We’re here today to get some insight into author, S.K. Radhakrishnan’s, debut novel; ‘I Have No Earthly Idea’. The story covers an immigrant's journey from India to the United States; as he grapples with love, self-discovery, career changes, and family. S.K. is not only an author, but he is also a physician assistant and medical professor from India. He practiced physical therapy for more than 13 years before acquiring his physician assistant training at Wayne State University.

He is currently the administrative chief and clinical neurosurgical PA in the Department of Neurosurgery, at Duke University Hospital. In April of 2018, S.K. received the “Meritorious Service Award” for distinguished service to Duke, on top of previously being awarded for his extraordinary patient care. Today- S.K. discusses his personal life and upbringing, his aspirations, and some of his inspirations for the novel.

Hello S. K.! I’d love for you to start off by telling us a bit about yourself, and how you started writing your new novel, ‘I Have No Earthly Idea’?

Hello! I trained and practiced as a physical therapist in India before coming to the United States in 1994. After 13 years of practice as a contract physical therapist in the Midwest – Missouri, Indiana, and Michigan, in 2002, I joined Wayne State University’s Physician Assistant (PA) Program and graduated in 2004.

Wayne State University PA Program Faculty selected me as one “who is most likely to achieve clinical excellence while advancing the ethics & standards of the profession” and presented me with the “Professionalism Award” for the Class of 2004.

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I came to Duke University Hospital in 2004 after being accepted into the Duke Postgraduate PA Surgical Residency Program. After successful completion of the residency program, I began my career as a surgical PA for Dr. Allan Friedman in the Department of Neurosurgery. Also, I am a guest lecturer at the Duke PA Program. 

In 2006, I was a recipient of the “Duke Strength, Hope, and Caring Award” for the extraordinary provision of compassionate care for patients. In 2013, I was appointed the Program Director of the Duke PA Surgical Residency Program.

In April 2018, I received the “Meritorious Service Award” for distinguished service to Duke. In August 2019, I received the “Henry ‘Buddy’ Lee Treadwell Award” for Recognition of Excellence in Teaching at the Duke Physician Assistant Program. Currently, I am the administrative chief and clinical neurosurgical PA in the Duke’s Department of Neurosurgery.

I took all writing assignments in college seriously and pride myself in writing detailed and thorough patient history and physicals and discharge summaries. Growing up in India, I learned to speak English in school and was very fluent when I came to America. However, I was not familiar with American slang and found myself in several hilarious and embarrassing moments due to misunderstandings with the language. 

A joke is best delivered in the first person, and I used to share these embarrassing stories with my friends. During my postgraduate PA Surgical Residency, one of the general surgery residents, Dr. Jeffrey Nienaber, volunteered my name at Charlie Goodnight’s (a local comedy club) amateur stand-up comedy night. On a whim, I auditioned and was selected to perform. I shared my embarrassing stories and was an instant hit and was invited back a few times.

I started writing for my stand-up comedy but being a PA surgical resident at Duke and averaging 80 hours a week and then a neurosurgical PA, I didn’t have time to make it to the amateur night. However, it did not stop me from writing. It took little effort to build a full-length novel around these comedy bits. 

My interest in writing was fueled by my love for movies, especially good heartfelt romantic comedies. However, it was two books that inspired me to take writing more seriously – and to write a novel. The storytelling by Dr. Abraham Verghese in Cutting for Stone taught me to write with a purpose, and the inspiring larger than life story of Dr. Paul Kalanidhi in When Breath Becomes Air motivated me to write. My love for romantic comedies made it an obvious genre to write in. “I Have No Earthly Idea” is my debut novel. I do want to make it clear. I am not comparing my book to these literary giants. While I am proud of my work, it pales in comparison to their contribution to literature.

How did publishing your first book change your process of writing future novels, if at all?

Writing my debut novel was a life-changing experience and I learned a lot about myself in the process. Albeit, a Rom-Com, through my characters I found myself giving voice to the silence bestowed upon some social issues. The process morphed me from writing jokes and comedy to tackle more mature and important issues.

I don’t take myself too seriously but as a writer, I took the proverbial obligation to be a mirror of society and allow myself to be touched by the issues that affect us all. I have also learned the importance of brevity in writing. When I finished “I Have No Earthly Idea” it was 700+ pages. Editing it down to 410 pages was excruciatingly painful but a valuable learning experience. 

What was the most difficult scene to write, and what did you draw upon to help create that narrative?

This is a two-part answer. Chapter 33, “Childhood Nightmares” was difficult to write as it deals with delicate and sensitive issues that as a society we are not comfortable talking about.

I debated if I should venture into these subjects but I had to be true to the characters and let them evolve and learn to be a conduit for the story to unfold itself. Becoming deeply vested in my characters and as an empathetic clinician with years of experience in taking care of complex patients and being able to identify with them certainly helped. 

That chapter, a crucial vignette in the story, was difficult to write but if you ask about one scene; I would refer to this one intimate scene in the story. Contrary to what some people may think when they see the cover of the book, it has only one intimate scene.

The story is about love and not sex. I did not want to go into any graphic detail but wanted to convey the gravity of the situation as it serves as a turning point in the story. Being raised in a modest family with Indian traditions, and growing up watching Bollywood movies of the 90s where they show two flowers in close contact to suggest intimacy between the hero and heroine or an elaborate song and dance sequence helped me write a scene that let the readers fill in the blanks. 

Your novel highlights the importance of lesser-known roles within the medical field, as a surgical physician assistant- did you see reflections of this ‘unsung heroes of healthcare’ narrative in your own sphere as Covid began?

It would be hard not to. One of the reasons I wrote this novel is to shed some light on physician assistants. It is a 50-year-old profession and physician assistants bridge a crucial gap in healthcare delivery and yet people are not familiar with the role of physician assistants.

Even the name is misunderstood with people including healthcare providers calling it a physician’s assistant. There is no apostrophe “s”. It is not a subservient profession but rather physician assistants are partners with their collaborating physicians and help deliver state-of-the-art healthcare to the patients. 

Covid has indeed highlighted the profession as PAs have stepped up to the challenge in all settings from urgent care to the ICU. What better way to pay tribute than to make the protagonist a PA in this romance in the healthcare setting. 

Jacket art for Radhakrishnan's new novel.

There’s this juxtaposition in your novel between choosing what’s safe, versus following your heart- what life lessons have you experienced that lent themselves to your work?

Well, I am an immigrant from India who came seeking greener pastures in the Land of the Free. Immigration comes with a negative connotation. My personal experience is that people are welcoming, helpful, generous, and kind. And immigrants that come to make their lives better, make extraordinary contributions to the society and economy. They help keep medicare and social security solvent. When done right, immigrants contribute more than they take. I let these life lessons reflect in the story.

‘I Have No Earthly Idea’ intersects some important themes such as; heartbreak, self-discovery, and culture- these topics could have an impact in a visual media setting as well. Have you considered what the story could look like as a feature or TV show?

The story and my narration have all the ingredients to make a compelling and successful movie or television mini-series. Several vignettes in “I Have No Earthly Idea” work beautifully as independent short stories, each transporting us to an entirely different, richly depicted scene—from the quaint cafes, temples, and streets of late-90s Madras to big, bold, vast America, orderly clinics and bright operating rooms. Although my writing is very descriptive, this immersive effect will come alive in visual media. 

You won’t find the contrived, saccharine ending of many pulp fiction romances in this story. But oddly enough, although you grieve with the hero, the story leaves you with a lingering smile. 

Good-natured to a fault, resourceful in tough moments, and charmingly witty, the protagonist is a genuinely lovable character, and you desperately want him to triumph. Movies and TV shows with an underdog generally do well. I’ll let you in on a secret. I depicted Annabelle Kingston as a redhead with Amy Adams in mind. I am a big fan of her and believe she can breathe life into Annabelle.

What was an early experience you had where you learned that language and writing had power? And how have you seen that play-out in your own novel?

Oh! This question takes me back to my childhood days in India and memories of my father. He was an ENT surgeon. As a child, learning to speak English, I picked up three bad words quickly – idiot, stupid, and bastard. He used to say “Anger is negative energy and bad words will only drain you.” Every time I used one of these words, my father used to say, “You’ll never learn the language if you express your anger or frustration with one bad word.

Express yourself with sentences and words.” My grandfather was the only physician for 6 villages and he was one of the few who spoke English fluently there. He used to read my letters written in English in front of everyone with pride. These childhood experiences with my dad and grandfather stressed the importance of using language to make people feel good. 

Though the story is about a man who spends his life seeking security, only to lose the one thing he holds most dear; it’s filled with subtle, bittersweet irony. The novel is so warm and heartfelt that it leaves you feeling charmed, rather than melancholic.

What can we look forward to seeing from you in the future? 

“I Still Have No Earthly Idea”. No pun intended. That is the title of the book I am working on. Also, I am working on a screenplay for my debut novel “I Have No Earthly Idea.”

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Thanks for reading! Want to stay connected and learn more about author S.K Radhakrishnan? Check out his Website, Blog, Instagram, and YouTube.