An extraordinary debut novel about an accomplished woman
who slowly loses her thoughts and memories to a harrowing disease
-- only to discover that each day brings a new way of living and
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 of
early-onset Alzheimer''s disease changes her life.
As the inevitable descent into dementia strips away her sense of
self, fiercely independent Alice struggles to live in the moment.
While she once placed her worth and identity in her celebrated and
respected academic life, now she must reevaluate her relationship
with her husband, a respected scientist; her expectations of her
children; and her ideas about herself and her place in the
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.
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
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
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
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
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:
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.
Lisa Genova graduated valedictorian from Bates College with a degree in Biopsychology and holds a Ph.D. in Neuroscience from Harvard University. She is a member of the Dementia Advocacy, Support Network International and DementiaUSA and is an online columnist for the National Alzheimer's association. She lives with her husband and two children in Cape Cod. "Still Alice" is her first novel.