Best-selling neuroscientist-turned-novelist Genova, author of several popular stories based on the experience of suffering debilitating diseases—notably Still Alice (2009), about a woman with early-onset Alzheimer’s—now tackles the impact of Huntington’s disease on one blue-collar Boston family.
Patrol officer Joe O’Brien is third-generation Irish in Charlestown. A tough cop with a soft interior, a loving wife and four adult children, Joe “doesn’t do doctors” but is going to have to learn, because there’s no dodging the diagnosis heading his way—one that Genova outlines on her opening page: Huntington’s is “an inherited neurodegenerative disease characterized by a progressive loss of voluntary motor control…proceeding inexorably to death in ten to twenty years.” Not only is there no cure, but there’s a 50 percent chance that Joe’s children will carry the gene, too. Genova’s straightforward storytelling lays out this unhappy scenario with maximum empathy as she switches between the perspectives of Joe and daughter Katie, a 21-year-old yoga instructor. While the parents worry and the siblings bicker and confront—or don’t—their fears and options, Genova conveys the facts of HD through encounters with doctors and genetic counselors, continuing the education as Joe’s symptoms intensify and the disease, or its possibility, undermines and redefines jobs, finances and relationships. Minor events do occur, but the stiflingly circular topic of the disease drives everything—Joe’s mood swings and suicidal thoughts, his wife’s wavering faith and Katie’s on-and-off wish to know her own fate. Genova’s intention once again is acceptance, and the wrung-out reader bids farewell to the family at a relatively calm and united moment.
This journey to a place of mindfulness, while inevitably affecting, often reads like fictionalized campaign literature for a worthy cause.