Still Alice tells the story of Alice Howland, a 50 year-old linguistics professor at Harvard who first forgets a word in the middle of a speech, gets lost in Harvard Square on her regular running route, and re-introduces herself to people she just met at a party before she sees a doctor and discovers she has early-onset Alzheimer’s disease.
From there, we see how Alice’s family—husband John and children Anna, Tom, and Lydia—deal with the disease’s gradual and tragic effects on their mother. She forgets how to make her classic bread pudding at Christmastime; she gets disoriented in her own home and can’t make it to the washroom in time; she believes her mother and sister just died recently rather than decades ago; she goes to the lecture hall where she is supposed to teach and sits down like a student; she can’t remember how to dress herself; she doesn’t recognize her own daughter.
Author and Harvard neuroscientist Lisa Genova does an excellent job at making this Alzheimer’s story come to life. Her scientific background certainly helps in chronicling the progression of the disease on her main character, but she can also write well. Her prose is concise and yet evocative. She doesn’t heap on pathos nor romanticize the disease. The Alzheimer’s Association even endorsed it, so I’d say she hit the nail on the head.
Genova chose to tell her story through Alice’s point-of-view, a decision that is much discussed for its limitations and its strengths. While it skews the accuracy of the bigger picture for the reader, it also more tightly links the reader to what Alice is feeling and thinking. Perhaps the most poignant example of this is when Alice asks a question to a conference presenter at Harvard in front of all her colleagues, bringing up a great point that no one had thought of before. I was so proud of her for showing her colleagues and herself that she is still smart and has something to offer. And then Alice sticks up her hand a few minutes later and asks the exact same question to the presenter, this time getting embarrassed and pitying looks and not knowing why. I felt embarrassed for her too, even cringing a little.
The relationships between Alice and John and Alice and her youngest daughter Lydia are the most fascinating. Lydia and her mother don’t get along very well. Lydia loves theatre and wants to make it as an actress and her mom thinks it’s foolhardy not to go to college. John, like his wife, is a Harvard professor who increasingly can’t cope with how the disease is changing Alice’s life. He works more and more so he doesn’t have to be at home with her. “It’s killing me” he tells her, to watch her suffer like this. So when he gets a once-in-a-lifetime job offer in New York, he wants to move there with Alice since he says she won’t know the difference anyway. His daughters strongly resist the idea.
In the (rather surprising) ending, he does move, but on his own. He visits her on the weekends. This seems like such a selfish decision, but in conversations I’ve had with people since reading it, I’ve maybe grown a little more sympathetic to his decision and how something of this magnitude affects the caretaker. And yet I find myself asking what do marriage vows mean about “in sickness and in health” if not for times like this?
In contrast to her dad’s decision, Lydia sacrifices a lot for her mom. She enrolls in college in Boston (for theatre) so she can move in with her mom to look after her. It’s interesting how Lydia was the one who got along the least with her mom and yet understood her the best. The last scene in the book is beautiful between the two of them—a poetic exchange where the reader sees that the disease hasn’t taken Alice’s emotion away—her ability to feel and understand love. It doesn’t reside in the brain, as Alice worried about in the beginning stages of her diagnosis. It resides in her heart.
Alice is still Alice.