Still Alice, Lisa Genova

I freely admit that a large part of my identity is defined by my not inconsiderable smarts.  When I was in elementary school, I was the stereotypical teacher's pet.  I easily comprehended the lessons, I always finished my work before everyone else, and I frequently had my nose buried in a book.  This caused me to be teased by the other students quite a bit (fourth grade was particularly brutal), and I was often alone.  In my moments of hurt and anger, I often comforted myself by telling myself that the other kids might be bigger and meaner, but I was smarter!  That defense mechanism from elementary school has lasted into adulthood.  No one is picking on me for being smart and loving to read and learn, but the ability to do all of those things has remained central to my own perception of who I am.

But imagine that the intelligence and knowledge that has become such a central part of my identity were suddenly fading, not because of old age or a freak accident, but slowly and inexorably due to early-onset Alzheimer's Disease.  This is exactly the fate that befalls the main character in the novel Still Alice by Lisa Genova.  Alice Howland is a 50ish Harvard psychology professor, ironically an expert in linguistics and the acquisition of language, when she begins having lapses in memory.  She chalks it up to stress and overwork-until the day that she gets lost three blocks from home.  She consults a neurologist, who gives the stunning and completely unexpected diagnosis of early-onset Alzheimer's disease.  Alice is completely taken aback-what will become of her teaching, her research, her speaking engagements?  As she and her family struggle to make sense of her diagnosis, she designs a daily test for herself.  She will ask herself five questions, and the day that she has trouble remembering the answers will be the day that she ends her life.  But with her memory fading fast and her family taking care of her, will she be able to keep her dignity and make her own choice?

Genova did a good job creating the character of Alice.  Using first person narrative allowed the reader to go along on the journey with her, and frankly it was terrifying.  Alice goes through the stereotypical stages of grief-denial, anger, depression, bargaining, and acceptance-and at each stage I was able to imagine myself in her shoes.  The way that Alice is written evoke empathy and not just sympathy in the reader, which in this particular kind of story is more important than a cerebral analysis. 

Genova also used Alice and her situation to highlight certain issues releated to Alzheimer's disease.  She makes a point to bring forward the genetic nature of the disease, and in fact Alice and her children are tested for the defective gene, only to discover that her daughter Anne, currently in her late 20s, is sure to develop the disease.  Alice, released from her responsilibities at Harvard and at a loss for what to do next, realizes there is a need for a support group not just for the caregivers of people with Alzheimer's, but for the sufferers themselves.  She even makes an impassioned speech at an Alzheimer's conference about remembering the humanity of the person behind the symptoms.

While this book packed a great deal of emotional punch, it is not exactly subtle in its theme-people who have Alzheimers are still people, and they know what is happening to them (at least for a while), and they should be treated in such a way that their dignity and pride is preserved.  Alice's suicide plan creates an interesting point for discussion, which makes it a decent book club selection.  That said, when I finished reading I felt a little bit like, "All that build-up for THAT!"  I was not a fan of the ending, but that didn't really take away from my enjoyment of the novel as a whole.  If you don't mind being sad on your vacation, this would actually make a decent spring break or summer read-it's easy and fast, but still has substance.