Inside the O'Briens by Lisa Genova Published by Simon and Schuster on April 7, 2015
Genres: Fiction / Family Life / General, Fiction / General, Fiction / Medical, Fiction / Places / United States, Fiction / Psychological, Fiction / Women
Pages: 343
Format: Audiobook
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A New York Times bestseller ▪ A Library Journal Best Books of 2015 Pick ▪ A St. Louis Post-Dispatch Best Books of 2015 Pick ▪A GoodReads Top Ten Fiction Book of 2015 ▪ A People Magazine Great Read
From New York Times bestselling author and neuroscientist Lisa Genova comes a “heartbreaking…very human novel” (Matthew Thomas, author of We Are Not Ourselves) that does for Huntington’s disease what her debut novel Still Alice did for Alzheimer’s.
Joe O’Brien is a forty-three-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, and each of Joe’s four children has a 50 percent chance of inheriting their father’s disease. 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. 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.
I have no idea where to start talking about this book. There’s so much happening and it literally goes so far beyond Huntington’s Disease. It’s about a family and life and something that just pops into their lap unexpectedly. A lot of things that pop into their lap unexpectedly, some big and some small. And all create a fork in the path that each must take by deciding how they will navigate to move forward. I discovered this book thanks to The Book Girls’ Guide In Case You Missed It (ICYMI) Reading Challenge: 2026 Edition and it left me feeling hopeful and broken and a little bit irritated. Let me tell you why.
I first came across Huntington’s Disease thanks to Thirteen on the TV show House all those years ago. It’s not a disease you hear a lot about in normal life unless you know someone with it. All that to say that everything I know about HD was learned from a fictional TV doctor more than 15 years ago. This book takes that ancient knowledge and deftly weaves in actual knowledge of the disease with the experiences of the O’Briens. I learned a lot without feeling like I was reading a textbook, it was seamless between knowledge and experience. The experience was the catalyst that made this book go from good to great. The weaving of the backstory of what Joe believed to be true only to determine was not truth to the speculation of the future story that each character has to decide how to move forward. Four children, four chances for them to test positive for the genetic lottery that is HD, four choices to be made for all the reasons you can, and sometimes don’t even think about to, imagine.
In some ways I felt like a voyeur while listening to this book. I know, sounds a little extreme but hear me out. We happen upon this family just before a diagnosis that is so devastating and emotionally charged. We are privy to how each and every family member deals with the bombshell that this means for all of them, Joe and his four children. And how that plays out to significant others in all the lives, especially Rosie as she contemplates the loss of her husband but also the potential of losing her children to this disease during her own lifetime. We are privy to all their what-ifs, their emotional spirals, and how they come to terms with the potential of all their futures. There’s a lot to unpack in this book and it’s all good. Not going to lie though, there were parts I felt too easy, parts I felt glossed over that I wanted more depth, and how dare the cliff hanger that was the ending. My need, want, to know more makes me feel voyeur. I didn’t have to be included in their story then I didn’t feel like I was given enough. I was so invested that I really want to see how this family truly does go forward from where the book left me. I feel like I know these people and I need (yes need) to know how it truly ends. Not the tragic known ending, but the holistic ending that brings this family full circle for me.
About Lisa Genova
Acclaimed as the Oliver Sacks of fiction and the Michael Crichton of brain science, Lisa Genova is the New York Times bestselling author of Still Alice, Left Neglected, Love Anthony, Inside the O’Briens, and Remember: The Science of Memory and the Art of Forgetting. Still Alice was adapted into an Oscar–winning film starring Julianne Moore, Alec Baldwin, and Kristen Stewart. Lisa graduated valedictorian from Bates College with a degree in biopsychology and holds a PhD in neuroscience from Harvard University. She is featured in the documentary films To Not Fade Away and Have You Heard About Greg. Her TED talks on Alzheimer’s disease and memory have been viewed over eleven million times.
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