June Book Club

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.

Alice Howland, happily married with three grown children and a house on the Cape, is a celebrated Harvard professor at the height of her career when she notices a forgetfulness creeping into her life. As confusion starts to cloud her thinking and her memory begins to fail her, she receives a devastating diagnosis: early onset Alzheimer’s disease. Fiercely independent, Alice struggles to maintain her lifestyle and live in the moment, even as her sense of self is being stripped away. In turns heartbreaking, inspiring and terrifying, Still Alice captures in remarkable detail what’s it’s like to literally lose your mind…

Reminiscent of A Beautiful Mind, Ordinary People and The Curious Incident of the Dog in the Night-time, Still Alice packs a powerful emotional punch and marks the arrival of a strong new voice in fiction.

Discussion Questions from the author…

1. 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 reactions, or some other reason?

2. After Alice first learns 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” (p. 71). 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?

3. 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 that of her family, to cope with Alzheimer’s?

4. “He refused to watch her take her medications. He could be midsentence, midconversation, but if she got out her plastic days-of-the-week pill dispenser, he left the room” (p.90). Is John’s reaction understandable? What might be the significance of his frequently fiddling with his wedding ring when Alice’s health is discussed?

5. When Alice’s three children, Anna, Tom, and Lydia, find out they can be tested for the genetic mutation that causes Alzheimer’s, only Lydia decides she doesn’t want to know. Why does she decline? Would you want to know if you had the gene?

6. 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?

7. Alice decides she wants to spend her remaining time with her family and her books. Considering her devotion and passion for her work, why doesn’t her research make the list of priorities? Does Alice most identify herself as a mother, wife, or scholar?

8. Were you surprised at Alice’s plan to overdose on sleeping pills once her disease progressed to an advanced stage? Is this decision in character? Why does she make this difficult choice? If they found out, would her family approve?

9. As the symptoms worsen, Alice begins to feel as if she’s living in one of Lydia’s plays: “(Interior of Doctor’s Office. The neurologist left the room. The husband spun his ring. The woman hoped for a cure.)” (p. 142). Is this thought process a sign of the disease, or does pretending it’s not happening to her make it easier for Alice to deal with reality?

10. Do Alice’s relationships with her children differ? Why does she read Lydia’s diary? And does Lydia decide to attend college only for her mother?

11. 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, she’s thinking of happier times, or she’s worried about her own mortality?

12. 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 ignored?

13. “One last sabbatical year together. She wouldn’t trade that in for anything. Apparently, he would” (p.226). 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?

14. Why does Lisa Genova choose to end the novel with John reading that Amylix, the medicine that Alice was taking, failed to stabilize Alzheimer’s patients? Why does this news cause John to cry?

15. Alice’s doctor tells her, “… you may not be the most reliable source of what’s been going on” (p.55). Yes, Lisa Genova chose to tell the story from Alice’s point of view. As Alice’s disease worsens, her perceptions indeed get less reliable. Why would the author choose to stay in Alice’s perspective? What do we gain, and what do we lose?

Suggested discussion questions from our Facebook friend Kathleen P.

We invite you to engage in our book club by submitting book ideas, summaries, discussion questions, recipes and hosting live discussions in your community or online with us! Send you thoughts to [email protected]. Thank you Kathleen!

1. What do you imagine is next for Alice? How do you see her days being spent? Her disease progressing? What do you think Lydia’s future holds?

2. Did this book change the way you see/think of Alzheimer’s disease? How?

3. A couple major ethical dilemmas presented themselves in this novel: A) Genetic Testing: How do you feel about Alice’s kids choosing, or not choosing, to be tested? How did you feel about Anne having embryos tested for the gene? B) Alice writing instructions to herself to take her own life. Where you disappointed that her plan didn’t work out as she had intended? Do you think her husband knew about her plan and intervened by taking the pills out of the drawer?

4. The author is a neuroscientist, so she knows a great deal about the science of Alzheimer’s disease. Do you think she has the experience to represent how one feels when they have this disease? Do you think her representation seemed accurate?

About the Book

In his first novel since The Corrections, Jonathan Franzen has given us an epic of contemporary love and marriage. Freedom comically and tragically captures the temptations and burdens of liberty: the thrills of teenage lust, the shaken compromises of middle age, the wages of suburban sprawl, the heavy weight of empire. In charting the mistakes and joys of Freedom‘s intensely realized characters as they struggle to learn how to live in an ever more confusing world, Franzen has produced an indelible and deeply moving portrait of our time.