205 reviews

Still Alice
by Lisa Genova

Published: 2014-12-02
Paperback : 352 pages
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468 clubs reading this now
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Recommended to book clubs by 203 of 205 members
From New York Times bestselling author and neuroscientist Lisa Genova comes the definitive—and illuminating—novel about Alzheimer’s disease. Now a major motion picture starring Oscar winner Julianne Moore! Look for Lisa Genova's latest novel Inside the O’Briens.

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From New York Times bestselling author and neuroscientist Lisa Genova comes the definitive—and illuminating—novel about Alzheimer’s disease. Now a major motion picture starring Oscar winner Julianne Moore! Look for Lisa Genova's latest novel Inside the O’Briens.

Alice Howland is proud of the life she worked so hard to build. At fifty years old, she’s a cognitive psychology professor at Harvard and a world-renowned expert in linguistics with a successful husband and three grown children. When she becomes increasingly disoriented and forgetful, a tragic diagnosis changes her life—and her relationship with her family and the world—forever. As she struggles to cope with Alzheimer’s, she learns that her worth is comprised of far more than her ability to remember.

At once beautiful and terrifying, Still Alice is a moving and vivid depiction of life with early-onset Alzheimer’s disease that is as compelling as A Beautiful Mind and as unforgettable as Ordinary People.

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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 reaction, or some other reason?

2. 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?

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 her family's, to cope with Alzheimer's?

4. "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?

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 like 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.)" (pg. 141). 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 to honor 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, is she thinking of happier times, or is she 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" (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?

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" (pg. 54). Yet, 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?

Enhance Your Book Club:

1. If you'd like to learn more about Alzheimer's or help those suffering from the disease, please visit www.actionalz.org or www.alz.org.

2. The Harvard University setting plays an important role in Still Alice. If you live in the Cambridge area, hold your meeting in one of the Harvard Square cafŽs. If not, you can take a virtual tour of the university at: http://www.hno.harvard.edu/tour/guide.html

3. In order to help her mother, Lydia makes a documentary of the Howlands' lives. Make one of your own family and then share the videos with the group.

4. To learn more about Still Alice or to get in touch with Lisa Genova, visit www.StillAlice.com.

Suggested by Members

Our club used some of the questions at the end of the book. Lots of discussion ensued.
by boilerreader (see profile) 01/14/17

Find someone who has a personal connection.
by [email protected] (see profile) 11/11/16

See the discussion questions that go with the book. They were very good.
by tina55 (see profile) 08/11/15

Would you want to have genetic testing done? Would this impact your fertility decisions?
Do you feel like John's decisions made sense? Were they cruel or in the interest of self-preservation?
How do you feel about Alice reading Lydia's diary? How did this impact their relationship?
by meags (see profile) 05/12/15

Intellect was a major component of John and Alice's marriage.How do you feel John addressed this loss in his marriage?
Her mother's butterfly necklace was very important to Alice and she named the file The Butterfly file with the directions for ending her life when she felt she had reached the point of lost quality of living. How do you feel these two things are related.
Do you belive there is reason for patients to remember specific members of their family longer- think of Alice's dwindling memory. How does this support/disprove your thoughts?
by BetsyO58 (see profile) 03/07/15

Was it understandable that Alice had such different relationships with her children? And then how the children reacted to her disease?
What did you think about her husband's insistence on moving to New York?
Discuss her suicide plan.
by nmatt0218 (see profile) 08/11/14

What are your thoughts about her husband? Was he faithful?
Explain why you think her daughters were so different in their relationship with her?
by kcmofel (see profile) 09/08/12

What were your feelings about Alice's husband? Were you empathetic to what he was dealing with or did you resent his actions and choices?
by Jess72180 (see profile) 03/03/12

What did you think when John handed her medication?
by Rite1g (see profile) 02/01/11

What overall message did you get from this story?
by ewoolley (see profile) 01/11/11

Notes From the Author to the Bookclub

No notes at this time.

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by Barbara T. (see profile) 02/21/20

This is a book that provides a totally different perspective on Alzheimer’s and dementia since it is from the point of view of the person experiencing the illness. As those in our book club are all in... (read more)

by Melanie M. (see profile) 02/17/20

by corlyn m. (see profile) 12/19/19

by Chary P. (see profile) 11/26/19

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