Inside the O’Briens by Lisa Genova

I was aware of the author Lisa Genova from the success of her book, Still Alice, so when given the opportunity, I was pleased that Netgalley and Simon & Schuster provided me an ARC of her novel, Inside The O’Briens, in exchange for an honest review.

Prior to the opening chapter, Genova introduces us to the symptoms of Huntington’s Disease (HD). Here is one of those horrendous illnesses which slowly robs the “victim” of control over various neurological functions worsening over time until they reach their inevitable death. Not only is there no cure, but there is little known about medical treatments to halt or lessen the symptoms. To make matters worse, since this is a genetic disease, the children of an infected parent have a fifty percent chance of also contracting HD. Symptoms don’t usually occur until the age of 35-45 with a life expectancy of an additional ten to twenty years. However, there are instances of early onset of this disease, robbing the individual of several decades of symptomless living.

A heart-wrenching topic which I normally would avoid (since ignorance is bliss), I was unwillingly drawn inside the life of the O’Brien family. Joseph and Rose began their relationship at the young age of eighteen, forced to marry when Rose became pregnant with eldest son JJ. Remaining in the same neighborhood where they spent their own youth, not far from historic Boston, the loving couple raise four children steeped in the Irish Catholic traditions of their ancestors. The opening chapter features a thirty-five year old Joe, a member of the Boston Police Department, having a melt down, expressing rage when he can’t find his keys and will be late for work. Fast forward ten years and Joe’s weird behaviors prompt his wife to take him to a neurologist for a check up. Joe insists his troubles stem from an old knee injury and dismisses the possibility of anything serious. When a diagnosis of the rare Huntington’s Disease is confirmed, the life of the O’Briens is irreconcilably changed. Not only does the family have to watch the symptoms slowly creep and take control of their father/husband, they also have to deal with the fact that all four offspring could have inherited this genetic marker. The story is told from the viewpoints of Joe, Rose, and youngest daughter Katie, revealing how siblings JJ, Patrick, Meghan, and Katie and their parents deal with the progression of the disease and their individual future prognosis.

Genova has a unique gift of sensitively dealing with the strength of character and human foibles required of individuals and families dealing with the crisis of life changing diseases, such as Alzheimer’s, Autism, or Huntington’s Disease. What is so compelling about Inside the O’Briens is that Genova brings us into the world of this family, making us care about their daily struggles. It’s a family not unlike many others filled with an underlying love of a life filled with badly cooked meals, mismatched dishes, old furniture, and the jealousy, squabbling,and closeness shared between siblings. While this might sound boring, it creates an entertaining “fly on the wall” peek at Sunday dinners and other family events. We feel the disappointments and triumphs of the characters as they deal with their day to day trials and tribulations. Even while we root for success, the reality of the inevitable ending is never a secret. Yet the focus is on life, and not death, despite the expected insecurities of all involved.

While I whole heartedly give this book four stars with a strong recommendation, my one complaint is a bit of repetition within the plot and the introspections of the main characters. The ending is also abrupt, resulting in an “oh no, you didn’t”, leaving us wanting more. Yet the results of Genova’s research is evident, easily leading to her heartfelt plea for donations towards research in this field, which with only 35,000 cases (versus 3 million individuals with breast cancer) does not receive the attention it deserves.

This review also appears on Goodreads.

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