Still Alice

Lisa Genova chose to write this novel from a close third-person perspective, and to employ free indirect discourse. Alice is told early on that she might not be the most reliable source of information, and as the novel progresses, our experience largely mimics hers. At times, the narrator explains what is happening and clarifies things for us; often, however, she does not, such as the day Alice accidentally attends her class, instead of teaching it. This leads us to question what we read and forces us to piece together our experiences much in the same way Alice is increasingly forced to do.

As a result, we can mark Alice’s deterioration through her lapses of reality, not just through the events but through the information that the narrator betrays or does not betray. Early in the text, when Alice is unable to remember a word, that word is withheld from us—as it is Alice—but as Alice is conscious of the lapse, so is the narrator, and so are we. Later, we get a mixture—at times we’re aware, but at others the narrator will simply switch from “Lydia” to “the actress,” and it is up to the reader to make the switch, too. By the end of the novel, reality is nothing more than a series of moments; even here, the reader sees the narrative perspective pull out some—even getting a chapter solely on John— which is an imperative, given how confusing Alice’s world has now become. 

Much like the blurred line between reality and Alice’s version of the world, we can track Alice’s decline through her understanding of time. Right from the start, time is a relative thing: there is a “real” time, but then there are the various versions of time that exist simultaneously in the Howland household. As the novel progresses, Alice becomes less aware of what time it is—if it’s dark after a nap, she doesn’t know if it’s morning or night and struggles to work out which it is, and even once goes to her Harvard faculty office in the middle of the night, completely unaware of the actual time. To that same end, time serves as a grounding mechanism for Alice, as well: we learn early that routine is good for Alzheimer’s patients, and her decline appears to hasten once routine is removed from the picture, such as on Cape Cod.

Time is more than that, though, as it functions as an actor itself. As much as the disease, time is a mode of attack: the particularly cruel nature of Alice’s situation is that she is so young when she develops it, making time a rather blunt instrument with which to wield the disease. It is also a prison: because of Alice’s young age, she can expect to live with Alzheimer’s for potentially decades, unable to escape her existence, waiting simply on time to run out. As a result, it becomes very important for Alice to attempt, at least, to maintain agency over time. In some ways, she fails: she is unable to carry out her original plan to end her own life before she becomes imprisoned by both time and the disease. On the other hand, if she is successfully able to embrace a more momentary existence and appreciate life from moment to moment, then she has managed to achieve agency over time. 

Alice and John have made their careers as scientists: Alice of the mind, John of humankind’s basic biology. Yet, the events of the novel, and the specifics of Alice’s situation, raise questions about the nature and limitations of science. This is not to say that the novel is anti-science, but rather that nature is positioned as cruel, uncompromising, and dominant, with humans playing catch-up. Alice’s disease, for example, is one for which we have no cure and, for most, no real way of even being certain of a diagnosis. (Alice is “fortunate” in that she was able to be tested for a genetic marker, but it is made clear that Alice’s case is an outlier case.) Making it worse is that the disease takes away the very things to which Alice has dedicated her life—her mind and her language—making this a particularly ironic fate. Further, the genetic nature of it means that Alice has unwittingly passed it on to at least one of her children, as well.

However, in other ways, science offers hope. Anna will succumb to Alzheimer’s, but thanks to scientific testing, her children will not. And, ultimately, it is the marriage of science—or, as Alice thinks of it, the mind—and the heart that proves to be the impetus for Alice to continue. Humans have limitations, the novel seems to say, but we persevere, and that’s what matters.