BOOK TO FILM: Still Alice

This book to film comparison contains spoilers.

movie posterAlice Howland, happily married with three grown children, is a renowned linguistics professor who starts to forget words. When she receives a devastating diagnosis, Alice and her family find their bonds tested.

I was worried that Still Alice would hit too close to home, since both my grandmothers have forms of dementia. It did. I cried many times while reading the book and watching the movie. But the story has given me a greater understanding and appreciation of my maternal grandmother’s struggle with Alzheimer’s disease. While both the book and the film are moving, there are some differences in the stories they tell.



The book takes place in Cambridge, with Alice and John working at Harvard University. The movie switches the location to New York, with the two of them working at Columbia. It’s a relatively minor change and the only real impact that I can determine comes with John’s job opportunity. His job offer is now in Minnesota instead of New York, increasing the possible distance and travel time between Alice and her kids if she were to move.


The role of technology

Since Lisa Genova set Still Alice in the early 2000s, technology (apart from Alice’s BlackBerry) plays a relatively minor role in the book. The movie, taking place in more recent times, includes the use of iPhones, Skype, and other technology. Alice’s instructions on her suicide are contained in a video message rather than a letter.

Google saves the day.

Google saves the day.

I do find it a bit strange that Alice is still able to operate Skype with little effort at such a late stage in the movie when she has trouble with other daily tasks like tying her shoelaces.

That being said, Alice admits quite early on in the book that she doesn’t like speaking on the phone because she can’t see the speaker’s face and quickly gets confused. The use of Skype helps to remedy this problem despite the question of how she’s able to remember how to initiate or answer a video call.


Incidents with Alzheimer’s

In the book, Alice’s diagnosis of Alzheimer’s takes a while to eventuate, as she keeps forgetting to organise an appointment with a doctor. The book actually starts a full month before the movie, allowing extra time for blink-and-you’ll-miss-it run-ins with memory loss.

The movie cuts through a lot of the smaller incidents and focus on the big picture things, like Alice getting lost while running, forgetting words and names, and other broad examples of Alzheimer’s. While I understand that some of the many incidents would have to be cut back, there were a few heartbreaking moments from the book which I missed.

I don't know about you guys, but I have better things to do than teach my class.

I don’t know about you guys, but I have better things to do than teach my class.

I feel that the incident where Alice turns up to her class and forgets that she’s supposed to be teaching it is an important point, as her sense of self is so wrapped up in her ability to teach. However, most notably absent is the occasion when Alice forgets that her mother and sister are dead and convinces herself that they’re coming for dinner.

When it has previously only affected her short-term memory, this intrusion of her Alzheimer’s on her long-term memory is, to me, an integral point in Alice’s decline.


The Howland family and dealing with Alzheimer’s

Since the book is written from Alice’s perspective, we quickly learn how early-onset Alzheimer’s has made Alice feel incredibly lonely. She starts a support group not for carers but for sufferers of early-onset Alzheimer’s and develops a sense of camaraderie with them. The support group allows Alice to feel valued and to be among people like her without feeling ashamed or burdensome.

I may not have my support group but I can still deliver a speech like a boss.

I may not have my support group but I can still deliver a speech like a boss.

The movie focuses more on how Alice’s family are dealing with her Alzheimer’s rather than how Alice is dealing with it. The idea of a support group is never suggested or explored, and Alice’s situation in the movie does invite a pervading sense of loneliness. Her only chance to truly shine and interact with other people dealing with Alzheimer’s comes with the delivery of her speech at the Dementia Care Conference. Though the speech did differ from the book, I found each version of it to be equally moving and beautifully-worded.

Just so we're clear, Lydia, I am the best Howland daughter.

Just so we’re clear, Lydia, I am the best Howland daughter.

Anna, Tom, and Lydia—the three adult Howland children—have very similar roles in both mediums, with various conversations delivered verbatim from the novel. The ongoing sibling rivalry and different methods of dealing with Alice’s condition come across clearly even though some bonding scenes are absent from the film.

The book has a certain ambiguity surrounding John’s decision to move for work. In the movie, there is no room for confusion: he decides to go and work in Missouri, unable to watch his wife’s rapid decline in health and memory. Lydia moves in not because she has decided to attend college (as she does in the book) but simply because she wants to be with her mother as long as possible and take away some of the burden from her father.

Hug it out, guys. Hug it out.

Hug it out, guys. Hug it out.

While John can be standoffish in the book, he is ultimately doing everything he can to find a cure or something to slow down his wife’s condition. In the movie, John sometimes comes across as a bit selfish and distant. This change in character is possibly because we don’t see him constantly researching various clinical trials and developments in Alzheimer’s disease.

But, as disappointing as John’s decision might be for audiences, it strikes me as entirely realistic. Not everyone can cope with the strain of caring for someone with Alzheimer’s, and it would be even harder to do so with a full-time job.


The verdict

Overall, I found Still Alice to be a very faithful adaptation of the source material. Julianne Moore does a remarkable job of portraying Alice on screen, and the supporting cast is admirable in its delivery. That being said, everything that Lisa Genova puts on the page is painfully familiar to me. The novel of Still Alice has a special place in my heart for all its embarrassing accuracy and passing anecdotes of memory loss. The wording of some incidents is so clever that I often had to skip back a few pages and make sure that I was remembering everything correctly. That kind of evocative writing is hard to surpass no matter how well a movie comes together.


3 thoughts on “BOOK TO FILM: Still Alice

  1. I’ve read the book and seen the movie, and concur with everything this writer says. Excellent review. My father-in-law has Alzheimer’s so I’m aware of how devastating it is. I too was stumped on why they moved Alice from Harvard to Columbia. She was a highly respected professor at Harvard. Too bad the movie avoided Alice’s interaction with the support group she formed. It would have given the movie a boost. Some concessions have to be made for the theater, I suppose. But for the most part the movie was true to the book and is worth seeing even if no one in your family has dementia. One thing: the movie has John moving to the Mayo Clinic, which is in Minnesota, not Missouri. In the book, he was moving to Sloan-Kettering in NY.

  2. Skype can be configured so that it automatically connects incoming calls from your contacts.

    Thanks for writing the comparison.

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