The Real Alzheimer's disease

Written by: Victoria Machin
Still Alice is “a debut novel about a 50-year-old woman's descent into early onset Alzheimer's disease”, written by first-time author Lisa Genova: she is an online columnist for the National Alzheimer's Association and holds a Ph. D in neuroscience from Harvard University. This is somewhat ironic as the protagonist, Alice, is an established professor in cognitive psychology at Harvard and lives by the brain’s ability and inability to function. The novel details how Alice discovers she has Alzheimer’s disease, how she deals with telling her family and, more difficult, informing her colleagues about her illness. With a great amount of difficulty, she cuts down her daily activities to accommodate her diagnosis and increasing limitations.
Alice Howland has a career similar to Genova's—she is a psychology professor at Harvard, living in Cambridge with her husband, John. The couple live a normal life and have normal marital disputes (spending quality time together, their daughter's move to L.A.) when the first symptoms of Alzheimer's begin to emerge. First, Alice misplaces her Blackberry, and then she becomes disoriented in the town she’s lived in for years. As confusion starts to cloud her thinking and her memory begins to fail her, she receives a devastating diagnosis: early onset Alzheimer's disease. From then on her life begins to steadily unravel. She gets lost in her own home, resigns from Harvard and eventually cannot recognize her own children. “As the inevitable descent into dementia strips away her sense of self, fiercely independent Alice struggles to live in the moment.” While she once placed her worth and identity in her celebrated and respected academic life, she now must re-evaluate her relationship with her husband, a respected scientist; her expectations of her children; and her ideas about herself and her place in the world.
Genova takes the perilous and novelistic approach of telling the story from Alice's perspective and this makes the story all the more poignant and devastating as Alice she first comes to terms with her diagnosis and then has to subsist with her declining cognitive abilities. The reader is able to identify and empathize with Alice as her disease progresses, feeling her utter frustration, fear and loneliness as her life as she knew it, is stripped away from her. At one point she confides in her husband, John, that she misses her former self, generating an intangible level of devastation to the average reader unaffected by Alzheimer’s disease. In the words of the author, "[Still Alice is] about identity and living a life that matters and about what a crisis does to relationships." More than many other books on the disease, this book takes the reader into the daily life of the patient – forgetfulness, losing direction, putting things in the wrong place – things that happen to this vivacious woman who is faced with leaving her career, a career which has defined her for 20 years. She can no longer give lectures; Often showing up and leaving class, not realizing it was her class to teach. At one point in the book, forty minutes into a fifty-minute lecture,
“She simply couldn’t find the word. For the first time she didn’t know the first letter or what the word sounded like or how many syllables it had. The word had completely eluded her.”The novel details the personal effects, the familial effects and the devastating symptoms of Alzheimer’s disease, producing a narrative novel of accurate biological reference. The biological disease is used to develop the heartbreaking storyline of Alice Holland and her tragic journey as she attempts to carry out a “normal” life. Genova describes the physical manifestations of the loss of brain cognitive response due to the disease. For example; when entering the University lecture hall Alice forgets she is the professor, there to teach a class, and simply sits there for hours on end completely oblivious as to what is ensuing. Generally, the novel encompasses Alice’s diagnosis of early on-set Alzheimer’s disease. This early stage of Alzheimer’s disease is when problems with memory, thinking and concentration may begin to appear in a doctor’s interview or medical tests. Individuals in the early-stage typically need minimal assistance with simple daily routines.
At the time of a diagnosis, an individual is not necessarily in the early stage of the disease; they may have progressed beyond the early stage.  The term younger-onset refers to Alzheimer's that occurs in a person under age 65, like in the case of Alice Holland who is in her 50’s. Younger-onset individuals are often employed, and have children still living at home. People who have younger-onset dementia may be in any stage of dementia – early, middle or late. Experts estimate that some 500,000 people in their 30s, 40s and 50s have Alzheimer's disease or a related dementia. Often when diagnosed with any disease but in particular when suffering with Alzheimer’s, the victim is instructed by a medical professional to seek out support groups and to perform daily mental tests, to expand one’s mental capacity. In Still Alice, Alice forms a support group of others suffering with the disease. Luckily, she has an amazingly supportive spouse, John, who is careful to do what is best for her and shows no signs of loving her less in spite of her diagnosis. As Alice finds it increasingly difficult to imagine who she is, she begins to not recognize her children – or calls her daughter by her long-dead mother’s name –she decides to take action. She gives herself mental tests on a daily basis, and she decides that when she can no longer answer these straightforward questions, she will pull her own “plug”.
The novel remains sympathetic to Alice’s biological decline. It takes place over two years, month by month, showing deterioration in its stages. The tone of the book, though, somewhat jarring, is slightly scientific. But it may be intentional, portraying a clinical distance from which Alice is watching her own changes and decline.

Lisa Genova, does a tremendous job of balancing the biological references to early on-set Alzheimer’s disease with enough character development and plot. This delicate balance enables the reader to connect with the core narrative, and become emotionally attached to the fictional characters. I would absolutely recommend this novel to anyone who enjoys an analytical yet sympathetic storyline, and for someone who just wants to curl up with good book and a cozy blanket and become engrossed in the lives of the characters.
Bibliography:
work
Curled Up With A Good Book: Still Alice by Lisa Genova (November 2009).2008.26 April 2010

Segal, Jeanne and Melissa Wayne. Alzheimer's Disease: Help Guide. April 2009. .
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Curled Up With A Good Book: Still Alice by Lisa Genova (November 2009).2008.26 April 2010