I finished Still Alice, Lisa Genova’s first novel, nearly a month ago but am only getting around to reviewing it now. I could blame this on a lot of things like NaNoWriMo, forgetfulness, or laziness, but in this case, it really had to do with having to sort out my feelings about it. Still Alice is the story of a middle-aged woman dealing with early-onset Alzheimer’s and its effects on her life and the lives of those she loves. As soon as I heard of this book, I knew that I would have to read it, and soon. When I was ten or eleven years old, my grandfather was diagnosed with Alzheimer’s and it wasn’t long before he was moved into a nursing home and gone forever. I didn’t understand much of it at the time. Therefore, it’s no surprise that Still Alice should have had such a hold on me as it helped me understand why and how I lost my grandfather.
To be honest, Genova’s writing isn’t spectacular. It’s very clear, straightforward prose, lacking in music or beauty in itself. And you know what? It doesn’t really matter. Still Alice may not be remembered for its way with language, but I will always remember it for its effect on me, and sometimes that’s what’s really important.
The plot revolves around the progression of the disease. Alice, a Harvard professor of cognitive linguistics is just going about her life when odd things start to happen – she loses things that are where they belong, gets completely disoriented and lost minutes from her house, forgets to go to the airport for a long-scheduled flight. After her diagnosis, life goes on as before, just with more struggles and difficulties. She still fails to understand her youngest daughter, still attempts to go on with her career, still goes on daily jogs for as long as she can. This is a novel about life with Alzheimer’s, plain and simple.
I have memories of my grandfather that still pain me. One Thanksgiving, his final Thanksgiving, he came to our house. It was the last place he would ever be outside of his nursing home. My uncle was clearing his place setting and when he moved to clear my grandfather’s dirty paper napkin, my grandfather started shouting for us to call the police, he was being robbed. On one visit to the nursing home, he stared at me, love in his eyes, and couldn’t find my name. He knew that he loved me, but he had no idea who I was. On several occasions, he told us about how he had just had visits from his siblings and parents, who were long gone. His deterioration was rapid and painful, and not soon to be forgotten.
Still Alice brought this all back to me. There are simple matters of forgetting – Alice loses a word, forgets a name, loses her glasses. And then there is a scene in which Alice goes to a class she teaches in a big lecture hall and sits down in the audience. She sits there twenty minutes, increasingly annoyed, before turning to her students saying, “I don’t know about you guys, but I have better things to do,” and walking out, annoyed at the professor for having wasted her time. These moments are the most painful: years of her life gone like they never happened and, worse yet, she never realizes the mistake. I remember visiting my grandmother’s first cousin, also afflicted by Alzheimer’s, in her nursing home. A man on the floor began shouting at my mother and me for shouting and running through the halls of his hotel. The reality of his situation had vanished for him, at least for the moment, much as increasingly happens to Alice.
Alice forgets the deaths of her mother and sister, forgets words, forgets where the bathroom is in her own home, forgets who her children are, forgets that the gaping black hole in her front hall is actually a rug she had bought years before. The disease makes no exceptions, attacking every sort of memory that we take for granted every day.
But it is not all terrible. In the midst of pain and loss, Alice still has the resources to love. She still can hold and kiss her grandchildren, can still come to terms with her daughter’s choices, can still establish what she wants versus what she doesn’t want. While the disease tears through her brain, literally shrinking her brain mass, she still remains who she ever was, and discovers more about who Alice really is.
The novel left me with a question that is significant as the descendant of somebody with Alzheimer’s. Assuming the information provided to be accurate (and I think it is, considering Genova’s background and the book’s factual nature), it is possible to be tested for a genetic mutation that would determine if Alzheimer’s is in your future. Two of Alice’s children are tested; her eldest, Anna, who is trying to become pregnant, tests positive and as a result has embryos that are without that mutation implanted in her uterus to guarantee that her children will not inherit the degenerative disease. Alice is relieved to know that at least these grandchildren will not be cursed with her own affliction and left to wish that she had had the same option – except that if she had done the same, she would not have Anna. Her middle child tests negative and her youngest child decides not to have the test. This is a very real question for me – do I have the test? If I’m positive, do I make the same choices that Anna made?
Right now, my answers are no and no. I don’t want to live a life of fear and expectation. I’d rather live right now and let come will come. I don’t want to be forced to choose one child over another. A cure may come before it’s even an issue and if not, I believe in living the life you’re given. I’m not sure if I believe in a god or not but even so, I don’t think it’s in my hands to make those choices. As little as I would choose a green-eyed child over a brown-eyed, I would not choose a child based on this possibility. I want to make the best of the life given to me and let come what may.
For anybody who has known and loved somebody with Alzheimer’s, I recommend you read this novel. It’s sad but powerful, and worth the tears. It will bring back painful memories but it will bring back the good as well. Ultimately, pain and happiness are inseparable. My strongest memory of my grandfather is still sitting on his lap and playing the hand-stacking game, and I wouldn’t give that up for anything, even if it comes at the cost of the memory of loss.