Book 76: Still Alice

Still Alice by Lisa Genova

When I saw this recently at Barnes and Noble, I remembered seeing it on Nicole's list of top ten books of the past decade on a discussion on the CBR's FB page. Otherwise, I am not sure if I would have picked this up since I don't know anyone with Alzheimers and don't necessarily have an interest in the topic. The novel was incredible, though. I've noticed sometimes it's harder for me to review and write about novels that I really liked, especially when they address deeper topics, because I never feel like I will be able to properly communicate just how impressive they were. As a result, I actually finished this two weeks ago but I've been a little intimidated to write about it.

Still Alice is the story of Alice Howland, a fifty year old professor at Harvard. After noticing that she is becoming more forgetful in odd ways, and finding herself lost on Harvard Yard, a place she has walked by every day for the past thirty years, she becomes rather frightened that there is something wrong with her. While at first she wants to believe it might be menopause, her disorientation makes her fear something more serious, and she tells her regular doctor she wishes to see a neurologist. She is quickly diagnosed with early on-set Alzheimer's (Genova says she tooks some liberties here for plot-purposes - often men and women suffer from the disease for several years before it is diagnosed because doctors tend to think of other reasons for the symptoms rather than Alzheimer's for people in their forties and fifties).

Her family cope in different ways, and have different views of how she and the disease should be treated. There is a sense at the beginning of the novel that even though Alice and John love each other, they have grown a bit distant - they no longer walk to work together, for example, and later Alice thinks that she wishes she rather than his work had been his passion. Alice is very intelligent: after all, she is a cognitive linguistics professor at Harvard, and the idea of slowly losing her entire identity and what has defined her scares her. As a result, she comes up with a set of five questions to ask herself daily to determine if she is still mentally capable or if she should commit suicide - the Alice at the beginning of the novel does not want to be around for the very end, but doesn't want to kill herself at this point and lose what time she does have left as herself with her family. I thought it was incredibly interesting to watch her answers as the novel progresses because I don't think it's quite what the Alice that came up with the questions had in mind. What Alice determines to be an appropriate answer changes over time. If, for example, she orginally asked for an exact date, by the end, Alice considers the response of a season enough.

In ways this reminded me of some debates I've seen online about quality of life and disabilities. While some people might think they would rather die than be disabled in a certain way, it actually disregards people who live with that disability and still find happiness. Or what they would actually do in that situation. Obviously, with Alzheimer's, it's much more complicated, but what Alice once defined as the necessities for happiness are no longer the same by the end. Even though Alice can no longer do most of the things she once did by the end of the novel or recognize many people, she still feels moments of pleasure and happiness. So at what point does life stop being life or become not worth living? Late in the novel, John asks Alice if she still wants to be here, and she says, "yes, I'm not done. I like sitting here with you." They are talking about completely different things, but even in her deteriorated state, Alice can still experience pleasure.

The novel is told from Alice's perspective, though in the third person. As the disease progresses, the writing becomes simpler in some cases. The reader sees things the way Alice sees them but remembers them better, such as when she meets a person twice in the same evening. I thought it was incredibly well done, and as I said, I don't know anyone with Alzheimer's but this felt very realistic to me, and it also didn't feel like the novel was being too heavy-handed or sentimental despite the topic.