Hi, everyone, and welcome to episode 7 of my podcast Leading A Double Life. I’m Kwei Quartey, a physician and author of the Inspector Darko Dawson novels. On my podcast, reflections on being a medical doctor and a writer. This episode, part one of a series on African Literature African Literature: What is it? African literature has been much written about. There is still debate about what it really is, its themes and its style and content. A notable aspect is that it includes both the oral and written literatures. The etymologic definition of literature is “writing formed with letters,” from the Latin littera (letters). Therefore, Pio Zirimu, a Ugandan scholar, suggested the word orature to replace the self-contradictory “oral literature.” Despite the ingenuity of the name, it didn’t really take hold, and “oral literature” is still the more popular term among scholars. Included in oral African literature is the African heroic epic. A prime example is the Sunjata (or Sundjata/Sundiata) Epic of the Mendeka peoples, relating the legend of Sunjata, the 13th century king of the Mali Empire. What is the stereotype about written African literature? The oral form of African literature is frequently mentioned and acknowledged in papers and books, but even supposedly knowledgeable scholars hold the view that written African literature barely made any appearance before the 1950s (as a result of colonization). In other words, before Chinua Achebe’s famous Things Fall Apart and other African writers’ works of that era, there was no good African literature to be found. TFA was one of the first African novels to garner international critical acclaim, but was that all there was? No, says Princeton professor of medieval, early modern, and modern African literature, Wendy Laura Belcher. She notes in her paper on African Literature, An Anthology of Written Texts from 3000 BCE to 1900 CE that while historians labor to overturn privailing misconceptions that Africa is a place without history, literary critics have done little to overturn a mistaken view that Africa has no literature. Some Westerners believe that writing on the continent was not done by Africans or in African languages. Belcher emphasizes, and others back her up, that in fact there is an at least 3000-year history of African writing. Why has some African literature escaped notice (or been ignored)? Much of African literature over the last millenia has disappeared from view because it has not survived, particularly in sub-Saharan Africa, but extant texts refer to these ancient documents as having existed. Second, many works were not published and therefore went unknown. Third, very few were translated from African languages into European languages, and they were therefore ignored. As much as scholars probe and dissect shining examples of twentieth century African literature, Belcher points out there are historical precedents to the works of the prominent modern-day African writers. For example, it could be argued that the pidgin English works of Amos Tutuola (The Palm-Wine Drinkard), (which Dylan Thomas called “fresh, young English”), Ken Saro-Wiwa (Sozaboy), and Uzodinma Iweala (Beasts of No Nation) were well preceded by Antera Duke‘s eighteenth century diary, which was written in Nigerian pidgin English and carried to Scotland by a Scottish missionary. Where is that ever mentioned in popular analysis? Historical categories of African literature One subsection of African literature emerged from the writings of Africans living outside of Africa– both slaves and African youths whom European colonists sent to study in England, France, Portugal, Italy, Holland and Germany. The Interesting Narrative of the Life and Adventures of Olaudah Equiano or Gustavus Vassa, the African (1789), was written by former slave Olaudah Equiano, who described the awfulness of slavery and the slave trade. Equiano was in the forefront of the movement in Britain to abolish slavery. His book was highly influential in bringing the trade to an end. Written in English, Equiano’s narrative received much attention, but another group of Africans in Europe had writings in Latin. Those have not commanded as much close examination. What are the ancient forms of African literature? The Arab expansion in the Sahel spread Islam to the region, and the 11th-century Berber-led Almoravid invasion of the Empire of Ghana (not to be confused with modern Ghana) brought with it a Kufic-derived Arabic script. Mali, Sudan, and Nigeria developed different styles of Kufic-derived calligraphy. The role of Arabic writing and literature in West Africa has been long underestimated. Ajami is an African-adapted Arabic script found in the Swahili, Hausa, Wolof, and Yoruba. It is 300 t0 500 years old. Another ancient written form in Nsibidi, which is an ideographic script with a system of symbols that was indigenous to what is now southeastern Nigeria. It dates back to at least 2000 BC. Many people don’t realize that the much-commercialized Adinkra symbols of Ghana also represent old, ideographic writing. It dates back to at least 1817, when the Englishman Thomas Edward Bowdich collected a piece of Adinkra cloth in 1817. The next oldest piece of Adinkra textile was sent in 1825 from the Elmina Castle to the royal cabinet of curiosities in The Hague. Lybico-Berber or Tifinagh script dates back to 3000 BC at least, and is the ancient writing of the Tuareg and other peoples in Morocco, Algeria, Mauritania, Egypt, Chad and Niger. The Egyptians invented three different types of scripts–hieroglyphic, hieratic and demotic; and yes, like it or not, Egyptians are Africans. Vai script (3000 BC to present) is a particularly lovely form of writing indigenous to Liberia and a small portion of Sierra Leone. It is a set of symbols representing syllables Other languages with syllabaries include Japanese. Summary Clearly, there is much more to learn about African literature. In reference to Ajami, Serigne Kane notes, “the writings of black African authors have long been neglected due to prejudice, as both Europeans and Arab scholars with the necessary linguistic competence to study their works have often deemed their insights of little or no scholarly interest or benefit, and most assume that sources of knowledge on Africa are either oral or written in European languages,” (quote from Fallou Ngom.) Much the same applies to other forms of African writings. Even the word “literature” seems to have been captured and held hostage by Eurocentric exceptionalism as its rightful and exclusive property. African literature has been viewed as that which developed as a result of the “civilizing influences” of invading Europeans. It’s time to take the blinders off and open up the mind. That’s all for this episode. Again, thank you for listening. If you’re hearing this on iTunes, please also check out my website, kweiquartey.com. That’s k-w-e-i-q-u-a-r-t-e-y dot com. The podcast episodes are also available there. I’m on Twitter as @doublekwei, one word. Until next time, be happy and healthy.

Leading A Double Life

LEADING A DOUBLE LIFE_007

LEADING A DOUBLE LIFE__EPISODE 006 Trials of a doctor-in-training—Part 1 Hi, everyone, and welcome to episode 6 of my podcast Leading A Double Life. I’m Kwei Quartey, a physician and author of the Inspector Darko Dawson novels. On my podcast, what it’s like to be a medical doctor and a writer. This episode, Trials Of A Doctor-In-Training, Part 1 In medical school, there are certain main subject categories like Anatomy, Physiology, Biochemistry, Pharmacology, Pathology, and so on. A med student has to study a lot, although there isn’t as much dry reading as there is in law school, for example. In case law, you might read a case Mr. X versus the State that is page after page of long, wordy paragraphs. In medicine, cases might have images to support clinical situations and break up the tedium. In neurology, for instance, you have diagrams of neural pathways that you must learn in order to understand a particular neurological disorder. It makes understanding the pathology easier, although it doesn’t necessarily give you less to memorize. In histopathology, a student is tested on the human tissues and different types of cells seen under a microscope. One of the most intimidating types of exams is when you’re given a certain amount of time, say 30 seconds, to identify a human cell type, and you must move onto the next station when the examiner rings the buzzer. Falling behind in writing down your answers can be a catastrophic domino effect. Among the subjects medical students have the most anxiety about, Anatomy is probably the mother of them all. It’s the study of the structure of bodily parts and their physical relation to each other, and the study of human anatomy traditionally involves dissection of the human body much the way many of us dissected frogs or mice in high school or college. For most freshmen and fresh-women in medical school, human anatomy is the first time to see and experience a dead body. I remember I was a little apprehensive about what it would be like, but I recall some other students who were almost paralyzed with anxiety. I remember the dissection hall as a large room with two long rows of stainless steel tables upon each of which was a male or female cadaver. My reaction to the bodies was surprisingly muted. They had an unreal, waxy, Madame Tussauds appearance. The skin texture was nothing like a live human. They reeked of the formaldehyde preservative, and sometimes it was so strong as to make my eyes water. In the end, I think even the students who were most worried about the cadavers got used to the idea pretty quickly, and two or three weeks in, no one batted an eye. Each student is usually assigned to a pod of 7 to 10 colleagues who stay together as a group with the same cadaver for the duration of the semester. Each pod follows the syllabus under supervision by a medical fellow, that is, a junior physician specializing in the field. The study of the cadaver’s anatomy follows major regions or systems of the body: head and neck, upper limbs, chest, abdomen and so on. But within each of those are subdivisions: for example, the head and neck will include the lymphatic, neurological and muscular systems. Whether you get a male or a female cadaver is luck of the draw, as is the amount of adipose tissue your cadaver has. Consider yourself lucky if you have a lean body. They are much easier to work with. I know of one medical school that traditionally has the staff and students hold a moment of respectful silence before the first cuts on the cadavers are ever made. They were once living human beings, and in a way they have sacrificed their bodies to us for the sake or our learning from them. I think that moment of silence is a wonderful gesture, and I wish my medical school had done that as well. Now, working in groups like our Anatomy pods is not always easy. One medical student often turns out to be something of a leader within the pod, but there can be friction between strong personalities. Sometimes you can feel intimidated by someone who always seems to know a lot more than you, or seems able to grasp the anatomy more quickly than you do. I always felt like I didn’t want to hold back the group if I didn’t get something, and preferred to ask another student or one of the supervisors after class. The problem with that is it’s always best to ask one’s questions in real time, and not after the fact. The amount of material to learn, absorb and memorize in Anatomy is staggering. A student needs to know where every nerve begins and ends, which muscles the nerve controls, the origin of every skeletal muscle and the bone on which it ends, and so on. Remember that there are something like 650 skeletal muscles in the human body. All of this information can become overwhelming, and the practical exams in which you’re faced with an unidentified organ, muscle or bone are nerve wracking. For all these reasons, Anatomy is almost certainly one of the most stressful subjects in the medical school years, but it can be also enjoyable. Most of the anatomical knowledge the medical student gains in Anatomy will stay with him or her throughout his or her life as a practicing doctor, and for those who go into surgery of any kind, whether it’s general surgery, orthopedics or neurosurgery, Anatomy is of the highest necessity. The name of the TV series “Grey’s Anatomy” originates from the all-time classic textbook, Gray’s Anatomy by British surgeon Henry Gray, with its iconic illustrations by Henry Vandyke Carter. Dr. Gray was born in 1827 and died of smallpox in 1861 at the tragically young age of 34. His 750-page textbook, first published in 1858, is highly acclaimed to this day for its masterful descriptive detail accompanied by some 365 extraordinary diagrams. The TV program spells “Grey” with an “e,” while the textbook “Gray” is with an “a.” The 41st edition, the latest, was published in 2017. Modern versions of the textbook connect anatomy more with clinical scenarios than the old editions. By the way, I’ve never seen an episode of “Grey’s Anatomy,” but I have used the textbook! If Anatomy is all about the structure of bodily parts, then Physiology is the function from the macro to the micro level. We can analyze how a person’s leg works by describing how the muscles contract, but inside the muscles are a collection of microscopic actin and myosin fibers that work together to create the muscle contraction, and within each fiber, certain chemical, electrical and neurological actions take place at the cellular level to bring about the desired effect. Although Anatomy is a superpower in the study of medicine, I probably enjoyed Physiology a bit more because it took less hard memorization and more understanding of process. Pharmacology and Biochemistry had the least appeal of them all. Which subject you love is a combination of your personal interests, abilities and background, as well as how good your teacher is and how much you like him or her. In med school, I noticed different study patterns among students. Some liked studying in pairs, others in groups, and those like me preferred studying alone. I often wished I could learn in a group setting because theoretically one should be able to benefit from exchange of knowledge, but I always found interjections from others in the group distracting, as if I kept getting knocked off a path I was trying to follow. Much later in my career—in fact after medical school—I realized that for me, the most effective way of studying for exams was to do as many practice questions as I could get my hands on, and that’s the way I study now if I need to take any tests for continuing medical education and so on. Just as in other fields like astronomy or engineering, the volume of knowledge and information in medicine seems to have increased several fold over the past decades, and has the way that knowledge is shared has also changed. In my next podcast, I’ll talk about how learning has evolved with the advent of a pocket-size device that can hold a lot more textbooks than you can lug around under your arm: your smartphone. That’s all for this episode. Again, thank you for listening. If you’re hearing this on iTunes, please also check out my website, kweiquartey.com. That’s k-w-e-i-q-u-a-r-t-e-y dot com. There’s a sign-up bonus, so to speak, right now. If you subscribe to my email list, you win a beautiful Page Anchor exclusively and directly from the lovely nation of Sweden. It’s a uniquely designed device that holds your pages open for you. The podcast episodes are also available on my website with accompanying show notes. I’m on Twitter as @doublekwei, one word. Until next time, be happy and healthy.

LEADING A DOUBLE LIFE_006

LEADING A DOUBLE LIFE__EPISODE 005 Religion, Marriage, and Murder Hi, everyone, and welcome to episode 5 of my podcast Leading A Double Life. I’m Kwei Quartey, a physician and author of the Inspector Darko Dawson novels. On my podcast, what it’s like to be a medical doctor and a writer. This episode, Religion, Marriage, and Murder. On Tuesday, August 29, 2017, a little under three months from now, my fifth Detective Chief Inspector Darko Dawson novel will go on sale. It’s called DEATH BY HIS GRACE, and like the other books in the detective series, it’s set in Ghana, my birthplace. Here’s my elevator pitch: Katherine Yeboah’s marriage to Solomon Vanderpuye is all the talk of Accra high society. But when it becomes apparent that Katherine is infertile, Solomon’s extended family accuses her of being a witch, hounding her until the relationship is soured. As some of Inspector Darko Dawson’s old demons resurface, he investigates a case of marital bliss turned deadly. If the fourth novel, GOLD OF OUR FATHERS, took Darko far from home, this one comes too close. Darko’s wife, Christine, is Katherine’s first cousin. So, as Darko wrestles with the case, family members inject their emotions and opinions into the investigation, including and especially Darko’s consistently annoying mother-in-law, Gifty. DEATH BY HIS GRACE is based in part on the real-life events of a Ghanaian friend of mine. The story has three major components: first, the ostensibly fairytale marriage of accountant Katherine Yeboah to lawyer Solomon Vanderpuye; second, religion, which plays a major role in the life of Ghanaians; and, third, of course, murder. Can’t write a murder mystery without a murder. Now Katherine’s and Solomon’s extravagant Accra wedding was a society event—one of those occasions at which anyone with social standing would want to be seen. But a year later, the marriage has lost its magic as it becomes apparent that Katherine is sterile. At that point, life turns hard and ugly. Solomon and his extended family begin to hound her, calling her a witch. In Ghana, fertility is very important, and having children in a marriage is the norm. In the West, we generally don’t disapprove if a married couple chooses not to have children, but in Ghana, that would be regarded negatively, and an infertile woman would fall under great suspicion. I say suspicion because one of the reasons some Ghanaians give for female infertility is that a witch or someone else has cursed the woman, or that the woman herself is the witch. One theory goes something like this: at night, the woman’s witch form, I guess you could call it, carries the fetus out of the uterus to her coven of fellow witches, who join her in devouring her baby. I know—not a pretty visual. Incredulous as it may seem, belief in witchcraft is still alive and well in Ghana, including among educated people. You might ask how that’s possible, but deeply held beliefs are often dissociated from education. I’d venture to say that there are educated Americans who believe God made the earth in seven days and that Adam and Eve were real people living in the Garden of Eden about 3000 years ago. And there are also lots of Americans who believe in ghosts, which I personally don’t. Anyway, back to Ghana—bottom line, try to avoid being designated a witch there. That might be funny if it weren’t so serious because Ghanaian women perceived as witches can be physically attacked, hurt and even killed by their accusers. Or these women can be subjected to dangerous traditional treatments of all kinds. In fact, as in my novel, if a woman is murdered and there was talk about witchcraft, take a look at the people who leveled that accusation because there may lie your suspects. If the marriage of Katherine and Solomon are front and center in the novel, the backdrop is religion. In 2013, a WIN-Gallup poll found Ghana to be the most religious country in the world. Not one of the most; the most. The poll used something called the “religiosity index,” defined as, “the percentage of the population who self-describe themselves as ‘a religious person’ in the following question: Irrespective of whether you attend a place of worship or not, would you say you are a religious person, not a religious person or a convinced atheist?” Some of the other countries on the “most religious” list include Nigeria at number two; Armenia, number three; Fiji, number four; and Macedonia, number five. On the other end of the scale, China is 47% atheist. Shifting to the US for a moment, a Pew Research Center study finds the top five most religious states are, Alabama, Mississippi, Tennessee, Louisiana, and Arkansas. I don’t see any surprised looks in the room. California, my home state, is number 35. The least religious state is New Hampshire. One of the important takeaways of the Gallup poll is that the poor are more religious than the rich. People in the bottom income groups are 17 percent more religious than those in the top income groups. I think you can see this on a macro and micro level wherever you go in the world. In Ghana, religiosity is everywhere. Some people go to church not just once a week on Sundays, but on one or two weekdays in addition. These may not be brief services either. They can be up to four hours of worship. If you are imagining small, humble churches, yes, there certainly are those, but Ghana also has a mammoth Pentecostal movement that involves mega-churches of the kind seen in the United States—huge structures that can seat the thousands flocking to their revered evangelist. Prayer vigils and so-called deliverance services take place in large venues like sports stadia and the Independence Square in Accra. The most famous and prosperous evangelist religious leaders, like Bishop Dag Heward-Mills, who also has churches in the US, are able to pack these audiences in as well as any music celebrity. Although religiosity spans the different levels of society, anyone going to these events will be struck by how many poor people attend. I think this correlates closely with the global findings of the Gallup poll. On a daily basis, Ghanaians don’t fail to remind you of their belief in God. When you say to someone, “Hello, how are you?” you’re likely to get the response, “By His grace,” which is shorthand for, “By God’s grace, I’m well,” or nowadays with socio-economic circumstances in Ghana so tough, you also hear, “By God’s grace, we’re managing.” Someone once quipped that Ghana has a lot of managers. I borrowed this ubiquitous Ghanaian phrase, “by His grace,” for my book title, DEATH BY HIS GRACE. I’ve thought a lot about what the title means. It could be asking: while God’s grace bestows good fortune on some, did He forget to protect others, like the perfectly decent, upstanding, and churchgoing Katherine Vanderpuye, who suffered an awful murder? A fundamental issue is whether a so-called man of God can be under the same level of suspicion of murder as an outright sinner. DCI Darko Dawson apparently thinks so, much to the dismay of some of his family members. I guess my novel raises the question also whether religion and belief in God, professed by so many people in Ghana, influences moral behavior there. From what I see for myself when visiting the country, the answer is no. If such a religious nation is seeing rising corruption, fraud, armed robbery, murder, and vehicle theft (of which I myself have been a victim), there’s either no connection between religion and crime, or there’s a negative correlation. On the other side of the coin, some non-religious countries have low rates of corruption and crime in general, the obvious example being the Scandinavian nations. During my research in Ghana for DEATH BY HIS GRACE, I went to religious services held by these prominent men of God. These events can be quite spectacular; particularly the deliverance services in which healing of the sick and casting out of demons take place. Also, speaking in tongues, or glossolalia, is characteristic of the Pentecostal and so-called charismatic churches. Most dramatic are the congregation members who become slain in The Spirit—that is, when the Holy Spirit presumably enters their bodies and causes them to collapse. For that, professional catchers are dispatched throughout the church or other venue to prevent people from hurting themselves as they drop to the ground. From a logistics and medical point of view, though, I don’t see how everyone falling to the ground can possibly be caught before impact. It’s doubtful then, that these are genuine instances of loss of consciousness because a lot more people would get hurt if that were the case. The casting out of demons can be extraordinarily violent and creepy. A person may writhe around on the ground screaming and sweating while a pastor yells at them in order to expel the demons. One girl in a church setting was worked on for more than an hour straight and the bishops trying to exorcise her had to take a break because they were so exhausted. At a service I attended run by a bishop called Boniga, there was a mother with her infant who suffered from epilepsy. The story was that the mother’s sister, presumably out of jealousy or hatred, had cursed the child. So mom came to Bishop Boniga with her baby to have the demons cast out. The so-called healing I witnessed by Bishop Boniga wasn’t terribly impressive either. An old man who was said to be wheelchair dependent from crippling arthritis threw his cane away after being touched by Boniga, and walked off the stage without the cane. However, I noticed later one of his family members came back to get it. The old guy probably endured the short walk off the stage, but I bet once he had done that, he felt overcome again by the arthritic pain. So, why all this piety with poverty in Ghana and other countries like it? It’s a question I put to myself all the time. Is it belief for the sake of belief? Is it that the charismatic faiths hold out the promise that God in His wisdom and at some point of His choosing, will bestow blessings and financial success on the worshipper? In other words, the harder you pray or speak in tongues, the more likely you are to get rich? Or is it that prayer, churchgoing, Bible study and so on, are lifestyles in which poverty-laden people experience a sense of power and fulfillment in a life that otherwise gives them precious little of that? I don’t have those answers, but that’s part of the reason I wrote the book. Writing a story with a backdrop I don’t fully understand is a way to explore it through the lens of murder, and that always renders it more intense. That’s all for this episode. Again, thank you for listening. If you’re hearing this on iTunes, please also check out my website, kweiquartey.com. That’s k-w-e-i-q-u-a-r-t-e-y dot com. There’s a sign-up bonus, so to speak, right now. If you subscribe to my email list, you win a beautiful Page Anchor exclusively from the lovely nation of Sweden. It’s a unique, pocket size device with both form and function that holds your pages open for you. The podcast episodes are also available on my website with accompanying show notes. I’m on Twitter as @doublekwei, one word. Until next time, be happy and healthy.

LEADING A DOUBLE LIFE_005

It's surprising how much similarity there is between a physician and a crime investigator.

LEADING A DOUBLE LIFE_004

Hi, everyone, and welcome to episode 3 of my podcast Leading A Double Life. I’m Kwei Quartey, a physician and author of the Inspector Darko Dawson novels. On my podcast, what it’s like to be a medical doctor and a writer. This episode, How I Got Published. One of the top most exciting times of my life was the day in 2008 that I learned Random House had accepted my first novel, WIFE OF THE GODS, for publication. My phone was buzzing with messages back and forth to and from my agent as she negotiated the deal. But I have to go back in time, because it was a decades-long road to that hallowed major publisher destination, and Random House is huge. After graduating from my Internal Medicine residency, I had returned to my old love of fiction writing. As a pre-teen, I’d written several adventure and mystery novels and won a few fiction-writing contests. My parents were very supportive and encouraging of my efforts, but at no point did they ever force me to write. I did it at urgings from within. I believe wanting or needing to write is something indigenous. It’s a part of me as much as the necessity to eat and sleep. I had been working as a newly employed Los Angeles physician for about a year when I began my first novel. At that time, I’d joined a writing group run by a former editor at one of the large publishers, and the literary world was buzzing about a steamy new novel called Destiny by Sally Beauman. It had been only half completed when it got a million-dollar advance from Bantam Books. It debuted at number six on the bestseller list a week before it was even published. It was 848 pages long, and one of those stories described with adjectives such as “sprawling” and “sweeping.” It was Danielle Steele-ish but was more explicit in its description of romantic exchanges, to put it delicately, particularly one jaw-dropping scene that everyone who read it remembers. I certainly do. I was quite taken with Beauman’s tome, and nothing preaches success like success, so I wrote my first novel called A Fateful Place along the lines of Destiny. Mine had an international flavor, taking place in England and the United States, with elements of the fashion world and British aristocracy. Essentially, Fiona, a young American woman visiting England mistakenly believes she has lost her baby boy, Julian, during a tragic ferry accident. In fact, the child has survived and been sold to a rather dodgy upper class British couple unable to have their own child. The lives of Fiona and Julian are separate until by happenstance they cross, and with devastating results. There were holes in the plot of this story large enough to drive a truck through. The question I have now is how I managed to fill some 750 pages with this story. I doubt I could do that now. I don’t recall how many literary agents I sent the manuscript to, but I could have built a paper house with all those rejection letters. Apart from the plot being grossly flawed, who was going to give any standing to a black author writing about the British and American white upper class? I should explain that most publishers don’t accept unsolicited manuscripts; that is ones that haven’t passed through a literary agent, who is, I suppose you might say, a gatekeeper. While I was waiting—in vain as it turns out—for an agent to snap up In A Fateful Place, I embarked on a new work of fiction based on the independent movie, Battle Of Algiers, about the war from 1954 to 1962 between Algeria and her French colonizers. I don’t remember which came first—the movie, or my interest in the war, but at any rate I personalized the historical events with a fictional character, Kamila, which was also the book’s title. Kamila, a young Algerian woman working in the French Quarter of Algiers, is caught up between the rival attentions of an Arab nationalist and a wealthy Frenchman. This novel I wrote very quickly—in about three months. I farmed it out to several agents without success. The rejection letters—sometimes no more than the word, “no--” kept pouring in. At some point I got disgusted and decided I was going to get Kamila published by whatever means possible. I turned to a so-called vanity press; that is, a publishing house that edits and prints your book at your cost. I chose Vantage Press, not to be confused with Vintage. Vantage is out of business now. I don’t remember how much they charged me, but it was a lot. To make things worse, I insisted on designing and printing the jacket covers myself and then shipping them to Vantage, all of which raised my expenses several-fold. The reason I did the covers was that Vantage had some of the dullest, most uninspiring jackets I’d ever seen. To their credit however, the line editors and proofreaders were excellent. Of course, right now we have a very large vanity press. It’s called Amazon.com. You can upload whatever you like to Kindle Direct Publishing. Barnes & Noble with their Nook, and Smashwords are other examples of that kind of platform. Back before the year 2000 when I was roaming the streets trying to hawk Kamila to bookstores, there was little chance of the novel getting anywhere because self-published books were regarded with great disdain at the time. They often still are, but online publishing has changed the landscape, and now a major publisher may chase after an author who has had phenomenal success with online self-publishing—case in point: Vintage (V-I-N) paying a massive advance to EL James for her Fifty Shades novels. With Kamila, I still had not found my footing as an author. People say, “Write what you know,” but more to the point is “Write what engages you,” and that wasn’t what I was doing. I had been ignoring what I innately knew about myself: one, that I’ve always loved murder mysteries; and two, that I grew up in Ghana, a culturally complicated West African country. It was time to combine those properties. In my first novel, WIFE OF THE GODS, at last I was writing about themes in which I was engaged: Ghanaian customs and traditionalism and their clash with modern thought, and how deeply ingrained indigenous beliefs could tie into a murder. When the first draft of WIFE OF THE GODS was done, I once again embarked on the painful process of looking for a literary agent. One said she wished she could represent me, but she wasn’t sure how she would market a book set in Africa. What she was saying was she would be swimming against the tide of American parochialism. Another agent, this time in the UK, put it more bluntly. “Two places in the world no one before the bestselling novels of Alexander McCall Smith, whose famous series with an African female protagonist is set in Botswana, in Southern Africa; and Khaled Hosseini whose bestselling books are set in Afghanista n. If the UK agent turned down those two as well, I’m sure he’s still kicking himself. Searching for an agent, it took me a while to realize I was doing it all wrong. True, I was picking literary agents who, according to different listings, handled fiction and mysteries or adventure, but the listings were too generic and didn’t drill deep enough. What kind of fiction, what kind of mysteries? I was randomly throwing darts and praying they’d hit the bull’s eye. I came across an online service called Agent Research and Evaluation, which has been around for about eighteen years and is run by Beverly Swerling, who is a novelist herself. She matches agents with the authors’ needs and provides highly detailed information about recent deals by literary agents. That way, the author can write a knowledgeable query letter to the agent saying something like, “I note with admiration that you recently sold X book by Y author to Z publisher.” Beverly taught me that it never hurts to flatter, praise or otherwise stroke an agent’s ego. They’re human too and they bruise and bleed just like the rest of us. Beverly guided me to an amazing agent Marly Rusoff, a former publishing executive at Houghton Mifflin, Doubleday and William Morrow. Based in Bronxville, New York, Marly was excited about WIFE OF THE GODS. It so happens that she tried to reach me on my landline, which I rarely picked up, and so all the while I thought she wasn’t interested, she was. Finally of course, we managed to get together. The elation I felt when I was finally told, “Yes,” after years and scores of “no” is indescribable. Marly’s pitching and negotiation skills were formidable evidently, because she got both Penguin and Random House in a bidding war for WIFE OF THE GODS. To make a decision about which to sign with, we set up two separate conference calls. As scheduled, I first called the VP of Penguin, but there was some kind of glitch in which she couldn’t be reached, and I had to leave a message. On the other hand, at Random House, the VP and one of its senior editors, Judy Sternlight, were ready and waiting for me and picked up on the first ring. I was bowled over by their warm reception, and even though Penguin did get back to me, the VP there did not sound as enthusiastic as the folks at Random. My experience with senior editor Judy Sternlight was outstanding. I learned invaluable lessons from her. Judy has the remarkable ability to draw out your best writing. She puts forward ideas, yes, but more than that, she stimulates them. Now, almost ten years later, Penguin and Random have merged, but Judy and I are with neither of thos e publishers. In 2012, I moved to a smaller house, Soho Press, which has been a terrific publisher for me; and Judy too has moved on, establishing Judy Sternlight Literary Services for authors in need of editorial assistance and book development of the highest standard. In the end, with the exception of a blessed very few, getting published isn’t easy. It never has been. But remember this: James Baldwin, JK Rowling, William Faulkner, Ernest Hemingway and Alice Walker, are just a handful of the many famous and successful authors who received at least one, and in many cases, several, rejection letters before acceptance. So keep on sending in those manuscripts!

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LEADING A DOUBLE LIFE__EPISODE 002 Code Blue Hi, everyone, and welcome to episode 2 of my podcast Leading A Double Life. I’m Kwei Quartey, a physician and author of the Inspector Darko Dawson novels. On my podcast, stories of what it’s like to be a medical doctor and a writer. This episode, Code Blue. The emergency room double doors burst open and two ambulance guys tear in with an unconscious man on their gurney. The ER trauma team usher them in as one of the EMS techs gives a brief rundown of what has happened. The man is a gunshot wound victim. As soon as he’s hooked up, the cardiac monitor shows he has flat-lined. The physician leading the team barks orders for IV infusions and different medications to inject into the victim’s veins in an attempt to resuscitate him. There’s been no response in the first ten seconds. “He’s still flat-line!” the doctor yells dramatically. “We need to shock him!” A team member removes the counter-shock paddles from the defibrillator, applies gel to their surface, rubs them together and puts them on the unconscious man’s chest. “Clear!” she shouts, and everyone steps back from the gurney. A shock is delivered, causing the man’s body to lift involuntarily a couple of inches off the bed. This could be a typical code blue scene from any number of popular television series about the drama in an urban ER. Pretty exciting, right? Maybe, but there are a couple big bloopers in the scene I’ll reveal to you a little later on in the podcast. But before I do that, here’s another scene, quite different, this time from a Netflix show called Rosewood: Preparing for a postmortem exam, Morris Chestnut as Beaumont Rosewood, a forensic pathologist, stands over a dead woman on an autopsy table. Rosewood has blue nitrile gloves on and wears a red V-neck shirt with dark blue jeans. He picks up the scalpel to begin his first incision. If you haven’t already figured out what’s wrong with that scenario, I’ll let you know in a little bit. TV programs and movies with medical or forensic content may consult physicians or other medical experts to ensure the scenes come off realistically. However, I feel American TV in particular appears preoccupied with having physicians, staff, and patients all young and beautiful. In the real world, it is often the graying, experienced physicians and nurses who are in charge of the team on duty in the ER. A dying patient really doesn’t care how beautiful his lifesavers are. My observations are that Europeans and Scandinavians are less afraid to show plain, average looking people on TV and in movies. The point is, they appear both genuine and genuinely smart. I don’t have much need for Code Blue situations in my detective novels, but forensic pathology and postmortem exams are a different matter. They are relevant and often crucial. All of my Inspector Darko Dawson books include at least one autopsy, and my novel Death By His Grace briefly describes some of the fascinating forensics of blood spatter—fascinating to me, anyway. By the way, if you use Luminol to make traces of blood fluoresce, the blood is destroyed forever and you can’t run any DNA on it. There’s something mesmerizing about the autopsy ritual—the donning of protective clothing before entry into the postmortem room, the approach to the dead person lying motionless on the autopsy table, examination of the external body before the traditional Y-incision made on the cadaver’s chest, and the anticipation of what information lies in wait to spring its surprise. It’s important to me also that the pathologist treats the dead body with respect, no matter how maimed and disfigured it may be. The murder victim is a silent self-witness to the crime. She can’t speak, but the autopsy is the way we ask her to nonverbally tell us the story of what happened. It’s certainly poignant, even maybe a little sad, that the procedure necessarily involves the infliction of more wounds than dead body already has, but obviously this time the motive is not to harm. Years ago when I had an interest in becoming a forensic pathologist, I requested permission from the LA County Medical Examiner’s Office permission to see the facilities and attend a few autopsies. A gracious and experienced pathologist there was happy to accommodate me, and she taught me a lot on my first visit. However, when the chief medical examiner at the time returned from a trip out of town and found out I was a novelist in addition to being a physician, he called me up and told me to forget about returning for another visit to the ME office. Curious, I asked him why. In reply, he said the director, cast, and crew of a certain Oscar-winning movie had once barged into the LA County Medical Examiner’s Office without full permission to film, and turned the place upside down. Whether that story was true or not, what did it have to do with me? “Just don’t come back,” the chief told me bluntly. Apparently he thought I was going to misrepresent the LA County ME in one of my novels. I have to say that a physician-author unobtrusively observing a few autopsies would have constituted the least of the LA County Medical Examiner’s problems. Not only back then, but to this day, the office has had tremendous challenges with a surfeit of cadavers, pending autopsies and lab reports. To their credit, just last week the ME’s office announced that they had cut the backlog by better than half. On TV shows, the detectives get an autopsy this afternoon and the DNA results tomorrow morning. The reality is not quite that sanguine. Around the world, many medical examiner offices are burdened with stacks of dead bodies waiting for autopsies, and I’m not using the word “stacks” metaphorically. In my novel Gold Of Our Fathers, Darko found the morgue in one hospital was so full of corpses that some were being stored in plain view on the floor, a very disturbing sight. Neither does Darko often have the benefit of DNA analysis, because in Ghana, blood and other fluid samples have to be outsourced to a lab in South Africa or the US, and the results take ages to come back. In the time it would take, the case would go cold. I’ve seen quite a few postmortem exams in my years of medicine, and in writing crime fiction I have a unique opportunity to impart to the reader what an autopsy is really like. I want to put the reader right there, so I describe the smells, sights, sounds and the tactile experience. Now back to the two scenes I described at the outset. First, let’s look at the one from Rosewood on Netflix: I wonder, did they even bother to consult a physician or other medical expert? It’s simply unheard of to perform an autopsy in street clothes. You can’t even enter the postmortem room dressed like that. One must wear Personal Protective Equipment: at the minimum, surgical scrubs, surgical cap, eye shield, mask, gloves, shoe covers and a protective apron. Some places also require fluid-resistant surgical jumpsuits with long sleeves and latex boots. You have no idea what you could get splashed with during an autopsy. Now the ER code blue scene. What are its issues? First, we don’t apply gel to the defibrillation paddles and then rub them together. That takes too long, it’s awkward, and could be dangerous. Instead, we put gel pads on the patient’s chest and press the paddles against them. It saves precious seconds. Thankfully, cumbersome defibrillation paddles are slowly becoming obsolete, now being replaced with adhesive pads that detect the cardiac rhythm as well as conduct the shock to the person’s chest as soon as the defibrillator is fully charged. These are the same kind of pads found included with the Automatic External Defibrillator machines you sometimes see in public places and on airplanes. Second, when someone has flat-lined on the monitor, we don’t ever, ever deliver a shock. Let me say that another way. No matter what you see on TV, you simply cannot, must not, shock a flat line. At best it will do nothing, at worst you might be nailing the poor fellow’s coffin shut. Assuming all the leads are connected the way they should be and the patient has really flat-lined, we proceed to shoot adrenaline straight into a vein. But no shocks. That’s like flogging a dead horse. The heart irregularities for which we give shocks are called ventricular tachycardia and ventricular fibrillation. That’s why delivering the shock is called defibrillation. There’s an impression that we give a person in cardiac arrest an electric shock, we are trying to “jump-start” the heart—you know, like a dead battery. That’s not correct. The purpose of defibrillation is to alter the electric charge in the heart’s cells all at once so that they become synchronized and hopefully resume normal cardiac electrical impulses. When defibrillation works, it’s a magical and gratifying moment. Sometimes the patient, who has been unconscious, will suddenly open her eyes, look around and mutter, “What happened?” On such occasions I’ve been tempted to say, “You just died, but we resurrected you.” A variation on defibrillation is called cardioversion, where we want to convert a non-life-threatening heart irregularity to a regular rhythm. In this procedure, we sedate the patient and deliver a synchronized shock. Although it gives him quite a jolt, he won’t remember it if he’s been adequately sedated. At least he’s not supposed to. I once had a patient—let’s call him Jasper—who bizarrely seemed to have enjoyed his cardioversion. Every time he came into see me he asked, “How ‘bout giving my heart another jumpstart, Doc? I feel like it needs it.” “Uh, no, Jasper. That’s gonna kill you.” “Sure, Doc,” Jasper said brightly, “but then you could just resurrect me again.” That’s all for this episode. Again, thank you for listening. If you’re not already acquainted with my website, kweiquartey.com, k-w-e-i-q-u-a-r-t-e-y dot com. please check it out and subscribe to my email list for alerts on my blogs, book giveaways, and contests with great prizes. The podcast is available on iTunes and my website, which is getting a makeover and will soon have a great new look. I’m on Twitter as @doublekwei. Until next time, be happy and healthy.

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Hi, everyone, and welcome to episode 1 of my podcast Leading A Double Life. I’m Kwei Quartey, a physician and author of the Inspector Darko Dawson novels. On my podcast, stories of what it’s like to be a medical doctor and a writer. This episode, Doctor-Writer, Incorporated. We’re going to look at a well-established but curious bond between writing and being a physician, and I’ll tell you a little bit about how it happened to me. We have records of doctor-writers as far back as the 5th century BC. Even St. Luke, one of the four Gospel authors, is said to have been a physician. John Keats, the English romantic poet who lived from 1795 to 1821, trained at Guy’s Hospital London. He had an aptitude for medicine, but he was ambivalent about it and feared he would never become the poet he wanted to be if he continued his medical training in earnest. He did continue up to getting his license, but ultimately, Keats chose poetry over surgery. On the other hand, Anton Chekhov, the great Russian playwright and short story writer born in 1860, practiced medicine throughout his medical career. Chekhov said, “Medicine is my lawful wife, and literature is my mistress. When I get fed up with one, I spend the night with the other.” Arthur Conan Doyle, the creator of possibly the world’s most famous fictional detective, Sherlock Holmes, began writing before he went into medicine and is said to have written his books while waiting for patients to show up. Apparently, they seldom did, and Doyle’s medical practice was never successful. Another physician writer was W Somerset Maugham, who trained and qualified as a physician, but never practiced. On successfully selling his first novel, Maugham abandoned his medical career. Two Harvard-trained physicians, Robin Cook and Michael Crichton, were phenomenally successful writers. Cook, an ophthalmologist, continued his practice while writing bestselling medical thrillers like Coma and Outbreak. On the other hand, Crichton, who died in 2008, dumped medicine on graduating. He never even got a license to practice. One of his quotes is, “Books aren't written - they're rewritten. Including your own. It is one of the hardest things to accept, especially after the seventh rewrite hasn't quite done it.” Crichton could not have been more spot-on. Khaled Hosseini, a contemporary of mine who sold a gazillion copies of The Kite Runner and other tour de force novels, practiced medicine in the same medical group as me, but for obvious reasons he left after The Kite Runner became so successful. I’d like to mention also Janet Asimov, who was a psychiatrist and wrote science-fiction and non-fiction; and Abraham Verghese, a professor at the Stanford School of Medicine and the author of the highly acclaimed Cutting For Stone. Dr. Verghese, an inspiring teacher, said, “I wanted the reader to see how entering medicine was a passionate quest, a romantic pursuit, a spiritual calling, a privileged yet hazardous undertaking.” So, we see from these examples there’s no set pattern as to whether these authors became doctors first, or the other way around. In my case, I wanted to be a writer from the early age of eight or nine. I typed or hand-wrote novellas, stapling the pages together between jacket covers I designed myself. My inspiration came from hundreds of books at home, both fiction and nonfiction. Most of all, I loved mysteries. My late Ghanaian father and my black American mother were both lecturers at the University of Ghana, where I grew up with my three brothers. My interest in medicine came years later in my early teens. My family and I were still living in Ghana at the time, and I was set on a science-intensive path that would take me to medical school. But circumstances became complicated at the beginning of my 2nd year. Not only did my father die of pancreatic cancer, but social and economic conditions in Ghana under the then military rule were abysmal. There was political unrest and frequent school and university closures. My mother came to the difficult decision to return home to New York and we, her sons, went with her. Now I faced the daunting task of getting into a new medical school. Through a combination of luck, doggedness, and hard work, I got into Howard University College of Medicine in Washington, DC. After graduating with my MD degree, I was tired of snow on the east coast, so I moved to southern California for my residency in Internal Medicine. During my training at the USC Medical Center in Los Angeles, I didn’t do any creative writing. Residency is an exhausting grind of long call hours and rounds with not enough sleep in between. After completing the training, I went through a strange period in which I felt anticlimactic about being a doctor. Hard to believe, but I was actually looking around for what other careers I could get into. I was sitting at a desk in the ICU of one of the hospitals in Los Angeles one morning and a nurse who knew me well asked me why I looked so despondent. I told her about the funk I was in, and she asked me: “Well, what else, besides medicine, do you want to do?” I said I’d always wanted to be a writer, to which she responded, “What’s stopping you?” Her observation, in the form of a question, was keen. Nothing was stopping me. So, with my love of writing rekindled, I began a creative writing course at UCLA extension, after which I continued several years in a writing group run by Marjorie Miller, who was a previous editor at Macmillan. I completed three novels during that time and attempted a few more that I didn’t finish. I self-published one of them, called Kamila, long before self-publishing became an okay thing to do in the publishing world. But it would be years before I would create my Inspector Darko Dawson series set in Ghana. The prototype character was quite different from the one in existence now. My original idea for him was taken from a French documentary I saw while vacationing in Paris in which a countryside detective in Cote d’Ivoire used the threat of witchcraft to make his suspects and witnesses talk. But for my novels, the rural setting seemed to be limiting, and although I’d observed rural life in Ghana, it was always from the outside in. I never lived it. Eventually then, Darko became an urban police detective who is often sent to remote parts of the country to solve crimes. I should say that when as I began the series, I had some catching up to do because I hadn’t been back to Ghana in some fifteen years, and the country had modernized significantly since I’d last been there, not to mention becoming a stable democracy. So to come full circle, why do doctors write, and in particular, fiction? What compels us to do it? Some people theorize that it’s a way to escape the burden we carry healing others—or trying to—and therefore it has a therapeutic value. Maybe so, but I have another theory that medical practice is the ultimate existential battle to alleviate what ails us. There’s a roadblock, though. Ironically, it’s the doctor himself or herself. A physician is human too—not infallible by any means, and capable of mistakes, sometimes big ones. The fight against illness and disease comes with wins and losses, and some of the time, doctors feel defeated, and it can be frightening discomfiting. But when we write fiction, we are absolutely in control. We determine the plot, characters, and the outcome. It’s a reassuring counterbalance to the unpredictable nature of medicine. So we write, and find ourselves restored with strength to work another day.

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Stories from Dr. Kwei Quartey about being both a crime writer and a physician

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Leading A Double Life

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