Still alice

There's a small bookshelf in the entrance to Chain Bridge Honey Farm which has a reasonable selection of second-hand books for sale. I spotted a good condition copy of Still Alice for 50p and decided to give it a read as the novel has been so popular since its film version was released. My first problem with the book however was caused by this duality. The Alice on the cover bears no physical resemblance to the Alice in the text, so there were a couple of significant points where I didn't immediately identify the small woman with dark curly hair described in the text with the straight auburn haired woman pictured. It does annoy me when publishers set their integrity aside to cash in like this! There must have other film images that would have been suitable and accurate to the prose. (Rant over!)

The novel itself is OK. Alice Hoffman is a Harvard University psychology professor specialising in language, who begins to lose her own ability to communicate as she develops early onset Alzheimer's disease. Oh, the (frequently hammered home) irony! Genova also piles on emotional triggers by including a historic family tragedy and a forthcoming possible birth so this could have been a real tear-jerker in the right hands. I didn't feel that any of the characters leapt off the page to me though. Alice's husband, John, is an unsympathetic creation seeming mostly to exist to spout medical information to the reader.

For me, this story and the affluent family at its centre were just too removed from reality, despite the novel telling a story that must have all-too-real elements for many families worldwide. There have been a number of dementia-related novels launched over the past year or so and, for a nuanced and deeply understanding portrayal of the disease and its harrowing effects, I would recommend Elisabeth Is Missing over Still Alice anyday.

Still Alice provides a believable and insightful view into what it's like to live with Alzheimer's Disease, specifically early-onset, or for someone in your family to come down with it, but it's hard to recommend without some big caveats.

First, the prose is often just... bad. Clumsy, forced metaphors, cliches everywhere, leaving nothing to the reader -- you name it. Second, the protagonist and her family are dripping with unexamined privilege, making them much harder to sympathize with even as their lives collapse. Finally, I kept spotting some uncomfortable expressions of ableism in the way things like addiction, mental illness, and intelligence were discussed, even as the book strives so hard to generate empathy for those with AD.

And yet, it's very successful, even powerful in this mission. Just don't go in expecting much more.

One other side note: the scientific consensus has changed a lot (and if anything, become less clear) in the years since Still Alice was published, so be sure to read the otherwise well informed discussion of AD mechanisms with a grain of salt.

This was a very hard book to read, not in that it was difficult to read but rather that the impact of the book was very hard to take. If you've read "Flowers for Algernon" and remember Algernon at the peak of his intelligence realizing that it's all slipping away, and watching his slow decline -- this book reminded me of that. It starts as Alice Howland, a brilliant 50-year-old cognitive psychology professor at Harvard, notices she's experiencing some odd lapses in memory. She is diagnosed with early onset Alzheimer's Disease, and the book follows the slow decline of her memory as well as the efforts of herself and her family to come to grips with the diagnosis and try to fight a disease for which there really is no way to fight back.

It's an insightful, painful, frightening read and does an excellent job of portraying how the disease affects Alice's memory over time. At what point does she stop being Alice? She wonders to herself: "Is the part of my brain that's responsible for my unique 'me-ness' 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?"

This is not an easy read, especially if you've ever seen this disease affecting a loved one. But it's very thought provoking and compassionately written, by an author who clearly knows the subject inside and out.