Friday 30 September 2016

Books: Family's battle with a deadly diagnosis

Fiction: Inside the O'Briens, Lisa Genova, Simon & Schuster, hdbk, 352 pages, €28.50

Published 26/07/2015 | 02:30

Acclaim: Julianne Moore won an Oscar for her performance in Still Alice, written by Lisa Genova
Acclaim: Julianne Moore won an Oscar for her performance in Still Alice, written by Lisa Genova
Inside the O'Briens

You may not be familiar with the name Lisa Genova, but you've certainly heard of her work. Her 2007 novel Still Alice, about a college professor's slow descent into the grip of early-onset Alzheimer's disease, was made into a film starring Julianne Moore, and the actress won several gongs at this year's awards season.

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Genova, a neuroscientist, originally self-published the compelling novel, which ultimately became a New York Times bestseller. She followed this up with a look at brain injury in Left Neglected and autism in Love Anthony. In her latest novel, Inside the O'Briens, she turns her scientific eye to another devastating diagnosis - that of Huntington's disease, a lethal neurodegenerative illness that can be passed from parent to child.

Joe O'Brien's mother died when he was 12 years old. She had been in hospital prior to her death and, ashamed, he had always believed that it was because of her alcoholism. But Joe has created a loving world of his own: he married his childhood sweetheart, Rosie, they have four grown-up children and the close-knit family never miss Sunday suppers together. He loves his job as a Boston cop and the camaraderie he shares with his friends and colleagues.

But Rosie begins to notice that all is not quite right with her 44-year-old husband. He loses his temper in shocking outbursts, his body betrays him as he fidgets and drops things. And she is not alone - his friends are beginning to wonder if he is drinking too much, which horrifies Joe as his mother's death had always haunted him.

Despite her husband's protests, she insists that he visits a doctor and he is eventually diagnosed with Huntington's disease. He is told that his symptoms will get worse and he will die within 10 years.

But much worse for Joe is the realisation that his mother was not a drunk. She too had suffered from the same cruel illness, and she had passed the gene to him, which means that his children have a 50pc chance of getting the disease. A simple blood test will determine their fate.

Genova looks at how one man's carefully constructed life can be shattered with a single sentence and, in Joe, she has created a character who is only too human - full of rage one moment and despair the next.

But what is even more compelling is the decision that his children must face - the eldest JJ is expecting his first child, Meaghan is a ballet dancer who has always exerted control over her body, Katie is a yoga instructor in the throes of first love, and young Patrick is already acting out.

As science advances, it is certain that more and more of us will face such dilemmas. Inside the O'Briens is divided between the reaction of Joe and that of his 22-year-old daughter, Katie, who isn't sure if she wants to know what her future may hold.

For this reader, it is the focus on Katie that is most intriguing. She is in love with a man she is afraid to introduce to her traditional Irish Catholic family and he offers her a future she had never dared to contemplate. But she is terrified of telling him about Huntington's and what a diagnosis may mean.

This is a thoughtful and engrossing novel that is a lot less bleak than its subject matter suggests. The O'Briens are a loving family, they have their flaws like any other, but they are determined not to be shattered by the sentence that life has handed down to them.

And it leaves the reader facing an uncomfortable dilemma of their own - who among us would really want to know if they are fated to develop an incurable disease?

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