Inside the O’Briens by Lisa Genova

Family dynamics after a diagnosis of Huntington’s disease, exquisitely portrayed with poignancy and tenderness.


In her fourth novel, Inside the O’Briens, Lisa Genova (Still Alice) introduces a traditional Irish Catholic family who have to cope with a neurological disease.

Over several years, Joe O’Brien, a proud, hardworking Boston cop, has been increasingly irritable and quick to anger, and has trouble concentrating on his paperwork. He starts stumbling and dropping things; there are murmurs of drink or drugs. When they finally see a doctor, the O’Briens learn about Huntington’s disease, an inherited neurodegenerative disease that over the course of 10 to 20 years will rob Joe of his ability to move, speak and eat on his own. It’s been causing his short temper and confusion. And there’s a 50-50 chance that each of his children has it.

Each of these young adults has a decision to make: they can be tested for the gene marker that predicts Huntington’s or they can live with uncertainty. The eldest has been trying to conceive; a baby would be at risk, too.

Sympathetic, absorbing, multifaceted characters compel the reader’s compassion. While Genova’s background in neuroscience allows her to portray medical issues accurately, the heart of the O’Briens’ story is human: how each member of the family copes with the news of Joe’s pending mortality; whether each child chooses to be tested; how knowing or not knowing guides how they live their lives. Their insular Irish Catholic community is likewise evoked with sensitivity and precision.

Poignant and painful, warm and redemptive, Inside the O’Briens displays Genova’s established strengths in bringing neuroscience to the lay reader, and portraying the power of love.

This review originally ran in the April 14, 2015 issue of Shelf Awareness for Readers. To subscribe, click here, and you’ll receive two issues per week of book reviews and other bookish fun!

Rating: 8 sippy cups.

The Vacationers by Emma Straub

An eccentrically fun family vacation, with far more style and spunk than your average beach read.


The Vacationers by Emma Straub (Laura Lamont’s Life in Pictures) is peopled by charming, funny, expertly portrayed characters who feel very real and yet slightly fantastical.

The Post family is headed from Manhattan to Mallorca for a two-week vacation, ostensibly to celebrate: Franny and Jim are approaching their 35th anniversary, and their daughter, Sylvia, has just graduated from high school. Joining them will be their son, Bobby, with his girlfriend, Carmen, and Franny’s BFF Charles and his husband, Lawrence. However, Jim has recently left his decades-long career at Gallant magazine amidst shame and scandal, and his transgressions at work have followed him home. Sylvia’s big goal of the summer is to lose her virginity before starting college in the fall. Charles and Lawrence’s is to adopt a baby–a plan they haven’t yet shared with the Posts. Bobby and Carmen are on uneven ground; they have a secret to break to his parents, and it doesn’t help that the Posts have never liked Carmen. More secrets and scandals, new and old, will come to light under the Spanish sun.

Straub’s greatest strengths are her endearingly quirky protagonists and a plot with more twists than a European mountain road, but her secondary characters are also cleverly wrought. The Posts’ absent hostess, Gemma, is Charles’s second-best friend; Franny tries not to let that annoy her. Sylvia’s local Spanish tutor, Joan (“pronounced Joe-ahhhn”), is a delectable temptation for both Sylvia and Franny, but it’s a retired tennis pro who really turns Franny’s head. Luckily, a motorcycle-riding pediatrician becomes Jim’s ally in trying to re-win his wife’s heart. Despite the considerable dysfunction of this family, this tale about them has a surprisingly happy ending.

This review originally ran in the May 30, 2014 issue of Shelf Awareness for Readers. To subscribe, click here, and you’ll receive two issues per week of book reviews and other bookish fun!

Rating: 9 olives.

Crossing to Safety by Wallace Stegner

crossing to safetyIn the fine tradition of For Whom the Bell Tolls and Of Mice and Men, Crossing to Safety borrows its title from poetry – in this case, Robert Frost. I find this an interesting tradition; it does not always necessarily yield greater meaning, at least not for me (perhaps if I were better with poetry!), but I’m sure it does say something about the author and his tastes, and maybe about the book itself as well.

Crossing to Safety is a novel of four people, told in first person by one of them. At the beginning, our narrator Larry Morgan and his wife Sally have just traveled to Vermont to visit old friends; it becomes clear fairly quickly that Charity Lang is dying, attended by her husband Sid. These four have been best friends for decades, although they haven’t always been as close (especially geographically) as they’d like. Before spending much time in the Vermont of the present, Larry begins remembering their youth together.

Larry and Sally were newlyweds and new graduates during the Depression, when Larry got a one-year post teaching English at the University of Wisconsin at Madison. It’s not much – not much money, and not much security for the future; but they’re young, Sally is pregnant, and this is the Depression; they will take whatever they can get. Larry is determined to produce as much writing as possible. He wrings every moment out of every day: eating, sleeping, teaching, prepping for his classes, and writing. They meet another young couple, the Langs, and are impressed with Charity’s warmth and 1000-watt smile, Sid’s open heart and intellect, and not least, their money. Both Sid and Charity come from backgrounds entirely different from Larry’s and Sally’s; but despite being very wealthy, Charity’s ambition for Sid’s academic career makes the Langs no less dependent upon the university’s approval than the Morgans are. Strangely, despite vastly different financial circumstances (and during the Great Depression, when these things matter possibly more than ever), the foursome is able to form a singular bond. The Langs are generous without seeming to be; they honestly take pleasure in sharing, or need to share, and the Morgans receive gracefully and understand that they are giving a service, as well.

In fact, one of the main messages of this novel is that of this uniquely strong and loving friendship, which while it does contain some jealousies and insecurities, handles them with such grace that they don’t seem to matter; but another of its main messages, for me, was about class. It’s every bit as rare and surprising to me that such a wealthy couple and one that needs to work so hard for its money could be so close, and I think that’s at least as powerful a point as the first one.

Crossing to Safety is a quiet novel, in terms of having relatively little action. Arguably the greatest challenge faced by our foursome – certainly, by the Morgans – is Sally’s near-death from polio, which cripples her permanently; and yet this action takes place off-screen, as it were. Where many of the past memories are presented in flashback form, Sally’s experience is merely referred to. In other words, while there are certainly evocative, moving events in the lives of the Langs and Morgans, Crossing to Safety is overwhelmingly contemplative and rearward-facing: quiet, more than anything.

And yet, as Terry Tempest Williams quotes in her introductory piece to my edition, and as Stegner writes as Larry Morgan, this story is not dramatic in the sense of big reveals, cheating spouses, or large conflicts. And that’s okay – it’s beautiful, in fact, as a celebration of friendship (even while acknowledging flaws and hiccups) and life itself. The latter part of the book deals with end-of-life issues, and perhaps because I work in a hospital for a living, I found this section particularly thought-provoking. Here, as throughout, none of our foursome handles things perfectly, but we can still love them all.

Crossing to Safety is quiet and loving and lovely as a representation of marriage, friendship, ambition, contentment, and end of life. Stegner is a beautiful writer; I’m won over.

Rating: 9 picnics.

Love Anthony by Lisa Genova (audio)

This whole post below the book cover image is mildly spoiler-y. So, briefly: Love Anthony concerns two unrelated women and their respective pursuits of personal fulfillment and happy family lives. One has a little boy with autism. There is pain, and some redemption. If those few lines appeal to you, consider reading the book before you read this review.

loveantThis is Lisa Genova’s most recent novel, and I have now run out. (Her earlier works are Left Neglected and Still Alice.) This is not my favorite of her novels – that would be Still Alice. But it might be the one I found most thought-provoking.

The story jumps back and forth between the lives of two women who are connected only tenuously for most of the book. First we meet Beth. She lives on Nantucket Island year-round, and has three young daughters and a husband named Jimmy, who we learn even before we meet him is having an affair. She tells him to leave, and he does. For the bulk of the book, one of the central conflicts of Beth’s life is her struggle to deal with his infidelity and decide the future of their marriage and family. And then we meet Olivia. She is newly living year-round on Nantucket, in the cottage that she, her husband David, and her son Anthony have for years used as a summer home or rented out to vacationers. Olivia has recently experienced a series of personal tragedies, and she’s struggling just to hold it together. First, her son has autism, and the knowledge that he would never do all the things she’d imagined him doing – making friends, playing sports, dating, working, moving out of the house – would never happen, is devastating. Next, her son dies. And then her marriage falls apart, in the stress of dealing with Anthony’s autism and Anthony’s death.

Both Beth and Olivia, then, are working to cope with the unfairnesses that life has thrown their way. And here’s a twist: Beth is a writer, something she’d almost forgotten in her years of marriage and motherhood; but when Jimmy leaves, she pulls out her writing materials and begins working on a novel. Olivia is a former editor of self-help books, now working as a photographer (taking beach portraits for all those vacationing families on Nantucket). When the two women meet and discover this synchronicity, Olivia reluctantly agrees to read Beth’s novel when it’s finished. Are you ready for the big play? Beth’s novel is about a little boy named Anthony who has autism.

Beth and Olivia were both well-developed characters with realistic lives and problems. Both experience quite a bit of personal growth. I struggled for a time mid-book, because I didn’t really like either character; Beth was too much a perfectionist, sort of bitchy in her desire for the perfect family portrait in matching outfits, unconcerned with her children’s lives as long as they match and are unstained. And Olivia couldn’t love her son as he was, couldn’t get past her desire for a “perfect” or “normal” child. I was exasperated with both of them. But then they both changed, grew, and if I have had strong feelings about these characters then maybe the author reached her goal. I think there’s been a longer arc in this story than in Genova’s past books, which I loved more unequivocally, but which got me less involved. By the end, both women have changed enough that I liked them better. But they changed by becoming more perfect, which I cannot entirely buy into, so I retain some hesitation.

The friendship Beth shares with a group of women on the island (Jill, Georgia, Courtney, and Petra) is another area where I’m ambivalent. These women are diverse and likeable; but they feel like types more than real people, at least when assembled as a group. And they’re so good! There’s no cattiness, no back-biting. It’s a tight-knit, loving, supportive group, and call me cynical, but *I* have certainly never had a group of girlfriends so awesome; it’s all I can do to find one at a time, at best. They are a lovely part of this story, if they can be believed; but I am not sure they can be believed.

My central concern, however, is in the unscientific nature of the melding and meshing of Beth and Olivia’s lives, and the novel that they share. Beth’s novel turns out to be about Olivia’s son Anthony; the character in the book not only shares Anthony’s name, but his whole world. There is a metaphysical or otherworldly subplot. Is the dead boy Anthony speaking through Beth? I lost my patience here. Lisa Genova writes about hard science, and reliably – she is a neuroscientist by training – and that’s one of my favorite things about her work. So, then, for her to shift into this realm of possibly communing with the dead was jarring for me, and not what I was looking for. I have nothing against a good ghost story, but her work feels to me like it’s aspiring to realism, and I was bothered by the supernatural element. It didn’t fit.

On balance, I really enjoyed Beth’s and Olivia’s stories. Moment to moment, I was totally caught up in their lives and rooting for them. I was fully engaged, and I take my hat off to Genova who took me from not really liking either of her protagonists, to sympathizing fully; there was real growth and development. But when I zoomed out a little, I was unconvinced by and frustrated with several elements of the plot, and the type-casting of certain characters. For my money, her earlier novels were far more persuasive and easier to love wholeheartedly. That said – I am anxious for more. Lisa! Get to work!

As a side note, I found it curious that one of our characters is a woman writing a novel about a boy with autism, because Lisa Genova is of course a real-life woman writing a novel about a boy with autism. I can’t help but wonder how much of that is autobiographical, and I love the journey that line of thinking can take me down. Additionally, Beth’s writing process was fascinating to me, and I expect anyone else who dreams of being an author will feel the same. (I suspect that many avid readers fall into this category.)

Debra Messing, who plays Grace on the tv show Will and Grace, reads this audiobook convincingly, with the shifts, sighs, and varying volumes that represent speech vs. thought; she communicates emotion; a fine job. I recommend the audio version.

Rating: 6 white rocks.

book beginnings on Friday: Love Anthony by Lisa Genova

Thanks to Rose City Reader for hosting this meme. To participate, share the first line or two of the book you are currently reading and, if you feel so moved, let us know what your first impressions were based on that first line.


I am thrilled to be falling into another absorbing novel by Lisa Genova. I love how she combines hard science (neurology, no less) with women’s lives, families, and relationships. A double beginning for you today. Prologue:

It’s Columbus Day weekend, and they lucked out with gorgeous weather, an Indian-summer day in October. She sits in her beach chair with the seat upright and digs her heels into the hot sand.

And Chapter 1:

Beth is alone in her house, listening to the storm, wondering what to do next. To be fair, she’s not really alone. Jimmy is upstairs sleeping. But she feels alone.

I think these two snippets give an accurate portrayal of some of the tension in this story. If you’re considering reading it, try and avoid reading about it first, is my advice.

I am still loving Lisa Genova, one of my favorite recent discoveries. Check her out. And happy weekend!

Still Alice by Lisa Genova (audio)

stillaliceI have a favorite book of the year so far, you guys. Still Alice is one of the most remarkable books I’ve read in some time. I enjoyed Lisa Genova’s second novel, Left Neglected, very much. (I listened to that one as an audiobook, too.) But Still Alice gripped me from the first lines, and never let me go – I was riveted. Let me tell you more.

The two books have more than a few threads in common. Both feature married women, with three children, in male-dominated fields with all the requisite toughness and work ethic but also with plenty of feminine soft spots, struggling to reconcile the two; both live in Boston. One could easily surmise that these are attributes shared by the author, a Harvard-educated neuroscientist-turned-novelist. Where Sarah of Left Neglected had young children, though, Alice Howland has grown children: one lawyer trying to get pregnant, one doctor just finishing his medical training, and one relatively wayward daughter who has scorned college in favor of acting. Alice is a Harvard professor of psychology, and her husband John is also a Harvard doc, working with human cells & a possible cure for cancer. She is nearing her 50th birthday when the book opens, and shortly after it, she is diagnosed with early-onset Alzheimer’s disease. The story is concerned with the progression of her disease, the changes it wreaks on her life and the lives of her husband and three children, and their struggles (independently and as a family unit) to handle these changes. It is also centrally about Alice herself, as a person, what Alzheimer’s does to her and her reactions & dealings with that disease. Again, the author is a neuroscientist, so while I (thankfully) don’t have any experience with Alzheimer’s disease by which to judge this portrayal, I trust Genova’s ability to tell it truly.

I became deeply engrossed in this story from the very beginning. Although told in the third person, we are very much inside Alice’s head (call it third person limited, for which I like this explanation because of the example chosen!). Alice felt very much like a real, flawed-but-likeable person. I was occasionally exasperated with her choices: to fight with Lydia over her acting career, to fail to appreciate her, and to put off telling her husband about her diagnosis. But I always sympathized, and liked her throughout. I would like to spend a day or a week with this woman. In fact, in telling Husband about this story as I listened to it, I referred to her as my friend. This is not something I normally do with fictional characters.

I was deeply emotionally involved. If I was angry with Alice for not telling John she had Alzheimer’s right away, I was even angrier with John for his reaction, and his repeated failures to be supportive. I wanted to cry when they began considering their future. And I did cry, often, as the disease progressed and Alice’s family was – still flawed and imperfect, but earnest and effortful and loving in their handling of these events. I hope it’s not too much of a spoiler to say that I was charmed by the silver-lining aspect, where Alice’s relationship with Lydia grew stronger in this time of sickness. I pondered whether it was a bit too fictional-happy, to insert such a silver lining, and decided it wasn’t.

This is a sad story, certainly, and I cried more than a few times. (I finished this book in the gym, and it took great effort not to weep on the elliptical machine. What would people have thought?) But there is love, and hope, and strength; Alice keeps a certain dignity that made me love her more as she got sicker. I can see how this would be a painful read for someone whose own life has been affected by Alzheimer’s, but I’m inclined to think it might be worth the pain for the beauty it expresses.

If you’ve read the book or don’t care to, highlight the white text to read my spoiler-y discussion below; but if you intend to read this book, don’t.

I was saddened by Alice’s decision to plan her suicide, but I respected it. When she got so sick that she couldn’t execute her own plans, I found that sadder still. I wondered a little at Genova’s decision to end the story the way she did, with Alice fading into gray; I would have liked to know her final fate, when and how she died, whether John moved her to a place she never wanted to be (a “home,” or New York), but I think this way was for the best. That fade-to-gray is probably most like the end of Alice’s own understanding of things – most like Alzheimer’s disease.

Unlike Left Neglected, this book is read by the author, and when I heard that I was thrilled, because my author-narrated audiobook experiences have so far been 100% wonderful. Still Alice is no exception. Genova’s goodreads page tells us she’s an actress as well as a neuroscientist and novelist, so perhaps it’s no surprise that she delivers her characters feelingly (or that she wrote a lovely, passionate actress character into this book). For the record, I really enjoyed the audio reading of Left Neglected, too, but I would never pass up an author-read version, and highly, highly recommend this audio version of Still Alice.

This is without a doubt going to make my list of best books read in 2013. I am so relieved to see that Genova has a third novel out already, Love Anthony, and is working on a fourth – whew! I can’t say enough good things about this book. I love Alice.

Rating: 9 thingies.

Left Neglected by Lisa Genova (audio)

Left Neglected evoked strong reactions from me, which I think is always a recommendation.

Sarah Nickerson is in her late 30’s, happily married to Bob, with three children (Charlie, Lucy and Linus), and a successful career in a male-dominated hectic corporate world of 80-hour work weeks. She is accustomed to using every odd moment to send emails, make phone calls, or read up on work; she would be lost without her nanny Abby; a slight traffic delay costs her the chance to read to her daughter before bed. In other words, she likes her life, but it’s jam-packed-full with no room for error.

The error comes one rainy day on the freeway; a traffic accident leaves Sarah with a unique sort of brain injury called “left neglect.” She’s missing the left side of her consciousness of the world. She can’t find or use her left arm, her left hand, her left leg; she can’t see things or people on the left side of the room, her dinner plate, her world. She can’t conceive of left. Sarah wakes up in a hospital and has to laboriously relearn everything. Juggling international corporate intrigue with a staff of 1000’s is no longer her primary concern; she can’t even dress herself.

Sometimes post-accident Sarah’s whining and frustration with her condition annoyed me, and sometimes pre-accident Sarah irritated me with her material and work-related priorities. But overall, she was definitely a sympathetic character; and if I was sometimes mad at her, that only made our relationship stronger in the end. As in a real friendship, we had our ups and downs, and our bond increased through those trials.

I sometimes felt that Genova tried to maximize the angst. Sarah’s flashbacks to the childhood death of her brother Nate, and its repercussions for her present-day relationship with her mother, might have been pushing the psych-drama angle a little bit. But overall, it worked.

I was reminded of another book, My Stroke of Insight by Jill Bolte Taylor. I read that one pre-blog so no review here, but it touched me very deeply. Taylor’s book is nonfiction, and deals with a different brain injury; but the two are similar in that they describe a brain injury from the patient’s perspective, along with the recovery. I suffered a brain injury in a bicycle accident in 2007, and while I was lucky to suffer less severe injury than either of these protagonists, I still found myself identifying. My own recovery was fascinating to me and made me think about things I’d never considered before; when I read My Stroke of Insight a year or so later, it helped me look at my own experience and learn from it. Left Neglected held a similar self-referential interest for me. (To go even further out on a limb: I’m now doing physical therapy following my knee surgery, and trying to get back to mountain bike racing. The connection is vague and yet I can’t help but compare my frustrations to the fictional Sarah’s. Again, my injury is very minor by comparison. But the cycle of optimism and pessimism, frustration and success, crosses over.) All of this means that when Sarah gets annoying – failing to recognize how lucky she’s been; refusing to work hard with her therapists; wanting to give up and cry – I’m annoyed, and yet I understand, too.

The massive change in the way Sarah views her world – and not just in terms of right and left – may seem ambitious, even unrealistic, to some readers. This might be said too of Taylor’s change in philosophy in My Stroke of Insight. But in both cases it rang very true for me. I felt that I had traveled so far with the protagonists, both fictional and non, that I was right there with them at the end of their stories. Is my outlook unique? Possibly, but I doubt it. I think we’ve probably all had some life-changing experience (hopefully less painful than the ones detailed here) that allows us to get inside Sarah Nickerson’s head a little bit.

Maybe it’s odd that I’m drawing such a strong parallel between two books that are really rather different, but they both affected me strongly. In the end I give Left Neglected very high marks, and I’m interested in Genova’s earlier novel, Still Alice. For those who are curious, she does have credibility in this subject matter: she has a PhD in neuroscience. Check it out. And if/when you have/do, please let me know if this book touches you as it’s touched me. Here’s to being thankful for our health!

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