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Book review: “Inside the O’Briens”

Lisa Genova is a novelist I would love to meet. She is a Harvard-trained neuroscientist, but she probably doesn’t spend much time in the lab these days. In   2007 she wrote Still Alice, which became a best seller and, as they say, a major motion picture. Still Alice portrayed a vibrant, brilliant professional woman facing early onset Alzheimer’s. She tries to make the most of the good years still left to her, while planning for her suicide when her dementia overtakes her.

Genova found a terrific niche. Americans are fascinated by the brain, how it works and how things go awry (cf. our current obsessions with Alzheimer’s and autism). Her next book, Left Neglected, depicted another woman, a hard driving executive who survives a car crash with her body and her intellect intact, but unable to connect to anything on the left side of her body. Her left field of vision, hearing, movement, smell, were all gone.   Almost more interesting than the neurological phenomenon is the story of how a woman who is her family’s main breadwinner negotiates her responsibilities in this new world. Love Anthony is the rather too sentimental story of a boy with autism, told variously from the perspective of Anthony and of his mother.

I just read Inside the O’Briens, published last year. I found it the most gripping of Genova’s novels. Joe O’Brien is an Irish cop in South Boston, the kind of guy that you want to describe as “salt of the earth.” He loves his job, his wife Rosie, and his four grown kids. But sometime in Joe’s forties, some odd things begin to happen: weird rages, an inexplicable fall, trouble concentrating.   Eventually Joe and his family are navigating the scary and challenging world of Huntington Disease. HD is a dominant genetic disorder, meaning that if even one parent has the disease, each child has a 50/50 chance of getting it. It is 100% penetrant: if you have the gene, you will certainly get the disease (if you don’t get hit by a truck first). The condition is marked by increasing neurological dysfunction, until you cannot move, eat, or speak, although you remain conscious and aware. Inside the O’Briens is a clever title that signals the double-barreled scope of the novel. On the one hand, the HD gene is “inside” Joe, and potentially inside each of his children, and an unborn grandchild. On the other hand, the story gets “inside” the close-knit family, and depicts how the O’Briens, individually and together, cope with Joe’s condition, with the social and economic implications of his early retirement, and with the real possibility that each of them could have the disease. Each of the kids has to grapple with the question of whether to get tested, and the oldest son and his wife must also decide whether to test their newborn baby.

This is a great beach or airplane book—a compulsive page turner that also leaves you with the feeling that you’ve entered someone else’s world and learned a lot.

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