Inside the O'Briens

Author: Lisa Genova
Genre: Contemporary Fiction
Type: e-book
Source: NetGalley
Pages (Hardcover): 352
Publisher: Gallery Books
First Published: April 7, 2015
First Line: "Huntington's Disease (HD) is an inherited neurodegenerative disease characterized by a progressive loss of voluntary motor control and an increase in involuntary movements."

Book Description from GoodReads:  From award-winning, New York Times bestselling author and neuroscientist Lisa Genova comes a powerful new novel that does for Huntington’s Disease what her debut Still Alice did for Alzheimer’s.

Joe O’Brien is a forty-four-year-old police officer from the Irish Catholic neighborhood of Charlestown, Massachusetts. A devoted husband, proud father of four children in their twenties, and respected officer, Joe begins experiencing bouts of disorganized thinking, uncharacteristic temper outbursts, and strange, involuntary movements. He initially attributes these episodes to the stress of his job, but as these symptoms worsen, he agrees to see a neurologist and is handed a diagnosis that will change his and his family’s lives forever: Huntington’s Disease.

Huntington’s is a lethal neurodegenerative disease with no treatment and no cure. Each of Joe’s four children has a 50 percent chance of inheriting their father’s disease, and a simple blood test can reveal their genetic fate. While watching her potential future in her father’s escalating symptoms, twenty-one-year-old daughter Katie struggles with the questions this test imposes on her young adult life. Does she want to know? What if she’s gene positive? Can she live with the constant anxiety of not knowing?

As Joe’s symptoms worsen and he’s eventually stripped of his badge and more, Joe struggles to maintain hope and a sense of purpose, while Katie and her siblings must find the courage to either live a life “at risk” or learn their fate.

Disclaimer:  My sincere thanks to NetGalley and Gallery Books for providing me with a complimentary e-book copy of this book in exchange for my honest review.

My Review:  Genova's first book, Still Alice, was one of my very first blog posts.  I adored it and have read and enjoyed Left Neglected and hoped that Inside the O'Briens would wow me again.  

As with her other books Genova, who has a degree in Biopsychology and a PhD in neuroscience, focuses on a family dealing with a debilitating and devastating disease.  I do not personally know anyone afflicted with Huntington's but after reading and adoring Five Days Left by Julie Timmer Lawson I knew what I was getting into with this new book in regards to the disease symptoms etc.

The difference with this book is that Inside the O'Briens deals with how this genetic disease can affect an entire family.  Since HD is a recessive disease only one parent needs to have the HD gene to pass it on which means their children have a 50/50 chance of getting HD too which means that large portions of families can be afflicted with HD.  The symptoms don't start appearing usually until around 35-45 years of age.

There is no treatment.  No cure.  No escaping HD.

Inside the O'Briens focuses on Joe's HD diagnosis and his increasingly devastating symptoms as well as the uncertainty of Joe and Rosie's four adult children's futures with the disease. It showcased how an HD diagnosis or potential diagnosis affects relationships within a family as well as the loved ones we choose outside the family.  

While I didn't find this book quite as tearful or powerful as I was expecting it did hit the old heart strings a time or two but with a much softer tone.  It was sad to see how HD affected Joe's job, future and family life.  Seeing Joe's children struggle with the decision to be tested for the HD gene and how their individual choices affected how they chose (or didn't choose) to live their lives was touching.  How will knowing or not knowing affect how you live your life?  How do you live with the guilt if you don’t have the gene but your sibling(s) do?  After a positive gene test do you continue to live your life to the fullest knowing that you will get HD in the future or do you cut ties with boyfriends and girlfriends to shield them from future pain?  Does this twinge or that memory lapse mean the beginning of HD symptoms?

In a book dealing with such a sensitive topic I expected to be pulled emotionally into the lives of the characters.  Unfortunately, overall I found Inside the O'Briens to have a weak character development and I felt disconnected to the characters and their decisions.  They felt flat to me especially Joe who came off as a stereotype.  It was only his realization of his mother's past that brought some depth to his character for me. 

Genova focuses mainly on the points of view of Joe and Katie, Joe’s youngest daughter. I wish that some of the other siblings and especially Joe’s wife, Rosie had their feelings and points of view brought to light.  Rosie, as the sole person in the family who doesn't have the possibility of having the gene, has a lot to deal with, including the possibility that she could lose everyone she loves.  Unfortunately she was a very tertiary character.

My biggest beef with this book was the ending ... or lack thereof.  Gah!!  Let's just say it left a lot to be desired and was highly frustrating.  I can understand why Genova wrote it the way she did but it didn't make it any easier to swallow.

Overall, I think this book was a decent read but not the tear-jerker I was expecting.  It will enlighten readers to the cruel and unforgiving effects of Huntington's Disease on the individual as well as the entire family.

My Rating: 3/5 stars