by Lisa Genova
Alice Howland’s life revolves around her work in linguistics in the Harvard psychology department, her husband, and her grown children. She is in the prime of her life at age 50: she enjoys excellent physical health, excels in her field of research, and takes pride in her family. Then one day, Alice becomes completely disoriented while merely blocks from her own home. This event acts as the turning point in her life; within months Alice is diagnosed with early-onset Alzheimer’s disease. John, Alice’s husband, and Anna, Tom, and Lydia, her children, struggle in various ways with the diagnosis and prognosis of Alice’s hazy future. The author describes eighteen months of Alice’s journey into the degenerative disease with incredible insight and from the point of view of the patient herself.
- Ms. Genova chose to tell the story from Alice’s perspective. While she uses a third-person limited narrator instead of first person, the way that the author conveys the story puts the reader into the shoes of the main character like no other book I have ever read. For example, on several occasions, the story was going along and all of a sudden I felt like I was rereading what I had already read. And I was! By “repeating” these events in the flow of the narrative, Ms. Geneva demonstrates how the mind of an Alzheimer’s patient works and pulls the reader into the story. Also, Alice’s expertise is in linguistics, so she prides herself on her ability to express herself eloquently; as she says, “Everything she did and loved, everything she was, required language” (74). As the novel (and the disease) progresses, the language Alice uses regresses. Her ability to use certain words disappears; she has an “appointment machine” instead of her trusty BlackBerry and doesn’t even bother wearing a “wrist clock” anymore (266).
- Little facts about Alzheimer’s disease and other dementias are tucked into the dialogue and descriptions. Whether all these tidbits have medical backing I don’t know, but even some things like the fact that Alice hates coffee reminded me of studies I have heard about coffee helps to ward off Alzheimer’s disease. Another example is that even early in her life with the disease, Alice demonstrates a desire for the known. She wants to be in her own home exactly how it’s always been. The reader can see how a change like a move could be devastating to dementia patients. Obviously, Ms. Genova did plenty of research for this novel, but it does not come across as didactic and preachy.
- The differing reactions of Alice’s husband and children demonstrate the various ways that “real life” people react to devastating news. I love how, though, Alice’s daughters especially choose to treasure the time that they have with their mother instead of denying it or ignoring it. In the beginning of the novel, Alice and her youngest daughter Lydia have a fairly volatile relationship, but ironically after the diagnosis, mother and daughter learn how to communicate despite their differences and in spite of Alice’s growing inability to express herself. Ironically, it isn’t until after Alice’s diagnosis that either woman can see, much less respect, the perspective of the other.
- I appreciate the different ways that Ms. Geneva demonstrates Alice’s descent into the deeper levels of Alzheimer’s. One example is her to-do list, which gets more and more specific as the disease progresses; simple key words no longer remind Alice of her obligations and she must give herself more information in order to complete the tasks she sets for herself. Another example is the “butterfly plan” questions she asks herself. Her answers to the self-administered questions illustrate the heartbreaking effect of Alzheimer’s disease–she eventually no longer knows where she lives or how many children she has.
- SPOILER ALERT! Alice wears a necklace given to her by her late mother that is a blue butterfly. The butterfly becomes a symbol to Alice of the freedom that the Alzheimer’s has taken away. When Alice decides to take her life in her own hands and plan for her eventual suicide, I was convinced that the outcome of this novel was going to leave me sickened and disheartened. I honestly could see no other way for the novel to end but with Alice’s death, especially since it is told from her point of view. However, I was pleasantly surprised to see that Alice’s well-laid plans were thwarted by her own inability to remember anything! The last few chapters and epilogue have a beauty in them that the rest of the book moves toward. In them is devotion, trust, and love. Had Alice killed herself like she planned to do, she would have missed out on so many good things in her life, and she would have stolen precious experiences from John and her children. Alice met and spoiled her grandchildren (even though she didn’t know who they were), and continued to live in an environment where her family loved and cared for her. John, Anna, Lydia, and Tom had the ability to show their love for Alice even beyond what she could comprehend. While living with Alzheimer’s disease (and living with someone with Alzheimer’s disease) is difficult, I know that benefits are there as well.
What Doesn’t Work:
- While I am sure there are some issues that could use some critiquing, this book hits too close to home for me to even say anything remotely negative. On that note, here’s a new section of my review that is totally not review!
Why This Book Could Also be Categorized as “A Book that Makes You Cry,” “A Book that Keeps You Awake at Night,” and “A Book that is Classified as a Horror Story”:
Here comes my personal relationship to the book. Feel free to skip this section, as it may or may not have anything to do with the book!
- My grandmother died from Alzheimer’s disease in 2010. She was 84. Reading Still Alice brought back all of the memories of watching her live with the disease. While Grandmother fit the stereotype of the elderly dementia patient (in contrast to the young and vibrant Alice), Alzheimer’s does not discriminate in how it affects its victims. I appreciate how Ms. Genova told the story from the point of view of Alice, rather than a caretaker. So much of the focus in Alzheimer’s care is on the caregiver and how the disease affects them (which it obviously does), but I think we forget that the person with the disease is still the same person despite being “gummed up with amyloid” (271). (Side note: remember the title of this book? That’s the conflict.) Alice’s voice revealed the fear that Grandmother must have felt, as well as the frustration she must have endured with the desire to express herself but the inability to do so.
- Yes, this book made me cry. The last book I can remember having the same effect was Marley and Me (and in my defense, I was home alone and pregnant! Crazy hormones.) In the latter part of the book, Alice gives a speech at an Alzheimer’s conference and tells her audience, “I’m losing my yesterdays” (251). I completely lost it at that point. The entire speech is incredible, but that line hit me as incredibly poignant. I thought of all the yesterdays Grandmother lost, all of the five-minutes-agos, as well as the tomorrows.
- Yes, this book kept me awake at night. I read this book over the course of less than 24 hours (something that hasn’t happened in a LONG time), and the night between I kept waking up trying to remember what was real and what wasn’t. That’s how good this writing is. Ms. Genova tricked me into thinking I was Alice, and it’s just about as scared as I’ve ever been. Which brings me to my next point…
- Yes, this book could be classified as a horror story. I cannot think of anything more frightening than to be in Alice’s (or Grandmother’s) position. I remember how near the end of Grandmother’s life, she spent much of it shaking and being so frightened of everything because she understood practically nothing of what was going on. In Alice’s case, though (and I hope in Grandmother’s), even though she didn’t know her daughters or grandchildren, she knew that she could trust them and that they loved her. SPOILER ALERT AGAIN! This is another reason that I am so glad that Alice’s plans for suicide did not work. Her love for her children and their love for her is so evident in the last few pages of the novel. How much they all would have missed out on if she had taken her own life! I saw this in Grandmother’s life as well. My Granddaddy so unselfishly cared for her up until the last few months of her life. He fed her, cared for her, and loved her like he promised to do even when she didn’t recognize him anymore. That “in sickness and in health” thing is true, y’all!
I’m not going to call this book the Great American Novel or anything like that, but I’m extremely close to labeling it a must-read. The premise is original and intriguing, and the perspective I gained from reading this novel opened my eyes to the version of Alzheimer’s disease as experienced by the patient. Hopefully this story is one that will become a part of history like so many other eradicated diseases, but for now, seeing this journey through Alice’s eyes will encourage empathy for those struggling with similar diagnoses. Alice’s story is intriguing and the language pulls the reader in from the very beginning. Ms. Genova has a way with words (some of my favorites come from the very first page: “cellular suicide” and “molecular murder”) that is original and beautiful. I think most people would enjoy and could benefit from reading it.
Mrs. Ethridge’s Report Card:
- My Rating: A-
- original storyline and perspective
- relevant to most people
- I love that Ms. Genova originally self-published!
- “Clean” Factor: C
- the language is a little rougher than I would like
- otherwise a clean read
- Book Clubishness: A+
- easy to read without being too elementary
- will inspire meaningful discussion
The movie releases on February 13 and stars Julianne Moore.
I would love to hear your thoughts! Have you read this one?
(Photo Credit/Amazon link: http://www.amazon.com/Still-Alice-Lisa-Genova/dp/1439102813/ref=tmm_pap_title_0?_encoding=UTF8&sr=1-1&qid=1423192533 )