Loss and Lucidity: Reviewing “Still Alice” by Lisa Genova

“She, Alice Howland, was sitting on a cold, hard chair next to an empty chair in a neurologist’s office in the Memory Disorders Unit on the eighth floor of Massachusetts General Hospital. And she’d just been diagnosed with Alzheimer’s disease. She searched her doctor’s eyes for something else, but could only find truth and regret.” 

We often mourn the loss of loved ones. To realise that someone you’ve known and loved your entire life will no longer be by your side when you wake in the morning is a most heartbreaking ordeal. 

Second to that is realising that someone you’ve known and loved your entire life no longer remembers you. Their eyes no longer light up in recognition when they see you, and they regard you how they would a stranger or an acquaintance: polite and civil, but distant. Sometimes even with hostility. 

Prior to reading Still Alice by Lisa Genova, I’d never thought much of Alzheimer’s disease. I regarded the condition with a detached complacency, associating it with those advanced in age. And while it is true that Alzheimer’s tends to affect people over the age of 65, that makes it no less difficult to accept for both sufferers of the disease and their loved ones. 

But Still Alice centres around a fictional high-achieving Harvard professor who discovers that she has early-onset Alzheimer’s disease at the unexpectedly young age of 50. Gripped by an overwhelming sense of helplessness and grief for the person she once was, Alice wrestles with the disease in a desperate attempt to retain her sense of identity. 

“More and more, she was experiencing a growing distance from her self-awareness. Her sense of Alice—what she knew and understood, what she liked and disliked, how she felt and perceived—was also like a soap bubble, ever higher in the sky and more difficult to identify, with nothing but the thinnest lipid membrane protecting it from popping into thinner air.”

A professor of cognitive psychology specialising in psycholinguistics, Alice is presented as an avid lover of language. Naturally, one of the most painful losses she has to bear as an Alzheimer’s patient is slowly losing the ability to communicate, comprehend, and to be comprehended — all of which require at least some mastery over language. 

“She thought about the books she’d always wanted to read… She had experiments to perform, papers to write, and lectures to give and attend. Everything she did and loved, everything she was, required language”. 

As a former linguistics student myself who loves reading, writing, and anything to do with language in general, I related to this on a personal level. The thought of being unable to read my favourite books, convey my thoughts coherently or express myself creatively through writing is truly unbearable. 

The book further explores Alice’s distress over losing her sense of identity. Being a lifelong academic, she prides herself on her intellect, independence and brilliance of mind. These qualities, so fundamental to her sense of self, were snatched away from her by Alzheimer’s, leaving a gaping hole in its wake. 

“She’d always been addressed with great respect. If her mental prowess became increasingly replaced with mental illness, what would replace that great respect? Pity? Condescension? Embarrassment?” 

Alzheimer’s is already a devastating blow to a regular person; what more to someone who relies entirely on her cognitive and mental abilities to make a living, and to derive purpose from life. The book does an excellent job at illustrating how Alice, a highly successful and accomplished individual who tied her self-worth to her intelligence and credentials, fell apart when she wasn’t able to live up to the sky-high standards she set for herself. 

“In the expansive grandeur that was Harvard, there wasn’t room there for a cognitive psychology professor with a broken cognitive psyche.”

Another central focus of the story is how Alice’s respective family members deal with the news of her disease, and how they attempt to overcome it. Previously complex familial relationships are complicated even further by the onslaught of Alzheimer’s. Most heartbreaking of all is when Alice slowly becomes unable to recognise those dearest to her. This change is demonstrated through how they are labelled in the later chapters of the book—Anna, her eldest daughter who gives birth to twins, becomes “the mother”. Lydia, her youngest daughter who aspires to pursue a career in acting, becomes simply “the actress”. Her husband John becomes “the man”, and at one point she even calls him “the kind stranger who had saved her life”. Names become foreign, terms of endearment non-existent. 

“This disease will not be bargained with. I can’t offer it the names of the United States presidents in exchange for the names of my children. I can’t give it the names of the state capitals and keep the memories of my husband.” 

Still Alice calls for Alzheimer’s patients to be treated with genuine understanding and compassion rather than patronisation. The book highlights how sufferers of the disease are often viewed with fear, cast out from their social circles, or even looked down upon. Negative connotations of mental instability and insanity are often associated with Alzheimer’s, making it extremely difficult for patients to continue with lives of normalcy within their communities. At one point, Alice compares Alzheimer’s to cancer, drawing rather interesting distinctions between the two with regard to societal perceptions: 

“[While] a bald head and a looped ribbon were seen as badges of courage and hope, her reluctant vocabulary and vanishing memories advertised mental instability and impending insanity. Those with cancer could expect to be supported by their community. Alice expected to be outcast. Even the well-intentioned and educated tended to keep a fearful distance from the mentally ill. She didn’t want to become someone people avoided and feared.” 

Despite all the bleakness that Still Alice appears to perpetuate through its detailing of Alice’s gradual degeneration, the book ultimately conveys a strong sense of empowerment in opposition to Alice’s helplessness. As seen from the title itself, she insists on remaining still Alice and refuses to allow the disease to take over the very core of her being. 

“Is the part of my brain that’s responsible for my unique ‘meness’ vulnerable to this disease? Or is my identity something that transcends neurons, proteins, and defective molecules of DNA? Is my soul and spirit immune to the ravages of Alzheimer’s? I believe it is.” 

Alice treasures her moments of lucidity and learns to live in the moment, refusing to let lapses of memory and function define her. She lives out the rest of her days taking comfort in the knowledge that she has lived an incredibly fulfilling life, even if the future is wrought with uncertainty and difficulty. Still Alice is about an Alzheimer’s patient, but ultimately it’s also about a remarkable woman who has lived her life to the fullest, pursued a path filled with passion and drive, and made a positive impact on the lives of the people around her. 

All in all, Still Alice is a haunting depiction of the destructive effects of Alzheimer’s on the human mind. The writing, far from being clinical, is real and raw—a story being told instead of medical facts being recited (though there is no doubt that this book is well-researched). Complex dilemmas are explored, difficult questions asked, and hope eventually prevails. This is a must-read if you’re hoping to get a better understanding of the disease through the perspective of an Alzheimer’s patient.

“My yesterdays are disappearing, and my tomorrows are uncertain, so what do I live for? I live for each day. I live in the moment.”

 

By: Megan Soh