'Still Alice' and Us

Julianne Moore accepts the award for best actress in a leading role for “Still Alice at the Oscars on Sunday, Feb. 22, 2015
Julianne Moore accepts the award for best actress in a leading role for “Still Alice at the Oscars on Sunday, Feb. 22, 2015, at the Dolby Theatre in Los Angeles. (Photo by John Shearer/Invision/AP)

So, I finally steeled myself and went with my wife to see Still Alice. I had been avoiding it, because I'm of the quaint view that movies should be fun and escapist. I enjoy fantasies like James Bond, Indiana Jones and even RED.

But I was also avoiding Still Alice because of how it cast the role of Alice. I disliked that she was played by Julianne Moore, a young 50-something who, by virtue of her age, distorts the sweep of Alzheimer's Disease. This disease, which increases in prevalence exponentially in older adults, is becoming the seminal public health problem of our time as the population ages. Because so many of us are now living longer, so much longer.

It is true, of course, that the rare cases of Alzheimer's in the young are serious, tragic and indeed heart-wrenching. But because of the far-smaller prevalence in middle-aged adults, it is a matter of less public importance. Public health is about numbers -- hence the attention to communicable diseases like tuberculosis, malaria, ebola or the more recent focus on non-communicable diseases like cancer, cardiovascular disease and diabetes.

Yet, against my better judgment (and with secret resentfulness), I did go see it this last weekend. I was so wrong. I found Still Alice to be a truly breathtaking film, and Ms. Moore's performance made me cry many times. It is no wonder she won the Oscar. And the film magnificently integrates Moore's emotional power with medical fact.

In the course of Alice learning to manage the disease, we learn some of the science of Alzheimer's. She and her doctor discuss the amyloid theory of causation, and they suggest creative uses of technology in the early stages to assist memory loss. We also learn about what little medicines are available, and how ravaging it becomes for people to achieve basic human functions, like bathing and cleaning. We are also treated to the stigma of Alzheimer's; stigma which causes Alice to keep quiet: she blurts out early in the film that she wishes she had cancer because for cancer people walk and wear ribbons. So, Still Alice also dramatizes the social isolation caused by the relative ignorance of and still profound stigma of the disease, both of which are very much related the preciously small amount of funding dedicated to finding a cure.

But perhaps most gripping effect of Still Alice is the sense that it will elevate focus and attention on this disease that is rapidly and inexorably becoming the public health, social and fiscal nightmare of our 21st century. Already, Alzheimer's consumes $604 billion annually -- roughly 1% of global GDP -- and rates are projected to skyrocket.

And here's where my initial misgivings about the casting of the film reveal one of its greatest strengths.

Brilliantly, emotionally and with rare genius and subtlety, Still Alice promises to not only raise awareness of, but provoke passion for Alzheimer's, precisely because it is not a story about someone's grandmother. Still Alice is not a public health poster. It is the powerful story of a young, smart, witty, vivacious, and beautiful Columbia University linguistics professor.

And this is precisely why we must watch it -- and why so many already have.

Consider the scene as Alice takes herself to a "care home." At this point, she is still cognizant and competent and, through her, we see the more common picture of the disease: old people who are on the slow march to death anyway. It is a sad and lonely image, sure, but also one that does not shock. Then, in contradistinction, we see Alzheimer's devastate someone in the prime of her life -- a life of a scientist and an Ivy League professor, no less.

For the "seniors" in the care home, we are inured and even hardened to the devastation of Alzheimer's, and we tend to see it as an inevitable stage in our aging. For Alice, we are deeply touched, troubled, motivated to great emotional heights of despair and anguish.

And here is the genius of the film: it balances the wreckage we feel for Alice with the public health crisis that is emerging globally. Alzheimer's demands attention not only because of the horror of its disease, which we feel from its effect on the small number of people like Alice, but also because of the numbers it will affect if we don't find a cure. It's not just the Alices of the world, but by the rest of us as well.

Until now, we have been lucky that Alzheimer's has been one of those "rare diseases." But now, with the dawn of our 21st century and the global mega-trend of all of us living decades longer -- those 30 years added to life in the last century with more to come in this one -- the "rare" phase of the disease is over. So, while Still Alice is about a rare occurrence, it is also metaphor for the progression of the disease across society, which we fail to understand at our peril.

Still Alice is a rare film that strikes a delicate balance. In dramatizing the genetics of Alzheimer's -- and articulating how a mother's Alzheimer's impacts the children and the children's children -- it manages to position a tiny slice of the "at-risk" population to show how, in this 21st century, we are all, in fact, at risk.