Inside the O'Briens
Lisa Genova, 2015
Gallery Books
368 pp.
ISBN-13: 9781476717791
Summary
A powerful and transcendent new novel about a family struggling with the impact of Huntington’s disease.
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.
Praised for writing that “explores the resilience of the human spirit” (San Francisco Chronicle), Lisa Genova has once again delivered a novel as powerful and unforgettable as the human insights at its core. (From the publisher.)
Author Bio
• Birth—November 22, 1970
• Where—N/A
• Education—B.S. Bates College; Ph.D, Harvard University
• Currently—lives on Cape Cod, Massachusetts
Lisa Genova is an American neuroscientist and author of fiction. She graduated valedictorian, summa cum laude from Bates College with a BS degree in biopsychology and received her Ph.D. in neuroscience from Harvard University in 1998.
Genova did research at Massachusetts General Hospital East, Yale Medical School, McLean Hospital, and the National Institutes of Health. She also taught neuroanatomy at Harvard Medical School fall 1996.
Genova married and gave birth to a daughter in 2000. Four years later she and her husband divorced, and Genova began writing full-time. To hear Genova tell it:
When I was 33, I got divorced. I’d been a stay-at-home mom for four years, and I planned to go back to work as a health-care industry strategy consultant. But then I asked myself a question that changed the course of my life: If I could do anything I wanted, what would I do? My answer, which was both exciting and terrifying—write a novel about a woman with Alzheimer’s (Cape Cod Magazine.).
In 2007 she self-published her first novel, Still Alice, which went on to became a major best seller and award winning film. Since then, Genova has written three other fictional works about characters dealing with neurological disorders.
Still Alice
Genova's debut novel follows a woman suffering from early-onset Alzheimer’s disease. Alice Howland, a 50-year-old woman, is a cognitive psychology professor at Harvard and a world-renowned linguistics expert. She is married to an equally successful husband, and they have three grown children. The disease takes hold swiftly, changing Alice’s relationship with her family and the world.
Self-published, Genova sold copies of the book out of the trunk of her car. The book was later acquired by Simon & Schuster and published in 2009. It appeared on the New York Times best seller list for more than 40 weeks, was sold in 30 countries, and translated into more than 20 languages.
The book was adapted for the stage by Christine Mary Dunford and performed by Chicago's Lookingglass Theatre Company in 2013.
A 2014 film adaptation starred Julianne Moore as the lead and co-starred Alec Baldwin, Kristen Stewart, and Kate Bosworth. Moore won an Oscar for Best Actress.
Other books
♦ Left Neglected (2011)
Genova's second novel tells the story of a woman who suffers from left neglect (also called hemispatial or unilateral neglect), caused by a traumatic brain injury. As she struggles to recover, she learns that she must embrace a simpler life. She begins to heal when she attends to elements left neglected in herself, her family, and the world around her.
♦ Love Anthony (2012)
Offering a unique perspective in fiction, this third novel presents the extraordinary voice of Anthony, a nonverbal boy with autism. Anthony reveals a neurologically plausible peek inside the mind of autism, why he hates pronouns, why he loves swinging and the number three, how he experiences routine, joy, and love. And it is the voice of this voiceless boy that guides two women in this powerfully unforgettable story to discover the universal truths that connect us all.
♦ Inside the O'Briens (2015)
In her fourth novel, Genova follows Joe O'Brien, a middle-aged Boston policeman diagnosed with Huntington's. There is no cure, and the disease is progressive and lethal. The story revolves around the fallout on Joe's family, including his daughter who is at risk for carrying the genes.
TV and film
Since her first novel was published, Genova has become a professional speaker about Alzheimer's disease. She has been a guest on the Today Show, Dr. Oz, CNN, PBS News Hour, and the Diane Rehm Show. She appeared in the documentary film To Not Fade Away. It is a follow-up to the Emmy Award-winning film, Not Fade Away (2009), about Marie Vitale, a woman who was diagnosed with Alzheimer's disease at the age of 45. (Adapated from Wikipedia. Retrieved 4/6/2015.)
Book Reviews
This novel of siblings rocked by their father's Huntington's disease is a total tearjerker, but ultimately it's a tribute to family love.
Glamour
An intimate, heartbreaking look at life with Huntington's disease.
Marie Claire
(Starred review.) [The] tale of a Boston police officer who learns that he has Huntington's disease.... This is a gut-wrenching and memorable read, most similar to Genova's Still Alice in its detailed portrayal of the disintegration and rebuilding of a family in the face of a horrible illness. —Mariel Pachucki, Maple Valley, WA
Library Journal
Best-selling neuroscientist-turned-novelist Genova, author of several popular stories based on the experience of suffering debilitating diseases...now tackles the impact of Huntington's disease on one blue-collar Boston family.... Genova's intention once again is acceptance, and the wrung-out reader bids farewell to the family at a relatively calm and united moment. This journey to a place of mindfulness, while inevitably affecting, often reads like fictionalized campaign literature for a worthy cause.
Kirkus Reviews
Discussion Questions
2. In the beginning of the novel, Joe is horrified to recognize his mother, Ruth, in his reflection. Why do you think that is such a painful realization? How do his feelings about Ruth change? Discuss the complex ties we all have with our parents.
3. Joe is fiercely proud of his job as a police officer, but admits that he sometimes feels constrained by the uniform and the trappings that come with assuming that identity. How do you think that internal conflict ripples through his children and their professional choices? Who do you think is most like him? Who is most different?
4. Katie is compelled to leave, yet still feels tethered. Discuss the role that family and tradition play in the novel. When is tradition helpful, and when does it hold us back?
5. In the ways they can see, through external physical traits and personality, Katie and JJ come from their dad. Does this mean they also have his Huntington’s? Discuss the interplay of nature versus nurture in the narrative. How does each sibling define themselves in both relation and opposition to their family?
6. Even in their darkest moments, the O’Brien family finds reasons to be grateful. Name some of them. Do these reasons change over the course of the story? How? Do you specifically relate to any?
7. As a cop, it is essential that Joe make split-second decisions in high-stress environments. He takes pleasure in it. But later into his diagnosis, as his body goes to war with his mind, we see him starting to think in the long-term. Discuss the dichotomy of instinctual versus analytical thinking in the novel. When do they contradict each other? When do they complement each other?
8. Joe is a born storyteller but Rosie is "intensely private" about her family, especially when it comes to difficult topics. How do they compromise these two opposing impulses throughout the narrative?
9. Ultimately, Joe becomes an unreliable narrator. He can’t predict his moods or even his movements. How does he use the reflections of people and his surrounding environment to monitor himself? Who do you think he depends on most, and why?
10. Discuss what Catholicism means to the O’Brien family, specifically the theme of purgatory as it attends to the implications of the Huntington’s genetic test. Do you think religion informs their decision-making? How?
11. Joe is well versed in both the immediate and reverberating effects of trauma, having served in the aftermath of the Boston Marathon terrorist attack. He is aware that every day on the job might be his last. How is that specific dread different from the terrible anticipation of a Huntington’s diagnosis? How is it similar? Do you think Joe can still find honor in death from his disease? If so, how?
12. The O’Brien and extended Charlestown community is incredibly tight-knit. But when does that closeness cross the line into exclusivity? Discuss Katie’s relationship with Felix. Why do you think she hesitates to introduce him to her family? How does their reaction surprise her?
13. In chapter 31, Katie guides her dad through a yoga routine and tells him to "be the thermostat, not the temperature." What do you think she means? And how does it influence Joe’s decision to change his mantra from "stay in the fight" to “stay in the pose”?
14. In the novel, we learn one HD symptom is "chorea"—jerky, involuntary movements—and is derived from the Greek word for dance. Discuss the role of movement throughout the story, in both its liberating and debilitating forms. Why do you think Meghan decides to leave the Boston Ballet to work with a more experimental dance company in London?
15. In chapter 34, Katie frets about the effect a HD diagnosis would have on Felix’s future. Discuss the feeling of accountability that often comes with living with a terminal illness. At what point do we all have to relinquish the illusion of having control over someone else’s life?
16. Discuss Joe’s realization that his mother, Ruth, communicated gratitude and love to her children when she was in end-stage HD. How does that trickle down through him and onto Katie? Do you think Katie moves to Portland? Would you?
(Questions issued by the publisher.)