Stephanie Jones: Book Review - Still Alice by Lisa Genova

The genesis of Lisa Genova’s debut novel Still Alice is far from mysterious, with the story of a Harvard psychology professor experiencing early-onset Alzheimer’s disease having roots in Genova’s own training in neuroscience at the same prestigious American institution. First published in 2007, Still Alice is being reissued in concert with the release of a film adaptation that is garnering acclaim for the performance of Julianne Moore, who plays Dr Alice Howland.

Alice is soon to turn 50 when the story commences in September 2003. She is happily married to fellow Harvard professor John Howland, and the couple has three grown children. Alice is recognized as a world-leading authority in her field of psycholinguistics, the study of the mechanisms of language, and is the envy of her peers for her detailed recall of innumerable research studies.

Less than two years later, the brilliance is gone. In Genova’s depiction, the prematurity and rapidity of the disease’s onset is both sickening and awe-inspiring, its effect on Alice’s mighty brain crushing and relentless. In fact, her intelligence serves as a protective instrument, in the analysis of a neurologist treating her – she may have up to five times the number of synapses to engage in any given task compared with an average person, which affords her superior cognitive function even as the disease claims her brain.

In some ways, Alice’s life has been marked by loss – her mother and sister died in a car crash many years ago, and her alcoholic father a year before the story begins – and she is perhaps less alert than she might otherwise be to the illness’ incipient creep. Mid-lecture, she loses a word; she gets lost on a run just a mile from her home; she leaves her phone behind at dinner. It is only Alice’s insistence on a diagnosis, instead of the ‘watching brief’ approach preferred by doctors after brain tumours and other sinister possibilities are ruled out, that leads to an Alzheimer’s finding.

Genova probes themes often left unexplored in stories of illness, such as the difference between how those suffering from diseases of the mind are treated differently from people with a more identifiable affliction, such as cancer. There is support for the caregivers of those with Alzheimer’s disease, but very little for the sufferers themselves.

Instead of rallying cries from her colleagues Alice is met with a compassionate but firm casting out, her illness somehow a rejection of their collective life’s work. She is permitted to stay on as mentor to one graduate student, but at his graduation only a short time later she fails to recognize him.

As a study of pathology by a subject matter expert, Still Alice is devastating. As a first novel, it is serious, cogent, and perfectly structured, the primary vantage point of Alice’s tense and distant relationship with her youngest child giving way to an examination of the effects a disease with hereditary roots has on a family. It is not only Alice who must come to terms with the vanishing of an expected future.