Howard Adelman

Losing Oneself

A Review of Still Alice

by

Howard Adelman

[For David, Debbie and Zach]

Look at Bellow’s portrait of Chicago to which the protagonist returns where he knows he cannot remain invisible. “The main threat [Bellow calls it a ‘liminal’ threat] in a place like Chicago is emptiness – human gaps and breaks, a sort of spiritual ozone that smells like bleach.” However, it is precisely this liminality, this role of the atmosphere of a place, that allows it to serve as an intermediate and transitional condition between failed efforts to disappear and successful, but crooked and indirect, ways to reappear.

If you read yesterday’s blog reviewing Saul Bellow’s novella Actual, if you do not have Alzheimer’s or some other cognitive condition or dementia that impairs memory, or if you are not getting old and forgetful, or if you are not, like me, suffering from a terrible memory for some things and a terrific memory for others, perhaps you will remember the above paragraph from near the end of yesterday’s blog and review. I did not know then that yesterday evening on Netflix I would watch the movie, Still Alice, with a grounded performance by Juliane Moore playing Alice Howland with a subtlety and grace that reveals both Alice’s strengths and increasing vulnerability. Still Alice premiered at the 2014 Toronto Film Festival and I missed seeing it then. During its theatrical release, I was out of town. However emotionally shaken I became last evening, I was really happy I saw the movie.

I do not believe I have seen a film before on Alzheimer’s – and there have been plenty in the last decade – that viewed the onset and progress of the disease from the point of view of the victim rather than a family member. The performance deserved an Academy award.

At least half a million Canadians suffer from various forms of dementia; Alice learned that she had contracted a rare type, early-onset Alzheimer’s, when she was a 50-year-old in the prime of her life and at the height of her career as a linguistics professor at, in the movie, Columbia University. There are early clues. She forgets the word “lexicon” during a lecture and, after some hesitation, substitutes, if I remember correctly, “word field.” She first really recognizes that something must be terribly wrong when she is taking her regular exercise running through the grounds and parks of Columbia University and suddenly finds she is lost and totally disoriented even though she is in the central commons of the campus. But the most severe blow does not come when the diagnosis is confirmed, but when she learns that early-onset Alzheimer’s is inherited and that each of her children has a 50/50 chance of inheriting the condition. Even Job never received news as bad as this.

If you read the book by Lisa Genova upon which the movie was based, it may be easier to remember the scene near the end of the movie when Alice’s youngest daughter, Lydia, also played brilliantly by Kristen Stewart, describes a metaphor of flying in the stratosphere above even the thinned out ozone layer that she can look down upon and observe how fragmented and thin and broken up it is. But then souls of the dead rise up to the ozone layer, thicken it and connect the parts together into a network to make it whole again.

She describes this to her mother who by then has trouble even recognizing her own daughter and who has just gone through a year in which the neurons in her brain were undergoing necrosis, premature dying off and then asphyxiating nearby cells so that one’s own cells that have given you your thoughts, that have made you who you are, and, that, in Alice’s case in a very specific and peculiar ironic way, have been the very object of her research and the foundation of her professional success, that are for everyone the basis for each person’s ideas and memories, those same cells now turn upon nearby cells in a process of molecular murder instigated by the cellular suicide of one of the neurons. The process makes no noise. The person in whose head this necrotic process is taking place only knows it, only figures out that something is wrong, because she begins to recognize that what is happening is not her, that she is losing herself.

Instead of a thinking and remembering brain, made up of networks of neurons, the network begins to break down. Gaps appear. The cells in a PET scan appear fragmented and broken. Further, as the cell membranes lose their integrity, the cell releases the deadly poisons of cell death into the extracellular space. The result – inflammation that prevents the phagocytes from reaching and removing the dead cells through pagocytosis. So the condition worsens. More networks breakdown and the process accelerates. Unlike the process that Stephen Hawking, played by Eddie Redmayne, goes through in The Theory of Everything, the deterioration is all the more shattering because it is mental rather than physical, because one loses one’s mind and one’s self and not just the functioning of one’s body.

In Lydia’s metaphor, however, with the death of the cells, with the death of the cell network, with the loss of integrity and increasing fragmentation, the souls of those dying people that are being lost, rise up to the real ozone layer in the heavens rather than Bellow’s imagined ozone layer in the streets of Chicago. Those souls link arms and form a new network that holds together and thickens the ozone layer. So death ensures the continuation of life.

For Bellow, the gaps, the emptiness, the necrosis, was neither in the heavens nor inside one’s head, but in the streets of Chicago. There the ozone layer lives, not in the stratosphere. It smells like bleach. And it performs a liminal function in linking a failed effort to disappear and a crooked and indirect way to reappear. In the film (and the novel) Still Alice, the disappearance of the self requires no effort and it is tragically successful What reappears is not a reborn self, a self who is saved, however imperfectly, but a soul that rises to the heavens and cures the layer that makes life possible on earth. And it does not smell like bleach.

Still Alice is the very opposite of a tale told by Bellow on exactly the same theme, but traveling in reverse direction. The movie is a tale of a disappearing self like the drip drip drip of a tap that gets faster and louder as each minute of the film passes and the inevitability of the self’s vanishing proceeds relentlessly and incrementally apace, recorded by camera work that is minutely fine-tuned and calibrated and to music that has the power to move without ever being noticed. Inevitability may be the given, but what is not given is the way Alice handles her condition, with logic, with common sense, and, finally, with a surrender to her heart as she loses the skills in her head.

Instead of ozone serving as a link between the loss and the rebirth, the loss and the rebirth save the ozone layer. In the end, while Bellow always tried to balance his writing between realism and the creative imagination, Still Alice is a film deeply rooted in the real, deeply rooted in hard science. But it takes the imagination of her actress daughter, Lydia, to bring salvation to that dying world. She is the only child of Alice’s three children that can and does accomplish the deed, for she is the only one that is an artist, an actor on the stage of life in which the imagination and emotions provide the proscenium upon which all life must be built, not the intellect.

At one time in the movie, Alice tells her daughter Lydia, a story. Lydia was the one child with whom she had the most strained relationship because her daughter insisted in following her muse rather than the hard realism of her mother. Alice tells Lydia a tale of a butterfly that she was told by her own mother when Alice at the age of seven became so upset when she learned that a butterfly lived its life of beauty for only one month. It isn’t the length of time one lives, but the intensity and the quality and the beauty that one brings to that life that counts, Alice’s mother told her. It is not a tragedy for a butterfly to have a short life. What matters is the beautiful life they have when they live. And the only memory Alice had to retain was that she had had a beautiful life.

What, Alice asks of Lydia, if I don’t recognize who you are and I do not recall how much you love me? Lydia replies, then I will remind you and show you how much I deeply love you. Then you will believe me. It is the now that counts even more than all the memories.

In this tale of losing oneself, in which, in Alice’s words, one experiences those moments when you are most afflicted, the self, instead of being within, floats before you just beyond your grasp. You feel not only that you are losing it, but that you are totally lost. For if you cannot control and keep hold of yourself, you cannot choose which memories to lose and which to cherish. As your yesterdays disappear, so your hopes and expectations of the future also vanish.

This is what Alice tells an assembly of neurologists and specialists in Alzheimer’s disease when she addresses them, lecturing as if she were still a professor in full control of her faculties, but who took three days to write the short speech and can only deliver it by crossing out each line in yellow as she reads so that she can retain her place in the speech and not forget where she is in her talk. Though she forgets, and though her ability to hope goes with it, she is still Alice and today still matters. So the opportunity to lecture again, to exercise her great gift of understanding language, its functions and its processes, to use her gift of eloquence once more, probably for the last time, was to her a great gift and, for the moment, she could bask in the sheer joy of the feeling it gave her.

There is not an ounce of melodrama, of false sentimentality, of saccharine sweetness in the whole movie. Juliane Moore plays Alice with subtlety and restrained understatement. Mostly, it is through her face, through her own reactions to each new discovery of her loss, that she allows us to experience the deterioration alongside and from within her. Perhaps the co-directors deserve some credit. For Richard Glatzer had some deep understanding of what Alice was going through because he suffered from the neurodegenerative disorder of Lou Gehrig’s disease, ALS or amyotrophic lateral sclerosis. His co-director, and his partner in real life, Wash Westmoreland, experienced Glatzer’s loss of self alongside him.

As Alice’s loses herself, she also gradually loses those closest to her – her devoted husband, John Howland played by Alec Baldwin, her older daughter, Anna Howland, played by Kate Bosworth, and her son, Tom Howland played by Hunter Parish. Except Lydia. For when she watched Lydia perform in a play – I believe it was Angels in America by Tony Kushner – and she could not even follow and recognize that the play was a reflection of what she was experiencing, and that Lydia could give the part so much power and strength of emotion because she had directly asked Alice how Alice had felt, how and what she really felt and was not satisfied with an answer like “OK,” or “It could be worse” or “not bad.”

Lydia wanted to know what Alice actually felt. Alice told her. But Alice could no longer comprehend what she saw and what she had witnessed. But it did not matter. For what she grasped was that the play – and life itself – was about love. Alice knew what she had felt. She felt not only that this had been the theme of the play, but she felt her daughter’s intense love for her, the intense love of the daughter with whom she had had such a strained relationship. And that love lived on in her heart, not in the network of neurons in her brain.

At one point in the movie when she looks at herself in the mirror and does not recognize the shrinking woman with the dull hair and the pale skin of her face and a head sitting on a body that no longer seemed to be able to support it as she shrivelled up before her and our eyes to match the necrotic behaviour of the neurons in her head, when she no longer could recognize her own self, she knew it was time. She spread soap suds or toothpaste or shaving cream over her face in that mirror. But by the time she recognized it was time, it was too late and all sense of time and memory and control over her life had passed her by. Claude Jutra, like myself also a medical student who never practiced medicine, whom I think was Canada’s best film director ever (I rank Mon Oncle Antoine among my top ten films), knew when it was time. He too had Alzheimer’s. When he was still able, in November 1986, he disappeared into the St. Lawrence River, a case of life imitating art for that is what one of his heroes had done. Alice lived on to teach us a deeper meaning to life.

I cried through the movie, not so much for Alice as for my brother Al. He had a blastoma in his brain when he was only 62 at the peak of his career as a cardiologist. I cried for the memories of watching him lose one cognitive and then one physical function after another. I cried as I watched everything that made Al the imperfect human being who he had been, vanish. I cried as I watched him disappear over a period of twelve months until he was simply a living, breathing corpse in a coma on his back that could neither see nor hear nor speak nor feel. I cried because I remember spending a month with him in Arizona as he sought to benefit from the latest far out experiment in combating his type of cancer, but each day he clearly and unequivocally deteriorated. I cried because I saw him fight for his life and to control his life, but, unlike Alice, by surrendering himself to be a guinea pig rather than, like Alice, using conniving and tricks and mental exercises to retain her memory and control for as long as she could. I cried at my anger at him for giving into his mystical propensities and grasping onto the handle of false hope instead of retaining the solid ground of his scientific training. I cried because, at the end, when the magic of any hope would have been relevant, he was past his due date. I cried because Alice as she became sicker evolved to become more open to her own children and turned into an even more extraordinary butterfly, while Al had turned himself back into a larvae, a ghost and a demon, in the hope that he could re-emerge once more through a second metamorphosis as a butterfly. I cried for each of his three children. I cried because I had not been able to follow him back into the new cocoon that he had made for himself and from which he would never again emerge. I cried because I deeply loved my brother and have missed him ever since. I cried because I was unable to convey that feeling Lydia conveyed to Alice before Al’s mind was totally eaten away by cancer.