Review – Inside The O’Briens by Lisa Genova

By | April 11, 2015

What would you do if the body and brain you rely on suddenly let you down – and would it change the person you are inside? 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 forever, but each of his four grown-up children has a fifty per cent chance of inheriting the disease. Observing her potential future play out in her father’s 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. 

Lisa Genova’s Still Alice, which I read back in 2010, had an immense impact on me. It’s one of those books that I’ve recommended repeatedly to others – it’s exceptionally well researched and written, and an incredibly moving experience. Here’s a link to my Goodreads review. Do try it if you haven’t already – or for those of you who like that kind of thing (I tend to prefer keeping my books and films separate) it’s also now a film starring Julianne Moore. There have been two other books from Lisa Genova before this one – Love Anthony and Left Neglected – neither of which I’ve read. I guess autism and traumatic brain injury just didn’t attract me the way Alzheimer’s did.

Lisa Genova’s Inside The O’Briens was published on 7th April by Simon & Schuster, and deals with Huntington’s disease. I was ready not to enjoy this book – isn’t that silly? But I’ve never heard of Huntington’s disease, never known anyone affected. I remained in that frame of mind through the first 20% – the book was all about a Boston cop (nothing particularly familiar there) and he kept going to baseball games/matches (forgive my inability to find the word – I have zero interest or understanding!) with a lot of detail about the play and scores. 

I was seriously wondering about setting the book aside when I realised how much I was actually enjoying it.  Because this isn’t actually a book where you need to understand or identify with the setting or the detail of the illness – its messages are truly universal. This is a book about love and understanding, about families, frustration and disappointment, hope and love, and it’s absolutely wonderful.

There are scenes and moments in this book which will stay with me forever. Joe’s physical deterioration is so well handled, with the chorea (the involuntary movements) increasingly visible to everyone. My heart broke for him as he directed traffic in the Boston winter, ice crystals forming on his moustache, the wind penetrating his several layers of clothing, only to find himself relieved of duty when complaints were received of him being drunk on duty. 

Joe is a truly heroic character – flawed in all the usual human ways, unable to understand why it’s happening to him but making the difficult decision to be strong for his family, drinking from his non-spill beaker and sometimes exploding in absolute frustration and anger. His wife Rosie is quite perfectly drawn too – immensely caring, continuing to cook her inedible family meals which all must sit down and eat, finally removing all the tatty religious statues that litter their home in the belief that God must have abandoned them.

I liked the way the author separated the key facts about Huntington’s from the narrative – being straightly factual about the physical effects, the outward manifestations, the 50/50 chance of passing it on through genetic transmission and the prognosis for the sufferers. It allows you to focus on the family, and much of that focus is on Katie, one of Joe’s four children, as she decides whether to find out if she has inherited the gene. She is so lovely – wrestling with her relationship with her successful dancer sister, agonising about introducing her black non-Catholic boyfriend to her parents, decorating her bedroom walls with inspirational quotes written in Sharpie, introducing her father to yoga as his bodily control deteriorates, needing to make some difficult personal decisions.

This book is wonderful – heartbreaking but inspirational, filled with love. I adored it – Huntington’s is a cruel and dreadful disease, and Lisa Genova does a wonderful job of raising people’s awareness through the medium of a story that moved me immeasurably.   

My thanks to NetGalley and publishers Simon and Schuster for my advance reading e-copy.

Lisa Genova is the author of the New York Times bestsellers Still Alice, Left Neglected, Love Anthony, and Inside the O’Briens. Lisa graduated valedictorian from Bates College with a degree in biopsychology and holds a PhD in neuroscience from Harvard University. She travels worldwide speaking about Alzheimer’s Disease, traumatic brain injury, and autism. She lives with her family in Massachusetts.