Still Alice

by Lisa Genova

  “John, why did you do this to the kitchen?” she hollered.

  “Alice, what are you doing?”

  The woman’s voice startled her.

  “Oh, Lauren, you scared me.”

  It was her neighbor who lived across the street. Lauren didn’t say anything.

  “I’m sorry, would you like to sit down? I was about to make some tea.”

  “Alice, this isn’t your kitchen.”

  What? She looked around the room—black granite countertops, birch cabinets, white tile floor, window over the sink, dishwasher to the right of the sink, double oven. Wait, she didn’t have a double oven, did she? Then, for the first time, she noticed the refrigerator. The smoking gun. The collage of pictures stuck with magnets to its door were of Lauren and Lauren’s husband and Lauren’s cat and babies Alice didn’t recognize.

  “Oh, Lauren, look what I did to your kitchen. I’ll help you put everything back.”

  “That’s okay, Alice. Are you all right?”

  “No, not really.”

  She wanted to run home to her own kitchen. Couldn’t they just forget this happened? Did she really have to have the I-have-Alzheimer’s-disease conversation right now? She hated the I-have-Alzheimer’s-disease conversation.

  Alice tried to read Lauren’s face. She looked baffled and scared. Her face was thinking, Alice might be crazy. Alice closed her eyes and took a deep breath.

  “I have Alzheimer’s disease.”

  She opened her eyes. The look on Lauren’s face didn’t change.

  NOW, EVERY TIME SHE ENTERED the kitchen, she checked the refrigerator, just to be sure. No pictures of Lauren. She was in the right house. In case that didn’t remove all doubt, John had written a note in big black letters and stuck it with a magnet to the refrigerator door.

  ALICE,

  DO NOT GO RUNNING WITHOUT ME.

  MY CELL: 617-555-1122

  ANNA: 617-555-1123

  TOM: 617-555-1124

  John had made her promise not to go running without him. She’d sworn she wouldn’t and crossed her heart. Of course, she might forget.

  Her ankle could probably use the time off anyway. She’d rolled it stepping off a curb last week. Her spatial perception was a bit off. Objects sometimes appeared closer or farther or generally somewhere other than where they actually were. She’d had her eyes checked. Her vision was fine. She had the eyes of a twenty-year-old. The problem wasn’t with her corneas, lenses, or retinas. The glitch was somewhere in the processing of visual information, somewhere in her occipital cortex, said John. Apparently, she had the eyes of a college student and the occipital cortex of an octogenarian.

  No running without John. She might get lost or hurt. But lately there was no running with John either. He’d been traveling a lot, and when he wasn’t out of town, he left the house for Harvard early and worked late. By the time he got home, he was always too tired. She hated depending on him to go running, especially since he wasn’t dependable.

  She picked up the phone and dialed the number on the refrigerator.

  “Hello?”

  “Are we going for a run today?” she asked.

  “I don’t know, maybe, I’m in a meeting. I’ll call you later,” said John.

  “I really need to go for a run.”

  “I’ll call you later.”

  “When?”

  “When I can.”

  “Fine.”

  She hung up the phone, looked out the window and then down at the running shoes on her feet. She peeled them off and threw them at the wall.

  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.

  She picked up the phone again.

  “Yes?” asked John, hushed and annoyed.

  “I want you to promise that we’ll run today.”

  “Excuse me for a minute,” he said to someone else. “Please, Alice, let me call you after I get out of this meeting.”

  “I need to run today.”

  “I don’t know yet when my day’s going to end.”

  “So?”

  “This is why I think we should get you a treadmill.”

  “Oh, fuck you,” she said, hanging up.

  She supposed that wasn’t very understanding. She flashed to anger a lot lately. Whether this was a symptom of her disease advancing or a justified response, she couldn’t say. She didn’t want a treadmill. She wanted him. Maybe she shouldn’t be so stubborn. Maybe she was killing herself, too.

  She could always walk somewhere without him. Of course, this somewhere had to be somewhere “safe.” She could walk to her office. But she didn’t want to go to her office. She felt bored, ignored, and alienated in her office. She felt ridiculous there. She didn’t belong there anymore. In all the expansive grandeur that was Harvard, there wasn’t room there for a cognitive psychology professor with a broken cognitive psyche.

  She sat in her living room armchair and tried to think of what to do. Nothing meaningful enough came to her. She tried to imagine tomorrow, next week, the coming winter. Nothing meaningful enough came to her. She felt bored, ignored, and alienated in her living room armchair. The late afternoon sun cast strange, Tim Burton shadows that slithered and undulated across the floor and up the walls. She watched the shadows dissolve and the room dim. She closed her eyes and fell asleep.

  ALICE STOOD IN THEIR BEDROOM, naked but for a pair of ankle socks and her Safe Return bracelet, wrestling and growling at an article of clothing stretched around her head. Like a Martha Graham dance, her battle against the fabric shrouding her head looked like a physical and poetic expression of anguish. She let out a long scream.

  “What’s happening?” asked John, running in.

  She looked at him with one panicked eye through a round hole in the twisted garment.

  “I can’t do this! I can’t figure out how to put on this fucking sports bra. I can’t remember how to put on a bra, John! I can’t put on my own bra!”

  He went to her and examined her head.

  “That’s not a bra, Ali, it’s a pair of underwear.”

  She burst into laughter.

  “It’s not funny,” said John.

  She laughed harder.

  “Stop it, it’s not funny. Look, if you want to go running, you have to hurry up and get dressed. I don’t have a lot of time.”

  He left the room, unable to watch her standing there, naked with her underwear on her head, laughing at her own absurd madness.

  ALICE KNEW THAT THE YOUNG woman sitting across from her was her daughter, but she had a disturbing lack of confidence in this knowledge. She knew that she had a daughter named Lydia, but when she looked at the young woman sitting across from her, knowing that she was her daughter Lydia was more academic knowledge than implicit understanding, a fact she agreed to, information she’d been given and accepted as true.

  She looked at Tom and Anna, also sitting at the table, and she could automatically connect them with the memories she had of her oldest child and her son. She could picture Anna in her wedding gown, in her law school, college, and high school graduation gowns, and in the Snow White nightgown she’d insisted on wearing every day when she was three. She could remember Tom in his cap and gown, in a cast when he broke his leg skiing, in braces, in his Little League uniform, and in her arms when he was an infant.

  She could see Lydia’s history as well, but somehow this woman sitting across from her wasn’t inextricably connected to her memories of her youngest child. This made her uneasy and painfully aware that she was declining, her past becoming unhinged from her present. And how strange that she had no problem identifying the man next to Anna as Anna’s husband, Charlie, who had entered their lives only a couple of ye
ars ago. She pictured her Alzheimer’s as a demon in her head, tearing a reckless and illogical path of destruction, ripping apart the wiring from “Lydia now” to “Lydia then,” leaving all the “Charlie” connections unscathed.

  The restaurant was crowded and noisy. Voices from other tables competed for Alice’s attention, and the music in the background moved in and out of the foreground. Anna’s and Lydia’s voices sounded the same to her. Everyone used too many pronouns. She struggled to locate who was talking at her table and to follow what was being said.

  “Honey, you okay?” asked Charlie.

  “The smells,” said Anna.

  “You want to go outside for a minute?” asked Charlie.

  “I’ll go with her,” said Alice.

  Alice’s back tensed as soon as they left the cozy warmth of the restaurant. They’d both forgotten to bring their coats. Anna grabbed Alice’s hand and led her away from a circle of young smokers hovering near the door.

  “Ahh, fresh air,” said Anna, taking a luxurious breath in and out through her nose.

  “And quiet,” said Alice.

  “How are you feeling, Mom?”

  “I’m okay,” said Alice.

  Anna rubbed the back of Alice’s hand, the hand she was still holding.

  “I’ve been better,” she admitted.

  “Same here,” said Anna. “Were you sick like this when you were pregnant with me?”

  “Uh-huh.”

  “How did you do it?”

  “You just keep going. It’ll stop soon.”

  “And before you know it, the babies will be here.”

  “I can’t wait.”

  “Me, too,” Anna said. But her voice didn’t carry the same exuberance Alice’s did. Her eyes suddenly filled with tears.

  “Mom, I feel sick all the time, and I’m exhausted, and every time I forget something I think I’m becoming symptomatic.”

  “Oh, sweetie, you’re not, you’re just tired.”

  “I know, I know. It’s just when I think about you not teaching anymore and everything you’re losing—”

  “Don’t. This should be an exciting time for you. Please, just think about what we’re gaining.”

  Alice squeezed the hand she held and placed her other one gently on Anna’s stomach. Anna smiled, but the tears still spilled out of her overwhelmed eyes.

  “I just don’t know how I’m going to handle it all. My job and two babies and—”

  “And Charlie. Don’t forget about you and Charlie. Keep what you have with him. Keep everything in balance—you and Charlie, your career, your kids, everything you love. Don’t take any of the things you love in your life for granted, and you’ll do it all. Charlie will help you.”

  “He better,” Anna threatened.

  Alice laughed. Anna wiped her eyes several times with the heels of her hands and blew a long, Lamaze-like breath out through her mouth.

  “Thanks, Mom. I feel better.”

  “Good.”

  Back inside the restaurant, they settled into their seats and ate dinner. The young woman across from Alice, her youngest child, Lydia, clanged her empty wineglass with her knife.

  “Mom, we’d like to give you your big gift now.”

  Lydia presented her with a small, rectangular package wrapped in gold paper. It must have been big in significance. Alice untaped the paper. Inside were three DVDs—The Howland Kids, Alice and John, and Alice Howland.

  “It’s a video memoir for you. The Howland Kids is a collection of interviews of Anna, Tom, and me. I shot them this summer. It’s our memories of you and our childhoods and growing up. The one with Dad is of his memories of meeting you and dating and your wedding and vacations and lots of other stuff. There are a couple of really great stories in that one that none of us kids knew about. The third one I haven’t made yet. It’s an interview of you, of your stories, if you want to do it.”

  “I absolutely want to do it. I love it. Thank you, I can’t wait to watch them.”

  The waitress brought them coffee, tea, and chocolate cake with a candle in it. They all sang “Happy Birthday.” Alice blew out the candle and made a wish.

  NOVEMBER 2004

  The movies that John had bought over the summer now fell into the same unfortunate category as the abandoned books they’d replaced. She could no longer follow the thread of the plot or remember the significance of the characters if they weren’t in every scene. She could appreciate small moments but retained only a general sense of the film after the credits rolled. That movie was funny. If John or Anna watched with her, they would many times roar with laughter or jump with alarm or cringe with disgust, reacting in an obvious, visceral way to something that happened, and she wouldn’t understand why. She would join in, faking it, trying to protect them from how lost she was. Watching movies made her keenly aware of how lost she was.

  The DVDs Lydia had made came at just the right time. Each story told by John and the kids ran only a few minutes long, so she could absorb each one, and she didn’t have to actively hold the information in any particular story to understand or enjoy the others. She watched them over and over. She didn’t remember everything they talked about, but this felt completely normal, for each of her children and John didn’t remember all of the details either. And when Lydia asked them all to recount the same event, each remembered it somewhat differently, omitting some parts, exaggerating others, emphasizing their own individual perspectives. Even biographies not saturated with disease were vulnerable to holes and distortions.

  She could only stomach watching the Alice Howland video once. She used to be so eloquent, so comfortable talking in front of any audience. Now, she overused the word thingy and repeated herself an embarrassing number of times. But she felt grateful to have it, her memories, reflections, and advice recorded and pinned down, safe from the molecular mayhem of Alzheimer’s disease. Her grandchildren would watch it someday and say, “That’s Grandma when she could still talk and remember things.”

  She had just finished watching Alice and John. She remained on the couch with a blanket on her lap after the television screen faded to black and listened. The quiet pleased her. She breathed and thought of nothing for several minutes but the sound of the ticking clock on the fireplace mantel. Then, suddenly, the ticking took on meaning, and her eyes popped open.

  She looked at the hands. Ten minutes until ten o’clock. Oh my god, what am I still doing here? She threw the blanket onto the floor, crammed her feet into her shoes, ran into the study, and clicked her laptop bag shut. Where’s my blue bag? Not on the chair, not on the desk, not in the desk drawers, not in the laptop bag. She jogged up to her bedroom. Not on her bed, not on the night table, not on the dresser, not in the closet, not on the desk. She was standing in the hallway, retracing her whereabouts in her boggled mind, when she saw it, hanging on the bathroom doorknob.

  She unzipped it. Cell phone, BlackBerry, no keys. She always put them in there. Well, that wasn’t entirely true. She always meant to put them in there. Sometimes, she put them in her desk drawer, the silverware drawer, her underwear drawer, her jewelry box, the mailbox, and any number of pockets. Sometimes, she simply left them in the keyhole. She hated to think of how many minutes each day she spent looking for her own misplaced things.

  She bolted back downstairs to the living room. No keys, but she found her coat on the wing chair. She put it on and shoved her hands in the pockets. Keys!

  She raced to the front hallway, but then stopped before she could reach the door. It was the strangest thing. There was a large hole in the floor just in front of the door. It spanned the width of the hallway and was about eight or nine feet in length, with nothing but the dark basement below it. It was impassable. The front hall floorboards were warped and creaky, and she and John had talked recently about replacing them. Had John hired a contractor? Had someone been here today? She couldn’t remember. Whatever the reason, there was no using the front door until the hole was fixed.

  On her w
ay to the back door, the phone rang.

  “Hi, Mom. I’ll be over around seven, and I’ll bring dinner.”

  “Okay,” said Alice, a slight rise in her tone.

  “It’s Anna.”

  “I know.”

  “Dad’s in New York until tomorrow, remember? I’m sleeping over tonight. I can’t get out of work before six thirty, though, so wait for me to eat. Maybe you should write this down on the whiteboard on the fridge.”

  She looked over at the whiteboard.

  DO NOT GO RUNNING WITHOUT ME.

  Provoked, she wanted to scream into the phone that she didn’t need a babysitter, and she could manage just fine alone in her own house. She breathed instead.

  “Okay, see you later.”

  She hung up the phone and congratulated herself on still having editorial control over her raw emotions. Someday soon, she wouldn’t. She would enjoy seeing Anna, and it would be good not to be alone.

  She had her coat on and her laptop and baby blue bag slung over her shoulder. She looked out the kitchen window. Windy, damp, gray. Morning, maybe? She didn’t feel like going outside, and she didn’t feel like sitting in her office. She felt bored, ignored, and alienated in her office. She felt ridiculous there. She didn’t belong there anymore.

  She removed her bags and coat and headed for the study, but a sudden thud and clink made her backtrack to the front hallway. The mail had just been delivered through the slot in the door, and it lay on top of the hole, somehow hovering there. It had to be balancing on an underlying beam or floorboard that she couldn’t see. Floating mail. My brain is fried! She retreated into the study and tried to forget about the gravity-defying hole in the front hallway. It was surprisingly difficult.

  SHE SAT IN HER STUDY, hugging her knees, staring out the window at the darkened day, waiting for Anna to come over with dinner, waiting for John to return from New York so she could go for a run. She was sitting and waiting. She was sitting and waiting to get worse. She was sick of just sitting and waiting.

  She was the only person she knew with early-onset Alzheimer’s disease at Harvard. She was the only person she knew anywhere with early-onset Alzheimer’s. Surely, she wasn’t the only one anywhere. She needed to find her new colleagues. She needed to inhabit this new world she found herself in, this world of dementia.