January 4, 2016

Inside the O'Briens

Update: I re-read this in April 2018 (this time for a book club discussion) and it was just as good as the first time around.

Inside the O'Briens by Lisa Genova
2015 Gallery Books
Finished on June 7, 2015
Rating: 4.75/5

Sympathetic, absorbing, multifaceted characters compel the reader's compassion. While Genova's background in neuroscience allows her to portray medical issues accurately, the heart of the O'Briens' story is human....Poignant and painful, warm and redemptive, Inside the O'Briens displays Genova's established strengths in bringing neuroscience to the lay reader, and portraying the power of love. ~ Shelf Awareness

Publisher's Blurb:

From the New York Times bestselling author of Still Alice, Lisa Genova, comes a powerful and transcendent new novel about a family struggling with the impact of Huntington’s disease.

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.

Praised for writing that “explores the resilience of the human spirit” (The San Francisco Chronicle), Lisa Genova has once again delivered a novel as powerful and unforgettable as the human insights at its core.
Another winner by Lisa Genova! I would have given it a perfect 5-star rating, but it became somewhat repetitive with regard to the details of the disease, as well as the family's reactions to the symptoms. However, as Still Alice did for Alzheimer's, Inside the O'Briens puts a face on Huntington's disease. (And what a horrible disease it is!) With authentic characters that feel as real as your next-door-neighbors, you can't help but be overcome with sadness for each of their fates.

On the dance of HD:

He's in constant motion, more than usual. She notices how he tries to make it all look normal. He'll stitch the tail end of whatever part of him flings or pops or twitches into some kind of larger, meaningful-looking action. He's become quite the improvisational choreographer. It's always the strangest dance she's ever seen.

His right leg snaps out as if he's kicking away an invisible pesky dog. So he follows his foot and stands up. Standing, he must mean to go somewhere, so he walks over to the windows. He pulls the shade, sticks his nose in it, and peeks out at the street. He stays there for a few seconds, muttering to himself. It makes sense that he would get up to look for signs of JJ and Colleen, but Katie's onto him. The impulse to rise out of his comfortable seat began with an involuntary leg thrust, not with a premeditated plan to look out the window.

As he returns to his chair, there's an extra bit of jostle in his step. She listens to the newly familiar jiggle of change in his pockets as he walks. The sound of HD.

She continues watching him, and he's more mesmerizing, and in some ways more horrifying, than anything on the news. He's like a train wreck or a car accident or a house fire, and she's the eyewitness, the rubbernecker who can't look away.

Next, his left arm flings up as if he's a nerdy student raising his hand in class. Then he bends his arm at the elbow and scratches his head as if he just happened to have a little itch. This is one of his signature moves. If you didn't know he had Huntington's, you'd think this guy must have a raging case of dandruff or head lice, or he's just plain weird. He doesn't seem to be consciously aware of his involuntary ticks or even his oh-I-totally-meant-to-do-that improvisations. He doesn't glance over at Katie to see whether she noticed. He doesn't seem embarrassed or fazed in any way. He simply continues watching the news as if nothing mentionable just happened. Nothing to see here. Certainly not any symptoms of an inherited, progressive, lethal neurodegenerative disease with no cure.
Final Thoughts:

Lisa is a great storyteller, but in addition to being sucked right into each and every one of her novels, I come away from the books with knowledge about the particular disease addressed, as well as an empathetic awareness for the victims. While all of her books have tugged (quite strongly!) at my heartstrings, I look forward to each new release, eager to see what she has researched and prepared for her audience. Folks, this one's a keeper to be re-read and passed around. Highly recommend. 

Visit Lisa's website to learn more about Huntington's Disease.


  1. Still Alice was so devastating, I'm worried I'm not up for a book like that again...

    1. I agree, JoAnn. Still Alice was so devastating, but perhaps because we're all at risk. Inside the O'Briens is also tragic, but the odds aren't quite as high for most of us. Still...

  2. Genova's books get so much praise - I really do need to read one of them soon.

    1. I loved them all, Kathy, although Love Anthony was my least favorite. Maybe start with one of the others.

  3. I so love her books. And I agree - the reader learns a lot about whatever she addresses. This one was very good or that was my opinion. I think I missed one of her books - the one about autism. I need to go back and read it. Wonder what she will tackle next?

    1. Love Anthony is the one about autism. It was my least favorite of the four. From what I've heard, she's going to write about ALS in her next novel. That will be a heartbreaker!

  4. You probably know about Woody Guthrie. His son Arlo didn't get it, and has four (?) children, all of whom are free from it as well. I wonder if the blood test is a new thing.

    1. Yes, I read about Woody Guthrie after you sent me an email with a much of links to a blog. What a relief his son didn't get it. I found this on Wikipedia: The genetic basis of HD was discovered in 1993 by an international collaborative effort spearheaded by the Hereditary Disease Foundation.

  5. Still Alice was wonderful and unfortunately I just haven't caught up with any of her other books. Great review and hope to get to this book one day!

    1. Iliana, I don't think you'll be disappointed with this one or Left Neglected. Not so sure about Loving Anthony. Good, but not great.


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