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Inheritance

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A profoundly moving novel about two women in very different worlds, whose lives are shaped by a single fatal gene.

In 2016, while in the early stages of IVF, Rose is shaken by the discovery that she carries a dangerous mutation of the BrCa1 gene. She begins to ask questions about her family history, and particularly her grandmother Nellie, whose early death left a hole in their family that was never quite filled. As the certainties in Rose’s life start to crumble around her, she becomes fixated on the shadowy figure of Nellie. Who really was this woman, and could her secrets reveal the way forward for the granddaughter who may share her fatal gene?

Inheritance tells the stories of two similar women in very different worlds, exploring how our circumstances – and the time and society we live in – can collide with what we’ve inherited to shape our lives. It’s a breathtaking and profoundly moving exploration of love, death and the dignified beauty of a quiet life.

In 2019, writer and General Practitioner Dr Kath O’Connor died from ovarian cancer while working on the final draft of Inheritance. Her partner and family, with Kath’s writing mentor, Inga Simpson, completed the manuscript so that Kath’s dream of publication could be realised and this beautiful novel could be shared. Royalties from the sale of the book will be donated to WomenCan: Funding Gynaecological Cancer Research.

320 pages, Paperback

First published January 21, 2023

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230 people want to read

About the author

Kath O'Connor

1 book1 follower
Kath O’Connor was a general practitioner, writer, swimmer and medical editor. She had essays and articles published in Eureka Street, The Australian Family Physician and the Medical Journal of Australia. Inheritance was completed after Kath won an Affirm Press mentorship. She was diagnosed with ovarian cancer in 2015 and wrote this novel while living with cancer, through many treatments and their side effects. After Kath’s diagnosis, she discovered that she shared a BrCa1 gene mutation with her grandmother, who died from the same disease in 1950. Kath lived in Castlemaine with her partner and their animals and died in 2019 at only 45 years old.

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Displaying 1 - 28 of 28 reviews
Profile Image for Rosh ~catching up slowly~.
2,284 reviews4,626 followers
May 31, 2023
In a Nutshell: A novel with an emotional story and an even more poignant backstory. I wish it had worked better for me, but the writing was too meandering, and the plot not exactly as promised.

Story Synopsis:
2016. Rose, an oncologist, is planning to go for IVF. During the initial testing, she discovers that she is a carrier of a mutated BrCa1 gene, which makes her highly susceptible to certain types of cancer. While she deals with the shock of this news, she learns about her grandmother Nellie, whose early death from stomach cancer was traumatic to the family. Rose also has to deal with her aged father’s health situation, which adds to her mental load.
The story comes to us in the alternating perspectives of Rose – written in the third person present tense, and Nellie – written in first person past tense.


First the backstory of the novel:
Author Kath O'Connor was a writer and General Practitioner in Australia. She was diagnosed with ovarian cancer in 2015 and wrote this novel while living with cancer, through many treatments and their side effects. After Kath's diagnosis, she discovered that she shared a BrCa1 gene mutation with her grandmother, who died from the same disease in 1950.

In 2019, Kath died from ovarian cancer while working on the final draft of Inheritance. She was just 45. Her partner and family, with Kath's writing mentor, Inga Simpson, completed the manuscript so that Kath's dream of publication could be realised. Royalties from the sale of the book will be donated to WomenCan: Funding Gynaecological Cancer Research.

I opted for this novel after reading the above note in the blurb. I thought this novel would be a poignant read about two women battling cancer. While this was partly valid, the end result was quite mixed for me.

Bookish Yays:
✔ The author’s experience as a medical practitioner is visible in all scenes related to medicine or health. Medical details are woven into the writing almost casually and without feeling exaggerated or complicated for us lay readers.

✔ Nellie’s historical timeline covers the medical aspects even more brilliantly, as her battle with stomach cancer comes across as emotional and genuine, especially because of being written in first person. Moreover, the cancer treatment of those days is also written accurately, presenting a sharp contrast between then and now.

✔ Rose’s timeline involves her relationship with her partner Salima, and her own father Ernie. The former offers a realistic look at a mature lesbian relationship, while the latter shows the difficulty of dealing with aged parents who can be quite adamant.

✔ I loved the cover, which so beautifully depicts the intertwined nature of Nellie and Rose through their shared genetic tragedy.


Bookish Nays:
❌ Salima’s background (Pakistani from Lahore) somehow doesn’t feel authentic. While I liked the representation, some parts of the portrayal just didn’t ring true to my South-Asian eyes.

❌ Each timeline wove in multiple elements in addition to the cancer-related theme. Rose’s track had her dad’s drunkenness and resultant health issues, and also references to the refugee crisis, courtesy his earlier work as an immigration lawyer. Nellie’s timeline, in addition to covering her cancer, also includes her friendship with rebellious Ruth, and their involvement with the communist and feminist movements. The disparate topics left me feeling annoyed because I was keen on knowing mainly about Nellie’s cancer and Rose’s genetic mutation and its effects. The rest felt like distractions.


All in all, the core arc of Nellie’s cancer is well-written and gut-punching. But the rest of the tracks diluted the overall impact of the book for me. Maybe if you go in better prepared to read a story with various hard-hitting issues instead of expecting a cancer-dominated plot, you will relish this poignant read better.

3 stars.


My thanks to Affirm Press and NetGalley for the DRC of “Inheritance”. This review is voluntary and contains my honest opinion about the book.




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Profile Image for Bek Ledingham.
11 reviews1 follower
February 19, 2023
A poignant story of a woman who finds out she has a gene that makes her very high risk for cancer. She finds out it’s come from her fathers side and his mum died young of ovarian cancer as she navigates the path of mastectomy and oophorectomy to reduce her risk.
It’s a story of difficult decisions, suffering and strength.
The author wrote it while she had ovarian cancer and this was published after her death.
Authentic, beautifully written.
Profile Image for Emma Fisher.
6 reviews2 followers
May 1, 2023
A beautiful parallel of two stories. As a future medical professional I loved reading the details of medical treatment and gaining further insight into Rose’s perspective. It’s also a salient reminder that we don’t control our genetics and we must choose for ourselves how to spend our precious time and energy. Very thankful to have read such a special book from Kath O’Connor that supports gynecological cancer research in Australia.
1,188 reviews
February 7, 2023
(3.5)
What drew me to the novel was the story of its publication. Its author, Dr. Kath O’Connor, had died in 2019 from ovarian cancer before completing the draft of her novel. Those close to her worked to finish the manuscript, its publication making real O’Connor’s dream.

Knowing the backstory clarified the personal significance of the author’s subject. In 2016 oncologist Rose must deal with her discovery that she carries the BRCA1 gene and with the choices she must now make regarding her future. Moving between 2016 and 1945 in dual narratives, O’Connor reveals the fate of Rose’s grandmother as she faced ovarian cancer and her impending death, carefully drawing the reader’s attention to the contrast between the treatments and lives of these two women. Each of the women’s stories was presented with sensitivity and detail, placing the health issues in the broader context of their very different lives.

I am not particularly a fan of the multiple narrative structure. I find the switching back and forth somewhat disturbs my focus. However, I understand the author’s intention in adopting this convention to trace the link between the women as Rose searched through her family history to learn more about the woman with whom she shared the gene. Overall the portraits were engaging.
Profile Image for Jane.
195 reviews
April 15, 2023
At first glance this novel may seem a little depressing; Nellie's story in 1945 does not end well for her, as she is diagnosed and treated for ovarian cancer; in 2016 Rose discovers she has the BrCa1 gene, responsible for breast and ovarian cancers. Yet it is not as sad as one might imagine; told from the point of view of each woman, in alternate chapters.
Rose and her partner are planning IVF treatment to begin their family, yet Rose has reservations which are not brought into focus until her recalcitrant father, living on a country property, has an accident and she needs to go care for him when he is discharged from hospital. This is her first taste of time to herself for introspection, as she discovers her link to Nellie, and her inheritance of the gene. There are several other characters which are drawn well, and add interest to the novel. The relationships of the characters to each other, and to their past, is well told.
Sadly, Kath O'Connor died before she could realise publication of her novel, yet at her partner's and family's insistence, Inga Simpson, her writing mentor, was able to bring the novel to publication.
Profile Image for Samantha Bones.
117 reviews4 followers
March 15, 2023
I was a little concerned when I read the blurb and publicity surrounding this book that it would be incredibly grim. Whilst it is very moving the storytelling also has a lightness to it that I didn’t expect. I really enjoyed the multiple layers used to flesh out Rose’s family history. The book was so many things: part detective story, part historical fiction, part love story and a clever exploration of the complicated and often troubled relationship between Rose and her father.
One negative for me personally was the editing/proofreading. I found multiple errors where the incorrect word was used: broach instead of brooch, flier instead of flyer and on the last page of the book the main character was referred to by the wrong name. I’m sure it will be reprinted when hopefully these and any other errors can be amended.
Profile Image for Christine Yunn-Yu Sun.
Author 23 books7 followers
August 29, 2023
Inheritance, published after the death of its author Kath O'Connor at the age of 45, attracted much media attention earlier this year. Not just because February was Ovarian Cancer Awareness Month.

The novel itself is a triumph, described as “limpid, deeply empathetic”. It was praised as “a remarkable testament to life”, “a beautiful book”, and “an incredibly strong debut”.

O'Connor's work was compared with Georgia Blain's Between a Wolf and a Dog, as Blain, too, died from cancer while working on her manuscript. It reminds this reviewer of Andrew McGahan's The Rich Man's House and Kala Heinemann's Pink Punk Mum – both were published posthumously, their authors taken by cancer.

What is it about death that casts such a shadow over our lives? It injects an icy fear into our hearts, a relentless warning that life should be lived to its fullest while there is still a chance. Think of the ghostly whisper from Dead Poets Society: “Carpe diem, seize the day. Gather ye rosebuds while ye may.”

On the eve of the first anniversary of the death of a beloved family member, this reviewer “reads” Inheritance as an audiobook narrated by Brigid Gallagher. It is a beautiful and thought-provoking encounter, thoroughly powerful and deeply immersive.

An impressive narrator, Gallagher brings the book's many characters to life, starting with how Nellie's husband does the “most perfect impression” of former prime minister John Curtin, “complete with the long pauses and the rolled R's”: “I call on you to eat your rabbit and your vegetables... The call is national. The call is individual, for 'no one else can do your share'.”

Gallagher does Nellie's voice slightly higher-pitched, perfectly conveying the self-sense of a woman trying to manage family and farm life in 1945 regional Victoria after surrendering her higher education and plans for a brilliant career. Aware that she will soon die from cancer, there is a mixture of forlornness and melancholy in her voice that tugs at the listener's heart. In contrast is the firm, thoughtful voice of her friend Ruth, a political activist who will profoundly shape the lives of Nellie and her descendants.

Then there is the calm, reflective voice of Rose in 2016, an oncologist searching for the origin of her BRCA1 gene mutation that, without a total hysterectomy and a bilateral mastectomy, will cause her early death from ovarian cancer. In contrast are the grumpy voice of Rose's father and the strained voice of her motherhood-aspiring partner, two forces that threaten to pull her life apart.

As Nellie contemplates her impending death and its impact on her two young children, and as Rose considers her life's options, we are further confronted by the important issue of human rights, including those of women and refugees. The narrator's tender, empathetic voice elicits that little echo in our hearts, whispering: How would we choose if we were the characters in the book?

A gifted author voiced by a talented narrator, exactly the way the book should be heard. Highly recommended.

Note: This book review was originally titled "A tender and poignant novel" and published under the title "A review of Inheritance: A tender and poignant novel" by Ranges Trader Star Mail, August 29, 2023, P.14.
Profile Image for Lisa (Insta: serenity.of.books).
223 reviews10 followers
November 22, 2022
This book took me by surprise – while I was reading it, I thought this is a good book & I enjoyed it but I’ve been surprised how much I have thought about it after finishing!

Inheritance by Kath O'Connor is a thought provoking and emotional read about a woman, Rose, who finds out she has a mutation of the BrCa1 gene which greatly increases her risks of both breast and ovarian cancer. As an oncologist, she is used to seeing her patients battle cancer and the impact this has on their lives so has many mixed feelings when she discovers her own situation. To make things even more complicated, she is having to return to care for her cantankerous father in the rural town where he lives after he suffers the repercussions of years of being an alcoholic. While there, she discovers through old papers that her paternal grandmother, Nellie, passed away from ovarian cancer in the 1940’s and therefore, discovers where she has inherited the hereditary faulty gene from. Rose becomes fascinated discovering more about Nellie’s story that her father has never shared with her. Told from the perspectives of Rose and Nellie over 2 timelines, 2016 and 1940’s, we uncover more of each of their lives and both the differences and similarities of facing cancer in very different times in history.

I found the storyline interesting and, how the treatment for cancer, both societally and medically, has changed over time. The medical content is very detailed, and I felt as a reader it gave me a good understanding of what both women were going through. There were some characters which I wish were developed further so I could understand them a little better and there was one plot line which left me with a few more questions than answers.

After finishing, I discovered the author, a doctor herself, passed away in 2019 at only 45 years old from ovarian cancer while finishing the final draft of this book. Her family and writing mentor finished the book so her dream of publishing could be realized. After she received her diagnosis in 2015, she discovered she shared the BrCa1 gene mutation with her grandmother who died of the disease in 1950. It broke my heart to read this story was inspired by such tragic reality.
But it warms my heart to hear royalties from the sale of the book will be donated to WomenCan: Funding Gynaecological Cancer Research and for that reason alone, I really hope this becomes a best seller and many women in particular can read this moving story.

Thanks to Netgalley and Affirm Press for sending this book for honest review. All opinions are my own.
Profile Image for Leanne.
817 reviews9 followers
December 24, 2023
Enjoyable, easy read which tells the story of two women, two generations apart; a grandmother and granddaughter who never got the chance to meet. Told by way of dual narratives, we meet Rose, an oncologist who is preparing for IVF in 2016. While undergoing preliminary testing, she discovers she carries the rare BrCa1 gene, which makes her a high risk of developing breast and ovarian cancer. This impacts on the clear future that she, and partner Salima had mapped out for themselves. It is while Rose is reluctantly taking time out to care for her irascible and demanding father who is suffering ill health due to his alcoholism, that Rose discovers that her grandmother, Nellie Ferguson must have also carried the gene as she died very young while Ernie, Rose’s father, was just a boy. We learn of Nellie’s early life and the latter stages of her illness in a storyline from 1945. This is a very poignant part of the book as we witness the suffering experienced by someone with this disease in earlier times. Also interesting was how the death of a beloved family member was handled with children back then.
Profile Image for Corinne Johnston.
953 reviews
April 15, 2023
I approached this book with some trepidation, knowing the author had died of Ovarian Cancer, knowing one or more characters may have OC, as the first anniversary of my best friend's death from OC had just passed. Beautifully written, the medical component in easy to understand prose, this is really a 4.5* from me. A slight quibble is that when we go back to 1945 or so, within those chapters are earlier years, if only they'd have been noted or in italics or something, would have made the fllow a little easier to read and comprehend. Such a loss to Australian literature, such a loss to her loved ones. Hopefully before too long researchers will give us diagnostics tools for this dreadful disease.
539 reviews2 followers
December 4, 2023
Inheritance has two storylines. In 2016, during initial testing for IVF, Rose discovers that she carries the BRCA gene mutation. While in 1945, Rose's paternal grandmother, Nellie, is diagnosed with ovarian cancer. These mirror the author's life. Kath O'Connor was living with ovarian cancer and died in 2019 before the book was finished. Her family and mentor completed the book after her death.

This isn't an action packed book. It's slow and meandering, but this is fitting for the subject matter. It was interesting to learn about cancer treatment in the 1940s and I was moved by Nellie's interactions with her young son.
Profile Image for Danielle McGregor.
525 reviews9 followers
December 28, 2024
A moving and powerful tale - especially as you begin the story knowing that the author passed away from ovarian cancer prior to completing the novel.

Two women’s stories told side by side, interlinked. Nellie’s first person story as she battles stomach cancer before cancer treatment was well honed (1945), was impactful and sincere. Rose’s story about her potential IVF journey with her partner, Salima intertwined with her difficult relationship with her alcoholic father, Ernie was again, impactful.

It’s not a fast paced story but it is engaging, well crafted and authentic. The fact that the author had a medical background is evident but not in your face.

Well worth a read - 4.5 stars.
31 reviews2 followers
March 5, 2023
A great read - I will miss hearing more of these wonderful characters

This book captivated me right from the start. As the storyline developed I was fully invested in the lives of all the characters and have found myself thinking of them long after finishing the book. It was beautifully written with great depth and understanding. A must read for sure.
Profile Image for Liane Flynn.
147 reviews
May 3, 2023
This is about Rose and her grandmother Nellie, about relationships - Rose with her alcoholic dad and Nellie and her friend Ruth - a pre lesbian relationship in another time. About life, making the best of relationships within a social context.
Engaging read.
Profile Image for Nora Nora.
1,047 reviews2 followers
February 19, 2023
Not really a review but just want to say I am so happy this book was published and my thoughts are with Kath’s family and friends.
Profile Image for Essie.
195 reviews1 follower
March 9, 2023
It has been a long time since a book has touched me so much. The writing is beautiful and insightful. Kath O'connor is a loss to the literary world. I never read a book twice, except maybe this one.
Profile Image for Sian.
16 reviews
March 16, 2023
Me on the train listening to this audiobook: 😭😭
430 reviews
April 6, 2023
Audio book. I should have concentrated more on it. Pretty good, connections in many ways across the generations.
Profile Image for Matt Eustace.
18 reviews
April 15, 2024
Interesting look at the concept of cancer inheritance and the way in which medical science has come so far. Able to keep the humanity throughout.
Profile Image for Penny O'shea.
455 reviews4 followers
June 25, 2023
I really enjoyed this book that tells the story of two women coming to grips with cancer and how it affects their lives. These women are grandmother and granddaughter, telling their stories 70 years apart, and the similarities and differences are well depicted. A moving tale that tackles some difficult issues and delves into family & friendship dynamics, ultimately leaving me smiling and crying, often at the same time.
Profile Image for Alma G.
192 reviews7 followers
June 29, 2023
Easy to read, enjoyable. Keeps you reading. 3.5 stars. In this instance, the dual narrative didn’t annoy me, it added to the story and depth.
Profile Image for Lisa.
376 reviews8 followers
December 12, 2024
Second review after a re-read for book club. I read this in novel form this time and have increased my rating from 4 to 5 stars. I'm not sure if it was the format change or the re-read but I really felt I appreciated the storylines even more the second time around. This novel is about life and the value we place upon both our own and others, particularly for women. Time will erase the majority of us, many leaving nothing beyond a trace in registry records, but then is there still value in the family and relationship building we create within our lifetimes? Teaching compassion, showing love and caring for those around us can be equally if not more important than being recognised for achievements.

Read as an audiobook, this is a beautifully touching novel about family, women, medicine intergenerational trauma and ovarian cancer. It is made all the more poignant by knowing the author was a GP who passed away from ovarian cancer prior to completing it and it has been published with the support of her family and mentor. Definitely a good read.
Profile Image for Rebekah.
247 reviews2 followers
May 2, 2023
This was a gorgeous and at times heartbreakingly real read. The author used some medical jargon that may be unfamiliar to a lay audience, and the ending was a little rushed, but as a GP who's best friend is an oncologist, it all rang very true.
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