Film Review: Still Alice

Alice Howland (Julianne Moore) is a good-looking fifty-year-old successful professor of linguistics; her loving husband (Alec Baldwin) is a brilliant research physician, she has three beautiful children, a brownstone in the Upper West side and a house at the Hamptons. This is the perfect stage for an impending disaster; in fact after some episodes of forgetfulness, a medical work-up gives the disaster a name: early-onset familial Alzheimer’s disease. From then on directors Richard Glatzer and Wash Westmoreland depict the relentless downhill course of the disease, sparing the viewer only its excruciating terminal stages.

“Still Alice”, adapted from Lisa Genova’s book, demands our full attention starting from the title: it tells us that Alice is still Alice notwithstanding the devastation of her brilliant mind brought about by the disease. The film also suggests that the true essence of a person may not lie in a successful career, a loving family or a beautiful (or just normal) mind, it lies in something far more difficult to identify: could it be our beliefs, memories or experiences? This intriguing question reminds us of the replicants in “Blade Runner” (Ridley Scott, 1982) searching for memories to assert their human identity.

The film goes further in asking whether one’s identity lies in the capacity to describe our feelings (what makes us sad or happy) or in our perception of our body and soul and the inevitable changes to our identity brought by time. Are we today the same we were, say, five years ago? Perhaps what makes us who we are is a mixture of all of the aforementioned as the American psychologist Daniel Gilbert put it “Human beings are a work in progress that mistakenly think they’re finished”.

But we also live in the minds of people around us and for Alice the perception of herself by family, friends and colleagues is particularly important to her. To the people who love her she will still be herself even when the final stages of the disease will deprive her of thoughts, memories and emotions. The butterfly necklace she wears reinforces this concept: the butterfly is a metaphor for change and Alice does change because of the disease while still remaining ‘herself’. “Still” also describes well the gradual loss of facial expressions and gestures that characterizes the progression of the disease, perfectly expressed by Julianne Moore, a truly deserved Academy Award as best actress.

Alice does not want to surrender to the disease; she tries to take control of the situation by exercising her memory, giving a talk to an audience of Alzheimer’s patients and their families and recording a video-message to be seen by her in the later stages of her illness. The welcome sentence: ”Hi Alice, I am you” in its plainness reminds us the aforementioned considerations about personal identity.

Alice’s husband’s response to her illness is open to the viewer to decide: Is he selfish? Is he being practical? Or is he hiding his suffering by running away from her? The relationship between spouses in the presence of Alzheimer’s was portrayed differently in “Away from her” (2006) where both the Alzheimer’s patient and her husband act selflessly, the wife voluntarily entering a long term care facility while the husband quietly accepts the friendly relationship that she entertains with another patient in the facility.

Anna (Kate Bosworth), the elder daughter, is Alice’s clone: flawless, successful and practical when she gets a positive genetic test for familial Alzheimer’s, but nonetheless moves on with her life. From then on she gradually disappears from her mother’s life.

Alice’s younger daughter Lydya (Kristen Stewart) is very different from her mother and sister, her life is not a success story always arguing with her mother in refusing to get a university education. However, in the end Lydya is the only one who lovingly and patiently takes care of Alice. Paradoxically, the gentle caring relationship which develops between Alice and Lydya could be the silver lining of such a devastating situation. The relationship between a parent with dementia and his children was portrayed before in the “The Savages“(Tamara Jenkins, 2007) where a brother and a sister get together to tackle the everyday problems of caring for their father with dementia, and finding solace and liberation from past traumas through caring.

Currently there are about 47.5 million people suffering from dementia at an annual cost (2010 estimate) of $ 607 billion worldwide. An apt description of the disease was given at the WHO Conference on Global Action against Dementia, Geneva 2015, by Dr. Margaret Chan:

“…I can think of no other disease that has such a profound effect on loss of function, loss of independence, and the need for care.

I can think of no other disease so deeply dreaded by anyone who wants to age gracefully and with dignity.

I can think of no other disease that places such a heavy burden on families, communities, and societies”

“Still Alice” is a welcome entry into the world of motion pictures exploring what it means for patients and families to live with dementia and perhaps by portraying so eloquently that complexity, some understanding and insight may be gained about how to “still” remain our own selves in the face of dementia.

STILL ALICE (2014)

Currently on general release in UK cinema

Edited by Dr Ayesha Ahmad

Authored by Dr Franco Ferrarini

Gastroenterologist and Internist in private practice with a special interest in functional gastrointestinal disorders and their treatment with hypnosis

Email for correspondence: francoferrarini.ff@gmail.com