Still Alice: A review.

We spent last weekend in IA visiting commenter Kim-in-IA and Husband-of-Kim-in-IA and their three boys, one of whom is my godson.   While we were there, spring arrived.   I had optimistically tossed a pair of sandals in my duffel bag, and you bet I wore them.  Our four children and their three children ran around in their big back yard (big enough to toss a Frisbee without losing it to the neighbor's roof, a novelty for my kids).  And Kim performed one of the coolest hostess acts ever when she tossed me a novel I hadn't read and said, "Here, this doesn't belong to me so I can't lend it to you, but why don't you just go ahead and read it straight through while you're here this weekend.  It's a quick read."

The novel was Still Alice by Lisa Genova, and it was indeed a quick read:  a page-turner, fascinating, not really what I would call deep, but with enough subtext and a little bit of mystery to keep me thinking about it for several days afterward.  Highly recommended, if only because the payoff is high compared to the amount of time it will take.  Absorbed very easily, like beach reading or interesting nonfiction, and yet it sticks around.  I finished it in less than a day, at times curled up on the couch, at other times reading it one-handed while I pushed the baby in Kim's tree swing.

(Now that I am a busy mother, I appreciate book reviews that tell me exactly how much undivided attention I have to give a certain book in order to enjoy it or at least follow it.  So now when I review books, I always stick that bit up front.  My apologies if you're wondering why I didn't begin with a hook that had anything to do with the plot.)

OK, so, Still Alice is the story of a 50-year-old woman, a Harvard psychology professor married to a Harvard biology professor, who is diagnosed with early-onset Alzheimer's disease.   The story is told in third-person limited subjective narrative mode (yes, I had to look that up), which is significant because although Alice does not tell her own story in the book, the narrator tells us her thoughts and feelings.  Such a narration restricts the reader to what Alice herself can see, feel, and understand; and the scope of  Alice's understanding narrows more and more toward the end of the book as her memory and cognition fail.    The reader follows Alice from her first suspicions that her neurological symptoms are serious, through her diagnosis and its confirmation, and then follows her through a rapid decline.  

It's a good thing the narrative style is so ambitious and well-pulled off.  I think Alice is not a very finely drawn character, even at the beginning of the book; she's a  bit of a caricature of "successful, brilliant, driven career woman."  That does not seem to me to detract from the book very much, because much of the backstory is left to the imagination, and because the disease (and the story) progresses so fast that the reader barely gets a chance to get to know Alice before she becomes altered.  I don't know whether this "sketchiness" was intentional on the part of Genova, a first-time novelist, but it works.  Alice's husband and grown children are the only other significant characters in the book, and the reader has to guess a lot about their motivations and feelings.  We only see and hear them through Alice's clouded glass.   

Besides being a pretty gripping story, there's a lot to learn in it about Alzheimer's disease; the author's got a doctorate in neuroscience, which she says opened a lot of doors to her as she researched the book.  

I came away from Still Alice with changed perspective.   First, of course, there was the fact that for the next few days I noticed EVERY SINGLE TIME I couldn't remember the word I was looking for, or opened the wrong cabinet looking for a measuring cup.  (This is maybe not a good book for hypochondriacs.)  But it's also a peek inside the mind of degenerative mental illness, one that I think will be enormously helpful for people who work with, care for, or love patients who suffer from dementia.  Since we can see what Alice is perceiving and processing, we understand  the reasoning behind each seemingly senseless, "crazy" act, and we know that the husband and children will never understand because she will never be able to explain herself to them:  but we the readers know why she painted the mirrors white, we know why she struggled violently to throw a heavy rug out the front door, we know why she burst into tears at this or that moment for no apparent reason.  Her frustration is palpable.  

It's also a profoundly life-affirming book.  This seems an odd thing to say about a book in which the main character devises early on a plan to commit suicide in the future, and in which this decision is put in a considerably sympathetic light.  I think the sympathy with which Genova treats it is entirely appropriate, though; Alice deserves our sympathy as she contemplates a future so horrible that she cannot imagine wanting to live it.  

And this makes it even more surprising that Alice goes on to live past the decision point of that future, and as we are shown her adult daughters defending her existence:  "She's not a burden.  She's our mother."  We see a woman who cannot recognize her own daughter, but who thrills to the sight of watching her perform in a play; a woman who relishes the taste of real ice cream; a woman who continues to enjoy music; who feels excitement in the presence of dear ones; who is recognized and loved by a baby grandchild.  

The title of the book gives a clue to what is, I think, the main thrust of the book.  "She's not herself anymore," people will say about someone with dementia or traumatic brain injury or something like that.  The book is an argument against that kind of language, which is -- I am convinced -- deeply wrong, and bound up in an idea of mind-body-spirit separation that I cannot support.  Alice is Alice all along.  Her brain deteriorates but remains "Alice's" brain, not some other person's brain or no brain at all;  the mind with which it is entwined, therefore, remains "Alice's" mind; Alice is still Alice, a whole person.  There is a poignant scene where Alice herself struggles to express what she is lost, and can only get out a few words:  "I miss myself," she tells her husband.  It's ambiguous (and I think it's telling that some publishers of translations -- notably the Dutch -- chose to title the book I Miss Myself instead).

 I resolve the ambiguity in favor of continuity, despite the paradox.  She cannot say "I miss myself" unless she is herself.  She has lost some of the things that made her "herself," but she has not lost all of them -- there is something "pristine" that she can feel still remains, and it's from within that pristine part that she's able to say, "I miss myself."  

The novel ends while Alice still has communication skills and physical capabilities.  I conjecture that she will never lose all the things that make Alice Alice.  But that conjecture is in the place where the reader has room to make private interpretations of what's going on; whether accidentally, or wisely, Genova leaves many such places in her novel.  It's a good read.

Comments

[Nancy]

Thanks for this thoughtful review. As someone who watched my grandfather (in his 80s) and an uncle (in his early 60s) live through this disease, I love the author's perspective. My relatives were still very much themselves, even as their memories and ability to function slipped away.
Nancy

[Lisa- Domestic Accident]

This is one of my favorite books of the year. I think I especially loved it because I'm a speech pathologist who specializes in dementia patients. It was very accurate, and while I certainly was disappointed that the husband stopped caring for her, I unfortunately think it's common- especially for those afflicted earlier in life. Her new book Left Neglected was good, but not as good as Still Alice. I'm looking forward to reading more of her works.

[Kim in IA]

Hey Erin,
Just getting around to catching up on some blogs. Your review of Still Alice is great. I hope somebody decides to pick it up based on your recommendation. I still think about the book quite often. Glad you got a chance to read it, hope you didn't have to stay up too late to finish it ;)