Saturday, May 23, 2015

Review: Inside the O'Briens

Inside the O'Briens: A Novel

About the Book:
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 Comments:
My dear readers, there is something I have to tell you.  I'm sure some of you have guessed, but for those who haven't, I'm going to come right out and say it:  I'm dying.  I don't know exactly how much time I have left, but my day is coming.  Ok, I'm not dying anymore today than the average woman my age is, but none of us make it out of this world alive, and I don't expect to be the exception.  However, there are people, people who feel fine, people who have no symptoms, who know that they are going to die young and who know what will likely kill them.  They have the gene for Huntington's disease, a genetic, progressive neuromuscular disease that manifests itself to most people when they are in their 40's.  Those of us who do not have parents who had Huntington's do not have to worry (providing our parents are old enough, or lived to be old enough, to have manifested the disease); those who have a parent with Huntington's have a 50% chance of developing the illness.  

This is the story of the O'Brien family.  They are Irish-Catholics who live in the Charleston area of Boston.  Joe O'Brien is a Boston police officer and the father of four adult children.  Gradually, he and his wife, especially his wife, come to the realization that something is wrong.  After being diagnosed with Huntington's Disease, he realizes that his mother, who he had been told was institutionalized due to alcoholism, actually died of Huntington's Disease.  As we follow the O'Brien family through the first years after Joe's diagnosis, we see how this awful disease changes their lives.  The now-adult children have to decide whether to have genetic testing that could reveal whether they will follow in their father's jerky footsteps.  While we learn something about all the family members, the main characters are Joe and his youngest daughter, Katie.

Katie has always felt like she lived in her sister's shadow, but now she has a boyfriend and a job she likes.  She has dreams for the future.  But does she have Huntington's Disease?  Does she want to know?  What difference will knowing make?  Those are the thoughts that run through her mind.  Two of her siblings have chosen to know; one adamantly claims he does not want to know.  She isn't sure. In order to undergo testing, Katie has to visit a genetic counsellor.  The protocol then calls for her to return for another appointment, if she wants the test.  Finally, once the results come in she has to return to the counsellor, who will open the envelope in her presence, and, perhaps, predict the type of death she will die.

While certainly not religious fiction, this was a book about faith.  The O'Briens are Catholic and, unfortunately, not so unlike many Catholic families today.  After baby number four, Joe refused intimacy with his wife until she went on the pill, It took his devout wife several months to give in, but she did give in--and then got a dog that she named Yaz.  She want to Mass regularly; he didn't, and now the kids don't go.  Even in his illness, Joe does not return to Mass, but he does start going to the church after daily Mass and sits in the pew in which he sat as a child.  One day he comes home and finds his wife in despair and sees that she has removed the many religious items from their home, and he convinces her that God is there and cares.

This book had me in tears and praying for families that face this disease.  I don't know what I'd do in Katie's place.  What do you do if the test is positive?  Do you get married?  Have kids?  Seek experiences now since you know you don't have a long future ahead of you?  Wallow in self-pity?  Worry that every forgetful moment, every muscle twitch, every bit of clumsiness is the beginning of the end?

I'd like to thank the publisher for making a review copy available via NetGalley  Grade:  A.  


  1. My dad died of complications of Parkinsons. Several nephews have Chrones. Genetic testing has been suggested by several of my siblings. I don't want to know- at least not yet.
    There is a part of me that is concerned that Solyent Green is in our future. Those who have been tested may be guilted into ending things for the sake of society (Just like aborting Downs children have been in this generation).
    Sounds like a good discussion book for us.

  2. Lisa Genova is a wonderful author isn't she? I loved this book and gained an understanding of Huntington's Disease that I didn't have before (when I thought I did).


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