Emotions vs. Economics

Still Alice
Lisa Genova

Still Alice, Book Cover

Click on the image to access Still Alice on Goodreads.

In Lisa Genova’s extraordinary New York Times bestselling novel, Alice Howland, an accomplished professor diagnosed with Alzheimer’s disease learns that her worth is comprised of more than her ability to remember.

Alice is proud of the life she worked so hard to build. At fifty years old, she’s a cognitive psychology professor at Harvard and a world-renowned expert in linguistics with a successful husband and three grown children. When she becomes increasingly disoriented and forgetful, a tragic diagnosis changes her life—and her relationship with her family and the world—forever.

At once beautiful and terrifying, Still Alice is a moving and vivid depiction of life with early-onset Alzheimer’s. The story is as compelling as A Beautiful Mind, which is in some ways similar and written in the same genre, and as unforgettable as Ordinary People.

I found that I couldn’t review this book immediately after reading it. I was just so overcome with its content and the fact that I was, at that time, seeing Alzheimer’s hasten my aunt’s demise. The experience made it almost impossible for me to approach this review. But, it’s been a year now and my aunt has passed on. It seems she died twice in some ways, at first mentally, no longer able to connect with me verbally or visually, looking through me and no longer at me; and then dying physically, about a year and a half later, on the day that was noted on her death certificate.

I remember reading Lisa Genova’s, Still Alice, while observing my aunt’s first death. The book resonated with me in many ways, but mostly in ways that validated my feelings of loss. It confirmed what I thought it was to abandon a life’s trajectory and to get stuck in the present. So, yeah, I loved the book, and the stains of my crocodile tears on its pages were a testament to that. The conflict between the Genova’s characters was real, their dialog and emotions were real; in fact, I was only taken from the reality of the story by its romanticized socio-economic premise. You see, Genova, with scene and setting, wrote the character, Alice, and her almost idyllic family, into a socio-economic minority, and that minority had more than adequate financial means to deal with this devastating disease. While Still Alice was successful at raising Alzheimer’s awareness, it also raised the fact that there are gaping social inequities in how we care for patients with the disease.

Alice, although I loved the dramatization of her in this literary form, was not indicative of the many that suffer from being priced out of long- and short-term care.

Genova ends the story of Alice with the youngest of her children, Lydia, stepping into the role of caregiver. The implication is that Lydia, a budding actress, will have the flexibility, unlike her siblings, to move to New York where her father and mother have relocated. This denouement seems quite tidy as New York is the perfect place for Lydia to pursue acting, care for her mother, and live happily ever after; but all of us who’ve relocated a loved one with Alzheimer’s knows, Lydia and her father will soon need help, especially as both of them are working.

The 2015 Alzheimer’s Disease Facts and Figures report revealed that in 2014, eighteen billion hours of unpaid care was given to patients by family members, the cost of which is almost impossible to gauge. It can be at any time between receiving the diagnosis and needing 24/7 care that families depend on friends, neighbors, and in-home help. This help can come in the form of housekeepers, “senior-sitters,” and/or health aides, all who must be paid out-of-pocket. When families can’t afford this, they are simply at a loss.

In a year, give or take, when Alice’s daughter gets an acting role, she and her father will have to devise a contingency plan for care. This is less than romantic compared to Genova’s beautifully written scenes, scenes in which we transition from, Alice, the healthy matriarch with squabbling adult offspring, to Alice, the woman who’s health necessitates getting real—really fast—but pragmatics surrounding Alzheimer’s are perhaps not for this book.

Genova is instead more interested in comparing the human condition to notions of community building in this writing. After the Alzheimer’s diagnosis, when Alice is still highly functioning, Genova shows the character build community through both in-person and online connections with other early-onset patients. We see that these connections and the idea of community are an overarching theme of the book. They begin with Alice’s connection to academia, and move into the conflicted connectedness of her family. They’re illustrated in the community connections that Alice forms between fellow patients and herself, and finally, and most importantly perhaps is the connection between Alice and her daughter especially as the disease eventually puts into perspective, the angst in their relationship. This is why I not only recommend you read the book, but use it to connect with a loved one.

As usually is the case, you should read the book first—the audio version is available and narrated by the author—then if you feel inclined, view the movie. Julianne Moore plays Alice in the movie and is especially convincing as the character. In fact, the whole cast creates a truly believable family, even as impetus for some of the interactions gets a little lost in the film medium. In other words, film can’t do what a book does; that is, give the character relationships and backstories adequate time to unfold. The film seems to lose some of the sense of how the disease affects Alice’s psyche.

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