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1 This Reading Group Guide for Left Neglected Includes an Introduction This reading group guide for Left Neglected includes an introduction, discussion questions, ideas for enhancing your book club, and a Q&A with author Lisa Genova . The suggested questions are intended to help your reading group find new and interesting angles and topics for your discussion. We hope that these ideas will enrich your conversation and increase your enjoyment of the book. INTRODUCTION Sarah's life is on track—the fast track. She and her husband both work 80 hour weeks at high-powered jobs in Boston, while spending as much time as possible with their three small children. Sarah is a juggler extraordinaire, keeping her demanding job and her family as balanced as she can. But when a car accident leaves her recovering from Left Neglect, a neurological impairment that robs her of her ability to control the left side of her body, she can barely get out of bed on her own. As Sarah struggles to resume her over-scheduled life, she must juggle new things—her son's ADHD diagnosis, the return of her estranged mother, and her own limitations. Given a traumatic opportunity to reassess what is really important in life, Sarah must decide where her priorities lie. QUESTIONS AND TOPICS FOR DISCUSSION 1. Is Sarah better off at the end of the novel than at the beginning? If so, in what ways? 2. Sarah has a series of anxious dreams in the nights leading up to the accident. How would you interpret these dreams? What do you think her subconscious is trying to tell her? 3. Is Sarah a better mother before or after the crash? How do you think she would answer that question? Consider the amount of time she spends with her kids, her ability to keep track of them, and the level of participation in their lives. 4. The second time Sarah and Bob meet with Charlie's teacher about his progress in class, they learn that he is the target of some bullying. Ms. Gavin tells them many children experience this whether or not they have disabilities. Do you agree with Charlie's teacher? Do disabilities like ADHD make a child more of a target than other kids? 5. Sarah's Type A personality seems like it should help her through her physical therapy, but her friend and therapist Heidi believes she needs to stop trying to "win" 1 and learn how to "adjust." Do you agree? Do you think by adjusting to her new limitations, Sarah holds herself back from a quicker recovery? 6. If Sarah had recovered completely, do you think she would have gone back to her high pressured job at Berkley Consulting? 7. While Sarah is in the rehabilitation hospital, she and Heidi trade watches, even though Sarah's is clearly the more valuable of the two. Toward the end of the novel, Sarah notes that Heidi is still wearing her expensive watch, but never asks for it back. Why do you think she doesn't reclaim her watch? 8. After Sarah's accident, Bob uses his cell phone at least once while driving in the car with Sarah and their kids. Why do you think he does that? Do we sometimes make exceptions for ourselves and do something unhealthy or risky in the interest of saving time or getting more done (like texting or using a cell phone while driving) even when we know it is dangerous? Why do you think that is? 9. At one point Bob argues that he doesn't think Vermont is a place to live full time when they are young. He sees it as a place to spend their retirement. Do you agree? What are the benefits of living and raising a family in a suburban setting versus a rural one? 10.Which character do you identify with the most? Which the least? Who is your favorite? 11.Is Sarah's mother's response to Nate's death understandable or unreasonable? 12.What did Sarah miss out on by having such a withdrawn mother? If her mother had been more available, do you think Sarah would be as high achieving? 13.Sarah's trauma gives her a chance to reconnect with her estranged mother. Why is it so hard for Sarah to forgive her mother? 14.Can working mothers really have it all—a successful career, well-adjusted children, a great marriage, a sense of well-being, and personal happiness? Or is that a myth? Does something always have to give? 15.Sarah's work/life balance before her disability is weighted toward work, whereas after it is weighted toward her family. How would you categorize your own work-life balance? Does Left Neglected make you reconsider any of your career decisions? 2 16.The back cover states that the novel is "about what we ignore and neglect in ourselves, in our families, and in the world around us." What do you think you are neglecting in your life? Yourself? Your relationships? Your home? Your job? ENHANCE YOUR BOOK CLUB 1. Sarah's ideal life is to live in Vermont, close to winter sports and away from the bustle of the city. Imagine an alternative life for yourself. What does your Vermont look like? 2. The New England Handicapped Sports Association is a real organization in New Hampshire. You can check out their website at http://www.nehsa.org . The Photo Gallery, in particular, has a lot of great pictures that can help visualize Sarah's snowboarding experiences. 3. Before the accident, Sarah muses about all the things that she wishes she and Bob could do, but don't make time for. Make your own list of things that you don't do as often as you'd like. Pick one to do before your next book club meeting, and share it with the group! 4. While she loves her high-powered job, Sarah periodically lets herself have timed crying sessions to cope with stress. Go around the group and share the coping mechanisms you use in your own life. A CONVERSATION WITH LISA GENOVA Your first novel, Still Alice , was inspired by your grandmother's struggle with dementia. What or who was your initial inspiration to write about Left Neglect? Over the years as a student and a neuroscientist, I'd every now and then come across a quick case study or mention of a patient with unilateral neglect. The information was almost always limited to pen and paper test examples of the symptoms of this condition—copying a picture of a face or a clock, circling all the letter A's on a page, or naming all the items shown in a picture. The patients always neglected to include the left eye, the numbers 7-11 on the clock, and the A's and items on the left side of the page. And while I thought this was fascinating, what captured my attention and wonder even more was imagining how these patients LIVE with unilateral neglect. What is life like outside the doctor's office? How does someone with this get dressed, go to work, cook a meal, eat a meal, function in a relationship, navigate a whole world 3 while only paying attention to half of it? Before I finished writing Still Alice , I knew I wanted to write about someone with Left Neglect next. You note that you interviewed many different kinds of women in preparation for Left Neglected , including women with careers, disabilities, families, or all of the above. What was the most surprising thing you learned during these interviews? I interviewed both men and women who have Left Neglect, their husbands and wives, their neurologists, acute care nurses, occupational therapists, physical therapists, speech therapists, rehabilitation specialists, physiatrists, and research scientists. I also interviewed a teacher and a guidance counselor to better understand how an elementary school handles a young child with ADHD, the executive director of New England Handicapped Sports Association, and women with educations and careers similar to Sarah's. The most surprising thing I learned was that someone with Left Neglect could learn to snowboard. I had originally imagined that Sarah would have to give up her love of skiing down Mount Cortland for some other, safer substitute—maybe cross country skiing on flat terrain or a sedentary activity like knitting. I have to thank Julia Fox Garrison here for telling me not to give up on Sarah and for suggesting that she might be able to make it down the mountain on a snowboard. I eventually met with Tom Kersey of New England Handicapped Sports who explained to me that Julia's hunch was indeed correct, and he showed me how they would teach someone like Sarah to snowboard. I was so genuinely surprised and thrilled to be able to give Sarah a snowboard and get her back on the mountain she loves. Which takes longer: the research for a book like this, or the actual writing? Which is more difficult: developing the research or developing the characters? For both Still Alice and Left Neglected , I did the bulk of the research up front before beginning any writing—a period of about 3-4 months. Writing the story took about a year and a half. I enjoy both, but research is far easier. I love that I have the opportunity to learn more about these conditions and to be able to get at answers and subtleties that can't be found in text books. It's always such a privilege to learn about Neglect or Alzheimer's from the experts—whether that means a physician or a person living with it.
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