Wednesday, April 8, 2015

Inside the O'Briens

Title: Inside the O'Briens
Author: Lisa Genova
Published: April 7th 2015 by Gallery Books
Format: Hardcover, 352 pages
Genre: Fiction
Source: My thanks to Netgalley and Gallery Books for an opportunity to read an advance copy of this book.

For me, the title was a bit of a play on words. Are we to look inside the O’Brien family or are we to look at the insidious gene mutation that is literally inside the O’Briens? Either way, this is a fascinating look at a family that is slowly being torn apart and put back together by a degenerative disease that is playing roulette with their lives.

Only forty-four years old, Joe O’Brien a police officer from the Charlestown, Massachusetts is beginning to think that something is not right. His body is jerking, he is becoming forgetful, and his temper is flaring. He is showing the same signs that his mother did before she went to the state mental institution. His problems are not hers, she was a raging alcoholic, and even the neighbors knew that and used her as local gossip. Joe’s problem has to be different, he does not drink to excess and he has a stressful job, that is all it is, job stress and four children. That is until he sees a neurologist and by a simple test he is diagnosed – Huntington’s Disease. A neurodegenerative disease with no cure that he has possibly handed down to each of his four children.

Each child has a 50 percent chance of inheriting their father’s disease. Each child has to make the personal decision if they want to take a blood test that will reveal their fate. Each child is currently in their twenties and if they are gene positive, symptoms should not begin to appear for another ten to twenty years. Joe Jr. and his wife have been struggling for three years to get pregnant. Before Joe Sr. tells his family, Joey and his wife conceive. What could this mean for their unborn child?

Oldest daughter Meghan is a lead dancer with the Boston Ballet, if she is positive how will this affect her choices and career. Patrick is still finding himself and would a positive diagnosis totally derail him? Last is twenty one year old Katie. She has forever seen herself at the black sheep. She is a yoga instructor and sure that she is not living up to anyone’s expectation. Then she meets the love of her life and a whole new world opens. That is until Huntington’s Disease could derail everyone and everything that she hold dear.

Each child must make their own individual choice. They see what their parents are going through and each must come to their own decision. Will they take the test or will they live with the uncertainty? Will they live with love in their hearts and continue to be there for their father, a man that taught them to never give up and to stay in the fight. Can they help him live with dignity so he can then be their first and best example of how to face HD?

Told through the perspectives of Joe Sr. and Katie, Lisa Genova takes the reader through every scenario, every realization, every fear that the O’Brien’s must face. It is heartbreaking and heartwarming as you watch a family break apart and come back together. As you watch a grown son finally understanding a mother that he thought abandoned him. A comprehension dawning that she never left and loved him until the end.

By the last chapter, I found myself holding my hand over each page not wanting to risk that the final outcome would be revealed too soon. I did not want to rush, I wanted Katie’s reality to hit me full force like it was about to hit her.

I loved this book; I loved how their story was told. I loved how each person was an individual and that they as a family were not the sum total of the disease.

Fact: The mutation associated with Huntington’s disease (HD) was isolated in 1993. Ninety percent of people at risk for Huntington’s disease choose not to know.

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