Inside the O'Briens

What a fantastic book sharing the genuine and authentic viewpoints of living with Huntington's Disease and/or being exposed to someone who has it.  This book does an amazing job showing the audience exactly what it's like to know someone with HD, be someone with HD, or be someone who has the HD gene in his/her family.  There is an unending amount of emotions that play into this disease from every angle.  Lisa Genova did a great job of sharing this with an audience that may or may not have any idea of what Huntington's Disease truly is.  

This disease takes a tremendous toll on someone and not just in ways that one would normally expect a disease to.  Due to Huntington's Disease being a genetic disease, it affects so many people beyond just the one person initially diagnosed with it.  In the book's case, this was Joe O'Brien.  A family-centered, middle-aged Boston police officer who has lived his entire life up until being diagnosed with no idea that Huntington's Disease even existed.  Through his diagnosis, he and his family are exposed to so many things that no one could have every prepared them for.  

While I could rave on and on about this book and how excellently it was written, I will just suggest that any and all readers take them time to read it or download the audio book for it!  You will not regret it.  As someone who has never met another person with Huntington's Disease or experienced its effects, I learned so much valuable information from Inside the O'Briens.  Not only is there an ample amount of HD knowledge to take away from the book, there is also great advice for those who live in fear of developing a disease or illness.  Living in a world where so many illnesses, diseases, disorders, etc happen around us everyday, it was enlightening to read advice from characters who have the (dis)advantage of already knowing their fate.  There are a few lines that really stood out to me as the book came to a close. 

"The thought is only terrifying if she chooses to be terrified.  The quality of her experience depends entirely on the thoughts she chooses.  Reality depends on what is paid attention to.  Whether she's gene positive or negative, she's determined to pay attention to living, not dying." (p. 335)

These statements are applicable to so many different situations in life.  In the character's case, they were applicable to her deciding right then and there that with or without the disease, her life will be focused on the same thing: living. 

Genova, L. (2015). Inside the O'Briens. New York City, NY: Gallery Books. 

Joe O’Brien

Current age of Client: 44 years old

Date of Occupational Profile Report: 4/19/18

Client Report	Reason the client is seeking OT services and concerns related to engagement in occupations (may include the client’s general health status)	Huntington’s Disease- chorea, temper outbursts, trouble focusing and paying attention, trouble remembering things, trouble carrying out gross motor movements, trouble coping with diagnosis
	Occupations in which the client is successful and barriers or potential barriers to his/her success in those occupations	-husband, father, grandfather, police officer, friend, community member, Boston Red Sox fan   -Struggles to maintain focus, control gross and fine motor movements, maintain temper, remember plans
	Personal interests and values	Maintaining prominent role within family, finishing out his duties as a police officer until the age he can retire, maintaining his self-image within his small hometown, Boston Red Sox, maintaining his independence,
	The client’s occupational history/life experiences	-H/o knee problems -Family h/o HD
	Performance patterns (routines, habits, & rituals) – what are the client’s patterns of engagement in occupations and how have they changed over time? What are the client’s daily life roles? Note patterns that support and hinder occupational performance.	-lives in a triple-decker home with his wife, 4 children and one of their spouses, and a dog; he currently resides on the bottom floor with his wife; occasionally there is not close parking available to his home -wakes up, showers/grooms, gets ready for work, work schedule can vary but often times he is there longer than the average 9 hours, comes home for dinner, occasionally walks the dog to clear his head after long days, prepares for bed, goes to bed -husband, assists with some household chores, father, grandfather, peer, police officer
	Aspects of the client’s environments or contexts, as viewed by the client	Supports to Occupational Engagement:	Barriers to Occupational Engagement:
	Physical	Lives on first story of family home and also home where he grew up	-Often driving for his job, which could become unsafe -Around handguns and other weapons on a daily basis
	Social	-Strong family support that live in same home -Strong work support from many lifelong peers that are also police officers -Known by many around the community that would help if knew the situation	-Living in small town also makes him worried that when people see his symptoms or learn of his disease that they will look at him and his family differently
	Cultural	Lives in a community that knows much about each other and would help one another	-Symptoms can mimic symptoms of drug and alcohol abusers, which worries him that he will be assumed to be one -Cannot seem weak at work where he is supposed to be seen as a respectable and strong police officer
	Personal	Wants to remain strong and present for his family so that they are not scared	Concerned that he will not be seen as the tough, respectable image he always has
	Temporal	Despite symptoms and problems of HD, he still has the time and chance to be present with his family and support them in each of their endeavors now that they are grown up	Wishes he could have just made it through the age of retirement so he could have spent more time home with his wife, children, and potential grandchildren
	Virtual	n/a	n/a
Context	Client’s priorities and desired target outcomes (consider occupational performance – improvement and enhancement, prevention, participation, role competence, health & wellness, quality of life, well-being, and/or occupational justice) (p. S34)	-be able to better manage the symptoms and side-effects of HD -be able to continue working as a police officer as long as he is safely able to -be able to spend quality time with his family -help himself and his family cope better with the circumstances of being diagnosed with HD