Still Alice by Lisa Genova

By Ekta R. Garg

December 2, 2015

Genre: Women’s fiction

Rated: Bookmark it!

My book club decided to read Still Alice. When the movie came out last year, it piqued my curiosity. Earlier this summer I got an Advanced Review Copy of Genova’s newest book, Inside the O’Briens, in which she tackles Huntington’s disease. I didn’t know at the time that using fiction to make people aware of challenging medical conditions was Genova’s…well, writing thing.

I did some enjoy parts of Inside the O’Briens, although I thought other parts could have been trimmed. But the book definitely achieved its goal: it taught me about Huntington’s. I’d heard of the disease but never knew much about it. In that regard Genova hit it out of the park.

Still Alice follows a similar pattern as Inside the O’Briens, but I think Still Alice is much better. Because Genova sticks only to the main character’s point of view, readers really get to know what early-onset Alzheimer’s is like. The result: a book that I’m still thinking about, despite finishing it almost four weeks ago.

Quick story recap: Alice Howland is a renowned cognitive psychology professor at Harvard. She’s got three grown kids and is married to a husband who has an equally esteemed career in the sciences. Alice has won awards, presented papers all over the world, and led her field with groundbreaking research. So when she starts to lose track of her things and forget appointments, she just thinks she’s stressed. The day she forgets how to get home—when she lives mere blocks from Harvard’s campus—Alice gets worried. This is more than stress, her logical, educated side tells her.

Still, she doesn’t want to admit anything’s wrong until her doctor delivers the crushing news that Alice has early-onset Alzheimer’s disease. What follows in the book is the way Alice handles the diagnosis, her prognosis, and the progression of this harrowing illness.

And it’s definitely harrowing. Author Lisa Genova is also a neuroscientist, which makes her books compelling and terrifying all at the same time. Compelling because she has the research and education chops to speak with authority on the subjects she chooses for her novels. Terrifying because in the two books of hers I’ve read, she’s written from the point of view of the characters undergoing the neurological crises.

I think Still Alice, in particular, touched me because I deal with and think about words all day long. Alice thinks about words and the way people communicate, so a disease like early-onset Alzheimer’s truly devastates her. As her disease progresses she starts losing the ability to tell people how she feels (because her brain is no longer able to process how to say the words) and also the ability to even know what words to use (at one point she can’t think of the word for “teenager” and calls them “medium children” with hard heads.)

Often I think I’m blessed because writing, unlike other professions, is something I can pursue for a long time. Recently I read The Homesman by Glendon Swarthout (the book club pick before Still Alice,) and in the end notes I read how Swarthout was writing until just a few years before he died. I want that to be me. I want someone to find me folded over my laptop, my latest manuscript open on the screen.

When I read Still Alice, however, it definitely shook me up. Alice is smart, educated, someone who stays active and busy. And at the age of 50 she gets her diagnosis. The age of 50. Within a few years she loses most of her ability to speak, and as she gets older, her doctor tells her before she loses her memory, things will get worse.

Early-onset Alzheimer’s is particularly terrible because while the patient’s mind is going all haywire, the rest of the body is fairly healthy. So the person could still live many years (well, until the patient starts forgetting to eat and forgets all the people around him/her and gets so freaked out by all the “strangers” that the person refuses to accept any food or nourishment from well-meaning family and healthcare providers.)

Ever since I’ve read the book, I’ve been spooked about forgetting things. I’ll make a mental list of things to do, and then when I forget one of them I start thinking, “What if I have early-onset Alzheimer’s?” Laugh if you want, but as we learn more about this disease and other forms of dementia it’s an issue I’ve thought about more than once.

It also doesn’t help that my paternal grandmother had some form of dementia toward the end of her life. I don’t know all the details, but I witnessed the dementia in its early stages so I know she dealt with something similar to Alice’s condition.

What surprised me, too, was how intricate Alzheimer’s disease is. Most people, including me (before reading the book,) think of Alzheimer’s as a disease where a person forgets things. It is that but also so much more.

The brain slowly loses the ability to judge spatial distances. At one point in the book Alice talks about the bumps and bruises she’s gotten because she struggles with knowing how far up or forward to lift her foot for a curb. Also, not only does a person forget others or memories, but as I mentioned a person also forgets words. Slowly, little by little, it’s like the brain forgets even how to form the words, never mind the actual terms used to name different objects. And you know that feeling when you see something familiar or hear something familiar—a favorite song from your teens, say, or your childhood home—and it triggers a memory? The brain forgets that too. The familiar thing and the memory itself.

In every story I write, I try to create a moment that will act as the emotional anchor. It may not necessarily be the climax, but I try to make it a moment that will stay with the reader long after s/he finishes the story. For me in Still Alice that “moment” happens when Alice, much deeper into the Alzheimer’s than she even realizes, comes across a computer file with a letter in it that she wrote to herself right after she got her diagnosis.

The healthy Alice is trying to convey something crucial to the advanced-Alzheimer’s Alice. The advanced-Alzheimer’s Alice can feel her former self’s compassion and the educated decision in the letter, but by the time she goes from downstairs to upstairs to follow the instructions her former self left she loses track of the directions and eventually forgets she came up to do anything at all.

She forgot the instructions in the amount of time it takes to go from the first floor of her house to the second floor. How many times have we jogged up the stairs with a particular directive in mind, completed the task, and gone back downstairs again? How would it feel to go from downstairs to upstairs (or vice versa,) reach there, and then look around the room wondering why (or, worse, how) we got there in the first place?

I enjoyed the book. I want to read it again. And I’m afraid to do so. But I can’t wait to talk about it with my book club when we reconvene in the second week of December and watch the movie together. I just hope…well, I hope I never have to deal with Alzheimer’s. At any stage. That may sound like a foolish thought, but it’s a fervent wish.