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| Lisa Genova (photo: Greg Mentzer) |
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Lisa Genova--who's been hailed as the Oliver Sacks of fiction and the Michael Crichton of brain science--is the author of Still Alice (adapted into an Oscar-winning film starring Julianne Moore), Left Neglected, and Remember: The Science of Memory and the Art of Forgetting, among others. Genova holds a degree in biopsychology from Bates College and a Ph.D. in neuroscience from Harvard University. Her sixth novel, More or Less Maddy (Gallery/Scout Press, January 14, 2025), features a young woman coming to terms with bipolar disorder.
Why bipolar?
I'm excited to talk about the distinction between a mental illness and a neurological condition. There's a stigma attached to the idea of mental illness. I can't trust you, you're crazy, you're dangerous--all of that gets piled on immediately. We would never refer to ALS, autism, or Alzheimer's as a mental illness. And yet depression, schizophrenia, bipolar--those are also neurological conditions. To distinguish them as mental illness seems to add an unnecessary burden on these folks that this is somehow their fault.
My neuroscience background is my unique lens on fiction and it's why I write, because these topics are so daunting and overwhelming, and fiction is such a lovely place to help people empathize. I picked bipolar disorder because I had a sense it was everywhere.
Every time I said my next novel was going to be about bipolar disorder, it got the same reaction: a mix of gasps, whispers, and applause. That's never happened with any other topic I've announced. People started DM-ing me on social media: I have a mother, I have a brother, I have a dad. Not necessarily offering to talk to me, although a lot of people did, but others were just thanking me already for this book I hadn't written yet. I felt an enormous sense of responsibility and opportunity to contribute something meaningful.
Your website identifies you as an "empathy warrior." Is that what drove you to fiction?
My grandmother had Alzheimer's. I was 28 when she got the diagnosis. I had a Ph.D. in neuroscience. Alzheimer's was not my area of expertise, but I had the vocabulary. I dove into the research, I read on how the disease was managed from a clinical perspective, but what was missing was, what does it feel like to have this? And how to feel comfortable with her Alzheimer's. I had a tremendous amount of sympathy for her, and for us, but I did not know how to be with her. If she started talking to plastic baby dolls, I left the room. I let my aunts take over. I felt heartbroken, frustrated, scared, and embarrassed. I felt sympathy, but sympathy actually drives disconnection. Keeps us emotionally separate. I didn't know how to get to empathy. I didn't have the understanding or the maturity to just be with her and imagine what it's like to be her in a room, not recognizing it as her home. Everything I'd been reading about Alzheimer's was from the outside looking in. The scientists, caregivers, and social workers have valuable points of view, but none of them were the perspective of the person who's living it. Fiction is where you get a chance to walk in someone else's shoes, find that human connection, that shared emotional experience. That was the beginning. When Still Alice worked, and I got feedback about how much it helped, there was so much appreciation--I just knew. I love doing this, and now I feel the value in it. I'm going to keep going.
How did you create Maddy?
I begin all my stories by reading as much as I can. I read lots of memoirs and textbooks, and then I go out and talk to people. For this book I sought out the authors of some of those textbooks. I talked to the guy who runs the bipolar treatment center at Mass General. I found a psychiatrist at McLean Hospital. I spoke with psychiatrists from all over. If you have diabetes, there's a single protocol, no matter where you live in the world. With bipolar that is not the case. You go to 10 doctors, you're going to get 10 different prescriptions. I'm always trying to tell the truth under imagined circumstances, but one thing I'm very cognizant of is my books are known for being informed. They're researched, and they're going to be used as a blueprint. They're used in medical schools, in OT, PT, speech pathology. I wanted to get the best practices right. My experts are always the people who live with it and their families. I spent a lot of time talking with lots of people. It's an ongoing conversation, it's in-depth and really intimate, and I'm grateful that people trust me with their stories.
Bipolar begins young. I wanted Maddy to be a woman. I wanted to consider the expectations of her to live a normal life as a woman, and the limitations that imposes. If this starts just as you're launching a life, how disrupting and confusing would that be? I wanted her to be a college student, with all those expectations and pressures. In making her a comedian, I wanted her to choose something that was outside the stability of the expected life. Comedy I liked because it's very public; she'd be in front of people. Comedians sort of live the bipolar experience. If you're killing it, that's the highest high. You're connecting, everybody gets you, there's a human bond. If you're bombing, it's the lowest of lows. It's a death. Weirdly, that swing is a nice metaphor for what it could feel like to be bipolar. I'm a big comedy fan, so this gave me a lovely excuse. Comedians who are great at what they do, it's because they're speaking truth. They're tapping into a vulnerability in the human condition. If I could write my character's comedy and that progression toward having something meaningful to say about accepting herself with bipolar, that would be really cool. It was terrifying, too, because I'd never written comedy. I did take a standup comedy writing class and I did a five-minute set.
Did you discover a new calling?
Oh no. Ohhhh, no. Not going to quit my day job.
Do you consider yourself an activist author?
That's what the "empathy warrior" is about. It's about humanizing, destigmatizing. These books are an opportunity. If I see someone with dementia, or who might be manic, my reflexive response isn't, I need to get away from that. My response becomes more, I'm not afraid of you. How can I help?
I advocate for resources for care and for research. In the author's note of this book I send people to the International Bipolar Foundation for more education, and to donate money if they'd like. I've raised millions of dollars for Alzheimer's care and research. And we're 15 years out from Still Alice, so I stay as an activist, advocate, empathy warrior. I want my books to be a reason for people to learn more, to contribute, to offer help. --Julia Kastner