Still Alice

Still Alice is an easy read in one sense: competently written and accessible, with many of the qualities of a page-turning novel. But it is also hard to read, in that it compellingly details the early stages of Alzheimer’s disease from the first person perspective. Alice, a 50-year-old Harvard professor, is diagnosed with early onset Alzheimer’s. The story is about how she and her family struggle as the disease progresses.

The author, Lisa Genova, is a scientist: a neuroscience teacher and researcher. This is her first novel. She uses her science background and extensive research into the disease to make the facts and effects of Alzheimer’s realistic and her empathy and writing talent to bring the story alive. Much non-fiction literature about disease makes grim reading; much literature for family caregivers is unrealistic in its expectations. This novel describes more of how people are than how they should be in an ideal world.

Alice’s husband John is a decent man, but his emotional withdrawal — at least from Alice’s point of view — is poignantly true to life. The different approaches of her three adult children sometimes clash and, again realistically, they start to talk about Alice as if she isn’t there. Pre-existing family tensions are exacerbated by the crisis. Meanwhile, we see the gaps begin to appear in Alice’s cognitive awareness. She hangs on to the career that has defined her until it is apparent that she can no longer do her job. She believes she will know when it is time to stop working but, inevitably, she is no longer a reliable observer of her own behaviour. She is determined to make her own decisions and even goes so far as to leave herself a self-administered test and instructions on her BlackBerry, but she doesn’t know what she will need to know once her grasp of the world weakens.

There is humour. Anyone who has experience of Alzheimer’s disease will know that it helps a lot, especially in the early stages, and it helps in fiction, too. Still Alice conveys this and other information about the disease, though subtly enough that it doesn’t come across as a lot of how-to advice. The book skirts that particular pitfall skilfully. It is a successful balancing act.

The writing is transparent enough, with occasional flashes of poetry. There is a lot of straightforward story-telling:

She seemed young enough to be a graduate student, but by December, Alice would have at least recognized even a first-year student. She remembered Marty mentioning that he’d hired a new postdoctoral fellow, a woman.

“Are you Marty’s new postdoc?” asked Alice.

The woman checked with Dan again. “I’m Dan’s wife.”

“Oh, so nice to finally meet you, congratulations!”

No one spoke. Eric’s gaze bounced from John’s eyes to Alice’s wineglass and back to John, carrying a silent secret. Alice wasn’t in on it.

When Alice receives her diagnosis, she seems to split apart from her physical body:

“…  I’m sure, Alice.”

Alice.

The sound of her name penetrated her every cell and seemed to scatter her molecules beyond the boundaries of her own skin. She watched herself from the far corner of the room.

Genova has created a work of fiction that simultaneously provides a lot of information that will be much appreciated by those with a family member with some form of dementia. But Still Alice stands on its own as a novel and Genova is a author worth watching.

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