The big A, Alzheimer’s disease, may have overcome the big C, cancer, as a diagnosis that
strikes fear in aging people’s minds. Many people develop some type of cancer, many of which are now cured and/or stopped in their tracks. Not so the big A – there is no cure for this condition, which can last up to 20 years and make a formerly intelligent, high-energy person into a speechless child unable to dress or feed herself, unable to speak or recognize family members, prone to wandering. A few new drugs can slow the disease’s path.
Lisa Genova, a Ph.D. in neuroscience who writes extensively about Alzheimer’s, has written a stirring novel, Still Alice, about a woman in her early 50s who learns she has early-onset Alzheimer’s. Somewhat ironically, Alice lives by words and how the brain works or doesn’t: she is a professor at Harvard in cognitive psychology and presents at a conferences around the world annually. The novel details how Alice discovers the disease, how she deals with telling her family and, most difficult, her colleagues, and how she pares down her daily activities to accommodate her diagnosis and increasing limitations.
More than many other books on the disease, this book takes the reader into the daily life of the patient – forgetfulness, losing direction, putting things in the wrong place – things that increasingly happen to this brilliant, vibrant woman who is faced with leaving her professorship, her primary self-definition for more than 20 years. She can no longer give lectures; she sometimes shows up and then leaves, not realizing it was her class to give. One of the first signs is this: Forty minutes into a fifty-minute lecture, “She simply couldn’t find the word. She has a loose sense for what she wanted to say, but the word itself eluded her. Gone. She didn’t know the first letter or what the word sounded like or how many syllables it had. It wasn’t on the tip of her tongue. Maybe it was the champagne. She normally didn’t drink any alcohol before speaking…” Alice no longer knows who she is.
As mentioned earlier, cancer has become a more hopeful diagnosis than Alzheimer’s. Alice expresses this so well:
“She wished she had cancer instead. She’d trade Alzheimer’s for cancer in a heartbeat. She felt ashamed for wishing this, and it was certainly a pointless bargaining, but she permitted the fantasy anyways. With cancer, she’d have something that she could fight… There was the chance that she could win… And even if defeated in the end, she’d be able to look them [her family and the Harvard community] knowingly in the eyes and say goodbye before she left. …Alzheimer’s Disease was an entirely different kind of beast. There were no weapons that could slay it…. The blazing fire consumed all. No one got out alive.”
Fairly early on, her wits still about her, she forms a support group of others stricken with the disease far too young. Luckily, she has an amazingly supportive spouse, John, who is careful to do what is best for her and who shows no signs of loving her less, or, as sometimes happens when a spouse is diagnosed with the big C, of leaving her/him. He is in it for the long haul. But is Alice?
Alice finds it increasingly difficult to imagine who she is. When she starts not to recognize her children – or calls her daughter by her
long-dead mother’s name – she puts a plan of action in place. She gives herself mental tests on a daily basis, and she decides
that when she can no longer answer these fairly straightforward questions, she will pull her own plug.
The book is entirely sympathetic to Alice, detailing her quite rapid decline. It takes place only over two years, month by month, showing deterioration in its stages.
The tone of the book, though, is somewhat chilly, a bit scientific. This is not surprising as the author is a scientist. But it also may be intentional, indicating a clinical distance from which Alice is watching her own changes and decline. In fact, I preferred the narrative and its pace to the actual writing. Still, the novel gripped me.
I have loved many books about the experience of Alzheimer’s, most especially Elegy for Iris, for novelist Iris Murdoch by her husband, John Bayley. I will add Still Alice to my increasingly long bookshelf of such memoirs and novels. This quiet and powerful novel is highly recommended for people who fear they may acquire the disease because it runs in the family, or for caregivers who deal with the elderly and/or memory-impaired. Readers with Alzheimer’s have highly praised the book’s accuracy and honesty. A portion of the sales of this book goes to the Alzheimer’s Association.