Book Review: Inside the O’Briens: A Novel by Lisa Genova

Inside the O'Briens: A NovelInside the O’Briens: A Novel by Lisa Genova
Publisher: Simon & Schuster Ltd
Paperback Release Date: September 24, 2015
My rating: 5 of 5 stars

Publisher’s Description:
The breathtaking new novel from the author of Still Alice, which was adapted into an Oscar-winning film starring Julianne Moore. Joe O’Brien is a Boston cop; his physical stamina and methodical mind have seen him through decades policing the city streets, while raising a family with his wife Rosie. When he starts committing uncharacteristic errors – mislaying his police weapon, trouble writing up reports, slurred speech – he attributes them to stress. Finally, he agrees to see a doctor and is handed a terrifying, unexpected diagnosis: Huntington’s disease. Not only is Joe’s life set to change beyond recognition, but each of his four grown children has a fifty-fifty chance of inheriting the disease. Observing her potential future play out in his escalating symptoms, his pretty yoga teacher daughter Katie wrestles with how to make the most of the here and now, and how to care for her dad who is, inside, always an O’Brien. Inside the O’Briens is a powerfully true and tender elegy to the resilience of the human spirit.

I loved Lisa Genova’s book Love Anthony so I was very excited to get my hands on her newest book, Inside the O’Briens. Genova puts her background in neuroscience to use again, this time to explore Huntington’s disease. I knew next to nothing about the disease going into the book. It is an awful degenerative disease with a horrible prognosis. There is no treatment or cure.

The child of someone who has Huntington’s has a 50/50 chance of having the gene that causes it. If one has the gene, then one will get the disease. Since the only cause of the disease is having the gene, one can go through genetic testing at any time to determine if one is gene positive. This raises an interesting dilemma. If you had a parent with Huntington’s, would you want to know if you will also have it? Especially knowing that your life will be significantly shortened?

This novel explores both what Joe is going through as a person living with Huntington’s and what life is like for Joe’s children, who must decide whether or not they want genetic testing themselves. Joe’s life as the disease progresses is heartbreaking. He goes from being a tough police officer who is always in control to someone who needs to rely heavily on others in a relatively short period of time. Genova does a fantastic job of getting into Joe’s mind and the complex emotions the disease’s progression brings up for him.

With regard to Joe’s children, Genova focuses Katie, Joe’s youngest daughter. The novel alternates between Joe’s point of view and Katie’s point of view. Katie struggles immensely with whether or not to get tested. How will her future be affected if she’s gene positive? What will happen with her relationship with her boyfriend Felix? If she’s positive, will he want to stay with her, knowing that the only way to have kids will be through IVF? Is it fair to stay with him on the chance that she is gene positive and he would end up having to be her care taker? Will not knowing make her life more or less stressful? Genova starts each section of the book with a fact or two about Huntington’s. Once of them was that over 90% of the children of people with Huntington’s choose NOT to get tested. That seems like a staggeringly high number to me.

This book brings up so many thoughtful questions though wonderful characters and a great story. It’s the first book I’ve read in quite a while that I could not put down. I read it in two days. Joe and Katie’s struggles were authentic and made me empathize with them. I felt like I was right there in the thick of it with them.

A word of warning. This book ended way before I thought it was going to. I read it on iBooks and was surprised when it ended about 20 pages before I thought it was going to. The book is not one that wraps up every plot point in a neat little bow. I was just left staring at my iPad with my mouth hanging open, stunned that it was over all ready. The good news is that the extra 20 or so pages are a discussion guide and author interview both of which were interesting. I liked reading about Genova’s writing process in the interview. This book would make an excellent book club selection and the discussion guide would be a great supplement for a group discussion. This book is definitely in my top five reads of 2015 – I highly recommend it.

(I received a complementary copy of this book for review.)

  • S.G. Wright

    Genova seems such a worthy medical issues author. You learn so much from her books. I’m still shaking a bit over Still Alice. Nice review, thanks.

  • HeatherAnne Norbury

    I haven’t heard of this book but this sounds like something I’d enjoy. Now – to find more hours in the day to read. :-)