email page print pageAll Topic Reviews
"Are You There Alone?""Who Could That Be at This Hour?"3 Willows4th of July99 DaysA Beautiful MindA Change in AltitudeA Corner Of The UniverseA Falling KnifeA Frog ThingA Great and Terrible BeautyA People's History of ChristianityA Question of BloodA Slight Trick of the MindA Step Toward FallingA Thousand Miles from NowhereA Tragic Kind of WonderfulA Voyage Long and StrangeA Wedding in December Abraham LincolnAcross the River and Into the TreesADHD NationAfter DarkAgainst EmpathyAgainst Medical AdviceAll the Bright PlacesAll the Way HomeAll Unquiet ThingsAlphavilleAlways Forever MaybeAlways Too Much And Never EnoughAmerica AmericaAmong the DepartedAn EducationAn Object of BeautyAnatomy of a MisfitAre You There, Vodka? It's Me, ChelseaAsymmetryBad BoyBad RatsBarbara the Slut and Other PeopleBeach RoadBeat the ReaperBeauty QueensBed of RosesBefore I DieBefore I FallBefore the FrostBig BrotherBiteBlack Elk SpeaksBlameBleed for MeBlonde FaithBlood, Salt, WaterBody SurfingBog ChildBoneMan's DaughtersBoomsdayBorder CrossingBorn Standing UpBoys Are DogsBoys Will Put You on a Pedestal (So They Can Look Up Your Skirt)Brava, ValentineBreak Through PainBreathingBridge of SighsBrief Interviews with Hideous MenBring Them HomeBrutalBy BloodC StreetCalm Beneath the WavesCanadaCellCemetery DanceChange Your Brain, Change Your LifeCheeverCinnamon KissCleopatraClose Your EyesCompulsionCountryCross CountryCyborgasmDakotaDancing at the Shame PromDarkest FearDavid Sedaris Live at Carnegie HallDead EvenDead Little Mean GirlDear Zoe,Death Without TenureDeceptionDefending JacobDefine NormalDeliriumDevil in the DetailsDiscovering Pig MagicDisturbing GroundDivergentDivine JusticeDivisaderoDoing ItDon't Wake UpDown the Rabbit HoleDr. Andrew Weil's Mindbody ToolkitDress Your Family in Corduroy and DenimDriftlessEven Dogs in the WildEvery Exquisite ThingEvery Little Thing in the WorldEye ContactFaith, Hope, and Ivy JuneFaking NormalFalling ManFamily and Other CatastrophesFamily FirstFans of the Impossible LifeFear of the DarkFellsideField of BloodFile Under: 13 Suspicious IncidentsFiregirlFlat Lake in WinterForest of the PygmiesFortunate SonFraudFreak the MightyFree RefillsFull Steam Ahead!Furiously HappyGenerosityGenomeGetting a Good Night's SleepGetting the Love You Want Audio CompanionGiftedGirl in TranslationGod Is DeadGod Is Not OneGods and BeastsGoing BovineGood and GoneGranny Torrelli Makes SoupGraysonHappy FamilyHappy Mutant Baby PillsHarmlessHe's Just Not That Into YouHealthy AgingHeartbeatHeftHigh HeatHolidays on IceHot MilkHotel on the Corner of Bitter and SweetHotel WorldHotels of North AmericaHow a Gunman Says GoodbyeHow Full Is Your Bucket?How Successful People ThinkHow to Build a HouseHow to See Yourself As You Really AreHow to Set a Fire and WhyHunger Makes Me a Modern GirlHurt Go HappyHypnography for MenHypnography for WomenI Am I Am I AmI Am Not Joey PigzaI Can See YouI Drink for a ReasonI Feel Bad About My NeckI'd Know You AnywhereI'm Traveling AloneIdiot AmericaIf a Tree Falls at Lunch PeriodIf I StayIf You StayImagine Me GoneIn ZanesvilleInfinite JestInheritanceInnocentInside the O'BriensInvincibleInvisibleIt Takes OneJennifer, Hecate, Macbeth, William McKinley, and Me, ElizabethJust LifeKeeping LucyKiss of Broken GlassKissing Ted Callahan (And Other Guys)Knife CreekLeaping BeautyLie to MeLies My Girlfriend Told MeLife After LifeLife InterruptedLife of PiLife StrategiesLisey's StoryLitLittle Black LiesLittle ScarletLive For Your Listening PleasureLiving Your DreamLong Shadow of Small GhostsLooking for BobowiczLosers BracketLost in the ForestLove Is a Mix TapeLove Times ThreeLove, AubreyLowboyMadappleMade for LoveMade For YouMagical ThinkingMagnificenceMaliceMan in the WoodsMarlenaMeditation in a New York MinuteMeetings with a Remarkable ManMiddlesexMind MappingMindfulness for BeginnersMirrorMaskMischlingMissing PresumedMolly Moon's Incredible Book of HypnotismMommies Who DrinkMunich AirportMy AbandonmentMy Life Among the Serial KillersMy Name Is RedMy One Hundred AdventuresMy Sister's KeeperName All the AnimalsNelson Mandela's Favorite African FolktalesNemesisNever Let Me GoNew York 2140Night FilmNina: AdolescenceNinety DaysNone of the AboveNot a Crime to Be PoorNothingNurtureShockObjects of My AffectionOdd Child OutOh My GothOlive's OceanOn Chesil BeachOne Flew Over The Cuckoo's NestOutliersOutside Looking InPaint It BlackPanicParadise LodgeParanoiaPeace Is Every BreathPeople Who Eat DarknessPharmakonPictures of Hollis WoodsPictures of YouPilgrim at Tinker CreekPlaying with FirePlease Stop Laughing at UsPositivityPresumed InnocentPretty Girl-13Prisoner of Night and FogPuddlejumpersPunkzillaPutneyQueenieRacing the DevilReady for AnythingRebuttalReleaseRequiemRescueRevolutionary RoadRoomRun for Your LifeSay You're SorryScatSchool of FearSearching for Sylvie LeeSeason to TasteSecrets of a Passionate MarriageSee How SmallSeeds of HopeSex and SpiritSide Effects May VarySilencedSimon vs. the Homo Sapiens AgendaSinlessSix Impossible ThingsSkelligSleeping BeautySleepyheadSnowSo Brave, Young and HandsomeSolitaireSomeday This Pain Will Be Useful to YouSourlandSquirrel Seeks ChipmunkStill in LoveStill MissingStory of a GirlStress ReliefSupreme CourtshipSurviving OpheliaSwimming to ElbaSworn to SilenceSycamoreSymptoms of Being HumanTeaseTeaseTell the Truth, Shame the DevilTen Minutes to RelaxTestimonyThat Old Cape MagicThe DrifterThe Abortionist's DaughterThe AccidentalThe Accidental BillionairesThe AdultsThe Almost MoonThe Anatomy of HopeThe ArrangementThe Art of ChoosingThe Art of Exceptional LivingThe Artist of DisappearanceThe Average American MarriageThe Bastard on the Couch CDThe Beat Goes OnThe Best AwfulThe Big LoveThe Boat RockerThe Book of JoeThe Book of LiesThe Book of the DeadThe Bookshop on the ShoreThe Boy at the KeyholeThe Boy Who DaredThe Boyfriend ListThe Brass VerdictThe Breakout PrincipleThe Burden of ProofThe Case for GodThe Case of the Case of Mistaken IdentityThe Cemetery BoysThe ChemistThe Chosen OneThe ClosersThe Consciousness PlagueThe Conspiracy ClubThe Cuckoo's CallingThe Dangerous Art of Blending InThe Day I Ate Whatever I WantedThe Dead Fathers ClubThe Death of Bunny MunroThe Devotion of Suspect XThe Disreputable History of Frankie Landau-BanksThe Diviner's TaleThe DollmakerThe Dressmaker of Khair KhanaThe Dutch HouseThe Dynamite RoomThe Earth, My Butt, and Other Big Round ThingsThe EndThe End of Our StoryThe Erotic EdgeThe Essential KamasutraThe Family GeneThe First Fifteen Lives of Harry AugustThe Forgotten GirlsThe Fortunate OnesThe Geography of You and MeThe Gift of an Ordinary DayThe Gingerbread GirlThe Girl in 6EThe Girl in the GardenThe Girl on Mill StreetThe Girl Who Kicked the Hornet's NestThe Girl Who Played with FireThe Girl with the Dragon TattooThe Grief of OthersThe Grim GrottoThe Guise of AnotherThe Guy Not TakenThe Heart of YogaThe Hearts of MenThe Heretic's DaughterThe Ice QueenThe Ice TwinsThe Immortal Life of Henrietta LacksThe InseparablesThe InterestingsThe Keeper of Lost CausesThe Keeper of Lost ThingsThe Kings of LondonThe Language God TalksThe Language of SecretsThe Language Of YogaThe Last ChildThe Last MileThe Last Time We Say GoodbyeThe Male BrainThe Man from BeijingThe Man in My BasementThe Man Who Couldn't EatThe Map of True PlacesThe Marriage PlotThe Memory Book The Mermaids SingingThe Ministry of Special CasesThe MuralistThe Museum of InnocenceThe Mystery of the Third LucretiaThe Myth of LazinessThe NarrowsThe Necessary Death of Lewis WinterThe New YorkersThe NewleywedsThe NixThe NursesThe Only Girl in the WorldThe Opposite of InvisibleThe Other Side of the StoryThe Outcasts of 19 Schuyler PlaceThe Particular Sadness of Lemon CakeThe PastThe Penultimate PerilThe Perfect GirlThe PostcardThe Pregnant WidowThe Promise of a LieThe PyramidThe Qi Healing KitThe Quiet RoomThe ReaderThe Republican BrainThe Rest of the StoryThe Royal Baths MurderThe Rule of FourThe Rules of SurvivalThe Savage CityThe ScarecrowThe Second GirlThe Secret Life of BeesThe Secret of Lost ThingsThe Secret ScriptureThe Secret SpeechThe Secret Wisdom of the EarthThe ShallowsThe SharkThe Shock of the FallThe Silent BoyThe SisterThe Song of the Jade LilyThe Sound of Broken GlassThe SpindlersThe Stillwater GirlsThe Story HourThe Story of Beautiful GirlThe Sudden Arrival of ViolenceThe Summer ChildrenThe Survival ListThe Survivors ClubThe Sweet Relief of Missing ChildrenThe Sweetness at the Bottom of the PieThe Tail of Emily WindsnapThe Tenth JusticeThe Thing About JellyfishThe Third AngelThe TouristThe Treasure Map of BoysThe Trouble with Goats and SheepThe Unexpected Inheritance of Inspector ChopraThe Unfortunate Decisions of Dahlia MossThe UnquietThe Unseen WorldThe VegetarianThe View from SaturdayThe WaveThe Weed That Strings the Hangman's BagThe Weight of the NationThe Whiz Mob and the Grenadine KidThe Whole TruthThe WilloughbysThe Witch ElmThe Witch's BoyThe Wolves of AndoverThe Words We Live ByThe Wrong Side of GoodbyeThe Year of the FloodThe Year That FollowsThe Yin Yoga KitThings You Didnt SeeThirteen Reasons WhyThis Beautiful LifeThis Body of DeathThis Book Is Not Good For YouThis Full HouseThis Is HowThose GirlsThose Who Wish Me DeadTony & SusanToo CloseToo Much HappinessTooth and NailTouchTransformation TriburbiaTrue BelieverTrue CompassTrust ExerciseTruth & BeautyTwinmakerTwistedTwo Can PlayTwo Little Girls in BlueUnaccustomed EarthUnder Rose-Tainted SkiesUnder the HarrowUnder the InfluenceUnder WildwoodUniversal HarvesterUnlessUnthinkingUp in the AirVacuum in the DarkVery ValentineVisits from The Drowned GirlVoid MoonWaiting for SunriseWalkingWarWatching the DarkWatching YouWays to Die in GlasgowWe Are OkayWhat the Dog SawWhen My Heart Joins the ThousandWhen We Were AnimalsWhen You Are Engulfed in FlamesWhen You Reach MeWhere She WentWherever You Go, There You AreWhite HotWild AwakeWild ChildWildwoodWill They Ever Trust Us Again?Wolf in White VanWomen's Murder Club Box SetYoga SanctuaryYou Know Me WellYou Look Different in Real LifeYou Should Have KnownYou Will Know Me
[This review contains spoilers.] Lisa Genova made a name for herself with her novel Still Alice, about a woman with Alzheimer's disease, which was recently made into a movie. She has declared that her goal is to raise awareness of neurological conditions through her fiction, and her new novel, Inside the O'Briens, features Huntington's Disease. The O'Briens live in the Charlestown region of Boston, an Irish neighborhood of mostly working class people who stick close to the place where they were born and raised. Joe and Rosie have four children, and although they are all now adults, Katie, Megan and Patrick still live at home. Their other son JJ has married and he and his wife are trying to have a baby. Joe is a cop while Rosie maintains the home. Every Sunday the whole family eats together. They argue about everything. Rosie is in her own way a strict Catholic; the house is full of angels and other signs of her religion. She didn't want to use contraception since that goes against the teaching of their church, but after 4 children, Joe insisted. Their children are not so religious, but Katie is a yoga teacher, and she takes her practice seriously. Megan is a professional ballet dancer, and JJ is a firefighter, so three of the children have lives that involve a lot of bodily strength and control. When Joe eventually realizes that he has Huntington's disease, one of his main worries is whether the has passed on the gene to his children. Each child has a 50% chance of inheriting it.
The novel mainly follows Joe's journey in his developing symptoms, his explaining them away at first, and then coming to accept he has a serious disease. It is a series of hard moments as he endures both the physical and emotional symptoms, which include involuntary bodily movements, a lack of physical coordination, forgetfulness, irritability, and rages. He starts to see the effects first on his ability to do his job, which is demanding, with long hours often standing outside in the cold, dangers from criminals and local youth looking to get into trouble, and tedious paperwork to complete. This leads to them going to a doctor, and they get the terrible news, which is given suddenly, without enough preparation. The phrase "Huntington's" is mentioned, and then Rosie goes to the internet to find out herself what it means. Once they start to understand what they are up against, they have to tell their children, and then the children have to decide whether to get tested to see if they are carrying the gene for the disease. The children handle the news differently, and it leads them to reevaluate their lives.
The novel follows Katie more than any of the other children. She is open to new ideas, and she has started dating a man from New York, which is in itself a deviation from her parents' expectations. But the man is also black and not Catholic, and these might be deal-breakers for her parents. When her boyfriend announces that he is moving to the West Coast and wants her to come with him, it is really tough for her to consider such a change. When she finds out her father has Huntington's, she feels like she has to stay and be there for him, even though she really wants to get out. She also has to decide whether to get tested, and she is torn. She goes to a genetic counselor to start the process, but does not follow through.
Genova has a style of writing that helps bring the reader into the situation. The tight-knit community of Charlestown gives the novel plenty of character, and the importance of religion and tradition makes the story very distinctive, even if it feels like a throwback to an earlier era. They have to confront their own values when their children don't conform to their own ideas. Joe also has to think back to the past, remembering his mother dying in a state hospital. He was told then that she was an alcoholic, but now he realizes that she can't have had a drink in her last five years, yet she her body was moving around and she could hardly speak. He comes to understand she was dying of Huntington's, and he had misjudged her his whole life. The link between the generations is especially important here, especially when Joe learns he will have a grandchild. When Joe starts to feel desperate and considers ending his own life, it is the example he will be setting to his children that leads him to stay living.
Inside the O'Briens is a book full of information about Huntington's but more than that, it provides an example of how a family can deal well with what has been called the cruelest disease. That includes medical, legal, and psychological details. There are many emotional moments, and the relationship between Joe and his daughter Katie is very touching, especially when they start practicing yoga together, and he learns a new way to relate to his body. Some of the plot seems a bit canned, and there's a slight feeling that the story has been set out to show the variety of different permutations of reactions that are possible. But this is definitely a novel I would recommend for those wanting to get a personal perspective on Huntington's disease. It raises many ethical issues and provide enough detail for readers to engage in them in a thorough way, so this would also be a useful text for a course in medical ethics.
© 2015 Christian Perring
Christian Perring, Professor of Philosophy, Dowling College, New York