Alice Howland is 50-years-old and has achieved great personal and professional success. She is a tenured professor at Harvard in the field of cognitive psychology and a world-renowned expert in linguistics. Her husband John is also a respected Harvard professor and researcher in biology. She has three grown children, Lydia, Anna and Tom. Although she’s had some tragedy in her life (her alcoholic father killed her mother and sister in a drunken car crash that only he survived), Alice has a satisfying and full life. Although her marriage has operated on cruise control for several years as she and John have pursued their separate careers and she and her daughter Lydia disagree about Lydia’s decision to pursue an acting career instead of college, Alice has a satisfying life—filled with travel, teaching and family events.
But lately, Alice seems to be forgetting things more often—losing her train of thought in the middle of a lecture she’s given hundreds of times, leaving her BlackBerry in a restaurant, mixing up times for appointments. But one day while out running, Alice finds herself completely disoriented and lost—in the town where she’s lived for more than 25 years and on a route she’s run countless times. Flushed and panicked, Alice wanders around her home town until her world suddenly rights itself and she knows where she is. But the experience shakes her to the core, and more lapses cause her to visit her long-time family doctor. Is it menopause? Stress? Depression?
After several tests, her physician sends her to a neurologist, who conducts more extensive tests and gives Alice shocking news: she has early-onset Alzheimer’s disease. Initially reluctant to share the diagnosis with her husband, Alice finally shares her secret with him. Like Alice, he is unwilling to believe it and pushes for more tests. But the worst proves to be true, and they face a future that seems bleak and hopeless—a future where Alice will slowly disappear until the faces of those she loves are the faces of strangers and her ability to communicate (the linchpin of her professional life) disappears as her brain is ravaged by the disease.
This book is heart-breaking. I struggled to read the last 65 pages or so because I was crying so hard I could barely see the words. I’ve always known Alzheimer’s is a cruel disease, but reading Alice’s story—and “experiencing” Alzheimer’s from the patient’s point of view—brings to life the horror and the tragedy of the disease in a way that makes it all too real. Lisa Genova has done something special with this book; she has given a voice to people who are slowly and irrevocably losing their voice. She’s managed to bring her readers inside the mind of an Alzheimer’s patient and take them on the journey from momentary lapses in memory to a world where the man you’ve been married to for years becomes “the man who owns the house” and your daughters become “the mother” and “the actress.”
In many ways, the book reminded me of Flowers for Algernon by Daniel Keyes. In that book, a young man named Charlie with an IQ of 68 undergoes a special experimental procedure to increase intelligence, which seems to have worked successfully on a mouse named Algernon. The experiment works, and Charlie’s IQ increases dramatically. However, the improvement is only temporary and he reverts back to his initial mental capacity. In the story, which is written as letters and notes in Charlie’s journal, you can track Charlie’s progress by the way he writes. Initially his writing is very simple and full of spelling errors. Then as his intelligence increases, the writing gets more sophisticated and the spelling errors disappear. Then, as he declines, the writing reverts back to how it was in the beginning. That book also made me cry; you mourn the loss of Charlie as you see him beginning to crumble mentally after achieving a “normal” life.
In Still Alice, you experience the progression of Alzheimer’s as Alice does—repetitive conversations, leaving a room after talking to a long-time acquaintance and coming back moments later and introducing yourself to them as if you’ve never met before, losing vocabulary. As Alice deteriorates, you experience her losses and gaps in memory as if it is happening to you, and this makes for heart-breaking reading. At the end of the book, when she wonders why she can’t go to her home and wonders why she is with the “man who owns the house,” my heart was full of sadness. One device Lisa Genova uses to chart the disease’s progression is a series of questions that Alice devises to “test” herself before her dementia gets too bad. The idea is that if she can no longer answer the questions, she should open a specific file on her computer and follow the directions there for committing suicide. As the book progresses, the answers get shorter and more inaccurate—charting her deterioration. It was a brilliant device, and I was sobbing when Alice finds her letter to herself and struggles to carry out its instructions.
As tragic as this story is and as horrible as the disease is, Genova is also able to present some beautiful moments as well. As the disease progresses, Alice lets go of many of the things that kept her separated from her family—healing her relationship with her estranged daughter and allowing her to realize what is truly important to her. Although I wouldn’t wish Alzheimer’s disease on anyone, I thought Genova offered some slight reassurances that the disease itself may possibly protect the people suffering from it at the end—giving them a simplified and almost childlike existence. The ending scene between Alice and Lydia offered a kind of bittersweet ending—reminding the reader that love can still be alive despite the ravages of the disease.
My version of the book included an interview with Lisa Genova about her research and motivations for the book. The book itself was given the “stamp of approval” by the National Alzheimer’s Association, and Ms. Genova writes for the organization in a professional capacity. In addition, she holds a Ph.D. in neuroscience from Harvard University. I think this is worth mentioning because this isn’t a writer who imagines what Alzheimer’s might be like. She studied and researched it and worked hard to accurately capture the diagnosis process, symptoms, treatment options and progression accurately. I, for one, applaud her hard work and decision to write this book.
I think this book is a must read for anyone affected by Alzheimer’s disease. I pray that this disease never touches me or anyone I know. I cannot imagine anyone being unaffected by this book. It will rip your heart out, and I suggest you do not read it without having many tissues nearby. I haven’t been this emotionally affected by a book in a long time, and, for this reason, I must give it 4.5 stars.
The Whys and Wheres
I got this book from Paperback Swap after reading positive reviews about it on many other blogs. However, nothing prepared me for the emotional impact of this book. I’ve promised my copy of the book to Caite at a lovely shore breeze, and I will be sending it to her with a pack of tissues. I read this book for the Same Word, Different Book part of the Take Another Chance Challenge, and I will be writing my reviews of About Alice, Travels with Alice and Alice in Wonderland in another post.