I'm concerned about this book on a number of structural levels. Let's list them here on paper so they're not all knocking around in my head all day.
1. I think it takes too long to get Joe diagnosed.
2. Mentions of 4/15/13, Boston Marathon, makes this all happening in present day. If I want to advance Joe's HD at all, even assuming he's at least 7 years in from page 1, we have to go into the future. At least 3 years, probably 5? Do you want to write about these characters in 2016, 2018? Is that too weird? You can drop out all reference to 4/15, but then the Red Sox references to post season play will have to jibe with previous seasons. That's doable. But I like the mentions of 4/15 and how it has affected Joe. Readers will be wondering if I don't mention it. Pink elephant in the room. Must figure out how to reconcile all this.
3. Switching over to Katie's pov now feels like it took too long. Maybe if I introduce her sooner that will give us the chance to know her, care and place her story in advance of her having to be concerned with HD. It might also help "space out" Joe's story over time more. I could make the kids a bit younger at the beginning of the story, allow for more time to go by before mention of B&E (and first mention of 4/15). I like that.
4. Not taking Joe all the way to end stage. I think I want to leave him vulnerable, in full courage, no longer able to walk or talk much (think Meghan).
5. Joe's mother, Ruth. Maybe we should be hearing from her. Make this a true generational story. Ruth's story with HD is one of ignorance, shame, isolation. I like this idea of Ruth, Joe, and Katie chapters to portray the different phases of HD: Nursing home/late stage; diagnosis/early and middle years; at risk/gene status questioning/symptom hunting. But man, that scares the shit out of me because that's A TON more work that I haven't even imagined yet.
Let's say that Joe's story drives the narrative. He's the powerhouse of this book, so keep going with his story. Maybe imagine Ruth and Katie separately and write their chapters as smaller vignettes aimed at revealing the generational tentacles of HD, how this is Joe's story but it is a repeating tale.
Thinking of that family tree again. Shaded circles and squares....