Cape writer Lisa Genova shares some of the personal stories behind her best-selling books

In Love Anthony, Cape Cod author Lisa Genova delivers a compelling tale about the unexpected friendship that develops between two women struggling with very difficult questions—and the autistic boy who helps provide the answers. Inspired by her cousin Tracey’s autistic son, Anthony, Genova wrote the novel to raise awareness and inspire compassion for autistic individuals and their families, while simultaneously exploring the theme of unconditional love.

Though there are some similarities between the novel’s fictional character, Anthony, and Tracey’s son—for example, they are both non-verbal—Genova says the character is not based on the “real life Anthony.” Genova conducted extensive research for the book, including interviews with parents of children who are on the severe end of the autism spectrum and are non-verbal as well as boys and men who are high-functioning, such as those diagnosed with Asperger syndrome.

“There are pieces of my cousin and her son in [the novel],” Genova says, “but my great hope is that all people who are affected by autism feel that some of their experience is represented in this book.”

A Cape Cod resident, Genova, 43, has just completed her fourth novel. Her first three titles—Still Alice, which was published in 2007; Left Neglected (2011); and Love Anthony (2012)—have all appeared on The New York Times Best Sellers list. The titles are extremely popular with book clubs across the country and Genova has appeared on talks shows, such as Dr. Oz, to speak about her books. This year, as part of a community-wide program in the town of Bourne called “One Book, One School, One Community,” Bourne High School’s administrators selected Still Alice as a reading assignment for the entire student body—and the public was invited to read along.

In September, a film based on the novel and starring Kristen Stewart, Kate Bosworth, Alec Baldwin, and Julianne Moore in the title role, premiered at the Toronto International Film Festival.

During a recent interview with Cape Cod LIFE, Genova took time out of her busy schedule to talk about the inspirations behind Love Anthony and her other novels, and how and why she chooses such challenging topics to write about. “Every book I write is trying to answer a question I care deeply about,” the author says. “In Love Anthony, I am trying to answer the question about love and what it means to love someone unconditionally.”

Genova uses her novels as vehicles to provide up close and personal glimpses into the lives of individuals afflicted with diseases such as Alzheimer’s or Huntington’s—a genetic neurodegenerative disorder that affects muscle coordination and leads to cognitive decline and behavioral symptoms.

In Love Anthony, Genova introduces readers to Anthony, the only son of David and Olivia Donatelli, who begins to show signs of autism by the age of 2. On the severe end of the spectrum, Anthony is non-verbal and has difficulties socializing with other children. Through a unique narrative style, the author provides him with a voice by revealing his thought processes to the reader.

In a passage where Anthony is engrossed in his favorite pastime—lining up rocks along the family’s living room floor—the author offers readers a window into his world as he notices his mother playing alongside him. “My mother’s face is on the ground just like mine,” Anthony thinks. “Your line of rocks is beautiful, Mom! Does it make you calm and happy, too? Do you love lining up rocks, too? I wish my voice weren’t broken so I could ask her. But then I look more closely at her mouth, and I see my mother’s face is smiling, and I don’t need a voice to know her answer.”

From her research, Genova learned that many parents of autistic children often endure raw and painful emotions, which can range from frustration and sadness to feeling excluded by or from others. She addresses these feelings through emotional journal entries written by Olivia, Anthony’s mother in the novel.

Here, Olivia writes of an emotional trip to a playground where she sees other mothers nearby, whose children can play independently. “The other moms were free to sit together at one of the picnic tables,” the journal reads. “Felt like I was in eighth grade all over again—the awkward outsider, not part of the “in” crowd . . . I felt how lonely I am while I watched this group of moms. A group I won’t ever be a part of . . . I hated them and wished I could be one of them in the same breath.”

In a later entry, Olivia writes of an experience with her son that inspired another powerful emotion: joy. “And so there we were,” her entry reads. “The two of us lying on the deck together, smiling at the sky . . . Anthony sat up and shot me a sideways glance and a pleased grin that I swear said, ‘Wasn’t that awesome, Mom? Didn’t you have the best time looking up at the sky with me?’ And then he screeched and flapped his hands and ran into the house. Yes, it was Anthony. It was one of the best times I’ve ever had.”

Genova says it can be difficult for children with autism to express their emotions—especially love. Similarly, it can be difficult for parents to know if their love is communicated effectively to their autistic children. “Think about the ways we show and express love to the people in our lives,” Genova says. “If you have a child who cannot speak and cannot make eye contact with people, if he doesn’t like being touched or hugged, how do you show your love to him, and how does he express it back? Loving someone with autism—like Anthony—takes unconditional love. My cousin Tracey’s capacity to love is so much bigger than it was before her son was here. She learned that from him.”

With an extensive background in the sciences—Genova graduated from Bates College in Maine with a degree in biopsychology and earned a Ph.D. in neuropsychology from Harvard University—the author is well educated on the topics she writes about. And though she covers Alzheimer’s, autism, and other diseases and disorders in her novels, her stories are not filled with medical jargon—nor are they loaded with scientific data associated with the conditions.

Rather, the author combines her past experience as a working neuroscientist with her talents as a writer to create fictional pieces that are both rooted in truth and presented in a way that offers readers a personal experience getting to know someone living with a disorder or disease. “What fictional stories like Love Anthony can do,” Genova says, “is bridge the gap between the scary scientific world and humanity.”

Genova’s first novel, Still Alice, tells the story of a 50-year-old woman who is diagnosed with Alzheimer’s disease. Genova was inspired to research and write this story by another loved one: her grandmother, the late Angelina Genova. “My grandmother was diagnosed with the disease at 85,” Genova says. “As a neuroscientist interested in biology, I could understand what the disease was, but as her granddaughter, I wanted to understand what it felt like—from the very first symptoms—and how to have a relationship with someone who has Alzheimer’s disease.”

Genova’s writing career began in 2004, following a divorce. Faced with the decision of returning to her previous profession, or writing a book she had been considering for some time, she chose the latter. “My daughter was only 4 years old, and I wanted to do something that would allow me to spend time with her,” she says. With the idea for a story about a woman diagnosed with Alzheimer’s disease tugging at her, Genova began penning what would become the first of her three best-selling novels.

Getting the book published, though, reads a bit like a Cinderella story. While Genova was naturally passionate about her story, publishers did not immediately share the sentiment. After sending query letters to 100 agents—and receiving nearly as many rejections—Genova says she decided to take a risk and self-publish the book. She gave herself one year to market the novel and find a publisher. “I was selling the book out of the trunk of my car, through word of mouth—anywhere I could,” she says.

Two months before the end of the one-year deadline she had self-imposed to get the book published, The Boston Globe gave the book a favorable review, setting into motion a series of events that led to the novel eventually getting picked up by Simon & Schuster of New York. Still Alice would go on to spend 40 weeks on The New York Times Best Sellers list, and today there are more than one million copies of the book in print. The novel has earned several awards, including the 2008 Bronte Prize and the 2011 Bexley Book of the Year and has earned praise from writers throughout the publishing industry. Beverly Beckham, a longtime writer for The Boston Globe, wrote the following in her review: “After I read Still Alice, I wanted to stand up and tell a train full of strangers, ‘You have to get this book.’”

In the film version of the story, actress Julianne Moore plays the story’s 50-year-old Harvard University professor who is diagnosed with early onset Alzheimer’s disease. “The book has done very well,” Genova says. “I never dreamed it would be as big as it is and that it would be embraced on such a worldwide level.”

Genova recently finished her fourth novel, Inside the O’Briens, which centers on a family living with Huntington’s disease. She lives in Chatham with her family.