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Still Alice (Genova)

Still Alice 
Lisa Genova, 2007
Simon & Schuster
320 pp.
ISBN-13: 9781439102817

Still Alice is a compelling debut novel about a 50-year-old woman's sudden descent into early onset Alzheimer's disease, written by first-time author Lisa Genova, who holds a Ph. D in neuroscience from Harvard University.

Alice Howland, happily married with three grown children and a house on the Cape, is a celebrated Harvard professor at the height of her career when she notices a forgetfulness creeping into her life.

As confusion starts to cloud her thinking and her memory begins to fail her, she receives a devastating diagnosis: early onset Alzheimer's disease. Fiercely independent, Alice struggles to maintain her lifestyle and live in the moment, even as her sense of self is being stripped away. In turns heartbreaking, inspiring and terrifying, Still Alice captures in remarkable detail what's it's like to literally lose your mind...

Reminiscent of A Beautiful Mind, Ordinary People and The Curious Incident of the Dog in the Night-time, Still Alice packs a powerful emotional punch and marks the arrival of a strong new voice in fiction. (From the publisher.)

The 2014 film adaptation stars Julianne Moore and Alec Baldwin. Moore won the 2015 Academy Award for Best Actress.

Author Bio
Birth—November 22, 1970
Education—B.S. Bates College; Ph.D, Harvard University
Currently—lives on Cape Cod, Massachusetts

Lisa Genova is an American neuroscientist and author of fiction. She graduated valedictorian, summa cum laude from Bates College with a BS degree in biopsychology and received her Ph.D. in neuroscience from Harvard University in 1998.

Genova did research at Massachusetts General Hospital East, Yale Medical School, McLean Hospital, and the National Institutes of Health. She also taught neuroanatomy at Harvard Medical School fall 1996.

Genova married and gave birth to a daughter in 2000. Four years later she and her husband divorced, and Genova began writing full-time. To hear Genova tell it:

When I was 33, I got divorced. I’d been a stay-at-home mom for four years, and I planned to go back to work as a health-care industry strategy consultant. But then I asked myself a question that changed the course of my life: If I could do anything I wanted, what would I do? My answer, which was both exciting and terrifying—write a novel about a woman with Alzheimer’s (Cape Cod Magazine.).

In 2007 she self-published her first novel, Still Alice, which went on to became a major best seller and award winning film. Since then, Genova has written three other fictional works about characters dealing with neurological disorders.

Still Alice
Genova's debut novel follows a woman suffering from early-onset Alzheimer’s disease. Alice Howland, a 50-year-old woman, is a cognitive psychology professor at Harvard and a world-renowned linguistics expert. She is married to an equally successful husband, and they have three grown children. The disease takes hold swiftly, changing Alice’s relationship with her family and the world.

Self-published, Genova sold copies of the book out of the trunk of her car. The book was later acquired by Simon & Schuster and published in 2009. It appeared on the New York Times best seller list for more than 40 weeks, was sold in 30 countries, and translated into more than 20 languages.

The book was adapted for the stage by Christine Mary Dunford and performed by Chicago's  Lookingglass Theatre Company in 2013.

A 2014 film adaptation starred Julianne Moore as the lead and co-starred Alec Baldwin, Kristen Stewart, and Kate Bosworth. Moore won an Oscar for Best Actress.

Other books
Left Neglected (2011)
Genova's second novel tells the story of a woman who suffers from left neglect (also called hemispatial or unilateral neglect), caused by a traumatic brain injury. As she struggles to recover, she learns that she must embrace a simpler life. She begins to heal when she attends to elements left neglected in herself, her family, and the world around her.

Love Anthony (2012)
Offering a unique perspective in fiction, this third novel presents the extraordinary voice of Anthony, a nonverbal boy with autism. Anthony reveals a neurologically plausible peek inside the mind of autism, why he hates pronouns, why he loves swinging and the number three, how he experiences routine, joy, and love. And it is the voice of this voiceless boy that guides two women in this powerfully unforgettable story to discover the universal truths that connect us all.

Inside the O'Briens (2015)
In her fourth novel, Genova follows Joe O'Brien, a middle-aged Boston policeman diagnosed with Huntington's. There is no cure, and the disease is progressive and lethal. The story revolves around the fallout on Joe's family, including his daughter who is at risk for carrying the genes.

TV and film
Since her first novel was published, Genova has become a professional speaker about Alzheimer's disease. She has been a guest on the Today Show, Dr. Oz, CNN, PBS News Hour, and the Diane Rehm Show. She appeared in the documentary film To Not Fade Away. It is a follow-up to the Emmy Award-winning film, Not Fade Away (2009), about Marie Vitale, a woman who was diagnosed with Alzheimer's disease at the age of 45. (Adapated from Wikipedia. Retrieved 4/6/2015.)

Book Reviews
After I read Still Alice, I wanted to stand up and tell a train full of strangers, "You have to get this book."
Beverly Beckham - Boston Globe

Reads like a gripping memoir of a woman in her prime watching the life she once knew fade away....A poignant portrait of Alzheimer's, Still Alice is not a book you will forget.
Craig Wilson - USA Today

Neuroscientist and debut novelist Genova mines years of experience in her field to craft a realistic portrait of early onset Alzheimer's disease. Alice Howland has a career not unlike Genova's—she's an esteemed psychology professor at Harvard, living a comfortable life in Cambridge with her husband, John, arguing about the usual (making quality time together, their daughter's move to L.A.) when the first symptoms of Alzheimer's begin to emerge. First, Alice can't find her Blackberry, then she becomes hopelessly disoriented in her own town. Alice is shocked to be diagnosed with early onset Alzheimer's (she had suspected a brain tumor or menopause), after which her life begins steadily to unravel. She loses track of rooms in her home, resigns from Harvard and eventually cannot recognize her own children. The brutal facts of Alzheimer's are heartbreaking, and it's impossible not to feel for Alice and her loved ones, but Genova's prose style is clumsy and her dialogue heavy-handed. This novel will appeal to those dealing with the disease and may prove helpful, but beyond the heartbreaking record of illness there's little here to remember.
Publishers Weekly

First novel efficiently showcases the experience of developing early-onset Alzheimer's. In 24 months, 49-year-old Harvard psychology professor Alice Howland exchanges the role of high-achieving teacher, wife and mother of three for that of a disoriented, inarticulate, forgetful shell of her former self. Stricken much earlier than most by this progressive, degenerative disease for which there is no cure, Alice loses her profession, independence, clarity and contact with the world with shocking rapidity in a narrative that sometimes reads more like a dramatized documentary than three-dimensional fiction. Genova, an online columnist for the National Alzheimer's Association, has a brisk style and lays out the facts of the disease-statistics, tests, drugs, clinical trials-plainly, often rather technically. The responses to Alice of her three grown-up children, who are also at risk of the disease; the struggles of her equally high-flying husband, a Harvard biologist; and Alice's own emotional responses, including fear, suicidal thoughts, shame and panic, are offered in semi-educational fashion, sometimes movingly, sometimes mechanically. Alice's address to the Alzheimer's Association Annual Dementia Care Conference is an affecting final public statement before her descent into fog and the loving support of her children. Worthy, benign and readable, but not always lifelike 
Kirkus Reviews

Discussion Questions
1. When Alice becomes disoriented in Harvard Square, a place she's visited daily for twenty-five years, why doesn't she tell John? Is she too afraid to face a possible illness, worried about his possible reaction, or some other reason?

2. After first learning she has Alzheimer's disease, "the sound of her name penetrated her every cell and seemed to scatter her molecules beyond the boundaries of her own skin. She watched herself from the far corner of the room" (pg. 70). What do you think of Alice's reaction to the diagnosis? Why does she disassociate herself to the extent that she feels she's having an out-of-body experience?

3. Do you find irony in the fact that Alice, a Harvard professor and researcher, suffers from a disease that causes her brain to atrophy? Why do you think the author, Lisa Genova, chose this profession? How does her past academic success affect Alice's ability, and her family's, to cope with Alzheimer's?

4. "He refused to watch her take her medication. He could be mid-sentence, mid-conversation, but if she got out her plastic, days-of-the-week pill container, he left the room" (pg. 89). Is John's reaction understandable? What might be the significance of him frequently fiddling with his wedding ring when Alice's health is discussed?

5. When Alice's three children, Anna, Tom and Lydia, find out they can be tested for the genetic mutation that causes Alzheimer's, only Lydia decides she doesn't want to know. Why does she decline? Would you want to know if you had the gene?

6. Why is her mother's butterfly necklace so important to Alice? Is it only because she misses her mother? Does Alice feel a connection tobutterflies beyond the necklace?

7. Alice decides she wants to spend her remaining time with her family and her books. Considering her devotion and passion for her work, why doesn't her research make the list of priorities? Does Alice most identify herself as a mother, wife, or scholar?

8. Were you surprised at Alice's plan to overdose on sleeping pills once her disease progressed to an advanced stage? Is this decision in character? Why does she make this difficult choice? If they found out, would her family approve?

9. As the symptoms worsen, Alice begins to feel like she's living in one of Lydia's plays: "(Interior of Doctor's Office. The neurologist left the room. The husband spun his ring. The woman hoped for a cure.)" (pg. 141). Is this thought process a sign of the disease, or does pretending it's not happening to her make it easier for Alice to deal with reality?

10. Do Alice's relationships with her children differ? Why does she read Lydia's diary? And does Lydia decide to attend college only to honor her mother?

11. Alice's mother and sister died when she was only a freshman in college, and yet Alice has to keep reminding herself they're not about to walk through the door. As the symptoms worsen, why does Alice think more about her mother and sister? Is it because her older memories are more accessible, is she thinking of happier times, or is she worried about her own mortality?

12. Alice and the members of her support group, Mary, Cathy, and Dan, all discuss how their reputations suffered prior to their diagnoses because people thought they were being difficult or possibly had substance abuse problems. Is preserving their legacies one of the biggest obstacles to people suffering from Alzheimer's disease? What examples are there of people still respecting Alice's wishes, and at what times is she ignored?

13. "One last sabbatical year together. She wouldn't trade that in for anything. Apparently, he would" (pg. 223). Why does John decide to keep working? Is it fair for him to seek the job in New York considering Alice probably won't know her whereabouts by the time they move? Is he correct when he tells the children she would not want him to sacrifice his work?

14. Why does Lisa Genova choose to end the novel with John reading that Amylix, the medicine that Alice was taking, failed to stabilize Alzheimer's patients? Why does this news cause John to cry?

15. Alice's doctor tells her, "You may not be the most reliable source of what's been going on" (pg. 54). Yet, Lisa Genova chose to tell the story from Alice's point of view. As Alice's disease worsens, her perceptions indeed get less reliable. Why would the author choose to stay in Alice's perspective? What do we gain, and what do we lose?
(Questions issued by publisher.)

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