Still Alice
by Lisa Genova

Pocket, 2009. ISBN 978-1-439-11688-3.
Reviewed by Susan Ideus
Posted on 02/27/2010

Fiction: Mainstream

Still Alice is beautifully crafted, emotionally evocative, thought-provoking, compassionate, and riveting. I rarely read a book straight through these days, but I could not put this one down. In no way do I mean to imply that this is a quick read or an insignificant one. To the contrary, Still Alice affected me as profoundly as any book I have ever read.

It is the story of Alice Howland, a tenured Harvard professor with a doctorate in Psychology. Her specialty is language formation and organization—a brilliant woman, a great teacher, a renowned researcher, a sought-after lecturer—who has been diagnosed with early-onset Alzheimer's. Early, as in her 50's, still at the pinnacle of her chosen and beloved career, still young enough to be anticipating further career advancement as well as retirement and grandchildren.

Alice relates her story in her own voice, and eventually in her own thoughts, as her faculty for speech diminishes much too quickly, albeit predictably, for this articulate and erudite woman—an especially cruel irony. Her mind knew, but she lost the ability to convey that inner part of herself. The reader travels each step of Alice's journey as she descends into the formless unknown, and unknowable, chasm of Alzheimer's dementia. Early on, her doctor insists that Alice always bring someone else along to appointments, since given the nature of her condition, she will not always be a good judge of what has been going on in her own life, or in the progression of her brain disorder.

For Alice, always the consummate organizer and scheduler, disorder is a good description of what became of her exterior life. What once made sense no longer did, the words she used with such precision were gone, and time and place lost context. After a while she could no longer participate in making decisions for herself and she slowly lost her independence. While frightened and frustrated and at times incredibly angry, her spirit remained intact. She continued to make her feelings and thoughts known as she was able. To the end, she fought for her dignity and that of other sufferers of dementia.

For Alice's family, there was fear of the unknown. Would her husband be able to, or indeed want to, take care of her as she slowly deteriorated? Himself a well-known research biologist, he had once shared so much in common with Alice. His educated grasp of the processes of disease gave him the tools to fight for her treatment, as well as insight into the probable futility of any cure. His frailty as a human made it hard for him to accept what was happening to Alice and mesh that with the future of his life as it had always been planned. Her children had to deal with the very real threat that her Alzheimer's was hereditary. One son and one daughter chose to find out their genetic predisposition through testing; the youngest daughter chose not to have the test. Their choices would have lifelong ramifications. So, this is also the story of Alice's family and the effect of a most puzzling and cruel and unpredictable disease on them. It is a story of triumph in the face of a disease has the ability to cause a family to come apart or pull together in a crisis.

The reader is not left without hope. As the book ends, we know that the core, the very innermost part of Alice, remains. Her career, her position in her family, her independence all stripped away, she retains the essence of the person who was Alice before Alzheimer's dementia wreaked havoc with all she was and all she knew. She loved and was loved.

Although this is a novel, there is much factual information in Still Alice. Genova's research was extensive, in both the medical aspects and the human. Few people in this day and age have not been affected by Alzheimer's, whether in their own family member, or that of an acquaintance. This book would be of great value to all of them. For myself, I will keep this book, reread it and share it. It is simply that good.

Lisa Genova holds a Ph.D. in Neuroscience from Harvard. Due in part to having a grandmother with Alzheimer's, she was drawn to this discipline. In researching Still Alice, she became more involved with the disease. She is a member of several dementia advocacy groups and is an online columnist for the National Alzheimer's Association. She lives in Cape Cod with her family. Still Alice is her first novel. Learn more on her website.

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