The World of Neither Here Nor There:
A Striking Depiction of Alzheimer’s in Lisa Genova’s Still Alice

         “‘I will forget today, but that does not mean that today didn’t matter’” (Genova 253). The words of what is perhaps the most influential speech of tenured Harvard professor Dr. Alice Howland’s life boldly ring out in a crowded auditorium. This auditorium however, is not filled with students, but with attendees of an international Alzheimer’s conference; Alice, a revered specialist in linguistics, is not merely an outsider looking in on the subject, but one of the approximately 200,000 individuals younger than age 65 who are living with early-onset Alzheimer's (Alz.org).

First-time author Lisa Genova holds a PhD in neuroscience and her 2007 novel Still Alice is a heartbreaking depiction of one woman’s journey after receiving a devastating diagnosis that leaves readers with their eyes reddened, their values shaken and the imperative understanding that life can be wickedly short.

As a fifty-year old tenured professor at Harvard University, the author of “well over a hundred papers” (194), an internationally acclaimed lecturer, the founder of “many of the flagship touchstones in psycholinguistics” (9), all while being the mother of three brilliant children, Alice’s promising career seems to only have just begun. But when her usual forgetfulness and disorientation escalates to the point where it can no longer be ignored nor blamed on sleep deprivation, menopause and the high stress levels of her profession, Alice is forced to confront a shattering diagnosis that has her “searching her doctor’s eyes for something else,” but only finding “truth and regret” (72). Alice keeps the devastating truth to herself for as long as she can, but eventually breaks the tragic news to her family, her friends and her colleagues. This beautifully crafted tale is told with startling honesty as a woman for whom “the word needy smack[s] a vulnerable nerve” (24) must inevitably learn to rely on others as her condition worsens and her impending loss of sanity and reason looms menacingly overhead. Told from the perspective of the victim, this incredibly believable and often uncomfortably close account of the progression of Alzheimer’s gives the readers a glimpse into what it is like to “feel [themselves] declining, feel [themselves] slipping into that demented hole. Alone” (216). But amidst all this defeat, a notable occurrence is that while the disease destroys Alice’s mind and her place in the world, it also strips away many of the trivial aspects of life that obstructed Alice’s exploring of the essence of who she really is and what really matters.

         “‘We feel like we are here nor there, like some crazy Dr. Seuss character in a bizarre land. It’s a very lonely and frustrating place to be’” remarks Alice about those suffering from Alzheimer’s (251). From the first few pages of the novel, Alice is easily seen as an independent, intelligent and dedicated individual. She is confident in who she is and with her position in her world and yet who she is rapidly spins out of control over the course of the novel and she begins to liken being diagnosed with Alzheimer’s with being “branded with a scarlet A” (252) as the social stigma surrounding her condition and the feeling of being outcast by society threatens to engulf her completely.

Another major influence on Alice is none other than her husband John, who goes through just as much if not more turmoil than Alice. This man who was once her intellectual equal must “‘[sit] and [watch] what this disease is stealing from [her]’” (235). John serves as a constant reminder for the reader of what Alice once was, and the fierce dedication, patience and love he has for his wife, even as she becomes someone entirely dependent is both inspiring and saddening. “‘I miss myself,’” notes Alice forlornly as she and John sit alone in what Alice no longer recognizes as their living room, after reading what she no longer recognizes is a book she wrote. “‘I miss you, too, Ali, so much’” is his gentle reply (285). This is one of the most simultaneously painful and touching moments in the entire novel that truly captures both of their characters; Alice feels genuinely lost because she quite literally cannot remember herself whereas John is grieving his loss of the woman he loves who, while there physically, is not the same woman she was merely a few months prior.

Another interesting development to analyze is how her diagnosis inadvertently compels the ailing Alice to attempt to repair her strained relationship with her youngest daughter Lydia. At the beginning of the novel, their connection is tense to say the least. Lydia has gone against her mother’s wishes to pursue an acting career in favour of a post-secondary education. This causes Alice too look at her daughter and see only “so much wasted potential, so much wasted time” (17). As Alzheimer’s slowly begins to take its toll however, Alice’s need for support and family outweighs their differences which allows “Lydia [to reach] out across the dishes and glasses and years of distance and [hold] her mother’s hand” (162). Alice finally claims that she is “so proud” of her once estranged daughter (233).  By having Alice abandon one of her once most firm beliefs that a university education is instrumental to success and instead focus on reconciling with her daughter, Genova demonstrates an enormous shift in Alice’s values as Alice comes to realize that what she wants from what little life she has left is to savour and rejoice intense love and strength her family provides.

         I strongly recommend Still Alice to anyone and everyone looking for a meaningful, moving read that leaves readers clinging to the last page as dearly as Alice Howland clings to the rapidly dissipating hope and purpose in her life. While some may falsely assume that this book would only appeal to those affiliated with the Alzheimer’s community, I find it is a work that can relate to a wide variety of individuals as Genova immediately draws you in by unleashing a wave after wave of Alice’s relatable insecurities within the first chapter that not only make Alice’s character seem more real but also engages the readers. The book immediately appealed to me emotionally, allowing me to connect and develop an attachment to this woman, making it all the more difficult to watch her heart-rending departure from the self-reliant soul she once was into someone she herself cannot identify when looking into a mirror. Early on, Alice’s doctor points out that she “may not be the most reliable source of what’s been going on” (74) and yet one of the aspects that most pleases me about the novel was that Genova chose to write from this “unreliable” perspective. In doing so she provides a powerful insight into what most people without Alzheimer’s would never experience as the readers are thrust into each of Alice’s daily frustrations and humiliations. It is point-blank terrifying at times, as we experience each blinding emotion right there with her, rather than observe her growing confusion with pity from the sidelines.

Genova holds nothing back, and delivers the most disheartening statistics and humiliating scenarios with crushing accuracy. For instance, a few short months after her initial disbelief and denial that certain attributes would ever apply “to someone like her” (73) Alice begins to demonstrate symptoms that correspond with the dreaded “Number 3” list on her Activities of Daily Living Questionnaire: “Must be fed most foods. Has no control over bowel or bladder. Must be given medication by others. Resists efforts of caretaker to clean or groom” (Genova 73). This gradual descent into helplessness is perhaps even more painful for the readers than for Alice herself because, unlike Alice, we are not able to forget what she has lost. But perhaps the greatest appeal for me in the book was the focus placed on the value of family and love above all else. This is shown through the unwavering support of Alice’s three children and husband, and her desire to see them succeed and be happy before she becomes unable to recognize them at all.

Ultimately, Still Alice is a terrifying portrayal of what it is like to literally lose one’s intellectual mind, cognitive capabilities, cherished memories and occasionally one’s hope, but shows how against all odds one can never be parted from what truly matters: the heart.

"Alzheimer's Facts and Figures." Alz.org. Alzheimer's Association, 2013. Web. 16 Nov. 2013. .
Genova, Lisa. Still Alice. New York: Pocket Books, 2007. Print.