just come out of the civil war and had lost everything. Nsukka was seen as the intellectual nerve center of the Biafra cause, so the Nigerian army took particular joy in destroying the library and lecture rooms. So I think when our parents came back in 1970, which was the year I was born, there was a general sense of wanting to rebuild and rebuild well. So you had this community where we had classmates from Russia and the US, because of course, it was the Cold War, so all these countries were sending their lecturers to African universities as part of the bait to either join the communists or join the capitalists. So in this relatively remote town, we had world class writers, artists, musicians, talented people coming and going - we also lived next door to Chinua Achebe (which I’ve probably said far too many times). But I think what that partly meant was that I was surrounded by books, especially at home as my parents loved reading. There were plenty of books, I was a precocious reader, and I started reading very early. I read Things Fall Apart when I was six-

NA: WOW!

IA: I also read Roots when I was six because I just wanted to read everything. I would go into my father's study and I would pick up books he had bought, and maybe hadn’t even read, and I would be halfway through before he even realised I was reading them. And so it was inevitable that when you read, at some point you start thinking about writing. You start making up your own little stories, and for me it started in primary school. 

I remember, I must have been about eight or nine, and we were travelling from Nsukka to see our grandparents in Abiriba, our ancestral hometown. About halfway through the trip, I said to my mother sitting in front, that I needed a piece of paper and the pen, and I wrote a poem about the expressway. I don't know where the idea came from, but I wrote it, and my parents said it was a very good poem – even though it wasn’t. I can still remember the words and I cringe, but I took it into school and my teacher was so excited about it, that she made the whole class learn and recite the poem for the next time our class was asked to do a presentation at our school’s assembly. As a nine-year-old who was used to saying “by William Shakespeare” at the end of poems, hearing my own classmates say “by Ike Anya” was really special.

NA: So you were clearly drawn to the arts early on, but as a “good Nigerian son”, you went on to study medicine and pursue a career in public health. I’ll never forget Khaled Hosseini speaking about how he used to wake up at 5am to write for 2 hours before getting ready to go to work as a physician. I’m interested to know how you balanced your writing with a demanding medical career. Were you always writing on the side? How did the two ambitions sit alongside each other?

IA: To be honest, I realised very early on that I could never do the prescribed writer thing of writing every day, because my days were just too full with my job. Even when I left work at the end of the day, my head was still full with work, so the idea of sitting down and writing when I got home felt impossible. I'm the kind of person who needs to be in the zone. There’s definitely a zone for me when I'm writing, and if I'm not in that zone, I can't write. 

So my solution was to take chunks of time off. I would find 3-4 days in my diary, block it off, go to Booking.com or something, find the cheapest but highest rated place, no matter where it was, and just go there for a few days. That forced me to write because I knew the clock was ticking, and once that time was gone, I wouldn't get time again for a while.

NA: That sounds like a solid strategy, and it clearly worked as you’ve now written a wonderful memoir about your journey to becoming a doctor. I attended an event where you mentioned that you find it difficult to write fiction, so I’d love to know what draws you to creative non-fiction. Why is this the form that calls you?

IA: Well, it's an extension of who I am. I tell stories a lot, and I tend to hog the conversation wherever I am – I've always been like that. But I think my interest in nonfiction was actually driven by discovering Abraham Verghese who wrote Cutting For Stone. I loved his writing in Cutting For Stone, but then I discovered two less well-known nonfiction books, The Tennis Partner and My Own Country which recounts his early days as a young physician in the US. I remember reading them, really enjoying them, and thinking, okay, so you don't actually have to write fiction. And of course, I knew you could write nonfiction, but there was something about reading those books that made me think about some of the stories I had that readers could be engaged by as much as they would be engaged by fiction.

NA: Do you think your medical career influenced your approach to writing in any way?

IA: I think so. In medical school you're taught that observation is a very important skill, and the writer too, has to be a good observer. Senior doctors will tell you that if you look carefully at the patient, before they open their mouth to tell you what's brought them, you should already have thought about a diagnosis just by watching how they've walked in and interacted with you. So I think that's a skill I had that was then developed by my writing, or vice versa. 

NA: I think the beauty of the way you wrote Small by Small is that it's not just a book for doctors. I didn't go past GCSE biology, but I still enjoyed it and I think everyone can read it and get something from it. I wanted to quickly talk about the actual writing process, I know you spent six weeks away in Ghana, what was that like? What did your days look like?

IA: So I was very lucky, but I was under a lot of constraints. I had six weeks unpaid leave that my boss had given me under very difficult circumstances, so I knew this was it and that I wasn’t going to be able to ask for any more time off, so I knew I had to write as much as I could. My friend found this  wonderful Christian retreat centre for me in the hills of Aburi, overlooking Accra - it was a very beautiful and serene environment which was great. It wasn’t luxury, it was very basic but they looked after me for those six weeks. I would wake up in the morning, I would take my laptop out on the balcony overlooking the garden, and I would just write for as long as I could. The words just came pouring out.

NA: That sounds so dreamy - I love it. And finally, what would your advice be to someone who was thinking about writing a memoir of their own one day?

IA: I think I’d share the advice that I got from Chimamanda which was: write as if no one is going to read it. So don't censor yourself. If you want to write about your abusive father, don’t try to make it nice for the public. You can always go back to edit out the bits that are particularly painful or hurtful. But if you begin by editing those thoughts, you can't produce anything. So pour everything out, regardless or whether or not you think you can publish it.  

I think memoir writing is actually something anyone can do because everyone can tell stories about their lives. 

Ike Anya is a consultant in public health medicine working in Nigeria and the UK, most recently supporting the NHS response to COVID in Scotland. An honorary lecturer in public health at Imperial College, he teaches at Bristol University & the London School of Hygiene & Tropical Medicine. A 2007 TED Global Fellow, he co-founded Nigeria Health Watch, EpiAfric, TEDxEuston and the Abuja Literary Society.

He is an advisory council member of the AKO Caine Prize and published in The Guardian, Huffington Post, Granta, Catapult & Eclectica and in the anthology of essays by Nigerian writers on Nigeria: Of This Our Country. Co-editor of The Weaverbird Collection of New Nigerian Writing, he has an MA in Creative Non-Fiction from UEA.

You can read an excerpt of Small by Small here.