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A debut novel about an accomplished woman who slowly loses her thoughts and memories to early-onset Alzheimer's

Neuroscientist Lisa Genova's first novel, Still Alice, has been endorsed by the National Alzheimer's Association with good reason: It's one of the few books that addresses what it's like to live with the disease from the patient's point of view.

Genova's work with Alzheimer's patients has given her a deep understanding of the disorder and its impact not only on the afflicted, but on their friends and family as well. She does a remarkable job of sharing that perspective with her readers. Most of us have a sketchy familiarity with Alzheimer's and its primary symptom: a gradual loss of memory. Genova moves her readers beyond their superficial knowledge to a more profound grasp of the illness, illuminating consequences of it that most haven't considered (for example, the eventual loss of the ability to read a novel, as Alzheimer's patients lose the capacity to keep track of a plot line).

The novel follows Alice Howland's life from her first suspicions of the illness through its conclusive diagnoses to how Alice and her family learn to cope as her condition worsens. Although the story's progression is somewhat predictable, the scenes Genova relates are generally unexpected. Like Alice, the reader never knows when the disease will impact a situation or simply lie dormant in the background. When Alice does exhibit symptoms, they seem to come when she, and the reader, least expect them.

Genova also explores the difficult decisions faced by Alzheimer's patients and their families. She delves into such subjects as treatment options, care facilities, coping mechanisms, genetic implications, and even suicide. The text occasionally gets a bit wordy and artificial during some of these discussions, but for the most part they add to the sense of realism the novel projects.

The book does lack a certain emotional depth. The narrator reports Alice's actions, but doesn't explore her feelings to any great extent; it's a bit clinical. This distance does, however, allow readers to develop a greater understanding of Alzheimer's while at the same time keeping them from becoming mired in the tragedy of the situation. There are two or three touching scenes between Alice and her daughters, but the author largely avoids melodrama. Readers will leave the book in a contemplative state of mind, eager to tell others what they've learned, as opposed to feeling they've been witnesses to a poignant family drama; we never really learn enough about Alice to mourn her ultimate fate.

Still Alice seems designed specifically with book clubs in mind. Not only does the subject matter lend itself to in-depth discussion, but the novel features both a reader's guide and an extensive author Q&A. Beyond the book club circuit, those curious about this insidious disease will find this an enlightening and enjoyable read.

About the Author
Lisa Genova, a first-time novelist, holds a Ph.D. in neuroscience from Harvard University and is an online columnist for the National Alzheimer's Association. She lives with her family in Massachusetts.

This review first ran in the April 1, 2009 issue of BookBrowse Recommends.

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