Illness, Marriage, and Family Theme Analysis

Although Still Alice primarily follows Alice Howland’s individual experience with Alzheimer’s, her marriage, family, and the ways her illness changes her relationships are some of the most important elements of the book. Both Alice and her husband, John, have worked their whole lives to accomplish their goals and give their three kids the best possible life, even though sometimes they disagree about what that means for their youngest daughter, Lydia. As Alice starts showing symptoms of Alzheimer’s, she’s forced to confront some major unacknowledged issues in their marriage. However, while her illness puts a strain on an already strained marriage, it creates a new kind of closeness between Alice and Lydia. In portraying Alice’s personal struggle with Alzheimer’s, Genova also provides a compelling glimpse in the unpredictable effects of one family member’s illness has on those closest to them—both positive ones that bring people together through the creation of a mutual understanding, and negative ones that drive others apart.

Alice has dedicated most of her life to her career, even at the expense of her relationship with her husband and time with her children. When faced with the knowledge that she’s about to lose all these things, Alice realizes what she really values, is time with her family. When Alice is forced to accept that she has a limited amount of time as herself, she makes a list of what she wants to do before her condition worsens and is surprised to find that “nowhere in that list was there anything about linguistics, teaching, or Harvard.” This reveals just how much importance she had formerly placed on her career, and how much she took her family for granted. Alice knows Alzheimer’s will steal her memories over time, but she also believes that her love for her children is “safe from the mayhem in her mind, because it lived in her heart.” Ironically, this means that the one thing she’ll truly keep is the one thing she had taken most for granted in her quest for success: her family.

Alice and John have many qualities in common: they’re ambitious, intelligent, successful, and love their children. However, even before Alice receives her diagnosis, it becomes clear that things aren’t as they should be, and her deteriorating memory highlights deeper, unacknowledged issues. For years, Alice and John enjoyed a “relaxed intimacy” with one another. Using this term to describe their relationship makes it seem idyllic, but it also implies that they have stopped trying to impress each other, romantically or otherwise. When John finds out about Alice’s Alzheimer’s, he goes through a period of denial followed by anger and finally acceptance. But perhaps his most striking response is “humiliation” when Lydia tells him she had noticed something was wrong, and he, “someone so smart, a scientist, [could] not see what was right in front of him.” This response reveals his dawning realization that he hasn’t paid enough attention to his wife, and is interpreted by him as his failure as a husband.

Finally, when John is offered a job in New York City and decides he wants to go despite Alice’s desire to stay and enjoy what time she has left with their kids, Alice realizes that “he’d always loved her, but she’d made it easy. This implies that this love for her, when truly challenged, isn’t equal to the love she has for him, as shown by her willingness to sacrifice all and his unwillingness to do the same. Rather than coming to the same realization about the importance of family, Alice’s diagnosis only seems to create more emotional distance between her and John, and ultimately to drive him away.

Although her marriage begins to deteriorate in stride with her mental health, Alice’s relationship with Lydia goes in the opposite direction and they grow closer as she gets worse. Alice is a strong believer in formal education, but Lydia initially decides to pursue acting instead of going to college. This is something Alice interprets as “rebelling against who we are,” as she tells John. As her condition worsens, Alice decides to read Lydia’s diary to get to know her before she forgets. By doing this, Alice “saw Lydia. And she loved her,” marking her readiness to understand and accept Lydia as she is and allowing herself to drop her walls so they can grow closer. Ultimately, it’s Lydia who best understands Alice, interpreting her confusion and offering answers without making Alice embarrass herself by asking for them. By portraying Alice and Lydia’s relationship this way, Genova highlights how an unexpected tragedy like an illness can bring formerly estranged loved ones together.

Alice’s Alzheimer’s has a profound effect on every member of her family, but not all those effects are negative. In Still Alice, Genova illustrates the complexities of dealing with a loved one’s Alzheimer’s and its ability to simultaneously wedge people apart and draw others together.