BOOK DISCUSSION GUIDE
Summary: This book is about a young woman’s
descent into dementia. And of course, we see her struggle against this
horrifying and inevitable descent. But interestingly, as her cognitive
capabilities diminish, we also get to see her grow. As her symptoms
worsen, Alice loses her cerebral life at Harvard, where she’d
placed her worth and identity, where she’d been valued and respected.
Without it, she embarks on a desperate search for answers to questions
like ‘Who am I now?’ and ‘How do I matter?”
and is forced to search for meaning and intimacy beyond career success
in her relationships with her husband and children, relationships previously
neglected or on autopilot. But has too much time and distance passed
in those relationships, and has Alice already lost too much of herself
to reconnect before she dies? --Lisa Genova
Author Biography: Still Alice is a compelling debut
novel about a 50-year-old woman's sudden descent into early onset Alzheimer's
disease, written by first-time author Lisa Genova, who holds a Ph. D
in neuroscience from Harvard University. She has done research on the
molecular etiology of depression, Parkinson's Disease, drug addiction,
and memory loss following stroke. She is a proud and active member of
the Dementia Advocacy & Support Network International.
How Lisa Genoa came to write the book (Listen to the link at the author’s
“My grandmother had Alzheimer's when she was 85, and I watched
this disease systematically disassemble her. As her granddaughter, I
was heartbroken. But as a neuroscientist, I was fascinated. I read a
lot in the scientific literature about what was going on inside her
head at the molecular level. I read a lot of nonfiction written by clinicians
and caregivers. But I couldn't find a satisfying answer to the question,
"What does it feel like to have this?" By the time my family
was caring for my grandmother, she was too far along to communicate
an answer to this question. But someone in the earliest stages could.
This was the seed for Still Alice.”
Observations and Questions:
1. Now Still Alice is a best seller, but originally, no publisher wanted
it and first-time novelist, Lisa Genova, could not even secure an agent
to help her sell her book. The story was thought to be one to appeal
only to those who have dear ones with Alzheimer’s Disease. Clearly,
the appeal of this book is widespread. What aspects contribute to the
book’s close-to-universal appeal?
2. Are the characters in Still Alice credible? Which ones support Alice?
Which ones disappoint her? Where do John’s actions and responses
fall? Are any of the characters less than believable? Why?
3. When Alice becomes disoriented in Harvard Square, a place she's
visited daily for twenty-five years, why doesn't she tell John? Is she
too afraid to face a possible illness, worried about his possible reaction,
or some other reason?
4. After first learning she has Alzheimer's disease, "the sound
of her name penetrated her every cell and seemed to scatter her molecules
beyond the boundaries of her own skin. She watched herself from the
far corner of the room" (pg. 70). What do you think of Alice's
reaction to the diagnosis? Why does she disassociate herself to the
extent that she feels she's having an out-of-body experience?
5. Is Alice’s speech to the convention chronologically out of
place? At that point, does Alice really seem capable of composing and
dramatically delivering this politically powerful speech?
6. Each of Alice’s children decides whether to take the genetic
test. Would you?
7. Do you find irony in the fact that Alice, a Harvard professor and
researcher, suffers from a disease that causes her brain to atrophy?
Why do you think the author, Lisa Genova, chose this profession? How
does her past academic success affect Alice's ability, and her family's,
to cope with Alzheimer's?
8. Alice answers the same several questions each day. One day she cannot
answer them and begins to follow the steps of her suicide plan. How
do you view Alice’s attempt at suicide?
9. "He refused to watch her take her medication. He could be mid-sentence,
mid-conversation, but if she got out her plastic, days-of-the-week pill
container, he left the room" (pg. 89). Is John's reaction understandable?
What might be the significance of him frequently fiddling with his wedding
ring when Alice's health is discussed?
10. Why is her mother's butterfly necklace so important to Alice? Is
it only because she misses her mother? Does Alice feel a connection
to butterflies beyond the necklace?
11. Lydia is accepted at two colleges to study acting. It makes very
little sense that anyone who is accepted at NYU would prefer Brandeis
(although Brandeis is a great school in general). This flaw in the plot
bothers me. Does it bother you? Or am I missing a subtle detail? Is
Lydia sacrificing NYU for the sake of allowing her mother to stay where
she can see her grandchildren?
12. In my experience with a friend who began showing signs of early-onset
Alzheimer’s Disease in the early 1980s, the loss of physical coordination
was the most visible sign. She was clumsy and tripped up on things.
She couldn’t stuff envelopes and lick stamps without a great effort.
How is Alice’s physical deterioration made known?
13. Alice's mother and sister died when she was only a freshman in
college, and yet Alice has to keep reminding herself they're not about
to walk through the door. As the symptoms worsen, why does Alice think
more about her mother and sister? Is it because her older memories are
more accessible, is she thinking of happier times, or is she worried
about her own mortality?
14. "One last sabbatical year together. She wouldn't trade that
in for anything. Apparently, he would" (pg. 223). Why does John
decide to keep working? Is it fair for him to seek the job in New York
considering Alice probably won't know her whereabouts by the time they
move? Is he correct when he tells the children she would not want him
to sacrifice his work?
15. Alice and the members of her support group, Mary, Cathy, and Dan,
all discuss how their reputations suffered prior to their diagnoses
because people thought they were being difficult or possibly had substance
abuse problems. Is preserving their legacies one of the biggest obstacles
to people suffering from Alzheimer's disease? What examples are there
of people still respecting Alice's wishes, and at what times is she
16. How do you rate the ending of Still Alice? What other endings can
Research Forum Interview with Lisa Genova
Questions and discussion provided by Audrey
This discussion guide made possible with public
funds from the New York State Council on the Arts, a State Agency. Sponsored
by the Mohawk Valley Library System and participating member libraries.