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December 2003
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 is very nervous about her next appointment with Dr. Davis because the appointment is on January 19th, which is the same day her sister and mother died and “she’d never received good news on that day.” Still, she goes in and takes some neuropsychological tests, many of which she is familiar with and involve simple recall and naming tasks, before being taken into his office. When Dr. Davis comes in, he is upset that Alice still has not brought a family member with her and insists that she brings someone with her next time.
The fact that Alice comes to this appointment alone, even though she had agreed to bring someone with her last time, indicates that she still has not talked to John about what has been going on. There is still a lack of trust on Alice’s part, and fear of what John might think if she admits her fears to him. Unfortunately, the fact that Dr. Davis says there will be a next time also indicates that she is about to receive bad news.
Themes
Dr. Davis tells Alice that her physical tests had come back clean and ruled out cancer or a mitochondrial disease. He also tells her that she scored well in most of the neuropsychological tests but has a “recent memory impairment that is out of proportion to [her] age.” She scored low on her memory tests “down to the sixtieth percentile in one.” Dr. Davis says this indicates that Alice has “probable Alzheimer’s disease.” When Alice asks if the word “probable” means she might not have it, Dr. Davis explains that it requires a sample of brain tissue to study and that this is a clinical diagnosis.
Although Alice’s worst fear (a brain tumor) has been ruled out, she is absolutely blindsided by her “probable Alzheimer’s” diagnosis. However, the word “probable” leaves a small amount of room for doubt, which is shown when Alice directly asks Dr. Davis if that means she might not have it. The fact that a true confirmation of the diagnosis can only come from a sample of the actual brain tissue highlights how difficult Alzheimer’s can be to identify and diagnose.
Themes
Alice denies that she could have Alzheimer’s because she’s only 50 but Dr. Davis explains that she has early-onset Alzheimer’s, which typically occurs in people under 65 and usually has a “strong genetic linkage,” which makes Alice think of her children. Alice asks what’s next and Dr. Davis explains that there are medications she can take that will slow the disease’s progress, but it can’t be cured or stopped. He gives her a list of vitamins and other medications to start taking. Dr. Davis also asks her if her family knows about her appointment and she says no. He makes her promise to tell her husband. Dr. Davis tells her to come back in six months and encourages her to get in touch with Denise Daddario, a social worker who can help her with resources. Alice again reflects that nothing good happens on the 19th.
Although she was surprised by the diagnosis, Alice seems quick to accept it as truth. This could mean that, on some level, she knew Alzheimer’s was a possibility. Alice continues to associate the 19th of January with the deaths of her mother and sister, but now this date is also associated with the death of her long-term hopes for the future. As Dr. Davis says, Alzheimer’s cannot be reversed, nor can the progression stopped. Even though Alice will not physically die and may in fact live for decades to come, her mind will gradually die away and destroy her sense of self with it.
Themes
Back at her office, Alice looks through some of the literature Dr. Davis gave her and studies the descriptions of various symptoms. Alice realizes that, for her, eventually, there will be “no more language.” This makes her think of all the books she had planned to read, papers she wanted to write, and experiments she wanted to perform. Alice looks back at her pamphlet to read about other symptoms, which include hallucinations, depression, irritability, problems sleeping, and apathy.
In the immediate aftermath of Dr. Davis’s news, Alice is left by herself to consider all that is going to happen to her in the near future. In fact, she doesn’t see much of a future for herself, especially with “no more language.” Furthermore, language is something she’s devoted her career to studying, so losing language means she will lose that major aspect of her identity.
Themes
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Alice realizes that her knowledge of Alzheimer’s is slim, but what she does know is that her hippocampus will be “mired in plaques and tangles” and that one day she won’t recognize her own family. She decides to look up more information on the Internet, but just then John comes into her office and asks if she’s ready to go. Looking at him, Alice feels that she’s not “ready to turn herself in” and tell him yet because then it will “become real.” She gets up and leaves the office with him.
The phrase Alice uses to describe telling John about her diagnosis, that she will have to “turn herself in,” further illustrates her fear of admitting weakness or vulnerability to him. Not only will the diagnosis “become real” once she tells John, but she feels she will be changed in his mind because she is no longer as strong as he believes she is.
Themes
Alice and John go to Mount Auburn, the cemetery where her family is buried. She stops in front of three headstones: Anne Lydia Daly, Sarah Louise Daly, and Peter Lucas Daly. Neither John nor Alice speak while they stand in front of the headstones, and Alice wonders what he’s thinking about. She also asks herself how she could have Alzheimer’s and which of her parents may have had it. Peter had always been an alcoholic, especially after the night when he drove drunk and caused the car accident that killed Anne and Sarah. Later in his life, Alice remembers that he became belligerent and “nonsensical,” which leads her to believe he may have had Alzheimer’s.
Unfortunately for Alice, two of the people she might have confided in at this moment, her mother and Anne, are buried in the graveyard in front of her. Dr. Davis told Alice that her form of Alzheimer’s (the early-onset variety) is strongly connected to genetics, which means at least one person in her family may have had it themselves and passed it onto her. Because of Peter’s alcoholism, Alice never had reason to suspect that his belligerence or strange behavior was the result of Alzheimer’s. So, by a cruel twist of fate, the same alcoholism that indirectly led to the deaths of Anne and Sara may have also prevented him from finding out about his possible Alzheimer’s. Therefore, Alice would also have been unable to take precautionary measures for herself, such as taking medications or making dietary changes to designed to slow its progress.
Themes
In her mind, Alice blames Peter for her Alzheimer’s and begins crying hysterically. Surprised, John holds her and lets her cry. Alice realizes that “no amount of crying would cleanse her contaminated brain” and John is probably worried, but she continues until she can’t anymore. John asks her if she’s okay and she nearly tells him about her Alzheimer’s but doesn’t. She worries about what he’ll think because he “love[s] her mind” and she might lose it: “How could he love her with this?” She tells him she’s just having a bad day and decides “she’d rather die than tell him.”
John’s surprise at Alice’s sudden outburst highlights how unused he is to seeing her cry, although he is able to be there for her in the way she needs him to be. Still, Alice is unable to believe John will still love her when her mind no longer works the way it used to, which is why she is still unable to come clean about her diagnosis when he asks her. Not only would Alice “rather die than tell [John],” she would rather die than live to see the day he no longer loves her the way she loves him.
Themes
Alice experiences “impulsive thoughts of suicide,” but is unable to act on them because she’s not ready to die. However, she does decide to tell John about her diagnosis. When she tells him, John asks who she had seen and when. She tells him about Dr. Davis and that she’s known for ten days. John tells her that Dr. Davis is wrong, and they argue over whether her forgetfulness is normal or not. John has trouble believing her, so she tells him about forgetting the bread pudding recipe and her disorientation in Harvard Square. When Alice tells him she’s afraid of what she doesn’t realize what else she’s forgotten, John suddenly remembers the incident with Dan’s wife. He tells her needs “to do some reading” and walks out of the room.
When Alice finally tells John about her diagnosis, he is predictably shocked by it. He is unable to reconcile his beliefs about Alice with his beliefs about Alzheimer’s patients, which is why he doesn’t believe Dr. Davis was right about the diagnosis. In fact, it isn’t until John remembers having seen Alice forget something she should have known (the incident with Dan’s wife) that he is willing to accept her diagnosis as a possibility. However, what Alice needs most is emotional support, which John doesn’t give her, instead leaving her alone to go “do some reading” in another room without trying to comfort her.
Themes
