Book Review: Still Alice

Title: Still Alice
Author: Lisa Genova

Alice Howland - Harvard professor, gifted researcher and lecturer, wife, and mother of three grown children - sets out for a run and soon realizes she has no idea how to find her way home. She has taken the route for years, but nothing looks familiar. She is utterly lost. Medical consults reveal early-onset Alzheimer's. 

Alice's slowly but inevitably loses memory and connection with reality, told from her perspective. She gradually loses the ability to follow a conversational thread, the story line of a book, or to recall information she heard just moments before. Genova's debut shows the disease progression through the reactions of others, as Alice does, so readers feel what she feels - a slowly building terror.
Even then, more than a year earlier, there were neurons in her head, not far from her ears, that were being strangled to death, too quietly for her to hear them. Some would argue that things were going so insidiously wrong that the neurons themselves initiated events that would lead to their own destruction. Whether it was molecular murder or cellular suicide, they were unable to warn her of what was happening before they died.
Imagine being at the top of your career. You've just turned 50. You're still strong. Your status in life and identity depends on a highly functioning brain. You teach brilliant minds in Harvard. You speak at local and international conferences about psychology. You conduct discussions with highly capable colleagues, researchers, doctors, and even nobel prize winners. And then all of a sudden, out of nowhere, you're diagnosed with an early on-set Alzheimer's disease that will rob you to be any of those above mentioned anymore. How would you feel? What would you do? How will you cherish the remaining moments when you're brain is still functioning? How will you spend your time?

These questions were also asked by Alice Howland when she was diagnosed with Alzheimer.  She felt devastated and robbed. She panicked. All of her life, she'd been using her brain actively. This story was told in her point of view. It was a good idea by the way, because I got a peek on how a person with Alzheimer's disease thinks. I felt her frustrations, her loss, her loneliness and even her happiness. There were some parts when I pity her but I feel proud for her because she fights her disease. She really tries very hard to remember important details. She even used post-it-notes and her blackberry to remember certain things. Her story opens the readers' minds see as people with Alzheimer's not the Alzheimer's itself. it tells us how they feel. How they grasp into something familiar but was now foreign to them.

I didn't like how John handled Alice's situation. I really wished for him not to have accepted the position at Sloan-Kettering because he has so much years ahead of him. He should have opted for a Sabbatical leave to spend his wife's remaining days when she can still remember things. He should have spent his time with her. I know he can't cope up and he can't accept the fact that his beloved wife has Alzheimer's but he should have considered what her wife wanted to do. [I can't help but compare him to Noah (The Notebook). How I wish that he replaced John.] He's so selfish but I know that he loves Ali and her misses her already. He's just weak to accept the reality. He should have met or talked with a support group.

Alice is lucky to have her children. They were really supportive. Lydia's idea of documenting Alice's life helped her coped up to remember past events. I'm glad that the technologies are more advanced today because we can prevent babies from accumulating a mutilated gene to prevent Alzheimer's. I like how her children accepted the news of her illness. Although Lydia and Alice didn't get on very well because of the path Lydia had taken, they did found a truce in the end. Lydia is so understanding, patient, and thoughtful. I love how she explains things to her mom - how they talk about her plays, about her friends especially her boyfriend, and how they share ideas. When this disease consumes a person, it should be important that s/he has a family to support her and to remind her of what s/he once was. It is important that they feel loved.

Alice's memory may have deteriorated fast, but the memory of what she did when she was well will always be remembered. She may have Alzheimer's, but she's still Alice.

This is a very powerful and emotionally captivating story that will leave you with puffy eyes and bucketful of information that you can share to your friends, relatives, and colleagues. It will cause you to pause, think, and question your health. Reading this book, I have the sudden urge to go visit a neurologist and have a check-up.

Lisa Genova made this really realistic. what other Alzheimer-related books failed to explain, this book surely did it all. Thanks to her expertise. If you have Alzheimer's or if you know anyone who might have one, you must read and share this book to them now. It will leave you wanting more. It's a page turner and unputdownable. It will help them tremendously. Good job Lisa!

Touching Moments
“I’m so sorry I have this. I can’t stand the thought of how much worse this is going to get. I can’t stand the thought of looking at you someday, this face I love, and not knowing who you are.”
She traced the outline of his jaw and chin and the creases of his sorely out of practice laugh lines with her hands. She wiped the sweat from his forehead and the tears from his eyes.
“I can barely breathe when I think about it. But we have to think about it. I don’t know how much longer I have to know you. We need to talk about what’s going to happen.”
“Good morning. My name is Dr. Alice Howland. I’m not a neurologist or general practice physician, however. My doctorate is in psychology. I was a professor at Harvard University for twenty-five years. I taught courses in cognitive psychology, I did research in the field of linguistics, and I lectured all over the world.
“I am not here today, however, to talk to you as an expert in psychology or language. I’m here today to talk to you as an expert in Alzheimer’s disease. I don’t treat patients, run clinical trials, study mutations in DNA, or counsel patients and their families. I am an expert in this subject because, just over a year ago, I was diagnosed with early-onset Alzheimer’s disease.
“I’m honored to have this opportunity to talk with you today, to hopefully lend some insight into what it’s like to live with dementia. Soon, although I’ll still know what it is like, I’ll be unable to express it to you. And too soon after that, I’ll no longer even know I have dementia. So what I have to say today is timely.
“We, in the early stages of Alzheimer’s, are not yet utterly incompetent. We are not without language or opinions that matter or extended periods of lucidity. Yet we are not competent enough to be trusted with many of the demands and responsibilities of our former lives. We feel like we are neither here nor there, like some crazy Dr. Seuss character in a bizarre land. It’s a very lonely and frustrating place to be.
“I no longer work at Harvard. I no longer read and write research articles or books. My reality is completely different from what it was not long ago. And it is distorted. The neural pathways I use to try to understand what you are saying, what I am thinking, and what is happening around me are gummed up with amyloid. I struggle to find the words I want to say and often hear myself saying the wrong ones. I can’t confidently judge spatial distances, which means I drop things and fall down a lot and can get lost two blocks from my home. And my short-term memory is hanging on by a couple of frayed threads.
“I’m losing my yesterdays. If you ask me what I did yesterday, what happened, what I saw and felt and heard, I’d be hard-pressed to give you details. I might guess a few things correctly. I’m an excellent guesser. But I don’t really know. I don’t remember yesterday or the yesterday before that.
“And I have no control over which yesterdays I keep and which ones get deleted. This disease will not be bargained with. I can’t offer it the names of the United States presidents in exchange for the names of my children. I can’t give it the names of the state capitals and keep the memories of my husband.
“I often fear tomorrow. What if I wake up and don’t know who my husband is? What if I don’t know where I am or recognize myself in the mirror? When will I no longer be me? Is the part of my brain that’s responsible for my unique ‘meness’ vulnerable to this disease? Or is my identity something that transcends neurons, proteins, and defective molecules of DNA? Is my soul and spirit immune to the ravages of Alzheimer’s? I believe it is.
“Being diagnosed with Alzheimer’s is like being branded with a scarlet A. This is now who I am, someone with dementia. This was how I would, for a time, define myself and how others continue to define me. But I am not what I say or what I do or what I remember. I am fundamentally more than that.
“I am a wife, mother, and friend, and soon to be grandmother. I still feel, understand, and am worthy of the love and joy in those relationships. I am still an active participant in society. My brain no longer works well, but I use my ears for unconditional listening, my shoulders for crying on, and my arms for hugging others with dementia. Through an early-stage support group, through the Dementia Advocacy and Support Network International, by talking to you today, I am helping others with dementia live better with dementia. I am not someone dying. I am someone living with Alzheimer’s. I want to do that as well as I possibly can.
“I’m no longer asked to lecture about language at universities and psychology conferences all over the world. But here I am before you today, giving what I hope is the most influential talk of my life. And I have Alzheimer’s disease.
“I’d like to encourage earlier diagnosis, for physicians not to assume that people in their forties and fifties experiencing memory and cognition problems are depressed or stressed or menopausal. The earlier we are properly diagnosed, the earlier we can go on medication, with the hope of delaying progression and maintaining a footing on a plateau long enough to reap the benefits of a better treatment or cure soon. I still have hope for a cure, for me, for my friends with dementia, for my daughter who carries the same mutated gene. I may never be able to retrieve what I’ve already lost, but I can sustain what I have. I still have a lot.
“Please don’t look at our scarlet A’s and write us off. Look us in the eye, talk directly to us. Don’t panic or take it personally if we make mistakes, because we will. We will repeat ourselves, we will misplace things, and we will get lost. We will forget your name and what you said two minutes ago. We will also try our hardest to compensate for and overcome our cognitive losses.
“I encourage you to empower us, not limit us. If someone has a spinal cord injury, if someone has lost a limb or has a functional disability from a stroke, families and professionals work hard to rehabilitate that person, to find ways to cope and manage despite these losses. Work with us. Help us develop tools to function around our losses in memory, language, and cognition. Encourage involvement in support groups. We can help each other, both people with dementia and their caregivers, navigate through this Dr. Seuss land of neither here nor there.
“My yesterdays are disappearing, and my tomorrows are uncertain, so what do I live for? I live for each day. I live in the moment. Some tomorrow soon, I’ll forget that I stood before you and gave this speech. But just because I’ll forget it some tomorrow doesn’t mean that I didn’t live every second of it today. I will forget today, but that doesn’t mean that today didn’t matter.
“Thank you so much. I’m so glad you were able to come and see me graduate. I feel so lucky to have been your student. I want you to know, you were the reason I chose linguistics as my field of study. Your passion for understanding how language works, your rigorous and collaborative approach to research, your love of teaching, you’ve inspired me in so many ways. Thank you for all your guidance and wisdom, for setting the bar so much higher than I thought I could reach, and for giving me plenty of room to run with my own ideas. You’ve been the best teacher I’ve ever had. If I achieve in my life a fraction of what you’ve accomplished in yours, I’ll consider my life a success.”

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