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March 2004
Themes
Key
LitCharts assigns a color and icon to each theme in Still Alice, which you can use to track the themes throughout the work.
Ambition and Success
Loss of Identity
Illness, Marriage, and Family
Alzheimer’s, Quality of Life, and Happiness
Summary
Analysis
Alice and John struggle to come up with a definitive plan for the future, especially because they are both a year away from being eligible to take a sabbatical year. They do decide to keep her diagnosis a secret from everyone except their children, and they plan on telling them about it when they are all home for Easter.
Because both Alice and John have achieved tenure, they can take a sabbatical year with each other soon. For them, this year symbolizes what might be the final time they are able to truly live with each other as husband and wife, after which Alice will likely have deteriorated to the point where she needs round the clock care and might not even remember John or their kids anymore.
Themes
With all the kids arriving home, Alice notes that Anna is turning down mimosas and a Bloody Mary in favor of water. However, she tells them that it’s just because she is preparing for an insemination the next week. Alice is excited but worries about what might happen. She asks herself if she would have chosen to have children if she knew about her PS1 mutation and what Anna will choose to do when she finds out.
Although Anna is thrilled at the possibility of being pregnant with her first child soon, for Alice this means that the PS1 mutation might get passed down to one more generation. This thought terrifies her because, as a mother, she doesn’t want to be the reason her children or grandchildren develop Alzheimer’s for themselves in the future.
Themes
When Alice tells Tom, Anna, and Lydia about her Alzheimer’s, and that she had been formally diagnosed several months before, nobody knows what to say. Tom asks if she’s sure, so John tells him about the PS1 mutation. Tom asks if it’s “autosomal dominant” and John says it is. They share a meaningful look and Anna frantically asks what that means. Tom explains that they each have a 50 percent chance of getting Alzheimer’s, which means if Anna carries it then her baby will face the same odds.
Like John, their children have trouble believing Alice can have Alzheimer’s. However, they are quicker to accept the diagnosis and the concern shifts from her to themselves—and, for Anna, her future children. As a biologist and medical student, Tom knows an autosomal dominant mutation means that all carriers will develop the disease.
Themes
Anna asks if they can get tested and Alice says that they can, but Anna is still worried about her baby inheriting it. Tom explains that there will “probably be a cure by the time any of our kids would need it.” Anna, however, is upset that this cure might not come in time for herself and her siblings, and Alice explains that one of the bonuses of getting tested is that if they do carry the mutation then they could start preventative care early, should such care be discovered in time.
Although it isn’t spoken, there is a deep sense of anger coming from Anna. For her—someone so dedicated to the idea of motherhood—this means that if she does get pregnant, she might soon find herself facing the same terrifying future as Alice, who she knows will one day forget them all and be unable to care for herself.
Themes
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Lydia asks Alice what medication she is taking and if it will stop the Alzheimer’s, so Alice explains her new regimen and that it will only slow down its progress. Tom observes that she must have caught it early because he hadn’t noticed any changes in her yet. Lydia replies that she knew something was wrong because Alice “doesn’t make any sense on the phone” and frequently repeats herself. John asks Lydia how long she’s noticed these things and Lydia tells him it’s been going on for about a year. Alice “sense[s] John’s humiliation.”
Ironically, it is the one child Alice is most distant from, both physically and emotionally, who has taken notice of the small changes in Alice’s life that indicated something was wrong. In fact, Lydia had noticed changes even before Alice herself had. This forces John to confront the fact that he has not been as good a husband as he could be, since he failed to notice anything at all despite being around Alice on a daily basis.
Themes
Anna announces that she wants to get tested and Tom agrees that he wants to, as well. Lydia, however, stays quiet and seems to zone out before announcing that she “[doesn’t] want to know.”
Lydia’s choice not to get tested shows that what she really wants is to enjoy and embrace life as much as she can, something she believes she’ll have difficulty with if her test comes back positive, since it will force her to go on with the knowledge that one day she’ll forget all of her experiences.
Themes
Anna sends Alice an email telling her that the insemination has failed, and she isn’t pregnant. However, she’s “not […] upset” and hopes the genetic test she had done will also be negative. The day that Anna and Tom are supposed to get their results rolls around, and Alice becomes certain that one of them has tested positive when they don’t arrive at her house on time. When they do come home, they are somber and quiet. Tom tells her that he tested negative, but Anna announces that she does have the mutation. However, she is still going through with in vitro once her embryos have had genetic testing to be sure they do not carry it. Alice envies the fact that Anna is able to make this decision for her children.
Although Alice is understandably upset that Anna has inherited the mutation, there is comfort to be had that modern technology can stop the pattern from continuing with Anna’s future children. For Alice, this is bittersweet: she was unable to save her daughter the heartache of knowing she will develop Alzheimer’s, but, in a sense, Alice’s diagnosis will be the reason her grandchildren never suffer the same fate.
Themes
Although Tom tested negative, he looks “pale, shaken, fragile.” Anna’s news has dampened the relief he must have felt over his results because “they [are] a family, yoked by history and DNA and love,” and he’s always been close with Anna. Anna tells them that she will tell Lydia herself.
Although it isn’t always made obvious, this shows that the Howlands are very close and love each other very much. What one of them suffers, they all suffer. On the other hand, it means they will always help each other get through these hardships.
Themes
