Inside the O'Briens

by Lisa Genova

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.

Genres: Fiction, Book Club, Contemporary, Audiobook, Medical, Family, Adult

343 pages, Hardcover

First published April 7, 2015

About the author

Lisa Genova graduated valedictorian, summa cum laude from Bates College with a degree in Biopsychology and has a Ph.D. in Neuroscience from Harvard University.
​
Acclaimed as the Oliver Sacks of fiction and the Michael Crichton of brain science, Lisa has captured a special place in contemporary fiction, writing stories that are equally inspired by neurological conditions and our shared human condition. She is the New York Times bestselling author of the novels STILL ALICE, LEFT NEGLECTED, LOVE ANTHONY, INSIDE THE O'BRIENS, and EVERY NOTE PLAYED. 
​
Her first work of nonfiction, REMEMBER: The Science of Memory and the Art of Forgetting, published March 2021, became an instant New York Times bestseller.
​
STILL ALICE was adapted into a film starring Julianne Moore, Alec Baldwin, Kristen Stewart, Kate Bosworth and 
Hunter Parrish. Julianne Moore won the 2015 Best Actress Oscar for her role as Alice Howland. Film adaptations for INSIDE THE O'BRIENS, EVERY NOTE PLAYED, and LEFT NEGLECTED are in development.
​
STILL ALICE was adapted for the stage by Christine Mary Dunford and premiered at the Lookingglass Theatre in Chicago in April 2013. It has since toured worldwide.
​
In 2015, Lisa was named one of the U.S. Top 50 Influencers in Aging by Next Avenue. She has appeared on Live with Kelly &Ryan, the TODAY show, CNN, PBS Newshour, Dr. Oz, and NPR and has been featured in the PBS specials Build a Better Memory Through Science and Supercharge Your Brain, as well as the documentary films To Not Fade Away and Have You Heard About Greg. 
​
Her first TED talk, "What You Can Do To Prevent Alzheimer's" has been viewed over eight million times.  Her most recent TED talk, "How Memory Works--and Why Forgetting is Totally OK" was the sixth most watched TED talk of 2021. A sought-after speaker/edutainer, she has headlined in speaker series alongside Barack Obama, Joe Biden, Gloria Steinem, Jay Leno, Malala Yousafzai, and Goldie Hawn.

She received The Pell Center Prize for Story in the Public Square, for "distinguished storytelling that has enriched the public dialogue," The Sargent and Eunice Shriver Profiles in Dignity Award, The Global Genes RARE Champions of Hope Award, and The American College of Neuropsychopharmacology Media Award for "informing the public about treatment and ongoing research in medical illness."

She has received an Honorary Doctorate of Humane Letters from Bates College, The Alzheimer's Association's Rita Hayworth Award, The Huntington’s Disease Society of America Community Awareness Award, and the Grubby Award for literary excellence.
​
She serves on the Advisory Boards for The Women's Alzheimer's Movement, HFC (Hilarity for Charity), and Compassionate Care ALS.

www.lisagenova.com

www.Facebook.com/authorlisagenova

www.Instagram.com/authorlisagenova

Reviews

[Petra X · Rating 2 out of 5]

To sum up in one word: Meh. In one sentence: stereotypical characters who have to face a single dilemma which can be solved in one of two ways and some choose one and some the other. The rest of this review is an elucidation of those two points.

First there was Still Alice which was a brilliant story of the devastation of early-onset Alzheimer's told by Alice herself. Then there was Left Neglected, about the disorder where the body does not recognise one half of the world, including itself. This could have been interesting but the protagonist was a self-obsessed, self-aggrandizing woman whose empathy extended only to the right side of her own world. Now, her latest book in the genre she invented, neurological fiction, 'neuro fiction', is this one, Inside the O'Briens.

All the characters without exception are stereotypical, the Irish cop who has a large family, the mother who might have died of the drink, the daughter who does yoga and is in touch with her inner self, the drifter boy who works in bars and may sleep around. They just weren't interesting. They have been written about so often you could predict the responses, at least I could.

So the book is about Huntingdon's. This is an always-fatal, devastating neurological disease with no treatment at all. If a parent has it, there is a 50% chance of the child having it. So the whole book rests on one premise only, would you get tested and know that at some point before middle-age you would show symptoms of the disease that will kill you or would you not get tested since there's nothing that can be done about it anyway?

That's it. It was all downhill from Still Alice. When I used to read Jodi Picoult and Alexander McCall Smith I had to get their new books but each one was written to the same formula and they had less and less to say. Probably, like in the music business, they had contracts to write x number of books and so even though they weren't buzzing with new ideas, plots and characters, they sat down and wrote for two hours a day and the editor shaped the literary effort into a saleable product. I feel like this about Lisa Genova now.

Two stars because I can't say I enjoyed this book, and if it hadn't been so light and easy to read and skim without missing anything crucial, I'd never have finished it.

[Will M. · Rating 5 out of 5]

I would like to thank Netgalley for providing me with an arc, in exchange for an honest review.

Huntington's Disease is a cruel disease. Once you're gene positive, there's no way out of it. The symptoms are terrible and will worsen over time. I can only feel sympathy toward people who have this merciless disease. As a future doctor, it only pains me to see how hopeless this disease is right now, but I have faith that one day there will be cure for this. It's only a matter of time.

While there are hundreds of books regarding romance with health resulting to death incorporated, I believe that this novel aims to inform. It's not supposed to make you feel light hearted, but rather to inform you how serious this condition is. There's a chapter in the end that provides a link wherein you can donate to help develop a cure. I honestly don't think that was meant to be a gimmick, because the author seems to exude genuine concern toward this matter. It can also be seen in the acknowledgments.

So enough with the disease awareness, I'm now going to talk about the novel itself. The perfect way for me to describe it would be that it was completely immersing. The plot was very interesting, and the characters are genuine and life-like. This novel is about a family with a father who has HD and a 50-50 chance of his children inheriting it. It was interesting to read about the family's way of coping with the disease. If the author was true to her word that she really did research on this (interviewing actual victims) then this novel is fantastic. I don't want to spoil anything but all I can say is that I hated and loved the ending. I want more of this book. It should've been longer. I didn't want to part ways with the characters. It feels like I still need time to read about their journey with HD. I'll surely remember them for a very long time. This is the only novel that truly made me feel like shit after reading. Anything medicine related is a plus point for me, in terms of enjoyment.

The one which truly made me feel like shit would be JJ being gene positive. He has a child, and there's a 50-50 chance of that child inheriting it. He didn't know, so his fate was the cruelest one of them all.

Regarding Katie, I normally would've been annoyed with all her confusion because it would seem like she's being unfair to everyone by making it look like she's the one who's suffering the most, but in this case, I also felt bad for her. I believe I'd also be like her, completely undecided on every life decision to make.

Joe was also really good to read about. He's the one with the disease in progress so I got to see what the disease can do. I can say this a million times but for me the gravity of it would never change, HD is such a terrible disease. It affects the people around the person with the disease, especially his wife. His wife who had to accept the fact that her 2 children and husband are HD positive, and that her other 2 are also in danger.

5/5 stars. I don't see anything wrong with the novel, other than it was shorter than it should've been. Completely indulging. One of my highest recommendations yet, but read this only if you can stomach a heart wrenching novel.

[Debbie · Rating 4 out of 5]

Man, what a good read! On the surface, this is simply the story of a close-knit working-class family that suddenly has to face the horrors of the fatal Huntington’s Disease (HD) when Joe, a cop, learns he has the disease and he gradually becomes more and more incapacitated.

But put this simple story into the hands of a writer such as Genova, and you have a masterpiece. The way she describes this family without drowning in sentimentality is an art. Genova’s pacing is spot on, her sentences pure, the story poignant. She knows how to grab you and keep you enmeshed with this family. You cry with the O’Briens, you sweat out their decisions, you worry with them, you feel their pain.

Oh, this disease is bad. Joe accidentally punches people, slurs his words, gets into rages. And it only gets worse. The disease whispers, “Oh, you think this is bad, well wait till you see this,” as some new and terrible symptom appears. The family is up against a monster, and ultimately the monster will win.

One of Joe’s 20-something kids, Katie, shares the spotlight as she agonizes over whether to find out if she carries the HD gene. She has a 50 percent chance. If she does have the gene, she will definitely get the disease.

It left me wondering what I would do. Find out my fate and be miserable and scared, or not find out and be miserable and scared? What do you gain by knowing you are going to get HD? Say you find out you have the gene, do you get out the bucket list and make the most of your life? Or do you retreat? Do you think about suicide?

I just learned that there was Huntington’s Disease among my great-great grandparents. It blows my mind to know that long ago, people in my family faced the same horrifying life as Joe. In the book, Joe’s mother had had Huntington’s and they locked her up in a mental hospital and labeled her a drunk. I wonder if my ancestors faced the same fate.

One big nit about the book: I didn’t buy that Joe continued working as a cop when he was first diagnosed. Really? He has people’s lives in his hands. He’s putting his partner and others at risk. Can he run fast enough? Is his hand steady if he needs to use his gun? Can people trust a cop who slurs his words and walks funny, and who is subject to fits of rage? I think he should have quit the force immediately, found a job that didn’t have such high stakes.

And a bigger nit: I didn’t like the way the book ended. I appreciate Genova’s intention, but it left me feeling ripped off. Will be interesting to see if the ending bothered others.

Other things that didn’t make me happy: the detailed descriptions of yoga positions and a baseball game. Luckily, yoga and baseball were minor side trips, only hogging a few pages. Still, at those times it felt like Genova was writing a user’s manual—I was very conscious of the author. I also wasn’t crazy about the affirmations, but that’s just me.

All of Genova’s novels so far have featured a hero who is faced with some medical horror (her most famous being Still Alice, about a woman with Alzheimer’s). It’s to Genova’s credit that she manages to educate us about disorders while telling a good story with complex characters we care about. She always does her research, but she never makes her novels preachy or pedantic. I’m impressed that she’s such a crusader; after the story, she even has info on how to donate to the HD cause. It makes me like her not just as a writer but also as a person.

Another novel about Huntington’s Disease is Five Days Left. It was way too sappy for me (I gave it only 2 stars), but it does give you another glimpse into the life of someone with HD.

Did I love Inside the O’Briens? Hell yes. I was riveted by this story; I was always hot to get back to it. I stayed up late reading it, and I raved about it to friends. And for the most part I didn’t look at page numbers—all tell-tale signs that I had a 5-star book on my hands. But toward the end, the description of all Joe’s symptoms seemed repetitive and tedious (I was peeking at page numbers all of the sudden), and I dropped my rating to 4 stars. It’s a great book, though. Not as amazing as Still Alice, but really good.

Thank you, NetGalley.

[Debbie "DJ" · Rating 4 out of 5]

I really liked Genova's book "Inside the O'Brians." She has a way of pulling me into the heart, soul, and life of so many different diseases. This story is about Huntington's Disease, and was told through the life of the O'Brian family. I enjoyed the Irish Catholic setting, a culture where family is highly valued. Of course this made it all the tougher, as the father is diagnosed leaving all four of his children with a 50/50 chance of inheriting the disease themselves. This is where the story leads us, into the lives of these four young adults wrestling with the idea of being tested. Much of the story is told through the eyes of the youngest daughter Katie, the one who has struggled with decisions all her life. It is mostly through her eyes that I watched in horror how quickly her fathers disease progressed.

The book did a fantastic job showing what Huntington's Disease looks like. A person with Huntington's can often look drunk as muscle control is lost.The social stigma which follows is heartbreaking. There were some great lessons to be learned here, not only about the disease, but about how to live one's life. Do we live mostly in the past, present, or future in our minds, and why? A beautiful line Katie had written was "Every breath is a risk - Love is why we breath."

I fully enjoyed this novel, my only complaint, it being too long. It felt repetitious at times. Sometimes every change in disease progression, it's consequences, and how it is handled became too much. I was frustrated, as I felt a little trimming down would have had more of an impact.

Still, these were small problems. The ending had me in the ugly cry, and I am forever changed by the information presented here on a dreadful disease that is Huntington's.

[Kelli · Rating 5 out of 5]

Pass the tissues...this one is a tearjerker (pronounced here as teeya jahkah). Both tragic and triumphant, this moving story was very difficult for me to put down. I was invested and engaged from the first page. Once again the incomparable Lisa Genova gives a face to a rare but devastating disease and places us in the home, heart, and mind of a family left to live with a diagnosis that has leveled them at the knees and will change all of their lives forever. This is a diagnosis that makes one seriously question whether uncertainty is the kinder fate and we stumble along with this family as they navigate this treacherous, unforgiving terrain.

I love a story that takes place at home and no doubt the references to the ballpark, the landmarks and all things Boston make it especially appealing to me. There is an authenticity to this book that truly defies explanation. This is exactly what Boston neighborhoods are. This is so accurate that I actually believe I can get in my car, drive to Charlestown, spend a half hour looking for parking, climb the stairs of any triple decker there and meet the O'Briens. They are there and that level of authenticity is what allows this fictional family to break my heart. They will break yours, too.

[Diane S ☔ · Rating 4 out of 5]

3.5 Once again, Genova takes a regular family, a family that could be yours or mine, and touchingly portrays this family confronted with extraordinary events. In this case the family is Irish Catholic, living in Boston, Joe is a police officer, he and his wife have four grown children. They have the usual problems, not enough time, a grown son still trying to find his way, testing their patience, one son married, and two daughters both somewhat settled in their careers. Life is good but hectic until Joe starts exhibiting some strange symptoms.

Huntington is a horrible disease, and one that children have a 50/50 chance of inheriting. This novel worked for me because this family was so likable, so easy in which to relate. Having a disease, that is life taking does become your whole life, becomes an obsession. There is guilt about passing this on to your children, crisis in faith, all the other emotions, really I can just imagine how devastating this would be.

Yet, life does go on, there are decisions to make, the present to live and this is what these characters, each in their own way must do. Find their way forward, look to a future, uncertain or not. That Geneva can educate while telling a story is to her credit. My only small criticism is that at times I felt she was a little heavy handed with the repetition of Huntington symptoms, but this is something she feels passionate about, and in no way lessened my involvement in the story. I also liked the way the novel ends, not exactly happy but hopeful.

ARC from NetGalley.

[Christine · Rating 5 out of 5]

I wish to thank Net Galley, Simon and Schuster publishing, and Dr. Lisa Genova for an ARC of this novel in exchange for an unbiased review.

Inside the O’Briens is an outstanding novel, possibly my favorite of all 20 books I have read so far this year. It is written by Dr. Lisa Genova, author of Still Alice. Joe O’Brien is a 44 year-old Irish Catholic police officer living in Charlestown, MA, the oldest neighborhood in Boston. Joe is diagnosed with Huntington’s disease (HD), a rare, untreatable, neurodegenerative illness. The disease is inherited. A person with HD has a 50% chance of passing the gene on to each child. Everyone with the gene will develop HD; everyone with HD will die. Joe has 4 young adult children--JJ, Patrick, Meghan and Katie. Joe and Katie are the protagonists, and the story is told by both their points of view (3rd person narrative).

What I like best about this novel is how Dr. Genova really focuses onto the many facets of this illness. Being a physician, I am aware of this disease, though I have never seen a patient with HD. I dare say most of the population not in the medical field has never heard of it. The author gives us a very clear picture of what Huntington’s disease is all about. She explains in easy to understand terms what the genetics of HD are, what is involved in finding out if you are carrying the gene, and what it is like for not only the patient to live with HD, but what the ramifications are on the patient’s family, friends and coworkers.

It is not an easy disease to live with. How will you spend the rest of your days and what will be your attitude? How will you relate to your family? It is very difficult for offspring to decide whether or not to undergo genetic testing. Do you want to know that you will die early of this grotesque disease? Or do you decline testing in order to hold out hope even knowing that a negative test would set you free. But will you truly be free even with a negative test? If you test positive or if you decline testing, will you want to marry? Would that be fair? Would you want to have children? Will every stumble, loss of balance or dropped glass be a sign that the disease is beginning? The questions are endless. By opening a window to the O’Brien’s lives, these and other questions are examined in depth through the lives of Joe, his wife Rosie and his children, especially Katie.

It is evident that a tremendous amount of research went into the writing of this fictional account. Dr. Genova has earned a PhD in neuroscience from Harvard University so she certainly has the background to write about Huntington’s disease. But it is the way she humanized this disease that moved me. The characters are so compelling, so realistic, and just so….human. To see their struggles in handling the entire situation and how they each came to terms with it was simply spellbinding. I thought about these people when I went to bed and when I woke up. I am still thinking about them after finishing the book. I will miss them.


In summary, Inside the O’Briens is both captivating and highly enlightening. I highly recommend it to all readers. This is my first Lisa Genova book. It will not be the last. 5 stars.

[Maxine (Booklover Catlady) · Rating 4 out of 5]

Sometimes a book educates you on matters you were unaware of but should not have been - like Huntington's Disease and how it destroys a person in the most cruelest of ways. Reading this was like a slap in the face, how was I so in the dark about this disease? Then again I have a nephrostomy and 99% of people don't know what that is.

Lisa Genova did that with Inside the O'Briens, not only a brilliant novel but one that brings awareness to an illness that I would guess not many would know a whole lot about. It reminded me somewhat, not so much in writing style but topic in some of the books written by Jodi Picoult.

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.

As HD is a genetic neurological disorder his diagnosis sends the whole family into a state of terrified limbo, it's a 50/50 chance a child of someone with the positive HD gene will have the positive gene too. Life expectancy is not great and quality of life and dignity are out the window by that point.

This is a book that really tackles some tough issues, including how the family cope to support each other whilst each dealing with their own fears and decisions to make. It's like someone dropped an atomic bomb in the lounge room and nobody is safe from it, nobody. It changes everything.

The strength in this book for me is in the characters, well developed, believable and complex. I was right there with them, in their home, feeling what they were feeling. The sheer helplessness, the anger, the grief, everything. You really do need to get emotionally invested in this book as you read, I got the best out of it that way.

Obviously not a light-hearted read, but it's written so well and Lisa Genova has done a top job of bringing to the reader's attention something that really should have a lot more support and publicity. As of now, there is no cure in sight for Huntington's Disease. There was however great strength and amazing family commitment exampled via this book.

The book hooked me from the first chapter, I fell in love with Joe and his battle to see what was happening to him, how it impacted his career in the police force, his dignity, his family, nothing was left untouched. He is a character that you just bond to and love. In fact I liked all the characters in this novel.

The children have to make the decision to get tested now or not to find out if they have the gene or remain in the dark and just wait and see. Can you imagine? Lisa painted their journey with that battle of whether to face the truth or not and the different way they each felt about it was brilliant. Not an easy read this one, it pulls on the heart strings and it's easy to get caught up in the emotions that are an undercurrent that makes this book so strong.

I finished the book at 3:00am, after devouring the last 50% of the book with matchsticks keeping my eyes open, I was so absorbed. It's now 4:32am here in the UK and I had to write my review before I lost what I was feeling. A book that made me think, made me feel. No real tears, but plenty of empathy. Glad to also be educated more on this awful disorder.

This should have been 5 stars but I give it 4.5 simply because I did not like the ending. It was the only bit of the book that let me down personally. It's the author's choice how to end a book but I felt empty with the need to know. Darn it. Can Lisa message me in secret to tell me?

So, a powerful, painful and highly addictive read that would appeal to many types of readers. I really enjoyed it and would recommend it to anyone. It's urged me to learn more about Huntington's Disease too.

It's been a hard review to write as I don't feel I can get across clearly enough how powerful the impact of it is, it's left me kind of drained, I need to recover and ponder the book over the coming week.

This review, plus book chat, giveaways and more can be found on my page:

https://www.facebook.com/BookloverCat...



Many thanks to the publisher for my copy of this book via NetGalley in exchange for a fair review.

[Linda · Rating 4 out of 5]

If you have ever read a book by Lisa Genova, then you know you will be treading into a lush field of the informative, the emotional, and the totally involved. You will never quite be the same. This book was no exception.

The story surrounds the O'Brien family who now must open the door and step through to the other side of Huntington's Disease. The knock was one that no one wishes to answer. Joe, the main character, has been recently diagnosed with the disease. He is the father of adult children, husband to Rosie, and a career Boston police officer. Sadly, he is but forty-three years old upon receiving the news of the diagnosis. And there is no possible good news. His children are now facing the possibility of a 50/50 chance of having the gene. Joe looks back at his own mother who was institutionalized as "a drunk". He now realizes that she bore the weight of Huntington's. And what is the eventual fate for him and for his children and their children?

I was completely unaware of the debilitating effects of this disease. Lisa Genova, once again, exposes her readers to a look behind the scenes of families who are dealing with situations that life does not prepare you for. The situations within the O'Brien family and the well-chosen dialog are honest and gut-wrenching. They are a family unit, but more importantly, they are characterized as individuals who react and relate differently. You'll find yourself angered, perplexed, and frustrated as the story unfolds.

Although this is a fictional story, it most certainly is reality for thousands of people who deal with the onslaught of this disease. It is the throw of the stone that ripples outward and affects all involved. Presently, there is no cure. Even treating the symptoms is hit and miss. Ms. Genova presents a challenge for us all....to bring attention to more research and to the intense hope of an eventual cure.

[Shaily · Rating 2 out of 5]

*NetGalley ARC*

Because I enjoyed Still Alice so much, I had high hopes going into this book. Unfortunately, I didn't love reading Inside the O'Briens. Half the time, I felt like I was reading a textbook on Huntington's Disease with some examples of how a family is affected thrown in for good measure.

Although it was good to get more than just Joe's perspective, Katie was an annoying character. Her chapters were the same wishy-washy words of should I, should I not, yoga, I don't know HD HD HD. I started to skim her chapters because there was no new information offered. It doesn't bother me that we don't find out Katie's test results, but I don't like that she essentially makes her decision to move to Portland with Felix because Meghan is moving to London and their apartment will be rented out, not because she came to her own conclusion separate of what her family members are doing .

I appreciate the awareness this book will bring to Huntington's Disease and think it's great that Genova is able to bring medical knowledge to a fictional novel. This one just needs a little more polishing.

[Suz · Rating 4 out of 5]

My second book with the theme of a tragic condition, Huntington’s Disease (HD), in almost as many weeks. This was a different take on my previous book, Remember Me, this one does not contain any theme of mystery, Lisa Genova’s approach was as I would expect, is based on the condition and the way it will affect one family, a strict Irish Catholic family, the O’Brien’s. This hereditary disease, and the myriad of characters and their voices, were given equal footing. I felt I knew each of this family’s members as the story progressed. I enjoyed the audio version of this book, initially not loving the narrator, but eventually this sorted itself out, growing on me.

I found it odd that the main character, the father Joe, a Boston cop who adored his job and was made for nothing else, was not made aware of this condition by his own father. It turns out Joe’s mother was not a drunk after all, she would have drunk to hide the depression and the disease that took her from her family. Joe thought he was visiting his mother who ‘drank herself to death’. It seems this was not the case. He was a young boy witness his mother’s body wither before his eyes, never knowing this fate would be his own.

The story was very content heavy in relation to HD, but not overly so. It was of course sad and depressing, but I enjoyed the story which focused on the way this neurodegenerative disease effects two generations of this proud Catholic family. Joe and Rosie married very young and had children just as young. As HD effects 50% of the offspring of those affected, this was a tragedy for the young family, one sibling had already started a family of his own and the children, all with a story of their own, were at the age of consent to choose to have the genetic testing. They can decide to learn their fate as they see their father’s body and mind succumb to this disease. All those who inherited the disease will die.

We mostly hear from the youngest O’Brien, Katie, a free-spirited yoga instructor who has always been jealous in the shadow of her older sister, a famed ballerina in the Boston Ballet. Katie labours on the decision to decide, whereas her older sister decides immediately.

The author is an expert in the diseases she writes about, and toward the end of the book, there is a scene where Joe, his cop buddies, and his youngest son Patrick, a drinker, a boy that doesn’t come home, the most troubled of the four O’Brien children, drops his beer. Father and son’s eyes meet, as this is surely an early sign. Joe has embraced HD, even printing T-shirts to confront those people ignorant of the disease, after all, he was a man in full uniform, directing traffic when members of the public called 911 to report a drunken officer directing traffic. This aspect was one which I found a tiny bit implausible, Joe continuing to work for as long as he did without more complaints.

Joe narrates his story and the figures are laid bare toward the end. Why would scientists research a disease where under 40 000 individuals suffer from HD, as opposed to millions of Alzheimer’s or breast cancer? Why would this insipid disease be researched at the same cost?

The O’Brien’s have their faith, they love hard and strong. They each have unique personalities, but this disease comes at such a cost. All will suffer cruelly before death and will know that offspring have the 50/50 chance. Rosie, the devout Catholic mother, is losing her family so immeasurably, and this information has dealt a cruel blow so swiftly.

Fiction never has all the answers, it is rare to have a neatly tied package, this book is definitley no exception.

I witnessed a man with this disease while I worked at a nursing home. I was young, and my understanding of this disease wouldn’t have been so full back then, but I will always remember old Reggie Wells, and these recent books have made me think about him a lot. I don’t think he had many visitors, and it does leave me feeling sad. It was 30 years ago and I remember him very well.

[Nancy · Rating 4 out of 5]

Posted at Shelf Inflicted

Alice Wexler’s brilliant scientific memoir, Mapping Fate, made me want to further explore the horror that is Huntington’s disease, so I decided to check out Lisa Genova’s fictional account of a Boston-area family who is affected.

Joe O’Brien, a Charlestown police officer, finally agrees to see a neurologist when his symptoms begin to affect his job performance. Not only does his diagnosis change his life, it also affects the lives of his wife, Rosie, and their four children, who have a 50% chance of inheriting this incurable and crippling disease.

While this story explores the disease and its devastating impact on Joe, it also, through the perspectives of his children, explores what it means to live a life at risk.

I loved getting to know the O’Brien’s, with all their quirks and flaws. I would have liked some deeper insight into the family’s relationships, particularly between the two sisters, Katie and Megan, and Joe’s relationship with his own sister, who moved across the country. I wanted to know more about what it was like for them growing up with a sick mother and not understanding what was wrong.

It must be difficult to watch a parent deteriorate from a disease knowing that there is a 50% chance a child may or may not get it. Though predictive testing is available for those at risk for Huntington’s, results from testing can have a major impact on every aspect of one’s life and the decision must be thought through carefully.

Lisa Genova does a wonderful job portraying the human, personal side of Huntington’s disease and the difficulties surrounding the decision to be tested. This is not the best fiction I’ve ever read. The prose, while not dazzling, is light, functional and accessible. I cared deeply about the O’Brien’s and appreciate the author’s efforts to raise awareness about this rare neurogenetic disorder while avoiding excessive sentimentality and melodrama.

I very much look forward to her other novels.

[Sharon · Rating 2 out of 5]

Inside the O'Briens had a great strong start, but I had trouble staying interested.

The first chapter showed us that Joe, the main character, was beginning to have symptoms of Huntington's Disease, though of course he doesn't realize it at the time. Then, the story jumps forward 7 years, only to keep taking us through several situations were he is having symptoms he doesn't understand or recognize. The author takes this time to introduce us to the family and get to know the characters, but it seemed like this is the point where the story should have picked up, but it never did.

When Joe finally receives a diagnosis, it is first by way of the doctor telling him what she "thinks" (prior to any testing), and the situation was so far from what would happen in real life it felt jarring. His wife began googling HD on their drive home, and at the following appointment - two months later - he is told that indeed, he does have HD. So he then asks, what is Huntington's Disease? As though he hadn't had two months to stew over it, worry, and research it, because the doctor had already told him that's what she thought he had.

The book is just too poorly paced and unrealistic to enjoy the story as the author attempted.

ARC received from NetGalley in exchange for an honest review.

[Carol · Rating 4 out of 5]

Lisa Genova really knows how to set the scene of a story and draw you in......44 year old Boston Police Officer Joe O'Brien has been diagnosed with Huntington's Disease shocking him and his close-nit family who soon discover they may also carry the fatal inherited gene. With no treatment to slow the progression or hope of cure in sight, Joe's children struggle with the decision of being tested to uncover their fate.

Informative and heart-rending read depicting a devastating, debilitating and deadly disease.

[Colleen · Rating 5 out of 5]

Lisa Genova does it again. Highly recommended for all sorts of readers. How she can take such heart wrenching medical topics and tell such important stories is such a gift. Thanks to Gallery Books for a free copy, and I am so glad to report this is one author I am keeping up with. And so well worth it. More research to cure this so importantly needed.

If you bring forth what is within you, what you bring forth will save you. If you do not bring forth what is within you, what you do not bring forth will destroy you. -The Gospel of Thomas, saying 70

Once you can imagine these things, you can't unimagine them. -Joe O'Brien

The pain that you create now is always some form of nonacceptance, some form of unconscious resistance to what is. -Eckhart Tolle

Life is a near-death experience. Stumble around in giddy gratitude while you still can. -Jen Sincero

What we think, we become. -Buddha

So hum (short for Sanskrit So aham) - That I am.

And her sick, addicted mind loves every gruesome, dramatic second of it.

There is white light and breathing in and out.

Hope is the thing with feathers
That perches in the soul
And sings the tune without the words
And never stops at all.
-Emily Dickenson

Being deeply loved by someone gives you strength,
while loving someone deeply gives you courage.
-Lao Tzu

Stay in the Fight - Boston Police Department

These demons don't know who they're fucking with. -Patrick O'Brien

Joe's got that genie-in-his-gut feeling that sees the truth light-years before his head does.

After all these years, he sees his mother. Re-membered.

And I don't want to spend one minute on this earth knowing two of my children are buried beneath it.
I'll tel you right now, I'm crawling into the casket with the last one. They're gonna have to bury me alive because I won't go on alone.

A drunk wife and a husband with HD. They make a fine pair. As they lurch down the hallway and finally make it to the kitchen, it occurs to Joe that this is the best anyone can hope for in life. Someone you love to stagger through the hard times with.

The thought became a fear that physically consumed her. But the thought is only terrifying if she chooses to be terrified. The quality of her experience depends entirely on the thoughts she chooses. Reality depends on what is paid attention to. Whether she's gene positive or negative, she's determined to pay attention to living, not dying.

Every breath is a risk. Love is why breathe.
I am.

[Angela M · Rating 4 out of 5]

4.5 stars .

I felt as if I knew Joe O'Brien. At first I thought it was because I lived just outside Boston when this story takes place so I really felt like I was there and that I knew this family. More likely it's because Lisa Genova does such an amazing job of letting you know this could be any family , anywhere .

This is about a family not so perfect but real in their flaws and yet perfect in their love and support for each other as they face Joe's diagnosis of Huntington's disease . By reading this novel, I certainly gained a better understanding of Huntington's disease . At most I knew that this was a debilitating disease without a cure . Genova makes us aware of so much more - the terrible symptoms , the hereditary nature of the disease and the toll that it takes on the victim as well as the family . Certainly her credentials as a neuroscientist make her more than capable of doing so. But she also gives us a beautiful story of a suffering family and how they sustain themselves through love and hope .

It is heartbreaking to see what happens to Joe , a career Boston Police Officer both , physically as well as emotionally , beginning with denial through acceptance that he will die of it and worrying about whether his children will get it . It's heartbreaking what this diagnosis is doing to his loving wife Rosie as she watches what is happening to her husband and worries about whether her four adult children have the muted gene . It's heartbreaking to see what is going on in the minds of their children - to be tested or not , to know their fate or not .

Amidst the heartbreak there is strength in the face of this tragic circumstance . I highly recommend this book , especially if you loved Still Alice also by Lisa Genova.

Thanks to Gallery Books and NetGalley .

[Mandy · Rating 2 out of 5]

I very much enjoyed Genova’s earlier novel Still Alice about Alzheimer's and felt that she dealt sensitively and convincingly with the effects it has on all those involved when a diagnosis hits a family. Unfortunately she has not been so successful in her attempts to write the same book again, this time focussing on Huntington’s. I can’t help feeling she (or her publishers) decided it would be a good idea to cash in on her earlier success by choosing another devastating disease and finding a story to fit the facts.
Joe O’Brien is your typical Boston-Irish cop leading a conventional Boston-Irish life with his Boston-Irish wife and four children. Then one day their life is upended by Joe’s diagnosis of Huntington's disease, a cruel affliction for which there is no cure. Joe’s four children are all very different from each other and this handily gives Genoa the opportunity to demonstrate a range of possible reactions. Visits to the doctor give an opportunity for some medical lectures and a mini-course on genetics. Joe’s normal blustering is shown to be no help to him as he gradually loses control of his body and mind but a clue is given in the opening pages about how he will ultimately deal with his dreadful situation. So all in all the book is formulaic and clichéd with the characters types rather than fully-rounded personalities, and I wasn’t convinced by any of them. Certainly it gives a moving and compelling account of Huntington’s and for that the reader must be grateful, but as a convincing work of literature it failed for me and I was disappointed. I hope Genova doesn’t feel tempted to choose yet another disease and explore it in the same lifeless way.

[Carmen Blankenship · Rating 5 out of 5]

First of all a huge thank you to Gallery, Threshold, Pocket Books and Netgalley for the ARC in exchange for an honest review.

There are certain times that I get frustrated at being limited to giving a book 5 stars. This is one of those times. Before I review this specific book, I just want to touch on Lisa Genova's body of work. After I read Still Alice, by chance, I immediatley searched Amazon for her backlist. Much to my dismay and astonishment it was her debut. How can a book so flawless be her first?!? Then I read her bio ... A degree in Biopsychology AND a PHD from Harvard? Then, I decide to email Genova about how much Still Alice impacted me. Guess what? She emailed right back and actually had a 'coversation' with me over email. So not only is she a gifted author, a doctor, and educator, but she is also very NICE! I would say it wasn't fair that one person had so much talent, but I have a feeling that while there is no doubt she has talent, I am pretty sure she has worked her arse off. OK, now on to Inside the O'Briens.

Inside the O'Briens introduces us to Joe, a proud Boston Police officer, his wife Rosie, and their four Children. Their whole family is rocked when Joe is diagnosed with Huntingtons Disease. A disease that is passed down genetically. Not only does the family have to struggle with the symptoms that Joe is presenting but the children (who are all adults) are agonizing over the decision to take the blood test that will tell them, with 100% accuracy, if they will suffer the same fate. While this is the premise of the book, it is so, so, so much more. I loved the O'Brien family. Their Irish pride and their closeness. I found myselft thinking of the O'Briens as I was curling my hair in the morning, driving to work, and just couldn't wait to get back to them.

What Genova is a genius at is educating you on diseases and also how they affect families. I loved Joe and loved how much he adored his "bride" and his children. I hate Huntington's Disease. It is a vicious disease that can go on for generations. I hope a cure is found soon. I make a very modest living but I will donate what I can as Lisa has so gracefully asked.

Honestly, this review could be 3 pages long if I wanted to describe how absorbed I was in this story. My Kindle has yellow highlighted pages in every chapter.

You don't need to even read the next review. Just click "BUY NOW' or however you purchase your books. Just purchase it.

[Elyse Walters · Rating 4 out of 5]

"Huntington's disease is a lethal neurodegenerative disease with no treatment and no cure --commonly called a family disease.

The most important thing about Lisa Genova's new book, "Inside the O'Brians", is that she brings awareness to readers of Huntington's disease --and the many different ways it consumes a family.

As Lisa tells the story about The O'Brien family --the reader begins to understand this disease deeper --physically--psychologically--mentally--financially--spirituality--.

There are pros and cons for siblings: A genetic test can tell them if they will get the disease. Siblings have a 50% chance of having a positive result, if one of their parents has it.

Lisa Genova does a beautiful job unpeeling the onion-skin layers of each family member's struggle to live a dignified life, as they are faced with serious choices to make. You'll meet Joe, Rosie, Katie, Meghan, JJ & Collen, and Patrick. While reading their story --the reader often wonders ---"what would I do"?

This is a heartbreaking disease -- heartbreaking shocking news for a family -- Its a must read for anyone who knows nothing about Huntington's disease.

Lisa Genova's medical-science knowledge mixed with her storytelling allows readers to 'feel' the sense of immediacy to find a cure for this progressive deathly disease.

Thank you Lisa -For making a difference in the world with the books you write! "ALL" of them are important.

I'll make a donation to the HD Human Biology Project -- www.LisaGenova.com

Thank You, Netgalley

[☮Karen · Rating 5 out of 5]

Imagine you've seemed jittery and moody lately, your speech is slurring occasionally, and man, those involuntary twitches in your face and leg are driving you and those around you batsh%! crazy. These are just some of the symptons of Huntington's Disease, a heritary affliction that lies dormant in you until you are approaching middle age and then gives you 10 years more after that. Ten torturous years, because you will be fully aware of your slide into hell. So by the time you find out you have HD, you have already had your own children, all of whom have a 50/50 chance of having it themselves, and a 50/50 chance of passing it on to their kids, and so on and so on and so on.

Such is the story of Joe O'Brien and his doomed family. As in Still Alice, the author gives us another tragic disease and asks the question, would you want to know if you are carrying the gene, or not?

Such a story could be a downer, so the author balances it perfectly with scenes of this amazing family. Joe and his saint of a wife Rosie, adult children Patrick, JJ, Meghan, and Katie. Mostly we have Joe's perspective alternated with Katie's. Told with humor and tenderness, this is a story that will resonate with you and bring some tears to your eyes.

Thank you NetGalley and Gallery Books for allowing me to preview and review this wonderful book.

[Carol Brill · Rating 4 out of 5]

Get out the tissues. "INSIDE" The O'Brien's is the perfect title for this wonderful book because Lisa Genova so skillfully puts us inside each character's world to experience their fear, pain, joy, and hope. She has an amazing talent for creating characters that are familiar, palpable and real without being cliché. From the minute I met Joe O'Brien I felt like I knew him and his wife Rosie. I had heard of Huntington's Disease but had no idea of the course of the disease or that it's hereditary. As the O'Brien family deal with a current diagnosis and the too real threat to the next generation, their fears and hopes, denial, and bargaining really resonated with me. Ms. Genova nails what it feels like to hear an unthinkable diagnosis and learn to live with it. A heartbreaking and hopeful story.
I have a quibble about the ending, one of those where I turned the page and gasped out loud, "Noooo! That can't be the end." Here's my review for New York Journal of Books http://www.nyjournalofbooks.com/book-...

[Vonia · Rating 4 out of 5]

Well, Lisa Genova is back. And has done it again. Another great book that completely immerses the reader in a world surrounding a medical or mental phenomena. All these illnesses, of course, involve the family as a whole. She beautifully illustrates exactly how true this is. There are touching scenes between various characters, and I could not help but fall in love with pretty much every single one of them. She did it with Alzheimer's in "Still Alice", Hemispatial neglect in "Left Neglected" (a neuropsychological condition where an individual is unable to process and perceive stimuli on one side of the body), and autism in "Love Anthony". Not surprisingly, Lisa Genova is an accomplished neuroscientist, with affiliations with Massachusetts General Hospital, National Institute of Health, Harvard, and Yale. I could not have more respect for this scientist that writes like that is all she does; in fact, better than most career authors.

This time, it is with Huntington's disease. I did not know much about this terrifying illness before reading this book aside from the basics. Reading Genova's books feels like I am reading nonfiction, in regards to the amount of facts and material I am learning. But better. Why? Because it feels real. And it is a lot easier to absorb for me when it is not in cut and dry textbook facts. "Inside the O'Briens" was no exception. By the end of this book, I was fascinated with Huntington's Disease and had to do a little more extra research on my own. In short, it is an incurable, hereditary brain disorder. The symptoms be include irritability, depression, small involuntary movements, poor coordination, trouble learning new information or making decisions, and involuntary movements known as chorea. As the disease progresses, these movements become more serious and they have trouble walking, speaking, and swallowing. People with this disorder also experience changes in personality and a decline in thinking and reasoning abilities. As illustrated in "Inside the O'Briens", it often appears as if this individual is an alcoholic (for the longest time, Joe 0'Brien thought his mother died from alcoholism rather than this genetic brain disorder, not to mention his co-workers on the Boston Police Force who spread rumors regarding his drinking, when he makes a specific effort to hardly ever drink more than a few on a given night).

The most fascinating statistic to me was the fact that 90% of those at risk (one of their parents have it; they have a 50% chance of being gene positive, which would equate to a hundred percent chance to contact the disease on average between the ages 35 to 45, inevitable death in 10 to 20 years) choose not to find out whether they are gene positive. I did a little investigating on this statistic and could not find anything restating this number. That is to say, Genova's statement is misleading. 10 to 20 percent request testing right away, while around 40 to 79 percent note intention during the next appointment, in the future, etcetera (The National Center for Biotechnology Information). As with all statistics, there are many variable that lead to unreliability of said statistics. In other countries, like New Zealand, the percentage is higher according to some sources. As a psychology scholar, this is simply fascinating to me, especially the studies that price the platitude of psychological effects of testing, i.e. education choices, relationship turnouts, decision making processes, suicide rates. To make matters worse, although relatively low, there is about a 1 percent chance for a false positive. Imagine living your entire early adulthood knowing that you are going to have Huntington's only to find out it was a lie. One might imagine that would be nothing but bliss, but you might be surprised by Sue the opposite.

There are main areas/themes that are explored in this book.

1) Obviously, Huntington's. The author has done here research and it is reflected in the insightful thoughts that battle inside the characters (to get the test or not?), the realism of the situations that arise (Joe knocking over one of his wife's favorite antiques, throwing a tantrum, falling over while taking walks, being regarded as an alcoholic by not only the public but close friends and associates he had not yet told the truth to). In addition, each of the three parts in the novel begins with a page with some scientific facts on Huntington's, textbook style. Highly beneficial.

2) The City of Boston. It has its own character here, giving identity to many of the characters. Landmarks area oft mentioned (The Freedom Trail, neighborhoods, sports arena, museums), "wicked" is used often, the Red Sox are named numerous times (even in a pitiful but sadly not unlikely prayer to save his family, in which the Red Sox winning the series is added at the end of the list), events such as the Boston Marathon shootings, descriptions are given regarding the historical significance of the city as well as the unique culture.

3) Family and Friends. Joe and Rosie have four children The importance of this is heightened ten fold by Joe's illness. The large family was already close, being Irish Catholic. Obviously with the "family disease", Realtors can only become more. More what? More everything! More drama, more emotion, more good, more bad; but always, inevitably, more bonding. Joe and Rosie have to tell their four children that they each have a 50 percent chance to contract this devastating disorder, which is made worse with oldest son, who is married and the couple having recently found out that Caroline is pregnant. There are several touching scenes, most notably between Joe and one of his best friends on the force, Joe and his youngest daughter Katie (my favorite being when Katie goes to Joe to discuss his suicide attempt and gives an emotional but very convincing argument that they need him, that they are all likely to have to live with this; the way he deals with Huntington's, the choices he makes, will serve as their example), Katie and Meghan, Joe and his mother (she is long gone, having died alone and misunderstood in the insane asylum from Huntington's; now that Joe has for the first time found out what really killed her, he is able to finally begin finding closure and healing), Joe and Rosie ("They walk together, listing and pitching, bumping off the hallway walls into each other's hips. A drunk wife and a husband with Huntington's. They make a fine pair. As they lurch down the hallway and finally make it to the kitchen, it occurs to Joe that this is the best anyone can hope for in life. Someone you love to stagger through the hard times with.")

4) Police Culture. Genova explores a lot of the psychological effects of being an officer. For Joe, it is a large part of his identity. When he realizes he will need to retire early, he is not only devestated, but feels as if he is losing a part of who he is.

5) Religion. Not being religious, this was quite bothersome to me. Rosie is highly religious, collecting Mary statues, church every week, traditional Sunday dinner with mandatory attendance for every family member, rain or shine. Fortunately, Joe might have been raised Catholic but had since realized he did not really believe. Interestingly but not surprisingly, after his onset of Huntington's, he began looking into religion again. In his words, "I need all the assistance I can get.") This also comes into play when it is highly suggested that they get a divorce (in order to ensure financial security; for all Joe's pension not to go to the state for his nursing care, they would need to divorce so he can sign over his pension and all other assets to Rosie). This is against everything Rosie stands for, but logic wins out in the end.

6) Yoga & Meditation. (Along with all the inspirational quotes, i.e. "Being deeply loved by someone gives you strength, while loving someone deeply gives you courage.") Katie is a yoga instructor. Interestingly, this plays an important part in the story. It is the bridge between her father and her, who have never been the closest. He had never been to one of her classes, but when he does, he finds it centers him, not to mention the physical benefits for his chorea.

7) Ballet. Older sister Meghan dances for The Boston Ballet. This obviously has significant connotations with the chorea that comes along with Huntington's.

The main con for me aside from the excessive religious overtones and focus on meditation and inspirational quotes is Genova's choice to use only two points of view, Joe's and Katie's. I would have preferred a few more, especially Rosie and Patrick (the "problem child").

Lisa Genova has called her readers to action. Requesting donations for Huntington's research, to date (5/18/2017), she has raised more than $48,500. I have not met her yet, but this tells me she is not only an impressive neuroscientist and an accomplished novelist, but probably an amazing person. I give you my silent applause, Lisa. On second thought, I am actually applauding you loudly right now.

[Ace · Rating 5 out of 5]

Every family has their battles and this particular family is dealing with Huntington's. I had to take a bit of a break about half way through but it drew me back as I kept thinking about what would happen and how they would cope. Anyone from the Boston area may love this even more than I did?

[Jenny (Reading Envy) · Rating 4 out of 5]

I only know of Lisa Genova through the film adaptation of Still Alice, and I would not have read another book by her unless it came to me through a book swap, which this one did. Still Alice gave my husband and I both the worst nightmares of our lives!

This author, who has a PhD in neuroscience, seems to prefer to write about diseases in novel form. This is no exception, and addresses Huntington's Disease. The book starts with Joe, a Boston cop who drops things for no reason and falls without tripping. His diagnosis sends the family into a tailspin, because HD is basically 50/50 for each offspring that they will also have the disease.

As a reader, you learn a lot about the disease, but you also come to care about the characters as they struggle through it. It also introduces some intricacies because the family is Catholic, and this introduces more issues in family planning, abortion, genetic choice, etc.

I sat and read the book in one evening, so it just doesn't let you go.

[Patrice Hoffman · Rating 4 out of 5]

Where do I start with Lisa Genova's Inside the O'Briens? I'm often faced with that decision when starting a review for a novel I believe brings so much to the table in terms of its insight, relatability, and the discussion it leaves in its wake. In an effort to not spoil anything I will be brief and only highlight the things that I still think about after reading this novel.

Joe O'Brien is an officer for the Boston Police Department, husband to Rosie, and father to four offspring when he finds out the most devastating news of his life. He's gene positive for Huntington's Disease. After a few too many mishaps, sporadic movements, and out of character rampages, he is convinced by his wife to seek help. She thinks he's gone crazy. After getting news of his true diagnosis, crazy seems like a lesser evil.

The novel progresses by telling the Joe's story by cleverly placing intricate details of the neurodegenitive disease and what it means for his future, and his family's future. He will become someone who is unable to control his movements, thinking, and behavior. His cognitive and motor skills will continue to decline until his untimely death. What's worse is that there is a 50% chance of passing this along to his children.

Inside the O'Briens explore how one Irish Catholic family tries to hold it all together while things seemingly fall apart. Joe can't help but feel the guilt of passing this along to his children while a few of his children battle wanting to know or not. This is where I was most intrigued.

We are given the most in depth story of Katie, who struggles between knowing and not knowing. Moving forward with life or allowing Huntington dictate how she would spend her life. Relating to her story is easiest and it constantly made me wonder: Would I want to know? Would I have the courage to find out what my future holds?

Overall, Inside the O'Briens is an interesting, sometimes heartbreaking look into the life of a family who deals with the cards they're dealt. I recommend this book to anyone who shows even a little interest in the subject and wants to get lost in a novel that will make you think, 'would I want to know'?

Copy provided by Simon and Schuster via Netgalley

[Barbara · Rating 5 out of 5]

“Inside the O’Briens” is one of those books you read and “lose time”: all of a sudden, it’s midnight and you forgot to eat. Genova is THE master at telling the stories of families who suffer from neurological diseases. This time, she covers Huntington’s disease.

I never go over what the book cover tells you, as it’s on track and descriptive of the rudimentary plot. What the cover never provides is how the reader is so absorbed in the story, feeling each character’s pain, duress, and confusion. It’s also a character study on how different personalities endure adversity. Not only will the reader learn about Huntington’s disease, but also the reader will be more compassionate when seeing a person who exhibits Huntington-like symptoms, and be apt to rush to judgment.

It is a great book club read, as each character in the novel reacts differently to stress. I found myself getting frustrated with a character. I found myself intrigued that other characters weren’t angrier. I’m going to beg my friends to read it; I’m going to beg my book club to read it. I want to discuss it with people to get their feelings about the characters reactions. I want to understand what I didn’t understand. It’s a must read!

[Elaine · Rating 5 out of 5]

After finishing Still Alice by Lisa Genova, my next read, quite by chance, was her latest book “Inside The O’Briens”, the story of Joe a 44 year old Boston Cop who has been diagnosed with Huntingdon’s Disease, and the effect that it has on him and his family. I was a little bit dubious at first, thinking “different disease, same story” but as the read went on I really, really enjoyed it and soon got caught up in the lives of this large Boston Irish family. Whereas Still Alice is told entirely from Alice’s point of view, in this book we also see the effect it has on Joe’s family, most notably through the eyes of Katie, his youngest daughter.

It is a horrible disease; cruel, relentless and fatal and the diagnosis has far reaching effects not only for Joe in his family life, but also his career. He is not a high flying big earner, just a hard working policeman and the author really showed the problems he was about to face in his working life now and in the future with regards to his pension and the cost of future care.

The real heartbreak of the story though is the genetic element. If you have the disease then there is a 50/50 chance that your children will have the mutant gene that causes it and if they have that gene then they WILL get the disease. Once again, the author really portrayed the dilemmas faced by his children. Should they be tested or not? Is it better to live in ignorance or is it better to know what is ahead of you? This is really where Katie’s story comes to life as we watch her agonising over whether or not to take the test, especially as she watches her siblings taking the test and getting their results. Although Joe is suffering from a fatal disease, the book is not about dying. It is about living with the disease, or the prospect of it, and not wasting what time you have.

This is an absolutely fantastic story. If you read Still Alice and warmed to the theme of that book, then I really think you would like this book. I cannot finish the review though without mentioning the ending. In one way it is absolutely perfect, but in another way it is so flipping frustrating! Many thanks to the publishers for the review copy.

[Britany · Rating 3 out of 5]

Joe O'Brien is a Boston cop, raising family of four in Charlestown, MA. He's got his routine down pat, family dynamics are close and slowly he succumbs to Huntington's Disease.

Watching Joe go through something like this at such a young age of 54, is a hard subject to read about. Even worse, is considering that the gene has a 50/50 chance to be passed down to his four children. Will they get tested and find out if they carry the gene? Or will they live their lives in complete oblivion?

I can tell how detailed Genova's research into this disease was, and I appreciated all the facts she presented throughout the book. Even though, I know statistically most people don't find out if they are gene positive, I found so glaringly hard to believe (and I've got no idea why). I appreciated the diligence and all the details to learn more about this disease without a cure, but something left me unable to fully connect with these characters as much as I had hoped.

[Michelle · Rating 5 out of 5]

With each page, I laughed or cried, but mainly both together. This book turned me into a giggling sobbing mess, and this will be in my top books of 2024.

Meet the O'Briens. There's Rosie and Joe plus their four adult children. JJ, Patrick, Meghan, and Katie. Each character is individual and vibrant, the sibling relationships are hilarious and heartbreaking, and the parent / children dynamics are raw, real, and relatable.

I didn't know anything about Huntington's' disease prior to reading this. With around 7,000 people in the UK dealing with this, it's hardly surprising that I haven't crossed paths with it, and I'm so glad I read this.

This is my third book by this author, and she's now an auto buy for me. Whatever she's writing, I'm here to read it. Each time she takes me on a journey of science with well thought out characters, which is assessable to my non medically trained brain and all the while breaking my heart, and I'll keep coming back for more.

An exceptional book by an exceptional author.

Five stars.

[Linda · Rating 5 out of 5]

What a wonderful book. We are introduced to an Irish Catholic family from Boston, the O'Briens. Joe and his wife Rosie have four young adult children, JJ, Meg, Patrick and Katie. Joe has served on the BPD for over 20 years when he begans having problems and is diagnosed with a rare movement disorder, Huntington's Diease. It's a progressive condition with no cure and there's a 50/50 chance of his children having the gene to develop HD. I loved the O'Brien family, well developed characters that I felt I knew personally. The thing that stood out to me most is the education we receive on HD and the great hope and love of a family dealing with a difficult circumstance. This touched me personally.
Lisa Genova has been a favorite author of mine since I read Still Alice and I look forward to her next book.