Many readers will have come to Still Alice via the 2015 big screen adaptation starring Julianne Moore in the title role. Moore, quite justifiably, won a Golden Globe for her portrayal of Alice, the university professor, wife and mother who finds herself diagnosed with Dementia at the relatively early age of fifty. Genova chooses to focus her novel on a reasonably rare type of Alzheimer’s which can be passed genetically from parents to children. A large part of the novel explores the relationship between Alice and her three children as they decide whether to have a genetic test and how they’ll deal with whatever the results turn up. The Dementia also places strain upon Alice’s close family ties as her children and her husband have to learn how to navigate her rapid decline, repositioning themselves as carers when they’ve previously been so dependent upon her. The third person narration offers us small glimpses into their confusion, disappointment and anxiety though most of the novel is focused on Alice. She is the hero of this quest.
I’d argue strongly that Still Alice is a quest narrative with much of the novel exploring ways in which Alice can find a way triumph over her diagnosis. You might argue that the possibility of suicide is introduced earlyish and revisited later when Alice is too confused to follow her own emergency exit instructions and consequently continues living by default. However, even the idea of an end of life plan could be seen as a kind of quest, with Alice retaining autonomy over her own existence. Genova is determined to find meaning and potential in the midst of Alice’s difficult story. A gifted public speaker and academic by trade, Alice gives a paper at a conference on Dementia, reminding the reader that she is still herself and can still contribute to society in spite of her diagnosis. Alice is also portrayed advocating for people living with Dementia and beginning a kind of support group for those diagnosed with the condition. The meaning is clearly implied. Alice is still an active and useful member of society. She is, in her own way, making Alzheimer’s work for her.
At several point, most notably later in the novel, Genova explores the complex tensions inherent within how Alice is viewed by the people around her. Her family are desperate for her to remain active, engaged and essentially, still herself. And yet, they’ve already begun the process of infantilising her as their roles as carers begin to trump their previously dependent roles.
“They talked about her, in front of her, as if she were deaf. They talked about her, in front of her, without including her, as if she had Alzheimer’s disease.”
Alice’s decline is rapid and brutal, Genova dates her chapters so the reader can see just how quickly the disease progresses over a period of two years. As the novel concludes Alice’s observations and interpretations about the world around her become less sophisticated, and in some ways, less anxious. By the final chapter, she’s lost the ability to recognise her own daughter and yet seems to be more peaceful than in the opening chapters where her mental confusion was a constant distress.
“Everyone walked, busy on their way to where they must go. She didn’t need to go anywhere. She felt lucky about this.”
It’s a comforting way to conclude a novel about a woman whose life has been gradually erased. It’s hard not to wonder whether Genova, compromises accuracy, to give her readers a satisfying conclusion. The novel’s ending raises some of the biggest questions implicit in all serious attempts to write about Dementia: how cognisant is the person living with Dementia, especially towards the end of their journey? And, if people living with Dementia are relatively cognisant, even late into their diagnosis, is it less troubling for the rest of us, as friends, family members and interested bystander, to simply pretend they’re not?
Still Alice was published by Simon and Schuster in 2007