As he works his way through his medical training, Ike Anya’s grandmother reassures him,
Everything worthwhile is achieved small by small.
Ike’s story charts the triumphs and failures of his student days through to his first demanding year as a house officer. A medical memoir unlike any from the West, this is filled with the colour and vibrancy of tempestuous 1990s Nigeria, where political unrest, social change and a worsening economy make a doctor’s life particularly challenging.
This book is a really vivid and powerful memoir about Ike becoming a doctor in the late 80s, early 90s in Nigeria. The worldbuilding and writing is very inviting and sucks you in. He paints such vivid pictures of Lagos, Enugu and Nsukka. Interspercing the English text with some Igbo sayings and sentences. The title comes from 'Okwa m da ezi unu, ife du m bu nkenta nke nta.' Indeed she always does tell us that everything worthwhile is achieved little by little, in small incremental steps. Small by small, like inch by inch, mile by mile. It was very informative on how medical school and hospitals ran and I learned a lot. Interweaving politics which affected him and his country was done is a very balanced and nuanced way. He talks about his love of reading fiction, and the way he writes absolutely shows that. I recommend this book to anyone, but specifically people in the medical field around the world. It’s good to get a look and another perspective.
I really enjoyed reading this. It is easy to read, and lighthearted but it tells a beautiful story. I have often wondered about some things on the journey to becoming a doctor but this book laid it out plainly, especially in the Nigeria of the 1990s. I liked that a lot of this story explores the importance of family and friendships, and honestly a lot of things are not so bad when you have support. Overall, this was a really good read. Would totally recommend.
I’m a fiction over non-fiction girlie any day. So when I really love non-fiction, it’s usually because it’s told with such captivating story-telling, like a grandparent telling you a bed time story. This is how small by small felt to me.
Anya’s story isn’t necessarily a rare one but it is a rarely told story, of perseverance and studying through tough political and economic times in Nigeria. I really enjoyed his perspective and I learnt lots! As a plus, Anya’s description of surroundings and environments is beautiful. You really get the sharp contrasts of Nsukka, Enugu and Lagos and I thought he was skilled in bringing these settings to life.
4 stars instead of 5 for two reasons: a) I wanted the story to keep going - would have loved to hear about his life after being a house officer and even how he moved to the UK and b) I felt sometimes that the story was too confined to studying medicine and didn’t include the natural other parts of life like romance, faith, family and politics in Nigeria. But then again, maybe these were intentional on Anya’s part. You can’t tell everything in a novel.
Ike Anya’s first book is subtitled Becoming a Doctor in 1990s Nigeria. It is a time-bound memoir that rings uncannily true for me—I became a Doctor in 00s Nigeria. Unlike Anya, I attended Obafemi Awolowo University, Ile-Ife, one of the prestigious universities like Anya’s University of Nigeria, Nsukka. If Anya and I were to compare stories with a medical student in any of these Nigerian universities today, I imagine it would be similar. Whilst telling a story unique to his experiences as a book-loving medical student at a pivotal moment in Nigeria’s turbulent political history, Anya was also telling Nigeria’s story, albeit from a middle-class gaze.
He brings to the fore the humanity of the colourful characters he meets in wards, clinics—desperate corners where diseases and medical treatments transact. It is an unlikely marketplace to understand the world and our society, but it provides much insight into how political decisions can influence hapless individuals. But it is not all grim and woe, there is humour and commentary on food, ethnicity, music, nightlife, beer. In a characteristically self-deprecating way, Anya strings vignettes and anecdotes in praise of memory. This nostalgia journey has been clarified by both time and distance. I found myself going through the corridors of time and comparing my memories of medical school and key national events (like the June 12 Elections of 1993). I was sad when the book came to an end. Oga, should we expect a sequel?
This was my first non-fiction read in a while, and ultimately, I enjoyed it. It’s a book about becoming a doctor in Nigeria, and it took me a while to get into it. Initially, I wasn’t sure about why the author had picked certain scenes to go into; I found some sections to be repetitive; and I felt that there was a lot of focus on the “we” as opposed to specific mention of the author’s own experiences within the broader whole.
However, a third of the way in, I got into it. I was taken by the anecdotes about the experience of practising medicine in Nigeria — of the shortage of equipment, of tribalism and cultural differences; of gender emphasis; and even of the prevailing political context. It was interesting to read about this time that existed when I was still so young/ before I was born— of how Babangida and Abacha affected the feelings and choices of the nation, of its people, and of the doctors in the book. It was also interesting to read about the specific patient cases — about a broad range of people, and also about ways that the country failed them (whether it was through armed robbery attacks, or lack of social services, or lack of sterile environments for treatment).
After a while, it felt like I was going on this journey with him, listening carefully to the turns in each patient encounter, willing him to finish his studies, and then to graduate from house officer. And then it ended, more abruptly than I would have liked, but I learned some things regardless.
This was so very good. In some ways, it's like all medical school memoirs, and in other ways very much not. Ike Anya has a sharp eye for social injustice, and narrates the toxic affect of NIgerian politics on the health service. I learned a very great deal about Nigeria that I didn't know and found myself wondering if I could manage a trip to Lagos.
While I don't particularly like nonfiction or anything medical related, I enjoyed most of my time with this book Dr. Anya is a wonderful storyteller
Reading this book was accompanied by such a feeling of nostalgia Though decades apart, it feels like we lived the same lives When the book ended, I wished for more _ locum stories, nysc tales, and beyond.
PS: Reading Dr. Anya's description of his love for books made me feel like I had met my kin
Some memoirs are full of flourish and wistfulness. The miracle of Small by Small is the author’s translation of the subconscious thought processes of the inexperienced medical student: the learning of a new language, the euphoria of being inducted into the cult of medicine.
The book begins with the dramatic moment of a crucial exam result. We then go back in time to get a clearer picture of the medical school in turbulent Nigeria.
The author comes from an educated family and his background plays into how he deals with his medical school and related issues. This is not a large book and the author picks and chooses details that he elaborates on with anecdotes while others get passing mentions. Food and habits of people are things that help set the background of the time and place that he is talking about.
The society and the struggle for medical supplies are stark even as more people try to join the profession. The people with the means and opportunities seem to fly abroad, a situation I have seen and read about in several other countries as well.
The politics of the country are briefly explained as well. More details are provided when they actively hinder the author’s progress ( as well as other students) through medical school.
It was a well written narrative with simple and direct information. I found some parts of it more engaging than others but it definitely gave me a view into a whole other country at a deeper level than I could have otherwise gotten from reading a fictional tale set in the same place.
I think people in the medical profession will appreciate this even more, although it is not a requirement to understand anything in the book, everything that needs an explanation has one.
I received an ARC thanks to Netgalley and the publishers but the review is entirely based on my own reading experience.
Haven’t read a medical doctor’s memoir since Ben Carson’s Gifted Hands and that was a long long time ago. But I enjoyed this as much as I did that one, even though this is a very different type of memoir.
In Small by Small, we follow Dr. Ike Anya in his younger years through his childhood, his admission into the University of Nigeria to study Medicine and his housemanship in LUTH.
In addition to its well-written prose, humor and political commentary, I liked that this is a book that shares all the Tea on what it feels like to qualify as a medical doctor in Nigeria. Since I am also an alumni of his Alma mater, albeit for an entirely different discipline, acquired in another era, I could relate to a lot of his University experiences that happened outside the classroom walls.
This book is set in the late 90’s, when Nigeria was still under military dictatorship and the author reflects on a lot as each event unfolds. Much like every honest Nigerian that picks up this book, I think it’s beyond appalling to see how much worse things have gotten even though the country since the transition to democratic rule twenty three years ago.
Didn't take me long to get through this book. A real page turner that I thoroughly enjoyed reading as Ike Anya weaves us through his journey from childhood and subsequently med school. I got to learn about the different branches of medicine (if I can put it that way 🫣) and the challenges that the health care system in Nigeria faces. I began to worry when I had read a significant portion of the book and noticed the number of pages left because I felt there was more I needed to learn. This book left me asking for more and I feel Ike didn't do much in writing where he is now and what he is doing. I guess he has his reasons for that. I love the fact that he is a bookworm and it is evident in his writing. All in all, a five-star book and I am looking forward to whatever else he has in the works (I hope!).
“𝘐 𝘸𝘪𝘭𝘭 𝘨𝘪𝘷𝘦 𝘮𝘺 𝘱𝘢𝘳𝘦𝘯𝘵𝘴 𝘵𝘩𝘦 𝘨𝘰𝘰𝘥 𝘯𝘦𝘸𝘴: 𝘵𝘩𝘦𝘪𝘳 𝘴𝘰𝘯 𝘪𝘴 𝘨𝘰𝘪����𝘨 𝘵𝘰 𝘣𝘦 𝘢 𝘥𝘰𝘤𝘵𝘰𝘳, 𝘢𝘧𝘵𝘦𝘳 𝘢𝘭𝘭.” This is memoir on becoming a doctor in 1990s in Nigeria. Anya takes us on a journey. From childhood, school days, decisions and choices made along the way through to his days in Medical School till he becomes a full fledged doctor. The many challenges and hurdles he faced and overcame,the time he nearly gave up among others. He touches on the several change in government, coup d’état and protests that affected and impacted his journey on becoming. Governance Friendship Education Family Health Care Expectations Disappointment This memoir is very informative and detailed. I enjoyed reading it and picked up a thing or two. Thanks to NetGalley @netgalley and Sandstone Press @sandstonepress for this eARC. “𝘌𝘷𝘦𝘳𝘺𝘵𝘩𝘪𝘯𝘨 𝘸𝘰𝘳𝘵𝘩𝘸𝘩𝘪𝘭𝘦 𝘪𝘴 𝘢𝘤𝘩𝘪𝘦𝘷𝘦𝘥 𝘭𝘪𝘵𝘵𝘭𝘦 𝘣𝘺 𝘭𝘪𝘵𝘵𝘭𝘦, 𝘪𝘯 𝘴𝘮𝘢𝘭𝘭 𝘪𝘯𝘤𝘳𝘦𝘮𝘦𝘯𝘵𝘢𝘭 𝘴𝘵𝘦𝘱𝘴.”
I wish I read this book small by small, because I didn’t want it to end. Despite my poor attempt at a pun, I truly thoroughly enjoyed the book.
The author takes us with him on the arduous journey to becoming a medical doctor. Filled with characters, stories and experiences of a medical system showing the early signs of deterioration in a country that’s going mad. He sets the stage and his medical journey takes centre.
I particularly like that the book uses vivid descriptions of things that happen. Certainly he cannot recall the conversations and scenes as clearly as it is depicted . But the retelling and reimagining adds colour to the story. Ultimately, I know he becomes a doctor, still I find myself rooting for him.
This book is so beautifully written that I had mixed feelings as I got to the very last page. I loved that the author took me on a beautiful journey, I'm sad to see such a lovely story come to the end. I related so much with the book that I felt all the emotions that came with each page. The humour, the sadness, the chills. I am so grateful to have the opportunity to read an amazing story. As a medical student myself, this book has been an encouragement to me, its amazing being able to read about the challenges of people we aspire to be like; to come to know that they went through similar stages we did; felt the same or similarly as we did. They came out of it, beat every challenge, small by small
Originally, I was drawn to this book as Dr Anya is a fellow alumni at LSHTM. I thoroughly enjoyed this book and truly respect Ike Anya. The respect and care he has for his patients is evident (unlike Adam Kay This is Going to Hurt, which at times felt disdainful of his patients e.g. quote "the longer the birthing plan, the longer the emergency C-section scar"). The challenges of training to be a doctor in 1990s Nigeria were eye opening for me: -Families of patients requiring a blood transfusion will have to return the following day to donate blood so that stocks stay reasonable in the blood bank (however, not all the families return to donate) -Sitting medical exams against the backdrop of much political unrest and times when campuses were not always open
I loved reading about the street side restaurants and the celebratory moments. I am so glad that Dr Anya published this book. A recommended read!
My interest in the memoir piqued when I saw that Chimamanda Adichie gave the book a nice review, I expected it to be nothing of short of fantastic and I was not disappointed.
Beautifully written with the perfect mix of truth and comic relief. Ike Anya’s central theme which is patience and préservante in achieving any goal in life was well communicated, and shone especially towards the end of the book.
Definitely will be picking it up again, when from time to time I need a reminder that anything in life can be gotten small by small.
I found the first 50 pages really dragged for me and the book was hard to get into as a result, but persevering really paid off here. The memoir follows the authors journey to becoming a doctor in Nigeria in the 80s/90s. It is an open and honest reflection of how healthcare is administered in Nigeria and the myriad challenges faced; from political and economic hardships to tribalism and fervent religious beliefs. It was an interesting read and I definitely learned a few things amongst the pages. 3.5/4
I loved this book. It's a brilliant, vivid insight into the rigorous, exhausting training to be a doctor, and a revealing insight into the realities of the healthcare system in Nigeria - I can't imagine having to arrange for relatives to give blood before being able to have an operation, or having to pay before being seen in A&E. I knew very little about the political situation in Nigeria in the 90s, and Dr Anya's account of how much more complicated the sociopolitical turbulence made an already tough journey is powerful.
Small by Small: Becoming a Doctor in Nigeria is incredibly relatable, capturing the universal struggles of medical training so well that it feels like living the same life, despite being set in the 90s and in a different part of the country. The book portrays how failure pulls you into a dark place, but in medical school, there’s no time to wallow – you have to keep moving forward, as if nothing happened, because the journey waits for no one.
A memoir about becoming a doctor in 90’s Nigeria. Enjoyable, inspiring and funny. Reading it made me want to become a doctor, despite the difficulties he faced on his journey. His story of becoming a doctor made it seem daunting, but attainable. This would be a good recommendation to younger readers who may be considering taking the same path.
I thoroughly enjoyed this book. It was part Nigerian history (without being preachy or tedious), part social and political commentary (the reality of living under Abacha and in the shadow of the Biafran War), but also autobiographical in a refreshing way. I didn't think I would enjoy the book as much as I did. Worth a read.
A fascinating insight into the authors journey applying for, studying, and eventually qualifying in medicine. More than that it’s a story of Nigerian society and politics at the time. The pacing was a little off in places. But overall a very engaging read. The sort of book where you learn a lot without realising it. I would recommend.
Thank you to Netgalley and Sandstone Press for a copy of this book.
This is a Ike Anya's memoir about how he became a doctor in Nigeria in the 1990s.
This memoir was very informative and gives us insight into the unique issues facing the Nigerian healthcare system at the time, both financial and cultural (eg. language barriers).
A wonderfully written work. Being surrounded by doctors, and also trained as a pharmacist too, so much of the book is relatable. I laughed hard from time to time reading the book sha 😂😂
As a young man growing up in Nigeria, Ike Anya made me understand the dynamics of the Nigeria settling in the early 90s while revealing to me the process it takes to become a medical practitioner.
Big thanks to Judith Audu for urging Pemi Aguda and I to buy it last year. If, like me, you love Adam Kay’s This Is Going To Hurt, then you’d really like this one.
This was an interesting memoir and made a worthwhile read for me. I had to visit the dictionary quite a number of times. Good for my vocabulary and thank you to the author for writing this book.
PS: I found myself reaching out for the book days after reading it. I guess it had become an evening companion over the course of the month that I read and I missed it. It takes a good book to do that.