Inside the O’Briens by Lisa Genova

By Ekta R. Garg

April 22, 2015

Rated: Borrow it

A Boston cop begins experiencing distressing symptoms and receives a devastating diagnosis: he has an incurable disease. His symptoms will only get worse as time passes, and each of his four children has a 50-50 chance of developing the same illness. As he deals with the double-barreled news that stares him down, he begins to understand the ferocity of his condition and what his children might face in their own futures. Author Lisa Genova (Still Alice) breaks down the complicated details behind another devastating affliction in the touching but somewhat lopsided new book Inside the O’Briens.

Joe O’Brien has served the Boston Police Department for more than two dozen years, and he takes pride in his work. At the age of 44 he knows he can keep up with most of the younger guys, except lately he has begun forgetting things. And his temper has started escalating to the point of rage, something that didn’t used to happen. For some reason he can’t move the way he wants to, stepping right when the drills dictate left, his limbs jerking in odd directions and at odd times.

But Joe doesn’t have time to worry about himself. He has four adult kids in their twenties living at home, one of them married, and Joe needs every ounce of energy so he can support his family. His wife, Rosie, puts up with the strange behavior for a while, but eventually she nags him to go to a doctor. Joe goes just to get Rosie off his back, even though he knows the doctor will just say his bum knee is acting up and he should probably stay off it for a while.

The doctor doesn’t even mention Joe’s knee; instead she gives him news that irrevocably alters his life. Joe has Huntington’s disease, a fatal neurodegenerative disease with no cure. Moreover, Huntington’s is genetic, and because of its makeup each of Joe’s children has a 50 percent chance of receiving the same diagnosis in about a decade.

As a policeman Joe has trained for most of his adult life to command any situation. To achieve and stay in control. But now he has begun to lose control of everything—his words; his actions; his emotions.

Joe and Rosie know they can’t keep the news from the kids, and they all react with the same horror their parents felt at getting the news. Each of them has to make a choice: to take the blood test that will reveal whether they have the defective gene that will lead to Huntington’s or to remain uninformed and take their chances.

Katie, Joe’s youngest, watches as her family members deal with their father’s diagnosis. His disease quickly invades their lives, and Katie debates with herself whether she should get the blood test done. Close to the time her father brings home his diagnosis, Katie begins a new relationship with someone she knows her parents won’t like. The Huntington’s just complicates everything, and Katie feels helpless; why can’t things return to their normal state? As her father’s disease progresses, though, Katie and the others realize that “normal” now has a new definition.

Author Lisa Genova treads familiar ground with Inside the O’Briens: that of what an incurable condition to do to a person and the family. Her background as a neuroscientist provides her with insight into Joe O’Brien’s world, and that insight makes Joe shine as a character. Readers will follow with deep interest Joe’s pride for his work and his vulnerability as his disease begins to take over his body. Genova will make the Boston PD and its Irish Catholic population proud; she has captured their respective worlds with startling and refreshing accuracy.

By the same token, however, Katie’s track in the novel serves as a little bit of a distraction. She turns into the stereotypical youngest child, which includes life choices that readers will predict well before Katie makes them. Her struggles with her father’s disease show up in an uneven fashion—the division between Katie’s portions and Joe’s portions don’t feel equally distributed—and readers might almost wish Genova had spent the entire novel in Joe’s point of view. Offering readers Katie’s point of view completes Genova’s goal of showing readers how loved ones deal with a shattering medical condition, but Joe is clearly the star of the book.

I recommend readers Borrow Inside the O’Briens.

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