Lisa Genova, whose first novel, STILL ALICE, was made into an Academy Award-winning motion picture in 2014, has made a career of exploring medical/neuroscience issues through character-driven fiction. In her debut, the focus was on early-onset Alzheimer's disease. Now, in her latest effort, INSIDE THE O'BRIENS, Genova uses her background as a neuroscientist and her talents as a novelist to explore the impact of a fatal genetic disease on a close-knit family.

Joe O'Brien is the consummate Boston cop. He lives in Boston's historic Charlestown neighborhood, traditionally the home of working-class folks like police officers, firefighters and workers at the nearby shipyards. Joe, his wife Rosie, and their four adult children share a townhome in Charlestown, a house they inherited and could now sell for millions of dollars, but Joe and Rosie couldn't imagine living anywhere else but "Town."

"In addition to the portrayal of a family in crisis, it offers readers a terrific portrait of Boston, a thoughtful consideration of urban gentrification, and a very personalized story of the brave new world of genetic testing and how it affects individuals' self-conception and future choices."

Joe is only in his early 40s, but has been finding himself increasingly clumsy, forgetful and fidgety. Rosie and his kids have also noticed an increase in his near-violent outbursts of temper over the past several years. His colleagues have started wondering if he might have a drinking or drug problem, but he has always been conscientious about keeping his drinking under control. After all, his mother drank herself to death when he was still a child.

But as Joe thinks back on his family history, he wonders if there might be more to his mother's story --- and when the medical testing Rosie demands results in a diagnosis of Huntington's disease, he realizes that his mother must have had HD as well. Huntington's is a progressive genetic neurodegenerative disease for which there is no cure. It results in death 10 to 20 years after symptoms begin to surface, typically in one's mid-30s.

INSIDE THE O'BRIENS is not only the story of Joe's reaction to his diagnosis; it's also about how his four children, especially his younger daughter, Katie, respond and the potential implications for their own future health. Each of them has a 50/50 chance of carrying the gene that will result in an inevitable death from HD --- and all of them have the opportunity to be tested and to find out if they do indeed carry that gene. Katie (a yoga teacher) and her sister, Megan (a professional ballet dancer), are particularly scared about what a diagnosis would mean for their careers, which rely so heavily on the strength of their bodies --- not to mention for the rest of their lives, their desire and ability to have families of their own.

The book alternates sections between Joe's and Katie's points of view, effectively delving into their fears and anxieties about the disease, as well as their hopes for the future. In addition to the portrayal of a family in crisis, it offers readers a terrific portrait of Boston, a thoughtful consideration of urban gentrification, and a very personalized story of the brave new world of genetic testing and how it affects individuals' self-conception and future choices. And, in the end, despite its undeniably sad premise, INSIDE THE O'BRIENS is also about resilience and hope --- a sentiment that Genova, who concludes her novel with a call to action, clearly hopes to instill in her readers as well.