Book Club / January
‘Still Alice’ explores love and loss of Alzheimer’s
For Lisa Genova, Alzheimer’s hit home intimately. Right at the dinner table. That’s where her beloved grandmother, Angie, was sitting, one evening in 2002, when the memory-stealing disease abruptly took her life.
Angie had been ill for a while. She had been diagnosed with the disease in 1998 — the same year Genova graduated from Harvard with a Ph. D. in neuroscience, ready to embark on a brilliant career.
Instead, Genova found herself contemplating her grandmother’s steady decline and death.
“It was heartbreaking,” she said, “to watch this disease steal piece after piece of my Nana. But while it was heartbreaking, it was also fascinating. There were still pieces of her I could recognize. She could still recognize and understand love. But she didn’t know who we were, or what was going on, or what time of day it was.”
“I understood what was going on, on a clinical level. But because this was my grandmother, I wanted to know what was going on, on a more personal level. What is it like to look in the mirror, and not recognize the face you see back?”
That question haunted Genova. “Still Alice,” which debuted on bookstore shelves this week and is the January selection of The Buffalo News Book Club, is the result.
Genova wrote it after ending a science career in which she worked as a strategy consultant for biotech, pharmaceutical and medical device companies, helping the companies decide their strategies for developing and marketing new products.
After leaving that job in the wake of her daughter’s birth, and going through a divorce in 2004, Genova decided to tackle the subject of Alzheimer’s in novelistic form.
“Still Alice,” Genova’s first work of fiction, is a thoughtful, moving exploration of what Alzheimer’s disease looks like, up close, from the initial signs of debilitation, through diagnosis and treatment, and into the end-stage territory of the disease.
Some 5.2 million people in the United States are living with Alzheimer’s right now, according to the national Alzheimer’s Association.
Genova said her move from science to writing was intimidating at first.
“I wasn’t a writer, I was a scientist,” she said.
But once she got started, the book’s subject matter took over, and the narrative began to tell itself, she said.
Two twists mark the novel as new ground:
First, Genova decided to tackle early-onset Alzheimer’s, instead of the later-onset variety of the disease that is far more common (and that afflicted her grandmother, who was diagnosed in her 80s). According to the national Alzheimer’s Association, about 200,000 of the 5.2 million people now living with Alzheimer’s are under 65 years old and are therefore considered early-onset.
Genova’s protagonist in the novel is Alice Howland, a 50-year-old woman who is a highly regarded professor of cognitive psychology at Harvard, and a leading intellectual in linguistics. Alice is married to another Harvard faculty member, and the mother of three children.
Genova said her choice of Alice Howland’s career and background was purposeful.
“This is a disease that robs you of your ability to think,” she said. “If your whole identity is wrapped up in your ability to think — that’s going to be a really far fall.”
The second twist is Genova’s choice of an unusual narrative perspective in the book.
She wrote it using the first-person point of view — a technique which allows Alice Howland to narrate her own story.
“I made that decision right away,” said Genova, who has remarried and has an 11-month-old baby in addition to her older daughter, now 8. “I knew that it would be a very powerful choice, to tell the story in Alice’s perspective. The story that hadn’t been told, really, is the story of what it’s like to have Alzheimer’s by the mind that’s becoming less and less. We sit right up against her Alzheimer’s, as it’s changing.”
In the course of the story, Alice undergoes a variety of medical tests and treatments. Genova renders them in minuscule detail, giving the reader a feel for what it’s like to be in the room when Alzheimer’s is diagnosed and measured.
She said her access to medical professionals and hospitals — she spent days following around doctors at Massachusetts General — was vast and top-rate, and she credits her Harvard doctorate for that.
“I did a lot of research for the book, to show Alice’s diagnosis, treatment and progression as accurately as I could. I found the degree opened every door. I could talk to every expert about this,” she said.
By the novel’s end, Alice Howland’s disease has progressed to a point where even she does not recognize herself.
Genova said she struggled over the ending to the book. Should it be happy or sad? Should it be realistic or idealized? What message about the end of the Alzheimer’s road should it convey?
She ultimately settled on an ending that is bittersweet but hopeful; some relationships in the book strengthen, a few weaken, and Alice is, at the conclusion, the “Still Alice” of the title.
“In the absence of a Hollywood ending, what sort of positive note could I end on for readers, that’s still truthful?” Genova asked.
“For me, it was that final note: that Alice can still understand love.”
As always, we are interested in your thoughts on “Still Alice,“ the Book Club’s January selection, and your suggestions for future Book Club reads. Please send your comments to: The Buffalo News Book Club, P. O. Box 100, Buffalo, N. Y., 14240. Or e-mail the Book Club at bookclub@buffnews.com.
Still Alice
By Lisa Genova
Pocket Books
320 pages, $15
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