Still Alice

“She simply couldn’t find the word. She had a loose sense for what she wanted to say, but the word itself eluded her. Gone.” 

This quote is likely the first moment Alice realizes that something may be wrong, as the word, lexicon, is common in her field, and it was established prior that this lecture, which includes the word, is one she knows cold. It also demonstrates the cloudy nature of the disease as she experiences it, and how concepts can just disappear. As these disappearances grow more numerous, the disease takes over.

“But Anna countered with the point that every professional woman considering children realized eventually: There’s never going to be a good time to do this.” 

One of the subtler themes in the novel is the recurring feminist lens. Alice is concerned here for her daughter’s ability to maintain a career while having children, and this concern is borne out of her own experience, as she recalls her own career stalling while John’s career progressed. Her department at Harvard is predominantly male, as well, while her disease primarily affects women, which will again leave John in the position to continue when she no longer can.

“Lydia’s unblemished report cards came with little noticeable effort. Anna paid attention to that. They were both competitive and fiercely independent, but Anna wasn’t a risk taker. She tended to pursue goals that were safe and conventional…” 

At the start of the novel, these character traits help to establish why Alice gets along with Anna while her relationship with Lydia is tense, as she cannot understand the perspective. However, Alice and Lydia, to an extent, meet in the middle as their relationship improves: Lydia takes her mother’s advice to establish a backup and go to college, but Alice, when it comes time to decide on alternative medication, takes the riskier option. This can be interpreted as Alice maintaining agency, which can more broadly be stated as a claim the novel makes about risk and independence, particularly in the face of terminal illness.

“But most of all, they shared a passionate quest to understand the mind, to know the mechanisms driving human behavior and language, emotion, and appetite. While the holy grail of this quest carried individual power and prestige, at its core it was a collaborative effort to know something valuable and give it to the world.” 

This quote is a description of Alice’s relationship with her colleagues. Two things are notable in this quote: first, their shared goals and research interests present a particular irony in Alice’s eventual diagnosis; she spent her life trying to understand the mind only to be brought down by a disease that ravishes it, one that no one understands. Second, it represents the tension in the novel between individuality and collaboration: Alice fights to retain her independence as she deteriorates while simultaneously recognizing and demanding her need for a family unit to support her.

“Once they were outside, she meant to ask John what that awkward saccade was about, but she became distracted by the gentle beauty of the cotton-candy snow that had begun to fall while they were inside, and she forgot.”

Alice’s distraction by the beauty of the snow shows her in the early stages of the disease—this quote is still prior to her diagnosis. But, it also shows an early shift to living in the moment and appreciating the beauty of the world around her. Alice rejects, subconsciously, the specifics of the party in order to, instead, appreciate nature.

“She imagined her students back at Harvard…[s]he understood exactly how they felt. Most of the neuropsychological tests administered that morning…were familiar to her…[s]he had, in fact, taken many of them before, serving as a negative control in the cognition studies of various graduate students. But today, she wasn’t a control. She was the subject being tested.” 

At various points, Alice’s disease and its progression are described in terms of role reversals, typically in a chronological regression. This is still early—technically prior to diagnosis—so at this point the reversal is with her students; later, she’ll regress further and become more childlike.

“Everything she did and loved, everything she was, required language.” 

As Alice considers the implications of her diagnosis, she has an existential crisis, realizing that she will eventually lose the ability to communicate. The thought terrifies her; she has spent so long defined by communication that she is unsure how she could move forward without it.

“She pictured her own name on a matching headstone next to Anne’s. She’d rather die than lose her mind.”

This passage is significant because this is the first moment we see Alice wrestling with suicidal ideations. The sleeping pills she eventually procures as a method of ending her own life on her own terms are representative of her own agency and a recurring motif of the novel; standing over her sister’s grave, the idea takes hold.

“‘Alice, does this all make sense to you?’ Stephanie asked. Although the context made the question legitimate, Alice resented it and glimpsed the subtext of conversations in her future. Was she competent enough to understand what was being said?” 

One of the more important shifts Alice must make is to understand what she does not or cannot understand. Alice has spent her adult life as a well-respected academic at an Ivy League university; she is reasonable enough to understand why such questions need to be asked, but nevertheless humiliated by her change in status.

“She didn’t have time for Alzheimer’s today. She had emails to return, a grant proposal to write, a class to teach, and a seminar to attend. And at the end of the day, a run.” 

For Alice, for the meantime, life must continue. She has not yet recused herself from teaching duties and wants to maintain her lifestyle as much as possible, while she still can. It isn’t yet that she begins to consider her professional duties as secondary to finding enjoyment while she still can; the hustle and bustle of life—or so she believes—is still her enjoyment.

“It was a solid piece of good news. But while everyone else continued to savor it, the taste turned slightly bitter for Alice. Despite her self-reproach, she envied Anna, that she could do what Alice couldn’t—keep her children safe from harm.” 

This passage reinforces the theme of family, in particular the bittersweet experience Alice has with it moving forward. Her family is her support, even though she feels as if she has failed them; she is happy that her grandchildren will be safe from Alzheimer’s even as she is guilt-ridden because she couldn’t do the same for her own children.

“‘And family members and friends are always welcome to come and participate in any of the activities and can join their loved ones for any of the meals.’ Aside from Harold, Alice saw no other loved ones. No other husbands, no wives, no children or grandchildren, no friends.”

Alice is beginning to wrestle with her eventual loneliness, as well as her fear of it. There are many reasons why she ultimately rejects the nursing home, but she feels as if ending up there would virtually guarantee loneliness—or, at the very least, it’s a risk she does not want to take.

“[W]hat did she want? Assuming the in vitro procedure worked, she wanted to live to hold Anna’s baby and know it was her grandchild. She wanted to see Lydia act in something she was proud of. She wanted to see Tom fall in love. She wanted one more sabbatical year with John. She wanted to read every book she could before she could no longer read. She laughed a little, surprised at what she’d just revealed to herself. Nowhere in that list was there anything about linguistics, teaching, or Harvard.”

At this moment, Alice begins to recognize what she considers to be important. This is a moment of epiphany concerning how she views herself. At another point, she wonders who she is, if not a Harvard psychology professor; here, she realizes that she is not concerned with that Alice in her final days.

“She’d said that she and other actors had to focus extremely hard to divorce themselves from verbal language in an effort to be honestly affected by what the other actors were doing and feeling. Alice didn’t quite understand the distinction, but she loved Lydia for seeing her handicap as an enviable skill.” 

One of Alice’s biggest fears is losing her language; her inability to communicate, to get to that point, initially terrifies her. It’s notable that it’s through a discussion of acting, which Alice rejected for so long, that Alice herself comes to understand different modes of communication, of following ideas from person to person.

“After a few minutes, Alice noticed that every seat at the table was occupied except for the one next to her, and people had begun taking up standing positions at the back of the room. Seats at the table were highly coveted…” 

Alice is gravely concerned with growing lonely and being cast aside, and as soon as she comes clean with her diagnosis, those fears are reinforced. Of course, we can’t be sure precisely why the seat was left open, so this also connects back to the larger question of what, as the disease progresses, is real in the narrative—we’re close to Alice, so our default is her perspective, but it is open to interpretation, as well.

“Alice knew that the young woman sitting across from her was her daughter, but she had a disturbing lack of confidence in this knowledge. She knew that she had a daughter named Lydia, but when she looked at the young woman sitting across from her, knowing that she was her daughter Lydia was more academic knowledge than implicit understanding, a fact she agreed to, information she’d been given and accepted as true.” 

This quote is representative of a number of things. First, the first real detachment that she experiences with her family; even at this moment, Alice struggles with Lydia, but does not have similar issues with Anna and Tom. Second, it demonstrates the unique way that Alice deals with the disease, as she can, at this point, still recognize a fact even if she is not clear on its justification. Third, it connects to later concepts of the fluidity of reality; Alice’s acceptance of the fact as true in this case is correct, but soon she’ll be unable to trust her own intuition on these matters, and she will become an unreliable source.

“Her head ached. She wondered if anyone had replied yet. She abandoned Dan’s thingy before she even finished the thought.” 

As her disease progresses, the narrative voice shifts, as well. It follows Alice closely through the novel, but here (and elsewhere) it also adopts her language, forcing us to work as Alice does to navigate her world.

“She didn’t know how much longer she could hang on to herself, but she’d convinced herself that she could make it through their sabbatical year. One last sabbatical year together. She wouldn’t trade that in for anything. Apparently, he would.”

Alice and John’s paths continue to diverge. Earlier, Alice wishes that she had been his passion, and John insists that he makes sacrifices, but from Alice’s perspective, she devotes an energy to him that he does not return, either because he is unable or unwilling. Regardless, each time he pushes distance between them, Alice’s condition appears to get worse.

“‘This next year is my one shot, John, not yours. This next year is my last chance at living my life and knowing what it means to me. I don’t think I have much more time of really being me, and I want to spend that time with you, and I can’t believe you don’t want to spend it together.’” 

The conflict between Alice and John comes to its climax here. Alice asserts her agency while she still can and simultaneously reminds John of the stakes.

“‘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.’” 

This comes from Alice’s speech at the Dementia Care Conference, but it connects to the theme of the limitations of scientific progress and the theme of self-identity. Alice has no control over the disease whatsoever; she has no agency, and there is nothing that can be done. She is at its mercy as to what she can and cannot retain.

“Now everyone was crying—the pink baby, the blue baby, the mother, and the woman next to the mother. Everyone except Alice. She wasn’t sad or angry or defeated or scared. She was hungry.” 

Despite that she was the subject of their argument and its resulting tears, Alice’s detachment has reached the point where she is unable to connect to what’s happening around her. She is in touch with the feelings, but she cannot feel them. She can only live in her moment and observe everyone else.

“She smiled, pleased with herself for finally having a confident answer for him. ‘Yes. I like sitting here with you. And I’m not done yet.’ She held up her something chocolate ice cream to show him. It had started to melt and drip down the sides of the cone onto her hand.”

Alice has passed the point of being able to follow the specifics of conversations, but her ability to understand emotions seems to have grown. She recognizes that the conversation is serious but is unable to understand the substance of the seriousness; for her, only aware of the moment, it is important to be able to say that she likes sitting where she is and that she’s not finished being in that moment. This passage is also important as it shows the extent to which she has regressed, as earlier in the novel her technique for avoiding dripping ice cream was described as automatic and second-nature to her.

“The man helped Alice stand. He felt and looked at her head…[h]e put his arm around Alice’s waist and his hand under her elbow, and she walked home with the kind stranger who had saved her life.”

Alice is no longer cognizant of the people in her life. She recognizes the kindness in John but is unaware of who he is. There will be moments that will bring her back to recognition from time to time, but she has finally reached the point of deterioration, where she can no longer recognize her husband.