Joe O’Brien is a Boston cop and father of four.  Youngest son Patrick lives with his parents, but his oldest JJ and JJ’s wife Colleen, and Joe’s two daughters (Meaghan and Katie) all live in the house Joe inherited from his father. Married to his sweetheart Rosie, and with all of his family around him—albeit on three different floors of the same building—Joe’s life is pretty sweet.

Until things start to go wrong. He’s in his late 30s when we first get a glimpse of what’s to come. His temper flares unexpectedly and his coordination occasionally suffers.

Fast forward seven years and 44 year old Joe only agrees to see a doctor because people are starting to think he’s an alcoholic. Joe blames an old knee injury for his body’s failures and unconscious movements, but there’s more and Rosie accompanies Joe when they’re referred to a neurologist.

Neither has heard of Huntington’s Disease (HD) before Joe’s diagnosis and they leave the specialist with reading fodder which will change their lives forever.

Unsurprisingly both Joe and Rosie collapse. The very-religious Rosie takes to more wine and prayer than usual and Joe remains steadfastly in denial. The police service is his life. He’s too young for retirement and would get no pension. The worst by far however is the fact that HD is hereditary and Joe’s children have a 50/50 chance of developing the disease themselves.

The oldest JJ’s still in his mid twenties and the usual onset of HD is mid thirties to forties. Life expectancy after symptoms appear is 10-20 years. And what comes between the onset and the end, isn’t always pretty. Joe knows. Although he didn’t realise it at the time, his own mother died with her family thinking she’d drunk herself to death.

Given the brilliant job author Lisa Genova did with Still Alice,  I expected Inside the O’Briens  to be traumatic and it was. Though not continuously. There’s quite a long lead-in but I sobbed so much in some sections I had to briefly put the book aside. (But… #spoileralert: I am a sook!)

Genova does a good job of unpacking HD for those of us not in the know. Some facts are inserted here and there. But mostly we learn as the O’Briens learn themselves.

The novel’s written in third person but from the perspectives of Joe and daughter Katie. Both are wonderful guides. I actually liked all of the characters in this latest book of Genova’s. They felt real. Their relationships felt real. Their problems felt real. We get very invested—particularly in Katie’s wellbeing—although all four children have the option of being tested to know if they carry the gene which will later see them contract the disease.

Naturally we readers ponder the dilemma, putting ourselves in the O’Brien family’s shoes.

Would I want to know?

I read a quote once which scared the bejesus out of me and resulted in a huge mindf*ck. It went something like… “If your life was a novel, would you turn to the last page to see how it ends?”

Yes. No. I. Don’t. Know.

My only (fairly minor) complaint about the novel is that the first chapter is somewhat redundant. It merely provides readers with a first hand example that Joe’s symptoms started seven years earlier. I think this could have been done differently… perhaps through an anecdote / family joke about something Joe did (seven years ago) for example. But… #whatevs. It wasn’t a deal-breaker, it just interrupted the flow somehow, although did set the scene for a few later time glitches (from my POV anyway!).

I know this book’s being promoted as “Genova doing for Huntington’s what she did for dementia/alzheimer’s” but I have to say I kinda balk at that a little. It makes it sound like she’s reducing life-threatening experiences to entertaining reading fodder. It does however, provide a very practical and moving insight into this disease for which there is no cure.

Inside the O’Briens by Lisa Genova published by Gallery Books will be released in Australia by Simon & Schuster and available from 7 April 2015.

I received a copy of this book from the publisher for review purposes.