Review: Inside the O'Briens

Inside the O'Briens

By Lisa Genova

Published: April 7, 2015

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.

My review:

Joe loves his family and he loves his job as a police officer in Charlestown, a suburb of Boston. He is looking forward to retirement in a few years to spend more time with his wife Rosie. Unfortunately Joe starts struggling with little things like writing reports and he begins fidgeting uncontrollably. It takes him awhile to finally go and see a doctor at Rosie's insistence. The diagnosis of Huntington's Disease seems to come out of nowhere and at first Joe is in denial. He also doesn't quite understand what this means for him and his family. What breaks him is the realization that his mom didn't die of alcoholism but of Huntington's Disease, the reason she lost her ability to control her body, had a nasty temper and ended up in an institution. Worst of all, as the disease is hereditary, each of his kids could end up with it.

I had previously read Still Alice which I loved so I had high expectations for Inside the O'Briens. I wasn't disappointed. While I did notice some similarities of the setup between both books, I think the author did a good job of getting into the head of a career cop in his early 40s. Like with Still Alice where the viewpoints are those of Alice and her daughter Lydia, the story is told through Joe's eyes and also that of Katie, his youngest child. Both Katie and her sister Meghan have physically demanding jobs. Katie is a yoga instructor and Meghan is a professional ballet dancer which makes their situation that much more poignant. Their oldest brother JJ is married and he and his wife are trying for a baby so this news couldn't come at a worse time. Their other brother Patrick is constantly plaguing his parents with worry over his partying lifestyle. 

The O'Briens are a very close family with Sunday dinners and they even live in the same building on different floors. Joe is the heart of their family but his devout wife Rosie is the glue that holds them together. His diagnosis is a blow to her faith and their marriage and relationships with their children suffer too. Katie is paralyzed with indecision about her future. The possibility that she might have HD keeps her from moving forward in her career and her personal life where she has found someone special who wants her to move with him across the country.

The ways that Huntington's Disease affect Joe and his children (who may also have inherited the disease) and his wife are the crux of the novel. How do you continue to live your life knowing what's coming? Is it better to be forewarned or to just live day by day and hope for the best? I think the title of the book refers to both life within the O'Brien household and also what is going on internally (physically and mentally) in the individual members of the family as they deal with Joe's diagnosis and their future.

This book is very sad but also moving. I loved the bonds that the O'Briens share and the love they have for each other as well as their determination. Joe does his best to keep HD from getting to him but he also suffers from depression (one of the side effects and very understandable given the circumstances). One of my favorite scenes in the book is the yoga class that he takes with Katie and how they both come to a new understanding of each other and find peace through it. While we know what future awaits Joe, he is inspiring in the way he chooses to meet that future. I'd recommend this book highly for book discussion groups and readers who loved Still Alice and other similar books.

I knew nothing about Huntington's Disease when I picked up this book but it is awful and like Alzheimer's there is no cure. In fact according to Huntington Disease Society of America, people say it is like having ALS, Parkinson's Disease and Alzheimer's at the same time. It usually hits in a person's 30s to 50s and they worsen over 10 to 25 years till death occurs. In between they lose physical ability to control their movements to the point that they are unable to walk and talk and become completely dependent on others. Hopefully Inside the O'Briens will help bring awareness to this disease and maybe help those whose families have been affected by it. You can find out more about HD at the HDSA website. 

Note: I received an ARC for review purposes courtesy of the publisher and Netgalley