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January 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
Stephanie Aaron, a genetic counselor, greets Alice and John with “a warm smile.” John explains Alice’s diagnosis and tells Stephanie that they want her screened for genetic mutations related to Alzheimer’s. Stephanie asks Alice what she is “hoping to learn” and Alice tells her she wants to confirm her diagnosis and John tells her they think “it’s a real possibility” that the diagnosis was incorrect. Stephanie then explains that a positive result is a confirmation, but a negative result isn’t necessarily proof that she doesn’t have Alzheimer’s. Stephanie asks Alice if this makes sense, which Alice knows is a reasonable question given the “context,” but is still mildly insulted. She tells Stephanie she understands.
In this scene, it is notable that John and Stephanie do most of the talking. In fact, only Stephanie bothers to ask Alice questions and to share her own thoughts while John takes charge when it comes to explaining her diagnosis and what kind of genetic mutations John wants Stephanie to look for. For Alice, this situation is somewhat humiliating because Stephanie asks her if she understands what’s happening as if she were a child or incapable of understanding basic concepts. This treatment takes a heavy toll on Alice’s identity as an intelligent and capable woman and foreshadows the struggles she will have to face as her illness worsens and people increasingly treat her differently.
Themes
Stephanie asks about Alice’s family history, and Alice explains the issues her father experienced in his later years, including the fact that she doesn’t “think he recognized [her] at all for the last several years.” Alice also explains that Peter had never been to a neurologist. Upset by the conversation, John explains that Peter died of liver failure, not Alzheimer’s, to which neither Alice nor Stephanie replies. After providing a few more details of her family medical history, Alice is taken back to have some blood drawn.
Unlike Alice, John struggles to hide his frustration and is still strongly in denial about even the possibility that Alice has Alzheimer’s. This is shown by John’s lack of patience with the questions about Peter: he knows that if they establish that Peter had Alzheimer’s, it would increase the likelihood that Alice’s diagnosis is correct, making the disease real for him as well as Alice.
Themes
Alice stares out the window as John drives. He tells her, “It’s going to be negative,” which prompts Alice to tell him that that wouldn’t change anything. Although John thinks there’s still room for doubt, Alice accepts her diagnosis from Dr. Davis. John has talked to him and believes that Dr. Davis only thinks Alice has Alzheimer’s because “that’s what he’s trained to see.” John tells her he thinks she’s just “exhausted and stressed” and that it can be fixed. Alice thinks he “sound[s] right” and considers that she might actually be depressed and that the diagnosis is wrong.
Though Alice has accepted her diagnosis, it’s clear that she doesn’t want to do so. This is why it’s so easy for John to convince her that her symptoms might be due to exhaustion, stress, depression, or anxiety. It is comforting to Alice to believe these things. Like her earlier belief that her symptoms were due to menopause, these causes could be easily treated and fixed, unlike the incurable Alzheimer’s.
Themes
Stephanie does not smile at Alice and John when they walk into her office. She offers to go over the same information as in their last visit, but Alice tells her she doesn’t need to and that she still wants the results. Stephanie tells Alice she’s “positive for the PS1 mutation,” confirming the Alzheimer’s diagnosis. John questions the “false positive rate” at the lab that ran the test, but Alice tells him the test is positive and he goes quiet.
Stephanie’s unsmiling expression when they see her confirms the results of Alice’s tests even before Stephanie shares the findings. Still, John wants to believe that it could be wrong, that there is still a wide enough margin for error that he can hang onto the belief that Alice doesn’t have Alzheimer’s. This leaves Alice in the difficult position of having to convince him to give up hope in the idea that she is actually healthy, when she is the one who needs his reassurance and support in this moment.
Themes
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Alice asks what this means for her kids, all of whom are in their twenties. Stephanie explains that they are all too young to be symptomatic, but they can have a test done that will tell them whether they carry the mutation, which results in Alzheimer’s for all carriers. Stephanie asks if Alice has told them about her diagnosis yet, and Alice tells her she hasn’t. Stephanie urges her to tell them soon, especially because Anna and Charlie are trying to conceive.
Alice’s genetic mutation is one that guarantees the carrier will develop Alzheimer’s, which further confirms her belief that her father must have had it. However, that also means she might be responsible for giving the carrier mutation to at least one of her children, and that child might pass it on to their children. However, this finding also gives her the ability to warn her children and, perhaps, to stop the pattern from continuing in her grandchildren.
Themes
Stephanie asks Alice and John if they have anymore questions and tells them she’s sorry they didn’t get the results for which they were hoping. On the way home, Alice and John are silent. Alice waits for him to say something, but instead of talking John “crie[s] the whole way home.”
Once again, Alice wants some kind of comfort or conversation from John, but he wraps himself up in silence and cries to himself. This, again, leaves Alice in the role of comforter when the roles should be reversed, creating an additional emotional burden for her.
Themes
