Still Alice

by Lisa Genova

  Today, they discussed a scene from Angels in America. They passed eager questions and answers back and forth, their conversation two-way, equal, fun. And because Alice didn’t have to compete with John to complete her thoughts, she could take her time and not get left behind.

  “What was it like doing this scene with Malcolm?” Alice asked.

  Lydia stared at her as if the question blew her mind.

  “What?”

  “Didn’t you and Malcolm perform this scene together in your class?”

  “You read my journal?”

  Alice’s stomach hollowed out. She thought Lydia had told her about Malcolm.

  “Sweetie, I’m sorry—”

  “I can’t believe you did that! You have no right!”

  Lydia shoved her chair back and stormed off, leaving Alice alone at the table, stunned and queasy. A few minutes later, Alice heard the front door slam.

  “Don’t worry, she’ll calm down,” said John.

  All morning she tried to do something else. She tried to clean, to garden, to read, but all she could manage to do effectively was worry. She worried she’d done something unforgivable. She worried she’d just lost the respect, trust, and love of the daughter she’d only begun to know.

  After lunch, Alice and John walked to Hardings Beach. Alice swam until her body felt too exhausted to feel anything else. The hollowed-out flip-flopping in her stomach gone, she returned to her beach chair, lay in the fully reclined position with her eyes closed and meditated.

  She’d read that regular meditation could increase cortical thickness and slow age-related cortical thinning. Lydia was already meditating every day, and when Alice had expressed an interest, Lydia had taught her. Whether it helped to preserve her cortical thickness or not, Alice liked the time of quiet focus, how it so effectively hushed the cluttered noise and worry in her head. It literally gave her peace of mind.

  After about twenty minutes, she returned to a more wakeful state, relaxed, energized, and hot. She waded back into the ocean, just for a quick dip this time, exchanging sweat and heat for salt and cool. Back in her chair, she overheard a woman on the blanket next to them talking about the wonderful play she’d just seen at the Monomoy Theatre. The hollowed-out flip-flopping surged back in.

  That evening, John grilled cheeseburgers, and Alice made a salad. Lydia didn’t come home for dinner.

  “I’m sure rehearsal’s just running a bit late,” said John.

  “She hates me now.”

  “She doesn’t hate you.”

  After dinner, Alice drank two more glasses of red wine, and John drank three more glasses of scotch with ice. Still no Lydia. After Alice added her evening dose of pills to her unsettled stomach, they sat on the couch together with a bowl of popcorn and a box of Milk Duds and watched King Lear.

  John woke her on the couch. The television was off, and the house was dark. She must’ve fallen asleep before the movie ended. She didn’t remember the ending anyway. He guided her up the stairs to their bedroom.

  She stood at her side of the bed, her hand over her disbelieving mouth, tears in her eyes, the worry expelled from her stomach and mind. Lydia’s journal lay on her pillow.

  “SORRY I’M LATE,” SAID TOM, walking in.

  “Okay, everyone, now that Tom’s here, Charlie and I have some news to share,” said Anna. “I’m five weeks pregnant with twins!”

  Hugs and kisses and congratulations were followed by excited questions and answers and interruptions and more questions and answers. As her ability to track what was said in complex conversations with many participants declined, Alice’s sensitivity to what wasn’t said, to body language and unspoken feelings, had heightened. She’d explained this phenomenon a couple of weeks ago to Lydia, who’d told her it was an enviable skill to have as an actor. She’d said that she and other actors had to focus extremely hard to divorce themselves from verbal language in an effort to be honestly affected by what the other actors were doing and feeling. Alice didn’t quite understand the distinction, but she loved Lydia for seeing her handicap as an enviable skill.

  John looked happy and excited, but Alice saw that he exposed only some of the happiness and excitement he actually felt, probably trying to respect Anna’s caveat of “it’s still early.” Even without Anna’s cautioning, he was superstitious, as most biologists were, and wouldn’t be inclined to openly count these two little chickens before they hatched. But he already couldn’t wait. He wanted grandchildren.

  Just beneath Charlie’s happiness and excitement, Alice saw a thick layer of nervousness covering a thicker layer of terror. Alice thought they were both obviously visible, but Anna seemed oblivious, and no one else commented. Was she simply seeing the typical worry of an expectant first-time father? Was he nervous about the responsibility of feeding two mouths at once and paying for two college tuitions simultaneously? That would explain only the first layer. Was he also terrified about the prospect of having two kids in college and, at the same time, a wife with dementia?

  Lydia and Tom stood next to each other, talking to Anna. Her children were beautiful, her children who weren’t children anymore. Lydia looked radiant; she was enjoying the good news on top of the fact that her entire family was here to see her act.

  Tom’s smile was genuine, but Alice saw a subtle uneasiness about him, his eyes and cheeks slightly sunken, his body bonier. Was it school? A girlfriend? He saw her studying him.

  “Mom, how are you feeling?” he asked.

  “Mostly good.”

  “Really?”

  “Yes, honestly. I’m feeling great.”

  “You seem too quiet.”

  “There’s too many of us talking at once and too quickly,” said Lydia.

  Tom’s smile disappeared, and he looked like he might cry. Alice’s BlackBerry in her baby blue bag vibrated against her hip, signaling the time for her evening dose of pills. She’d wait a few minutes. She didn’t want to take them just now, in front of Tom.

  “Lyd, what time is your performance tomorrow?” asked Alice, her BlackBerry in hand.

  “Eight o’clock.”

  “Mom, you don’t have to schedule it. We’re all here. It’s not like we’re going to forget to bring you with us,” said Tom.

  “What’s the name of the play we’re going to see?” asked Anna.

  “Proof,” said Lydia.

  “Are you nervous?” asked Tom.

  “A little, because it’s opening night, and you’re all going to be there. But I’ll forget you exist once I’m onstage.”

  “Lydia, what time is your play?” asked Alice.

  “Mom, you just asked that. Don’t worry about it,” said Tom.

  “It’s at eight o’clock, Mom,” said Lydia. “Tom, you’re not helping.”

  “No, you’re not helping. Why should she have to worry about remembering something that she doesn’t have to remember?”

  “She won’t worry about it if she puts it in her BlackBerry. Just let her do it,” said Lydia.

  “Well, she shouldn’t be relying on that BlackBerry anyway. She should be exercising her memory whenever she can,” said Anna.

  “So which is it? Should she be memorizing my showtime or totally relying on us?” asked Lydia.

  “You should be encouraging her to focus and really pay attention. She should try to recall the information on her own and not get lazy,” said Anna.

  “She’s not lazy,” said Lydia.

  “You and that BlackBerry are enabling her. Look, Mom, what time is Lydia’s show tomorrow?” asked Anna.

  “I don’t know. That’s why I asked her,” said Alice.

  “She told you the answer twice, Mom. Can you try to remember what she said?”

  “Anna, stop quizzing her,” said Tom.

  “I was going to enter it in my BlackBerry, but you interrupted me.”

  “I’m not asking you to look it up in your BlackBerry. I’m asking you to remember the time she said.”

  “Well, I did
n’t try to remember the time, because I was going to punch it in.”

  “Mom, just think for a second. What time is Lydia’s show tomorrow?”

  She didn’t know the answer, but she knew that poor Anna needed to be put in her place.

  “Lydia, what time is your show tomorrow?” asked Alice.

  “Eight o’clock.”

  “It’s at eight o’clock, Anna.”

  FIVE MINUTES BEFORE EIGHT O’CLOCK, they settled in their seats, second row center. The Monomoy Theatre was an intimate venue, with only a hundred seats and a stage floor just a few feet from the first row.

  Alice couldn’t wait for the lights to go down. She’d read this play and talked about it extensively with Lydia. She’d even helped her run lines. Lydia was playing Catherine, daughter of her mathematical genius-gone-mad father. Alice couldn’t wait to see these characters come alive right in front of her.

  From the very first scene, the acting was nuanced, honest, and multidimensional, and Alice became easily and completely absorbed in the imaginary world the actors created. Catherine claimed she’d written a groundbreaking proof, but neither her love interest nor her estranged sister believed her, and they both questioned her mental stability. She tortured herself with the fear that, like her genius father, she might be going crazy. Alice experienced her pain, betrayal, and fear right along with her. She was mesmerizing from beginning to end.

  Afterward, the actors came out into the audience. Catherine beamed. John gave her flowers and a huge, emphatic hug.

  “You were amazing, absolutely incredible!” said John.

  “Thank you so much! Isn’t it such a great play?”

  The others hugged and kissed and praised her, too.

  “You were brilliant, beautiful to watch,” said Alice.

  “Thank you.”

  “Will we get to see you in anything else this summer?” asked Alice.

  She looked at Alice for an uncomfortably long time before she answered.

  “No, this is my only role for the summer.”

  “Are you here for just the summer season?”

  The question seemed to make her sad as she considered it. Her eyes welled with tears.

  “Yes, I’m moving back to L.A. at the end of August, but I’ll be back this way a lot to visit with my family.”

  “Mom, that’s Lydia, your daughter,” said Anna.

  The well-being of a neuron depends on its ability to communicate with other neurons. Studies have shown that electrical and chemical stimulation from both a neuron’s inputs and its targets support vital cellular processes. Neurons unable to connect effectively with other neurons atrophy. Useless, an abandoned neuron will die.

  SEPTEMBER 2004

  Although it was officially the beginning of fall semester at Harvard, the weather was steadfastly adhering to the rules according to the Roman calendar. It was a sticky eighty degrees that summer morning in September as Alice began her commute to Harvard Yard. In the days just before and following matriculation each year, it always amused her to see the first-year students who weren’t from New England. Fall in Cambridge evoked images of vibrant leaves, apple picking, football games, and wool sweaters with scarves. While it wouldn’t be unusual to wake up on a late September morning in Cambridge to find frost on the pumpkin, the days, especially in early September, were still filled with the sounds of window air conditioners tirelessly groaning and fevered, pathologically optimistic discussions about the Red Sox. Yet each year there they were, these newly transplanted students, moving with the uncertainty of unseasoned tourists along the sidewalks of Harvard Square, always burdened by too many layers of wool and fleece and an excess of shopping bags from the Harvard Coop packed with all the necessary desk gear and sweatshirts bearing the HARVARD brand. The poor sweaty things.

  Even in her sleeveless white cotton T-shirt and ankle-length black rayon skirt, Alice felt uncomfortably damp by the time she reached Eric Wellman’s office. Directly above hers, his was the same size, with the same furniture and the same view of the Charles River and Boston, but somehow his seemed more impressive and imposing. She always felt like a student whenever she was in his office, and that feeling hovered especially present today, as she’d been called in by him “to talk for a minute.”

  “How was your summer?” asked Eric.

  “Very relaxing. How was yours?”

  “Good, it went by too fast. We all missed seeing you at the conference in June.”

  “I know, I missed being there.”

  “Well, Alice, I wanted to talk with you about your course evaluations from last semester before classes begin.”

  “Oh, I haven’t even had a chance to look at them yet.”

  An elastic-bound stack of evaluations from her motivation and emotion course sat somewhere in her office, unopened. Harvard’s student evaluation responses were entirely anonymous and seen only by the instructor of the course and the chair of the department. In the past, she’d read them purely as a vanity check. She knew she was a great teacher, and her students’ evaluations had always nodded in unwavering agreement. But Eric had never asked her to review them with him. She feared, for the very first time in her career, that she wouldn’t like the image of herself she saw reflected in them.

  “Here, take a few minutes and look them over now.”

  He handed her his copy of the stack with the summary page on top.

  On a scale from one, disagree strongly, to five, agree strongly: The instructor held students to a high standard of performance.

  All fours and fives.

  Class meetings enhanced an understanding of the material.

  Fours, threes, and twos.

  The instructor helped me to understand difficult concepts and complex ideas.

  Again, fours, threes, and twos.

  The instructor encouraged questions and the consideration of differing viewpoints.

  Two students gave her ones.

  On a one-to-five scale from poor to excellent, give an overall evaluation of the instructor.

  Mostly threes. If she remembered correctly, she’d never received lower than a four in this category.

  The entire summary page was splattered with threes, twos, and ones. She didn’t try to convince herself that it represented anything but the accurate and thoughtful judgment of her students, without malice. Her teaching performance had outwardly suffered more than she’d been aware of. Still, she’d be willing to bet anything that she was far from the worst-rated teacher in the department. She might be sinking fast, but she was nowhere near the bottom of the barrel.

  She looked up at Eric, ready to face the music, maybe not her favorite tune but probably not wholly unpleasant.

  “If I hadn’t seen your name on that summary, I wouldn’t have thought anything of it. It’s decent, not what I’ve ever seen attached to you, but not horrible. It’s the written comments that are particularly worrisome, and I thought we should talk.”

  Alice hadn’t looked beyond the summary page. He referred to his notes and read aloud.

  “‘She skips over huge sections of the outline, so you skip it, too, but then she expects us to know it for the exam.’

  “‘She doesn’t seem to know the information she’s teaching.’

  “‘Class was a waste of time. I could’ve just read the textbook.’

  “‘I had a hard time following her lectures. Even she gets lost in them. This class was nowhere near as good as her intro course.’

  “‘Once she came to class and didn’t teach. She just sat down for a few minutes and left. Another time, she taught the exact same lecture she did the week before. I’d never dream of wasting Dr. Howland’s time, but I don’t think she should waste mine either.’”

  That was tough to hear. It was much, much more than she’d been aware of.

  “Alice, we’ve known each other a long time, right?”

  “Yes.”

  “I’m going to risk being blunt and too personal here. Is everything okay at home?”r />
  “Yes.”

  “How about you then, is it possible that you’re overstressed or depressed?”

  “No, that’s not it.”

  “This is a little embarrassing to have to ask, but do you think you might have a drinking or substance problem?”

  Now she’d heard enough. I can’t live with a reputation of being a depressed, stressed-out addict. Having dementia has to carry less of a stigma than that.

  “Eric, I have Alzheimer’s disease.”

  His face went blank. He had been braced to hear about John’s infidelity. He was ready with the name of a good psychiatrist. He was prepared to orchestrate an intervention or to have her admitted to McLean Hospital to dry out. He was not prepared for this.

  “I was diagnosed in January. I had a hard time teaching last semester, but I didn’t realize how much it showed.”

  “I’m sorry, Alice.”

  “Me, too.”

  “I wasn’t expecting this.”

  “Neither was I.”

  “I was expecting something temporary, something you would get past. This isn’t a temporary problem we’re looking at.”

  “No, no, it’s not.”

  Alice watched him think. He was like a father to everyone in the department, protective and generous, but also pragmatic and strict.

  “Parents are paying forty grand a year now. This wouldn’t go over well with them.”

  No, it certainly wouldn’t. They weren’t shelling out astronomical dollars to have their sons and daughters learn from someone with Alzheimer’s. She could already hear the uproar, the scandalous sound bites on the evening news.

  “Also, a couple of students from your class are contesting their grades. I’m afraid that would only escalate.”

  In twenty-five years of teaching, no one had ever contested a grade given by her. Not a single student.