Book Review: “Still Alice” (2007)
by Alan F. Zundel
I avoided reading this book for a long time. Several years, I think, although I don’t really remember. No dementia jokes, please.
My sister sent me the novel and highly recommended it as a look inside the deteriorating mind of a woman with early-onset Alzheimer’s disease. Our mother suffered from dementia for many years at the end of her life.
I lived across the country and was not a caretaker for Mom, nor was I able see her frequently. Because of that, from my point of view she declined very rapidly. My reactions to her skipped all too quickly from “I am losing her” to “I’ve already lost her.” In the last years she did not know who I was and seemed to dislike me when I spent time with her. I never felt that from her before, and it was painful.
I wasn’t ready to revisit those memories, so I avoided that book.
My wife almost gave away the book a few times, but I kept retrieving it and putting it back on the shelf. I felt I had to; I don’t know why.
Finally this week I read it.
It is a beautifully written book; lean but evocative. What it evokes is the experience of withdrawing from the world when sick or seriously injured, and the fears of being lost and abandoned as a consequence.
Alice Howland is a fifty-year old professor of psychology at Harvard whose episodes of forgetfulness take on a sudden and scary significance one day when she is out for a run in her neighborhood and cannot remember the way home.
The responses of her family members serve as a counter-point to Alice’s own reactions to the rapid progression of her illness. They are sharply drawn, particularly her husband John and adult daughter Lydia, an aspiring actress. Although the tale is told from the view of Alice, the reader has the advantage of realizing what is happening to her family even when Alice cannot understand what she is witnessing.
The suspense in the narrative derives from the question of whether Alice will commit suicide. Early on she forms a plan for how she will do this when the disease reaches the point where she does not remember key facts about her life. The reader is left guessing what she will do when the time comes to implement the plan. To the credit of the author, Lisa Genova, the denouement includes a surprising and touching twist.
I do not generally like “disease of the month” stories, as the story arc is so familiar that it is hard to make it fresh. Some readers like familiar plotlines and books which make them cry, and they will not be disappointed with this one, but I look for more originality. Ms. Genova pulled it off beyond my expectations.
Alice’s journey seemed real to me, with barely a misstep in it. I cared about the characters and was riveted by her rapid descent into a world that was familiar and foreign at once. The details in descriptions were telling and, although this is her first novel, the author demonstrated an economy with words that I envied.
My only quibbles were with two scenes near the end. A speech Alice gives struck me as an unlikely and obvious plot device, and a switch in one of the final chapters to John’s point of view took me out of Alice’s head and out of the spell of the novel. But these are minor flaws and for the general reader will hardly be noticeable.
As any good novel will do—and this is an excellent novel—in reading it I felt aspects of my own life more deeply.
Although I was not a caretaker for my mother, I was a caretaker for another family member who went through a serious disease. Of course the book brought up some of the fears and frustrations of that time in my life, but that was not the only experience that it brought up for me.
First, just before and around the time my mother died I had serious memory problems, continually losing items like keys and umbrellas at the clinic where I worked and having trouble finding the right words or remembering names. I pushed down the fear that these were early signs of dementia, but the fear remained as a dark whisper inside me. Luckily the symptoms were due to sleep apnea and eventually ameliorated by using a CPAP machine.
Second, I left an established career in academia during my early fifties, just as Alice did but for different reasons. It has taken much longer than I anticipated to even begin to establish a new career, and so I have had many days with time on my hands and the lack of structure that a job brings. This, along with the way young people increasingly see me as an alien being from the remote frontier of seniorhood, have given me an unwelcome taste of Alice’s loss of the socia identity and gave her a place in the world.
Alice’s journey is one that most of us will take, one way or another—the journey from the thick of life to its margins. It is not just people with dementia who become sidelined from life before they are ready, this can also happen to people who have a chronic illness, a serious injury, a mid-life job loss, or live long enough to get old.
Her journey reminds us that in the seeming margins we might see the truth more fully, the preciousness of the ordinary that can so easily be lost. The lesson, one which is not at all heavy-handed yet still unavoidably brought home in this fine novel, is how important it is to pay attention to what you truly value in your life while you still have it.