Still Alice

by

Lisa Genova

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Alzheimer’s, Quality of Life, and Happiness Theme Analysis

Themes and Colors
Ambition and Success Theme Icon
Loss of Identity Theme Icon
Illness, Marriage, and Family Theme Icon
Alzheimer’s, Quality of Life, and Happiness Theme Icon
LitCharts assigns a color and icon to each theme in Still Alice, which you can use to track the themes throughout the work.
Alzheimer’s, Quality of Life, and Happiness Theme Icon

Alice Howland was, according to her own approximation, in the best physical condition of her life when she was diagnosed with Alzheimer’s. She regularly takes long runs, eats healthy foods, never drinks to excess, and doesn’t smoke. She feels “young, strong, and healthy,” even at 50. Alice has enjoyed good health, so her Alzheimer’s diagnosis takes her completely by surprise and leaves her wondering how much of her future will be worth living for as the disease takes away her memories, coordination, and, ultimately, her ability to control her own body. Despite her predictions, Alice’s quality of life is not ruined by her disease—she experiences happiness even after she forgets the names and faces of her children, her husband, her career, and even her self-awareness. In Still Alice, Lisa Genova challenges readers’ beliefs about living with Alzheimer’s, and shows that there is still happiness and fulfillment to be had even the disease’s advanced stages.

Alice is young, healthy, and looking forward to maintaining a high quality of life for many years to come, which makes her Alzheimer’s diagnosis even more surprising and tragic. Alice loves taking runs and the exhilarating feeling she gets at the end of her typical route. In fact, she imagined running strong well into her sixties,” which emphasizes how confident she was that she had many good, healthy years in front of her before finding out about her Alzheimer’s. Intellectually, Alice carries her “memory burdens” with ease, enjoying her knack for remembering the details of certain psychological and linguistic studies off the top of her head faster than her Harvard colleagues. This further emphasizes Alice’s potential for a long, productive, and fulfilling life—especially as regards her career—and deepens the sense of unfairness of her diagnosis. Furthermore, her “whole body looked strong and beautiful” at 50. This provides a striking contrast to her rapidly deteriorating mind and memory.

Alzheimer’s also forces Alice to reevaluate her expectations of the future. Although she had planned on spending many years enjoying her children, grandchildren, and prestigious position at Harvard, she grapples with thoughts of suicide as a preferable alternative to losing her memories and control of her body. Among the many horrors of Alzheimer’s, Alice is initially most terrified by a life with “[n]o more language” because all that “she did and loved, everything she was, required language.” Alice foresees a future in which she has lost her identity, thus preventing her from enjoying a high quality of life. Alice has always been an independent woman, but as the risk of getting lost mere blocks from her home increases, she finds herself “at the mercy of John’s availability.” To her, the loss of independence reinforces her plan to end her life before she becomes a burden on her family. The most difficult part of Alice’s disease is that she finds herself simply “sitting and waiting to get worse” without any hope of getting better. In essence, Alice is sitting and waiting for her condition to get bad enough that she can justify ending her life, and this effectively prevents her from truly enjoying what happiness her life still has to offer her.

Alice ultimately does not go through with committing suicide, though her mental health deteriorates beyond the point at which she planned to end her life. Despite the seriousness of her condition, Alice is still able to experience true happiness, which contradicts her previous beliefs about the late stages of Alzheimer’s. Alice originally formulates her suicide plan while she eats an ice cream cone and realizes that she wants to enjoy life for as long as she can. According to Alice, it is only “when the burden of her disease exceed[s] the pleasure of […] ice cream” that she wants to be allowed to die, meaning that it is only when she can’t enjoy the simple things that life will not be worth living. Additionally, Alice’s plan hinges on the belief that she will be aware of the burden of her Alzheimer’s. However, the very nature of Alzheimer’s ultimately prevents her from being aware of anything outside of her present moment. And, as Genova illustrates in the final pages of the book, Alice still experiences meaningful happiness in the moment as she savors the new-baby smell of her “delicious grandchildren” and is “moved […] to tears” by Lydia’s acting, even during the late stages of Alzheimer’s.

Alice’s continued happiness even after she loses her career and memories of her husband and children is meant to highlight the fact that people with serious diseases like Alzheimer’s can still be happy, and, therefore, don’t deserve to be treated simply as unfeeling Alzheimer’s patients, but should be respected as human beings who are still capable of feeling human emotions and living meaningful lives.

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Alzheimer’s, Quality of Life, and Happiness Quotes in Still Alice

Below you will find the important quotes in Still Alice related to the theme of Alzheimer’s, Quality of Life, and Happiness.
September 2003 Quotes

How could he, someone so smart, a scientist, not see what was right in front of him?

Related Characters: Dr. Alice Howland, Dr. John Howland
Page Number: 4
Explanation and Analysis:
October 2003 Quotes

She was clearly older than forty, but she wouldn’t say she looked old. She didn’t feel old, although she knew she was aging. Her recent entry into an older demographic announced itself regularly with the unwelcome intrusion of menopausal forgetting. Otherwise, she felt young, strong, and healthy.

Related Characters: Dr. Alice Howland
Page Number: 35
Explanation and Analysis:
January 2004 Quotes

She thought about the books she’d always wanted to read, the ones adorning the top shelf in her bedroom, the ones she figured she’d have time for later. Moby-Dick. She had experiments to perform, papers to write, and lectures to give and attend. Everything she did and loved, everything she was, required language.

Related Characters: Dr. Alice Howland
Page Number: 73-74
Explanation and Analysis:

She’d rather die than lose her mind. She looked up at John, his eyes patient, waiting for an answer. How could she tell him she had Alzheimer’s disease? He loved her mind. How could he love her with this?

Related Characters: Dr. Alice Howland, Dr. John Howland
Page Number: 78
Explanation and Analysis:
March 2004 Quotes

In the month since their visit to the genetic counselor, he’d stopped asking her for help finding his glasses and keys, even though she knew he still struggled to keep track of them.

Related Characters: Dr. Alice Howland, Dr. John Howland
Page Number: 91
Explanation and Analysis:

John had agreed to walk with her to Harvard every morning. She’d told him she didn’t want to risk getting lost. In truth, she simply wanted that time back with him, to rekindle their former morning tradition.

Related Characters: Dr. Alice Howland, Dr. John Howland
Page Number: 92
Explanation and Analysis:

And although the thought of staying on too long terrified her, the thought of leaving Harvard terrified her much, much more. Who was she if she wasn’t a Harvard psychology professor?

Related Characters: Dr. Alice Howland
Page Number: 96
Explanation and Analysis:
May 2004 Quotes

She remembered being six or seven and crying over the fates of the butterflies in her yard after learning that they lived for only a few days. Her mother had comforted her and told her not to be sad for the butterflies, that just because their lives were short didn’t mean they were tragic. Watching them flying in the warm sun among the daisies in their garden, her mother had said to her, See, they have a beautiful life. Alice liked remembering that.

Related Characters: Dr. Alice Howland, Sarah Louise Daly
Related Symbols: The Butterfly Necklace
Page Number: 111
Explanation and Analysis:

She laughed a little, surprised at what she’d just revealed to herself. Nowhere in that list was there anything about linguistics, teaching, or Harvard. She ate her last bit of cone. She wanted more sunny, seventy-degree days and ice cream cones.

And when the burden of her disease exceeded the pleasure of that ice cream, she wanted to die.

Related Characters: Dr. Alice Howland
Page Number: 118
Explanation and Analysis:
July 2004 Quotes

Moonlight reflected off her right wrist. SAFE RETURN was engraved on the front of the flat, two-inch, stainless steel bracelet. A one-eight-hundred number, her identification, and the words Memory Impaired were etched on the reverse side. Her thoughts then rode a series of waves, traveling from unwanted jewelry to her mother’s butterfly necklace, traversing from there to her plan for suicide, to the books she planned to read, and finally stranded themselves on the common fates of Virginia Woolf and Edna Pontellier. It would be so easy. She could swim straight out toward Nantucket until she was too tired to continue.

Related Characters: Dr. Alice Howland
Related Symbols: The Butterfly Necklace
Page Number: 146
Explanation and Analysis:
August 2004 Quotes

Lydia reached out across the dishes and glasses and years of distance and held her mother’s hand. Alice squeezed it and smiled. Finally, they’d found something else they could talk about.

Related Characters: Dr. Alice Howland, Lydia Howland
Page Number: 162
Explanation and Analysis:
September 2004 Quotes

She had no classes to teach, no grants to write, no new research to conduct, no conferences to attend, and no invited lectures to give. Ever again. She felt like the biggest part of her self, the part she’d praised and polished regularly on its mighty pedestal, had died. And the other smaller, less admired parts of her self wailed with self-pitying grief, wondering how they would matter at all without it.

Related Characters: Dr. Alice Howland
Page Number: 187-188
Explanation and Analysis:

In the beginning, they did. They lived their lives together, with each other. But over the years, it had changed. They had allowed it to change. She thought about the sabbaticals apart, the division of labor over the kids, the travel, their singular dedication to work. They’d been living next to each other for a long time.

Related Characters: Dr. Alice Howland, Dr. John Howland
Page Number: 188
Explanation and Analysis:
October 2004 Quotes

She’d authored well over a hundred published papers. She held this stack of research articles, commentaries, and reviews, her truncated career’s worth of thoughts and opinions, in her hands. It was heavy. Her thoughts and opinions carried weight. At least, they used to.

Related Characters: Dr. Alice Howland
Page Number: 194
Explanation and Analysis:

She tried to be understanding. He needed to work. But why didn’t he understand that she needed to run? If something as simple as regular exercise really did counter the progression of this disease, then she should be running as often as she could. Each time he told her “Not today,” she might be losing more neurons that she could have saved. Dying needlessly faster. John was killing her.

Related Characters: Dr. Alice Howland, Dr. John Howland
Page Number: 197-198
Explanation and Analysis:
December 2004 Quotes

They talked about her as if she weren’t sitting in the wing chair, a few feet away. They talked about her, in front of her, as if she were deaf. They talked about her, in front of her, without including her, as if she had Alzheimer’s disease.

Related Characters: Dr. Alice Howland, Dr. John Howland, Anna Howland, Tom Howland
Page Number: 225
Explanation and Analysis:
February 2005 Quotes

More and more, she was experiencing a growing distance from her self-awareness. Her sense of Alice—what she knew and understood, what she liked and disliked, how she felt and perceived—was also like a soap bubble, even higher in the sky and more difficult to identify, with nothing but the thinnest lipid membrane protecting it from popping into thinner air.

Related Characters: Dr. Alice Howland
Page Number: 242
Explanation and Analysis:
March 2005 Quotes

“My yesterdays are disappearing, and my tomorrows are uncertain, so what do I live for? I live for each day. I live in the moment. Some tomorrow soon, I’ll forget that I stood before you and gave this speech. But just because I’ll forget it some tomorrow doesn’t mean that I didn’t live every second of it today. I will forget today, but that doesn’t mean that today didn’t matter.”

Related Characters: Dr. Alice Howland (speaker)
Page Number: 253
Explanation and Analysis:
June 2005 Quotes

What she saw in them, she recognized in herself. This was something she knew, this place, this excitement and readiness, this beginning. This had been the beginning of her adventure, too, and although she couldn’t remember the details, she had an implicit knowing that it had been rich and worthwhile.

Related Characters: Dr. Alice Howland
Page Number: 276
Explanation and Analysis:
Summer 2005 Quotes

She wanted to tell him everything she remembered and thought, but she couldn’t send all those memories and thoughts, composed of so many words, phrases, and sentences, past the choking weeds and sludge into audible sound. She boiled it down and put all her effort into what was most essential. The rest would have to remain in the pristine place, hanging on.

“I miss myself.”

Related Characters: Dr. Alice Howland (speaker), Dr. John Howland
Page Number: 285
Explanation and Analysis: