Lisa Genova has a PhD in neuroscience from Harvard University. Her knowledge and understanding of this particular field of study comes across in her writing. Everyone now knows (thanks to the Oscar-winning movie adapation) that Still Alice is about woman with early-onset Alzheimers. Left Neglected is about a woman with a traumatic brain injury; Love Anthony is about a woman whose son has autism. What I find unique about Genova’s books is that she’s able to weave in the scientific explanations of what’s going on with her characters, without being dry or boring, or obviously trying to shoe-horn the information so as to provide context for something else. When I heard Genova had another book coming out, I was really excited to find out what it would be about.
The press release for this book has a quote from Jodi Picould at the top, in bold, red capitals:
Remember how you couldn’t put down Still Alice? Clear your schedule because you are going to feel the same way.
Let’s just cut to the chase here: she’s not wrong.
Inside the O’Briens is about the O’Brien family: parents Joe and Rosie and their adult children, JJ, Patrick, Meghan and Katie. Early in the book, Joe begins to make strange, involuntary movements that begin to get worse. He thinks it’s stress, but when he’s asked whether he has a drink or drug problem, he finally agrees to see a doctor and is sideswiped by a diagnosis of Huntington’s disease.
Huntington’s disease is a genetic condition. If one parent carries the gene, each of their children stands a 50% chance of also carrying it, and developing Huntington’s as well. The description of Huntington’s in the book is frankly terrifying and Genova finds a way to show four different sides of it: the final stages, the early stages, having the gene but no symptoms, and not knowing yet if you have the gene.
This is a brilliant book that doesn’t just dwell on the onset and progression of a truly awful disease, but also asks the question: if you had a 50/50 chance of having the gene yourself, would you want to know whether you had it?
As the story progresses, Joe is forced to leave his job as a Boston cop and faces the worry about whether his pension will be enough to look after wife as well as pay his medical bills as his condition progresses. This is another side of terminal illness that we don’t often think about.
The book is written from two perspectives. At first, it’s all from Joe’s perspective, but later on there are sveral chapters told from his youngest daughter Katie’s perspective. She spends most of the book watching her dad deteriorate, and trying to figure out whether she wants to know whether she’s gene positive. Every time she stumbles or drops something, she wonders, “is this the beginning of it?” The book also explains the process of genetic testing. Having not really thought about it before, I suppose I just assumed you would go and get a blood test, and then they would either call you or you would go in and get your results. In actual fact you go for genetic counselling first with someone who explains the genes and what they’re looking for, and what the possible outcomes can be, and there is a delay before you can be tested or get results.
What I really love about this book is that (as with Genova’s other books) it’s not a book about a disease; it’s a book about a family. And they’re a normal family; they don’t sit down and openly discuss every little detail of their lives in big, open discussions like you see on TV shows. Sometimes they don’t get on; sometimes Katie doesn’t get on so well with her older sister and feels a little jealous of her.
This book really tugs at the heart strings and makes you think about the people in this world who are living with Huntington’s. In the penultimate chapter Genova has found a perfect way to illustrate how many people have Huntington’s, and how that number relates to the rest of the US population. It’s a perfect analogy to illustrate the situaiton Joe and his children find themselves in.
Despite sounding like a rather hopeless, depressing story, somehow this is not. Somehow, despite the terrifying facts of the disease , the story is uplifting and filled with hope. It makes you feel all warm and fuzzy inside and the last few pages of the book make you feel weirdly optimistic for the future. Quite how Lisa Genova has managed to get an outcome like that when we know the future involves an undignified, drawn-out death for at least one of the characters is entirely beyond me.
I really enjoyed reading this book, and found it hard to put down. Having been so excited when I found Lisa Genova was releasing this book, I’m pleased to say I was not disappointed. I would recommend this book to anyone who has read her other books – but also to anyone who hasn’t read them, and just likes a bloody good story. Now… when is her next book out?
Inside the O’Briens by Lisa Genova is published on Thursday 24th September in paperback, priced £7.99.
NB I was provided with a copy of this book for the purpose of review, but all opinions are my own.
Thanks for reading.