Accio Book Review: Inside the O’Briens

Every month, my library holds a reader’s advisory event called Beans n Books. Over cookies, tea, and coffee, a panel of 3 library staff members deliver book talks to an audience of about 30-40 people.  Each panel member presents 2 books, chosen based on a monthly theme.  This week’s theme was We Are Family: every family has their secrets, stories, and sagas.  This week was also my first time being a part of the panel, and I must say, it was so fun.

It was also a little stressful and nerve-wracking.  Stressful because the 30-40 people who usually attend are a very well-read group, and I stressed over picking titles that were engaging and enthralling and yet not too popular.  I didn’t want the majority to have read them already, otherwise I’d be preaching to the choir.  Nerve-wracking because I really did love the novels I chose, and I wanted my book talks to do them justice.

Needless to say, all was well as most people had not read either book I presented (Inside the O’Briens and Imagine Me Gone), and the audience said our panel was very engaging and enthusiastic.  I have to agree with that – I was lucky to be presenting with two very sweet, very energetic, and very friendly co-workers.  Go team!

But anyway, you’re here for a book review.

Below is the review I gave at Beans n Books on Inside the O’Briens by Lisa Genova, my new favourite novel.  (It will probably be your new favourite novel, too.  Or in the very least, your next Book Club book.  You’re welcome).



Inside the O’Briens by Lisa Genova

I’ve chosen to share with you all today the book Inside the O’Briens by Lisa Genova.  Lisa Genova is a NY Times Bestselling author, a neuroscientist-turned-novelist, and a yogi (as per her Instagram account, @authorlisagenova).  She lives in Massachusetts with her 3 children.  Oh, and she also has a PhD in neuroscience from Harvard (“About Lisa”, 2017).

Some of you may recognize this author if you’ve read or seen the film adaptation of her book Still Alice, in which she tackles Alzheimer’s.  Inside the O’Briens is her fourth and most recent novel, which was published in April 2015.

Now, before we even get to Inside the O’Briens, some of you may be wondering how a neuroscientist becomes a novelist.  I wondered this myself, so I did a little research.  In an interview with The Boston Globe in May 2016, Genova said that she started writing when her Grandmother was diagnosed with Alzheimer’s: “I didn’t know how to march through her dementia.  That lack of understanding kept me at such an arm’s length from her”. Though she started as a self-published writer, selling copies of Still Alice out of her car, she now has a career what she describes as “accessible stories about people living with neurological conditions who are ignored, feared, or misunderstood.  I see the stories as a vehicle for empathy and social change” (English, 2016).

If you’re interested in learning more about Lisa Genova, you can check out her website,

Inside the O’Briens has been on my reading list for at least a year and a half, ever since I heard about it through my mom’s book club.  Well, thanks to my new year’s resolution to read more, I finally got around to reading it.  And all I can say is I’m sorry I didn’t read it sooner.

At the heart of this novel are the O’Briens, a family of Irish heritage living in Charlestown, Boston’s oldest town, two years after the Boston Marathon Bombing. 43-year-old Joe O’Brien has a great life: he’s a Boston police officer, married to his high-school sweetheart, Rosie, who is a devout Catholic, and together they have four children, all in their twenties: JJ, Patrick, Meghan, and Katie.  Joe has no complaints really (minus a bum knee and a son who he thinks might be doing drugs).  He’s just looking forward to the day he can retire and enjoy his time with Rosie.

This Joe is not the one we’re introduced to on Genova’s opening pages, though.  We first meet a 36-year-old Joe, who can’t find his gun as he’s running late for work.  His stress over his missing gun quickly transforms into pure rage:

“He’s going to be late for roll call, and Sergeant Rick McDonough, five years younger than Joe, is going to have a word with him again or maybe even write him up.  He can’t stomach the humiliating thought of it, and something inside him explodes.

He grabs the cast-iron skillet on the stove by the handle and sidearms it across the room. It smashes a sizable hole in the drywall not far from Katie’s head, then lands with a resounding BANG on the linoleum floor. Rusty brown bacon grease drips down the daisy-patterned wallpaper like blood oozing from a wound.

The kids are wide-eyed and silent.  Rosie says nothing and doesn’t move.  Joe storms out of the kitchen, down the narrow hallway, and steps into the bathroom.  His heart is racing, and his head is hot, too hot.  He splashes cold water over his hair and face and wipes himself dry with a hand towel.

He needs to leave now, right now, but something in his reflection snags him and won’t let go.

His eyes.

His pupils are dilated, black and wide with adrenaline, like shark eyes, but that’s not it.  It’s the expression in his eyes that has him arrested.  Wild, unfocused, full of rage.  His mother.

It’s the same unbalanced gaze that used to terrify him as a young boy.  He’s looking in the mirror, late for roll call, glued to the wretched eyes of his mother, who used to stare at him just like this when she could do nothing else but lie in her bed in the psych ward at the state hospital, mute, emaciated, and possessed, waiting to die.

The devil in his mother’s eyes, dead for twenty-five years is now staring at him in the bathroom mirror” (Inside the O’Briens, 2015, p. 5-6).

That’s the Joe O’Brien we’re introduced to.  Wild, out of control.  But it isn’t until later we all (the O’Briens included) learn the reason behind this rage.

It’s Huntington’s Disease.

As Lisa Genova writes in the preface of this novel, Huntington’s Disease (or HD) is an “inherited neurodegenerative disease characterized by a progressive loss of voluntary motor control and an increase in involuntary movements… proceeding inexorably to death in ten to twenty years” (Inside the O’Briens, 2015, ).  It is also characterized by dramatic mood swings, disorganized thinking, OCD, paranoia, and memory impairment.  To date, there are no effective treatments, no cure, and no Huntington’s survivors.

It is also 100% genetic, meaning that each of Joe’s 4 kids have a 50% chance of having the HD gene.  While children of a parent with HD can take a blood test that will tell them if they too have the HD gene, there is no cure.  You simply live knowing HD is in your future.  Or, you choose to not take the test and to not know your fate.

Huntington’s Disease has been called the cruelest disease known to man (Inside the O’Briens, 2015, p. ).

So while Joe’s diagnosis and slow yet steady decline into the inevitable hell of HD certainly is a major part of this family’s story, Inside the O’Briens also pivots around the genetic fate of each of the O’Brien children.

JJ is a firefighter, and his wife, Colleen, and him have been trying to start a family.  Patrick is a bartender and probably isn’t going too far in life. Lately, he’s been coming home drunk or doesn’t come home at all. His father is worried he’s on drugs, and his Catholic mother is turning a blind eye to the fact that he stays at a different girl’s place every week.  Meghan dances for the Boston Ballet, and Katie, the youngest O’Brien, is a Yoga Instructor.

None of them are older than 25, but they are not only faced with their Dad’s lethal HD diagnosis but they must decide how much they want to know about their own futures.  Do they take the blood test? What if they are gene positive? What if they’re not? What if they’re not but their siblings are? Can they handle the constant anxiety of not knowing? Can they handle an HD positive result?

At times, Inside the O’Briens was a difficult and somber read, as we as readers bear witness to Joe’s physical and mental decline, and the humiliation, depression, and frustration that accompanies HD.  We are there as Joe’s fellow officers think he’s drunk on duty; we’re there as Joe is stripped of his badge and gun; and we’re there as Joe and Rosie have to make difficult financial decisions.

But we’re also there in the remarkably hopeful moments. We’re there as Joe tries to find the honour in living and dying with HD.  We’re there as his children rally, and mend strained relationships.  And we’re there as the O’Brien family learns “to define life not by fear but, instead, by love” (from the inside cover jacket of Inside the O’Briens).

In a book talk that Lisa Genova did for Chapters Indigo (which you can watch on YouTube), she says that the ultimate lesson of Inside the O’Briens is that “through the power of family, love, and gratitude we can triumph over any hardship”.

And this is a lesson that seems to have resonated with a major audience, as Inside the O’Briens has won numerous awards.  According to Genova’s site, Inside the O’Briens has won a People Magazine Pick award, was #12 on the NY Times Bestseller list, and was the #1 hardcover fiction title in Canada in 2015.  Inside the O’Briens was also named an Indie Next Pick and Library Journal called it one of the best books of 2015.

All in all, if you’re looking for a book with lovable characters, a novel that will challenge you to the core, and a story that is ultimately hopeful in its depiction of the power of love and family, I would highly recommend that you add Inside the O’Briens by Lisa Genova to your “To Read” list.


“About Lisa”. (2017).  Retrieved from

English, B.  (2016, May 9).  Author Lisa Genova turns scientific fact into fiction.  The Boston Globe.  Retrieved from

Genova, L.  (2016, April).  Inside the O’Briens. New York, NY: Simon and Schuster.


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