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“Unsparing in her depiction of the disease’s harrowing effects, neuroscientist Genova also celebrates humanity.” —People

“Sometimes it’s easier to tell truth in fiction...And she tells it with heart and hope.” NPR

“Her juxtaposition of scientific detail with compassionate, heartfelt storytelling is unparalleled.” Bookreporter

Every Note Played will grip and gut you.”The Boston Globe

From neuroscientist and New York Times bestselling author of Still Alice comes a powerful exploration of regret, forgiveness, freedom, and what it means to be alive.

An accomplished concert pianist, Richard received standing ovations from audiences all over the world in awe of his rare combination of emotional resonance and flawless technique. Every finger of his hands was a finely calibrated instrument, dancing across the keys and striking each note with exacting precision. That was eight months ago.

Richard now has ALS, and his entire right arm is paralyzed. His fingers are impotent, still, devoid of possibility. The loss of his hand feels like a death, a loss of true love, a divorce—his divorce.

He knows his left arm will go next.

Three years ago, Karina removed their framed wedding picture from the living room wall and hung a mirror there instead. But she still hasn’t moved on. Karina is paralyzed by excuses and fear, stuck in an unfulfilling life as a piano teacher, afraid to pursue the path she abandoned as a young woman, blaming Richard and their failed marriage for all of it.

When Richard becomes increasingly paralyzed and is no longer able to live on his own, Karina becomes his reluctant caretaker. As Richard’s muscles, voice, and breath fade, both he and Karina try to reconcile their past before it’s too late.

Poignant and powerful, Every Note Played is a masterful exploration of redemption and what it means to find peace inside of forgiveness.

Product Details

ISBN-13: 9781508244400
Publisher: Simon & Schuster Audio
Publication date: 03/20/2018
Edition description: Unabridged
Sales rank: 1,194,674
Product dimensions: 5.20(w) x 5.30(h) x 0.80(d)

About the Author

Acclaimed as the Oliver Sacks of fiction and the Michael Crichton of brain science, Lisa Genova is the New York Times bestselling author of Still Alice, Left Neglected, Love Anthony, and Inside the O’Briens. Still Alice was adapted into an Oscar-winning film starring Julianne Moore, Alec Baldwin, and Kristen Stewart. Lisa graduated valedictorian from Bates College with a degree in biopsychology and holds a PhD in neuroscience from Harvard University. She travels worldwide speaking about the neurological diseases she writes about and has appeared on The Dr. Oz Show, Today, PBS NewsHour, CNN, and NPR. Her TED talk, What You Can Do To Prevent Alzheimer's, has been viewed over 2 million times.

Dennis Boutsikaris won an OBIE Award for his performance in Sight Unseen and played Mozart in Amadeus on Broadway. Among his films are *batteries not included, The Dream Team, and Boys On the Side. His many television credits include And Then There Was One, Chasing the Dragon and 100 Center Street.

Dagmara Dominczyk's film credits are Rock Star, The Count of Monte Cristo, Kinsey, and Lonely Hearts. On television she's appeared in Five People You Meet in Heaven, and 24. Her Broadway appearences are Closer, Enchanted April, and The Violet Hour.

Read an Excerpt

Every Note Played

If Karina had grown up fifteen kilometers down the road in either direction north or south, in Gliwice or Bytom instead of Zabrze, her whole life would be different. Even as a child, she never doubted this. Location matters in destiny as much as it does in real estate.

In Gliwice, it was every girl’s birthright to take ballet. The ballet teacher there was Miss Gosia, a former celebrated prima ballerina for the Polish National Ballet prior to Russian martial law, and because of this, it was considered a perk to raise daughters in otherwise grim Gliwice, an unrivaled privilege that every young girl would have access to such an accomplished teacher. These girls grew up wearing leotards and buns and tulle-spun hopes of pirouetting their way out of Gliwice someday. Without knowing specifically what has become of the girls who grew up in Gliwice, she’s sure that most, if not all, remain firmly anchored where they began and are now schoolteachers or miners’ wives whose unrequited ballerina dreams have been passed on to their daughters, the next generation of Miss Gosia’s students.

If Karina had grown up in Gliwice, she would most certainly not have become a ballerina. She has horrible feet, wide, clumsy flippers with virtually no arch, a sturdy frame cast on a long torso and short legs, a body built more for milking cows than for pas de bourrée. She would never have been Miss Gosia’s star pupil. Karina’s parents would have put an end to bartering valuable coal and eggs for ballet lessons long before pointe shoes. Had her life started in Gliwice, she’d still be in Gliwice.

The girls down the road in Bytom had no ballet lessons. The children in Bytom had the Catholic Church. The boys were groomed for the priesthood, the girls the convent. Karina might have become a nun had she grown up in Bytom. Her parents would’ve been so proud. Maybe her life would be content and honorable had she chosen God.

But her life was never really a choice. She grew up in Zabrze, and in Zabrze lived Mr. Borowitz, the town’s piano teacher. He didn’t have a prestigious pedigree like Miss Gosia’s or a professional studio. Lessons were taught in his living room, which reeked of cat piss, yellowing books, and cigarettes. But Mr. Borowitz was a fine teacher. He was dedicated, stern but encouraging, and most important, he taught every one of his pupils to play Chopin. In Poland, Chopin is as revered as Pope John Paul II and God. Poland’s Holy Trinity.

Karina wasn’t born with the lithe body of a ballerina, but she was graced with the strong arms and long fingers of a pianist. She still remembers her first lesson with Mr. Borowitz. She was five. The glossy keys, the immediacy of pleasing sound, the story of the notes told by her fingers. She took to it instantly. Unlike most children, she never had to be ordered to practice. Quite the opposite, she had to be told to stop. Stop playing, and do your homework. Stop playing, and set the dinner table. Stop playing, it’s time for bed. She couldn’t resist playing. She still can’t.

Ultimately, piano became her ticket out of oppressive Poland, to Curtis and America and everything after. Everything after. That single decision—to learn piano—set everything that was to follow in motion, the ball in her life’s Rube Goldberg machine. She wouldn’t be here, right now, attending Hannah Chu’s graduation party, had she never played piano.

She parks her Honda behind a Mercedes, the last in a conga line of cars along the side of the road at least three blocks from Hannah’s house, assuming this is the closest she’ll get. She checks the clock on the dash. She’s a half hour late. Good. She’ll make a brief appearance, offer her congratulations, and leave.

Her heels click against the street as she walks, a human metronome, and her thoughts continue in pace with this rhythm. Without piano, she would never have met Richard. What would her life be like had she never met him? How many hours has she spent indulging in this fantasy? If added up, the hours would accumulate into days and weeks, possibly more. More time wasted. What could’ve been. What will never be.

Maybe she would’ve been satisfied had she never left her home country to pursue piano. She’d still be living with her parents, sleeping in her childhood bedroom. Or she’d be married to a boring man from Zabrze, a coal miner who earns a hard but respectable living, and she’d be a homemaker, raising their five children. Both wretched scenarios appeal to her now for a commonality she hates to acknowledge: a lack of loneliness.

Or what if she had attended Eastman instead of Curtis? She almost did. That single, arbitrary choice. She would never have met Richard. She would never have taken a step back, assuming with the arrogant and immortal optimism of a twenty-five-year-old that she’d have another chance, that the Wheel of Fortune’s spin would once again tick to a stop with its almighty arrow pointing directly at her. She’d waited years for another turn. Sometimes life gives you only one.

But then, if she’d never met Richard, their daughter, Grace, wouldn’t be here. Karina imagines an alternative reality in which her only daughter was never conceived and catches herself enjoying the variation almost to the point of wishing for it. She scolds herself, ashamed for allowing such a horrible thought. She loves Grace more than anything else. But the truth is, having Grace was another critical, fork-in-the-road, Gliwice-versus-Bytom-versus-Zabrze moment. Left brought Grace and tied Karina to Richard, the rope tight around her neck like a leash or a noose, depending on the day, for the next seventeen years. Right was the path not chosen. Who knows where that might’ve led?

Regret shadows her every step, a dog at her heels, as she now follows the winding stone path into the Chu family’s backyard. Hannah was accepted to Notre Dame, her first choice. Another piano student off to college. Hannah won’t continue with piano there. Like most of Karina’s students, Hannah took lessons because she wanted to add “plays piano” to her college application. The parents have the same motive, often exponentially more intense and unapologetic. So Hannah went through the motions, and their weekly half hour together was a soulless chore for both student and teacher.

A rare few of Karina’s students authentically like playing, and a couple even have talent and potential, but none of them love it enough to pursue it. You have to love it. She can’t blame them. These kids are all overscheduled, stressed-out, and too focused on getting into “the best” college to allow the nourishment passion needs to grow. A flower doesn’t blossom from a seed without the persistent love of sun and water.

But Hannah isn’t just one of Karina’s piano students. Hannah was Grace’s closest friend from the age of six through middle school. Playdates, sleepovers, Girl Scouts, soccer, trips to the mall and the movies—for most of Grace’s childhood, Hannah was like a younger sister. When Grace moved up to the high school and Hannah remained in middle school, the girls migrated naturally into older and younger social circles. There was never a falling-out. Instead, the friends endured a passive drifting on calm currents to separate but neighboring islands. They visited from time to time.

Hannah’s graduation milestone shouldn’t mean much to Karina, but it feels monumental, as if she’s sustaining a bigger loss than another matriculated piano student. It trips the switch of memories from this time last year, and it’s the end of Grace’s childhood all over again. Karina leaves her card for Hannah on the gift table and sighs.

Even though Hannah’s at the far end of the expansive backyard, Karina spots her straightaway, standing on the edge of the diving board, laughing, a line of wet girls and boys behind her, mostly boys in the pool, cheering her name, goading her to do something. Karina waits to see what it will be. Hannah launches into the air and cannonballs into the water, splashing the parents gathered near the pool. The parents complain, wiping water from their arms and faces, but they’re smiling. It’s a hot day, and the momentary spray probably felt refreshing. Karina notices Hannah’s mom, Pam, among them.

Now that Hannah is moving to Indiana, Karina assumes she won’t see Pam at all anymore. They stopped their Thursday-night wine dates some time ago, not long after Grace started high school. Over the past couple of years, their friendship dwindled to the handful of unfulfilling moments before or after Hannah’s weekly piano lesson. Tasked with shuttling her three kids to and from a dizzying schedule of extracurricular activities all over town, Pam was often too rushed to even come inside and waited for Hannah in her running car. Karina waved to her from the front door every Tuesday at 5:30 as Pam pulled away.

Karina almost didn’t come today. She feels self-conscious about showing up alone. Naturally introverted, she’d been extremely private about her marriage and even more shut-in about her divorce. Assuming Richard didn’t air their dirty laundry either, and that’s a safe bet, no one knows the details. So the gossip mill scripted the drama it wasn’t supplied. Someone has to be right, and someone has to be wrong. Based on the hushed stares, vanished chitchat, and pulled plastic smiles, Karina knows how she’s been cast.

The women in particular sympathize with him. Of course they do. They paint him as a sainted celebrity. He deserves to be with someone more elegant, someone who appreciates how extraordinary he is, someone more his equal. They assume she’s jealous of his accomplishments, resentful of his acclaim, bitter about his fame. She’s nothing but a rinky-dink suburban piano teacher instructing disinterested sixteen-year-olds on how to play Chopin. She clearly doesn’t have the self-esteem to be the wife of such a great man.

They don’t know. They don’t know a damn thing.

Grace just finished her freshman year at the University of Chicago. Karina had anticipated that Grace would be home for the summer by now and would be at Hannah’s party, but Grace decided to stay on campus through the summer, interning on a project with her math professor. Something about statistics. Karina’s proud of her daughter for being selected for the internship and thinks it’s a great opportunity, and yet, there’s that pang in Karina’s stomach, the familiar letdown. Grace could’ve chosen to come home, to spend the summer with her mother, but she didn’t. Karina knows it’s ridiculous to feel slighted, forsaken even, but her emotions sit on the throne of her intellect. This is how she’s built, and like any castle, her foundational stones aren’t easily rearranged.

Her divorce became absolute in September of Grace’s senior year, and exactly one year later, Grace moved a thousand miles away. First Richard left. Then Grace. Karina wonders when she’ll get used to the silence in her home, the emptiness, the memories that hang in each room as real as the artwork on the walls. She misses her daughter’s voice chatting on the phone; her giggling girlfriends; her shoes in every room; her hair elastics, towels, and clothes on the floor; the lights left on. She misses her daughter.

She does not miss Richard. When he moved out, his absence felt more like a new presence than a subtraction. The sweet calm that took up residence after he left filled more space than his human form and colossal ego ever did. She did not miss him then or now.

But going to these kinds of family events alone, without a husband, tilts her off-balance as if she were one cheek atop a two-legged stool. So in that sense, she misses him. For the stability. She’s forty-five and divorced. Single. In Poland, she’d be considered a disgrace. But she’s been in America now for over half her life. Her situation is common in this secular culture and imposes no shame. Yet, she feels ashamed. You can take the girl out of Poland, but you can’t take Poland out of the girl.

Not recognizing any of the other parents, she takes a deep breath and begins the long, awkward walk alone over to Pam. Karina spent an absurdly long time getting ready for this party. Which dress, which shoes, which earrings? She blew out her hair. She even got a manicure yesterday. For what? It’s not as if she’s trying to impress Hannah or Pam or any of the parents. And it’s not as if there will be any single men here, not that she’s looking for a man anyway.

She knows why. She’ll be damned if anyone here looks at her and thinks, Poor Karina. Her life’s a mess, and she looks it, too. The other reason is Richard. Pam and Scott Chu are his friends, too. Richard was probably invited. She could’ve asked Pam if Richard was on the guest list—not that it mattered, just to be forewarned—but she chickened out.

So there it is, the stomach-turning possibility that he might be here, and the even more putrid thought that he might show up with the latest skinny little twentysomething tart hanging on his arm and every self-important word. Karina rubs her lips together, making sure her lipstick hasn’t clumped.

Her eyes poke around the yard. He’s not standing with Pam and the cluster of parents by the pool house. Karina scans the pool, the grilling island, the lawn. She doesn’t see him.

She arrives at the pool house and inserts herself into the circle of Pam and Scott and other parents. Their voices instantly drop, their eyes conspiring. Time pauses.

“Hey, what’s going on?” Karina asks.

The circle looks to Pam.

“Um . . .” Pam hesitates. “We were just talking about Richard.”

“Oh?” Karina waits, her heart bracing for something humiliating. No one says a word. “What about him?”

“He canceled his tour.”

“Oh.” This isn’t earth-shattering news. He’s canceled gigs and touring dates before. Once, he couldn’t stand the conductor and refused to set foot onstage with him. Another time, Richard had to be replaced last minute because he got drunk at an airport bar and missed his flight. She wonders what reason he has this time. But Pam and Scott and the others stare at her with grave expressions, as if she should have something more compassionate to say on the subject.

Her stomach floods with emotion, her inner streets crowding fast as a fervent protest stands upon its soapbox in her center, outraged that she has to deal with this, that Pam especially can’t be more sensitive to her. Richard’s canceled tour isn’t her concern. She divorced him. His life isn’t her problem anymore.

“You really don’t know?” asks Pam.

They all wait for her answer, lips shut, bodies still, an audience engrossed in watching a play.

“What? What, is he dying or something?”

A nervous half-laugh escapes her, and the sound finds no harmony. She searches the circle of parents for connection, even if the comment was slightly inappropriate, for someone to forgive her a bit of dark humor. But everyone either looks horrified or away. Everyone but Pam. Her eyes betray a reluctant nod.

“Karina, he has ALS.”

Reading Group Guide

This reading group guide for Every Note Played includes an introduction, discussion questions, and ideas for enhancing your book club. 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.

As an accomplished concert pianist, Richard received standing ovations from audiences all over the world. The last time that happened was eight months ago. Since then Richard has been diagnosed with ALS, and his right arm is paralyzed, leaving him unable to play.

Three years ago, Karina finalized her divorce with Richard, but she still hasn’t moved on. Karina is paralyzed by excuses and fear—stuck in an unfulfilling life as a piano teacher, afraid to pursue the path she abandoned as a young woman, and blaming Richard and their failed marriage for all of it.

When Richard becomes increasingly paralyzed and is no longer able to live on his own, Karina becomes his reluctant caretaker. As Richard’s muscles, voice, and breath fade, both he and Karina try to reconcile their past before it’s too late.

Poignant and powerful, Every Note Played is a heartbreaking exploration of regret, forgiveness, freedom, and what it means to be alive.

Topics & Questions for Discussion

1. Why do you think Lisa Genova chose the title Every Note Played for this novel? How did the title help your reading of the novel? Richard and Karina were both professional pianists. Describe how they relate to the music they played. Were there any notes or compositions that were particularly meaningful to them?

2. Karina wonders if she could “have seen the red flags through the thick haze of lust at twenty.” (p. 43) What do you think? Were there any warning signs that Richard wasn’t the person he seemed? Describe their early relationship. What initially drew Richard and Karina to each other?

3. Discuss the structure of Every Note Played. What’s the effect of having the chapters alternate between Richard’s life and Karina’s? Does it help you understand both of the characters? If so, how?

4. As he is performing, Richard remembers Karina telling him, “Being married is more than wearing a ring.” (p. 2) What triggers this memory for Richard? Explain Karina’s statement, particularly in light of her marriage to Richard. Were you surprised to learn the reasons for their divorce? What does being married mean to you?

5. Upon learning of Richard’s diagnosis, Karina pays him a visit. “She had such good intentions,” and wonders how it went “so wrong.” (p. 32) Describe the visit. Did you learn anything that surprised you about their relationship? What are Karina’s motivations for visiting Richard? Do you think that her intentions are good? Why or why not?

6. While Richard and Karina were both classically trained pianists, Karina’s true passion is playing jazz piano. What does she like about jazz? Why does Richard prefer classical music? Do their musical preferences reflect their personalities? How so?

7. Richard comes to think of Bill as “equal parts brother, doctor, parent, and friend.” (p. 96) What did you think of him? How does he help Richard preserve his sense of dignity and humanity? What’s effect does Bill have on Karina?

8. While Richard’s ALS is progressing, he reflects on how “in a million ways, living with ALS is a practice in the art of Zen.” (p. 98) For example, although Richard dislikes Broadway musicals, he does not tell Bill when Bill sings show tunes. Why not? Can you think of any other instances when Richard practices “the art of Zen”? What are they?

9. While visiting Richard, Karina reflects on how “the story of their lives can be an entirely different genre depending on the narrator.” (p. 29) Explain this statement. How would you characterize the story of Richard and Karina’s marriage as told from Karina’s perspective? What about Richard’s? Are there any other instances in Every Note Played when two characters experience the same event completely differently based on their perspective? What are they?

10. Who is Alexander Lynch? Describe his performance. How is seeing it a transformative experience for Karina? Explain why Karina originally resisted going on the trip where she encounters Alexander. Do you agree with her rationale? Why or why not?

11. Describe Richard’s relationship with his brothers. Why is he reluctant to tell them of his diagnosis? What did you think of Tommy and Mikey? Were you surprised by Tommy’s apology? Explain your answer. How does Tommy’s apology and the ensuing conversation help Richard see another side of his brothers? Why might Richard’s “big, brave, tough jock brothers [be] scared of their father, too”? (p. 221)

12. Upon hearing that Grace has told her boyfriend that Karina is “an amazing pianist,” Karina is “caught surprised, moved that Grace would describe her this way.” (p. 38) Describe Karina’s reaction to Grace’s praise. Why did Karina give up her career? How much blame, if any, does Richard deserve? What does Karina think?

13. Describe Dr. George. How is Dr. George able to relate to Richard and put him at ease? Dr. George suggests that Richard consider recording “legacy messages.” What are they? What does Richard think about them? Discuss legacy messages with your book club. If you were in Richard’s situation, for whom would you want to record these messages? What would your messages say?

14. At the clinic, the practitioners use the term care, “and Richard doesn’t openly object but care is not provided every three months when he comes for his appointment.” (p. 51) Why does Richard continue to go to the clinic? Does Richard’s opinion regarding the “care” that he gets at the clinic change? If so, why? Are there different ways to provide care? What kind of care does Kathy provide to Richard? Compare and contrast it with the care that Bill and Karina provide him.

Enhance Your Book Club

1. When Richard first listens to jazz, “The compositions are scribbles, run-on sentences without proper grammar and no punctuation.” (p.224-225) Listen to jazz, including some of the artists that Richard does, such as Miles Davis, Herbie Hancock, and John Coltrane, with your book club. Did you like what you heard? Discuss your thoughts with your book club.

2. Karina bakes makowiec for her family’s Christmas Eve dinner. Find a Polish recipe and try it with your book club. What do you think of it? Do you have any culinary traditions associated with the holidays? Share them with your book club. Why do you think Richard asks Karina to feed him some of the makowiec?

3. Listen to Maurice Ravel’s Piano Concerto for the Left Hand with your book club. Did you enjoy it? Why is this musical composition particularly meaningful to Richard? Are there any musical compositions that hold a special place in your heart? What are they?

4. To learn more about Lisa Genova, read more about her other books, and find out when she will be in a city near you, visit her official site at

A Conversation with Lisa Genova

How did the experience of writing Every Note Played compare to your previous writing experiences? Your previous novels have been critically acclaimed New York Times bestsellers—did you feel added pressure while writing this one?

I wrote this book much faster than any of my other books. Eight of the people I’d come to know with ALS died before I finished the final draft. This disease can move with alarming speed, and I think this lent a sense of urgency while I was writing, that I couldn’t write fast enough. I was very much aware that many of these new friends of mine would die before they had the chance to read what they had helped me create. I penned the first draft of Every Note Played in less than a year, and it came out of me almost fully formed.

The only pressure comes from the sense of enormous responsibility I feel to the people living with these conditions and diseases. ALS is brutally unfair, cruelly debilitating, shockingly fast, and deadly. For the families who invited me into their lives at their most vulnerable, who shared their fears and hopes and tears and naked truths, and for every family traveling a similar journey, I want to make the best use of what they so generously gave me. I want to make them proud. I want this story to expand the world’s consciousness of ALS beyond the ice buckets, to generate a compassionate awareness that contributes to better resources for care and research that leads to treatments and ultimately an end to this hideous disease.

Many of your novels center around neurodegenerative diseases. Why did you decide to focus on ALS in this novel?

This book began with Richard Glatzer, who, along with his husband Wash Westmoreland, wrote and directed the film Still Alice. Richard had bulbar ALS, which means that his symptoms began in the muscles of his face and neck. I never heard the sound of Richard’s voice. He brilliantly codirected Still Alice by typing with one finger on an iPad. Shortly after the film premiered at the Toronto International Film Festival, I told Richard that I wanted to write about ALS next and asked him if he would help me understand some of what he’s experiencing. He was all in. We communicated by email. At this point, both of Richard’s arms were paralyzed. He wrote to me with his big toe. I am forever grateful to him for all he gave to the creation of the film Still Alice, for sharing with me what it feels like to live with ALS, for showing us all what grace and courage look like, for not giving up on his dreams. Richard died on March 10, 2015, shortly after Julianne Moore won the Oscar for Best Actress.

Were there other people who informed your research?

As with all of my books, I do intensive research. My goal is to tell the truth under the imagined circumstances, so I need to know the details in detail. This can’t be done in a Google search. I came to know thirteen people living with ALS, all in various stages of the disease, from less than a week after diagnosis to the day some passed away. Eight of the thirteen died before I finished writing this story. I’m honored, humbled, and forever changed by knowing all of these beautiful people and their families, grateful for every exquisitely intimate insight they shared with me. I became particularly close to Kevin Gosnell (and his family), Chris Engstrom, and Chris Connors, and miss them immensely. I shadowed neurologists James Berry and Merit Cudkowicz and nurse practitioner/codirector Darlene Sawicki at the ALS Clinic at Massachusetts General Hospital; I had countless invaluable conversations and road trips to the beds and living rooms of people living with ALS with Ron Hoffman, founder, director, and hero of Compassionate Care ALS; I interviewed Jamie and Ben Heywood, who lost their brother to ALS (their family’s story is profiled in the film So Much So Fast and in the book His Brother’s Keeper: A Story from the Edge of Medicine by Jonathan Weiner); I spent time with Rob Goldstein and the amazing folks at ALS TDI; I visited Steve Saling and Patrick O’Brien at the Leonard Florence Center for Living; (see Patrick’s documentary TransFatty Lives); I learned about Hospice care from Kathy Bliss and augmentative communication options from John Costello; I FaceTimed with folks who didn’t live near me, as far away as British Columbia.

Can you tell us about your writing process? Did knowing that ALS is a terminal illness affect the way that you wrote? Were there any turns that the plot took that surprised you?

The process for this book was similar to every book I write. I frontload with several months of pure research, and then I continue the research while writing. For more on my research and writing processes, see my blog:

Knowing so many people with ALS who were approaching their imminent deaths and facing it with them definitely affected the way I chose to write this novel. Although I’d touched on mortality and death in all of my previous books, death is almost an unavoidable main character in a story about ALS. There’s no dancing around it. I had many candid conversations about death and dying with the people I knew with ALS, and I read many books on this topic, including When Breath Becomes Air by Paul Kalanithi, Being Mortal by Atul Gawande, The Tibetan Book of Living and Dying by Sogyal Rinpoche, Awake at the Bedside by Koshin Paley Ellison and Matt Weingast, and How We Die by Sherwin B. Nuland.

Plot turns that took me by surprise? I was shocked when Richard’s father died. I did NOT see that coming!

Do you have any favorite scenes in Every Note Played? What are they?

My favorite scenes were:

The “This One Smells Like Cherries” fight between Richard and Karina

Every scene with Bill

The chapter with Richard’s brothers

Music plays an important role in the lives of Richard and Karina, and you wrote about each of their styles with such authenticity. How did you accomplish this? What were you listening to while you wrote?

I knew very little about classical and jazz piano before writing Every Note Played, but that had to change if I was going to write about playing, hearing, and loving piano from the perspectives of these highly trained pianists with any believability. I read Thinking in Jazz: The Infinite Art of Improvisation by Paul Berliner, Miles: The Autobiography by Miles Davis, and Journey of a Thousand Miles by Lang Lang. I saw and heard Jeremy Denk play classical piano in Miami, Joey Alexander play jazz in Boston, and Wynton Marsalis play jazz in New Orleans. I watched many YouTube videos of pianists. My favorite is Vladimir Horowitz. I interviewed several professional pianists, including Simon Tedeschi, Jesse Lynch, David Kuehn, and Dianne Goolkasian Rahbee. And I took piano lessons from Monica Rizzio and Abigail Field! I often listened to Bach, Schumann, Chopin, Debussy, and Liszt while writing this story. You can find a playlist with all of the classical pieces mentioned in Every Note Played at my website:

What would you like your readers to take away from Every Note Played?

Maybe prior to reading Every Note Played, readers read Tuesdays with Morrie, watched The Theory of Everything, or dumped buckets of ice water over their heads. They probably had some awareness of ALS. I hope they now have a deeper and more compassionate understanding of what it feels like to live and die with this disease.

Also, when people think about ALS, their first thoughts and fears focus on the horror of not being able to move or speak, on being locked in. Alongside Richard’s ALS, we additionally saw the many ways he and Karina were stuck in narratives of blame, fear, and excuses, trapped in psychological and emotional prisons. Before ALS steals Richard’s ability to speak, both were perfectly capable of saying anything. Their voices were physically intact. And yet, they weren’t able to say what needed to be said to set each other free, to speak the needed words of apology, to offer forgiveness. I hope readers also use this story to reflect on the ways in which they might be paralyzed in their own lives, and maybe with a shift in perspective, they’ll see that “the door is so wide open.”

Are you working on anything now? Can you tell us about it?

I’m writing a nonfiction book about memory. My next novel will be about bipolar disorder. Oh, and I’m right now re-reading the script for Inside the O’Briens! J

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Every Note Played 4.6 out of 5 based on 0 ratings. 28 reviews.
Anonymous More than 1 year ago
Without a doubt a difficult but informative read. As a pianist my myself I knew the read would be challenging. The in-depth feelings of music and performance tingle with reality. The anger and denial of death is realistic. I faced ovarian cancer twice. My hat is off to an emotional and speedy read of a disease not discussed.
CynB More than 1 year ago
Every Note Played by Lisa Genova is the tragic, heartbreaking story of one man’s battle with ALS,. Genova spares no detail, and the progression is truly horrific. Although this story is unspeakably sad, it is well-told and stands as a reminder to make every moment count, say what you need to say to those you love, and live your life as fully as possible.
MWgal More than 1 year ago
Every Note Played is so well written. The descriptions of the ALS physical decline is painfully accurate, as well as the emotions associated with it by patient, caregivers, and family. I also loved the music references- - classical as well as jazz. Well done!
Bridgett Deem Nelson More than 1 year ago
I'm not sure what it is about Lisa Genova's books, but despite the lack of an action-packed plot, I literally cannot put her novels down. I was introduced to Genova's exquisite writing in her novel, Still Alice. It was one of my few 5-star rated books of 2016. Although incredibly sad and difficult to read, emotionally, I also found it to be heartwarming and inspirational. I can say the same about Every Note Played. The main characters, Richard, a world-famous pianist who develops ALS, and Karina, his ex-wife and caregiver, are about as far from perfect as two humans can be. At times, neither is overly likable--they certainly both have their faults. But it never mattered. In fact, I feel their imperfections and short-comings make this book more real. You truly feel as though you're reading a story about your neighbors down the street, or some acquaintances you met at a work holiday short, people you actually know. The fact that Richard was incredibly arrogant, self-absorbed, and historically unfaithful, adds an interesting dynamic to the story. His family does not give him a pity party upon learning of his diagnosis...and surprisingly, he doesn't give himself one either. So many times in novels, characters are given "saint-like" qualities and then die. From the viewpoint of an avid reader, that can feel manipulative. Yes, this amazing person're supposed to cry now. Every Note Played, thankfully, doesn't manipulate your emotions at all. It's simply a look at the daily lives of an ALS patient, brought to readers from a writer/physician who has, for years, looked into the eyes, and souls, of ALS patients...who knows their heart aches and struggles. And what struggles they are! ALS is a horrifying, terrifying way to die. When the tears finally did come for me, it wasn't during the part one might have expected. Is Every Note Played sad? Of course. Will I cry? It's a real possibility. I certainly did. Should I still give it a go anyway? Abso-freaking-lutely.
diversified-reader More than 1 year ago
Every Note Played is another amazing story by the very talented Lisa Genova.This book, like her others, is deeply and extensively researched. ALS is a terrible and debilitating disease. Through her characters, Richard(the concert pianist suffering from ALS), Karina (ex-wife), and Grace(their daughter), the reader understands the emotional toll the family member undertakes with each action expressed or labored over. This is a story about letting go, forgiving oneself and others, and ultimately freedom…of a disease and a life renewed. The author takes the reader on an emotional roller coaster ride from the very first page and does not let us off that ride until the story concludes. There is a myriad of detailed and visual descriptions that one cannot help but be part of the story…totally and utterly engaged in these characters’ lives. The author also sheds light on the role of caregivers, the financial burden of this debilitating disease, and the many drugs, equipment, and technology needed to make the patient as comfortable and functional as possible. With this story, Lisa Genova has most effectively given voice to a disease that robs a person of their sense of self, their dignity, and ultimately their life. This is a book you will remember long after the final page is read.
SherreyM More than 1 year ago
Lisa Genova, author and neuroscientist, pulls all her talents and skills together to once again engage her readers. In Every Note Played, Genova tells the devastating story of a world-renowned pianist facing the greatest performance of his life–battling the diagnosis of ALS, also known as Lou Gehrig’s disease. Every cell in Richard’s being is devoted to his music and performance. He knows his left arm will go next. As I read this line from the synopsis, I could hear a family member stating almost the same during her siege with ALS. During that time and during the reading of Every Note Played, I pondered what it must be like to know in a given day what you’ll be losing next. The mind is not struck down by the disease. In the case of Richard, his obsession with his career has already cost him his family, a wife and daughter. He lives alone and must rely on caregivers to help him throughout the day and night. Until… His ex-wife, Karina, decides she must help him. Neither approaches this renewal of relationship graciously but throughout their struggle, we learn so much of what relationships both in families and friendships should be about. The former husband and wife are no longer competitors in their music careers or as parents, something they neither did very well. Many readers describe Richard very well–arrogant, self-absorbed, rude, hurtful. I agree with their assessment. However, Karina wasn’t much better it seems when they were married. And now she decides to assume the caregiver role. There are many poignant scenes involved in the development of Genova’s characters in Every Note Played. Some are mildly emotional. Others are heartbreaking. I’m not sure how Genova goes about her writing but she is capable of using the simplest words to share the most difficult and painful scenes. I applaud her ability to share Richard with us and be so accurate in her depiction of his loss of first the use of his fingers, then his hand, and right behind that his arm. Genova gives us a complete picture of living, or should we say dying, with this disease. With all her books, Genova has the edge right there for her readers but it is a subtle edge. These are not action-packed thrillers; they are human stories using fictional characters. Needless to say, they are page turners! It is hard to believe one could find a favorite quote in a book telling such a painful story, but I did: Everything begins and ends. Every day and night, every concerto, every relationship, every life. Everything ends eventually. My Recommendation: Despite my personal connection with this particular disease, I believe I would still have enjoyed Every Note Played. No, it isn’t a feel-good book, but Genova’s writing is educational, heartfelt, well-written, and authentic. To my mind, she is one of our top authors of today. I highly recommend this book.
C_Fowler More than 1 year ago
Every Note Played is the emotionally wrenching story of an internationally celebrated pianist, the family he left behind to pursue his musical career, and his sudden diagnosis at age 45 of ALS. The reader is given a no holds barred look at this horrific, degenerative disease and all of its devastating effects on both Richard Evans and his very reluctant caregiver, his ex-wife Karina, and their daughter, Grace. We get an intimate look at Richard's and Karina's realized dreams, sacrificed dreams, and the selfishness that wrenched them apart and completely destroyed their marriage. This book is well composed, compassionate and excruciatingly honest. It continually touched my heartstrings as I ran through a gamut of emotions while reading it. The characters are well written, and all too human -- which makes Every Note Played so particularly moving. I am so glad I had the opportunity to read this book and very highly recommend it. I received a copy of this book from NetGalley. All thoughts and opinions are solely my own.
Anonymous More than 1 year ago
I had a dear friend who passed at the age of 57 from ALS. I think of her often. This story gave me an insight as to what she must have been going through and feeling during those short 6 months between diagnosis and her passing. Lisa Genova is a wonderful author. I read Still Alice and sobbed through much of the end. Several family members had Alzheimer's and it hit close to home. I plan to read more of her books.
Ronnie293 More than 1 year ago
Every Note Played is an emotional and well researched story on the degenerative disease ALS. When Richard, a concert pianist, is diagnosed with ALS he is at first in denial but as the degeneration of his muscles progresses he must face a life without his beloved piano. Richard is a person who has a single minded love of playing piano that is at obsession level. the notes and tune are all he thinks of during his waking hours. "He is no longer playing the music. The music is playing him." "Without the piano, how can he live?" Genova describes the symptoms and the progress of the disease in a poetic and personally touching voice laced with overwhelming compassion. The characters' inner feelings are expressed with clarity and sensitivity. Richard and his wife are divorced after a bitter build-up of blame on both sides. The accusations and hurt had still not been resolved and as it burned away in both of them neither knew how to start the repair. Genova focuses on relationships and forgiveness, the all consuming job of caring for a terminally ill loved one and the wonderful job done by home help workers. As devastating as the disease is, the advances in technology to aid the sufferers and their carers is amazing to read about. A recommended read. The emotion is real and not over dramatised *I received a free copy from the publisher.
bookgal1 More than 1 year ago
Lisa Genova is one of the most elegant, compassionate writers I have ever had the pleasure of reading. Her ability to research and transform medical science into an engaging and touching story that we can all relate to is unmatched. In this wonderful and powerful book, she has humanized the disease of ALS and given the victims of this disease a voice, helping us understand just how devastating it is for all involved. Parts of it may make you uncomfortable, but the honesty with which she writes is one of the reasons her books are so compelling. You will leave this story with a sense of empathy for those afflicted with ALS, as well as those who care for them. Beautifully written, unforgettable, emotional and gut-wrenching, this is not one you should miss. Many thanks to the publisher and NetGalley for allowing me to read a review copy. This is my honest opinion.
Laeljeanne More than 1 year ago
Karina’s musical talent surpasses her boyfriend Richard’s, but she sacrifices her dream to their marriage and child, and then falls in love with jazz, a genre abhorrent to Richard. He builds his career as an international classical pianist, his inflating ego one of many factors in their divorce. He attempts to hide the onset of ALS from his fans, his agent, and Karina. Due to circumstances and finances, Richard moves back in with Karina, who takes over his care with the help of home health aides. In the year that robs Richard of his body, he at last opens up emotionally to his estranged daughter, and eventually he and Karina find a kind of peace. Beyond being a graphic, heart-wrenching depiction of a man succumbing to a fatal disease, this story shows how women accommodate men and lose themselves, accepting a smaller life. It’s also a homily to home health aides who make the effort to maintain the dignity of their clients. The rolling flow of the writing is interrupted only by the excessive use of analogies, whole paragraphs at times. In Author Notes, Genova offers a peek into her research and sources for an accurate representation of living with ALS. The details are so vivid, if she’d written in first person, this novel would have read like a memoir. I was fortunate to receive a digital copy of this wonderful story from the publisher through NetGalley.
Twink More than 1 year ago
Lisa Genova writes the most brilliant stories. Her latest book, Every Note Played, is one of her best. Richard is a world class pianist - he lives to play. He's also a father and an an ex-husband - both roles he is/was not so successful at. But then Richard starts having problems with his hand - and his arm. And then the diagnosis - ALS (Amyotrophic Lateral Sclerosis) - a disease that paralyzes the diagnosed - and there is no cure. With no one else to turn to and limited finances, Richard asks his ex-wife Karina to tend to him. She reluctantly agrees. Genova's exploration of love, loss, grief and ultimately forgiveness and redemption is so gut wrenchingly good. We are privy to both Richard and Karine's thoughts as they navigate this new uncomfortable reality while trying to make peace with what has come before - before it's too late. Genova is a neuroscientist. Her descriptions of the progression of Richard's ALS are graphic, real and hard to read. Hard to read as I had tears in my eyes multiple times. I was aware of this devastating disease, but learned much through this book. I chose to listen to Every Note Played. Some books are even better as an audiobook. This was the case with Every Note Played. The narrators were absolutely perfect. Dennis Boutsikaris 's voice is expressive, capturing the range of emotions that Richard is experiencing. His enunciation is clear and his voice is pleasant to listen to. He changes his delivery as Richard's disease progresses. Dagmara Dominczyk's voice is quietly measured, not rushed and very much suits the character of Karina. Genova's words are powerful, her characters authentic, and her premise relevant to everyone's life in so many ways. Absolutely recommended.
TheThoughtSpot More than 1 year ago
A heartwrenching and heartwarming realistic fiction story! Thanks to a Goodreads giveaway, I received Every Note Played by Lisa Genova! As the main characters and their lives are set up for the story, I’m interested and sad at the same time. You never know what life is going to bring your way and it made me remember and appreciate how good my life is. The book is difficult to read because the reader gets a bird’s eye view of what Richard is feeling, going through and ultimately losing because of ALS and his life regrets. This touching novel brings the reader into the life of someone diagnosed with ALS and includes all of the intimate details of his struggles with the disease and the relationships that have built him into the person he is. Ultimately a tale of forgiveness, Every Note Played opens our eyes to the patients, loved ones, patient care, technology and research based on ALS. The author put a lot of research and love into this novel and her notes are shared at the end of the book, along with stories of real ALS patients and the inspiration they have given to everyone they left behind, which are their legacies. ALS research continues and as Every Note Played was going to press, a new breakthrough occurred and was in a trial in Japan, giving hope and possible help to patients worldwide. 5 stars for this heart wrenching and heartwarming realistic fiction story!
Meemo_B More than 1 year ago
Some 5-star books aren't easy to review. It's hard to say I enjoyed this book, or that I loved it. Yet I did. Lisa Genova tackles difficult subjects, and difficult characters, and does it beautifully. Anyone with some familiarity with the nature of ALS knows that it must be a horrifying diagnosis to have to accept, much less live with. But that's just what the characters in this book deal must do, and in doing so they come to terms with each other and their failed marriage as well. These aren't perfect characters who had been living a charmed life. They had difficult pasts that contributed to the issues in their marriage and their relationship after their divorce. Genova details the progression of Richard's disease with expertise and compassion, and gradually exposes both characters' pasts, and it isn't always a pretty read. But it all feels very real, and I found it difficult to put down.
Deb-Krenzer More than 1 year ago
I never really knew a lot about ALS before this book. I had only heard of it - connected to Lou Gehrig and Stephen Hawking. Also, there was an episode on "Suits" about it. I only knew it was a disease that could cause paralysis and death. Through this book, I learned a lot more about this dreadful disease and the ways that it takes over your body and what will eventually happen to you. Although the time frame is different for all who have the disease. This book tells it all through a story about a very egotistical classical pianist who has enjoyed the fortune and fame of being famous. It has definitely gone to his head. All he can think about is himself, music, his piano and other women. He leaves his family, including his daughter, who he has left right alongside his wife. An eye opening, very sad story about ALS, divorce and family. I recall my first tear while reading this book. It was near the beginning of the book, when the pianist discovered his plight. This one phrase "Could that be the last embrace of his life?" really hit me hard. Excellent read! Thanks to Gallery, Threshold and Pocket Books and Net Galley for providing me with a free e-galley in exchange for an honest, unbiased review.
Fredreeca2001 More than 1 year ago
This book is amazing! Richard is not really a character you like. He is an accomplished pianist which has toured the world. He is arrogant, a terrible father, and definitely not a great husband. When he is diagnosed with ALS, his world changes for the worst. The author did a BRILLIANT job with Richard. I hated him at first but when his body starts to fail him, he changes in so many ways. Karina is not a saint either. She does help him when he needs her the most. But, she cannot let go of the damage he already caused. The tragedy of a life unfinished, the tragedy of family and marriage, the tragedy of this disease are just a few areas touched on in this book. This is about past hurts, past regrets, and lost dreams. This is a roller coaster ride of feelings! Don’t miss it! I received this novel from Netgalley for a honest review.
Anonymous More than 1 year ago
A story beautifully told with a view of the sadness and reality of ALS.
Anonymous More than 1 year ago
KindleLady More than 1 year ago
I picked Lisa Genova's "Every Note Played" because it was a deeply personal story for me, since my Father had ALS. He passed away in 2000, and I wanted to see if this book would show the advancements in treatment and improvement in aids for people living with this most horrible disease. The book did so much more, as I continued to draw parallels in the lives of Richard, Karina and Grace and my family. The book is beautifully written, and very honest. Even though it stirred up many emotions, I am so glad I read it, and I feel others without my history will be glad they read it too. Thank you NetGalley for giving me an ARC to read and review.
suekitty13 More than 1 year ago
Depressing but also very informative This book was unrelentingly bleak. I didn't expect a ton of laughs from a book about ALS but this was seriously harsh. There was no light in the dark and it made it really hard to get through. It's a super honest and graphic depiction of what living and dying with ALS is like for both the patient and the caregivers and it's just as depressing and brutal as you would imagine. As always. Lisa Genova brings personality and humanity to all her characters, I especially loved Bill, but the main character is the disease which permeates every aspect of the story and these characters' lives. It was depressing but also very informative. It might be helpful (and terrifying) for those diagnosed with the disease and their loved ones because it certainly paints a vivid picture of what to expect.
KateUnger More than 1 year ago
Lisa Genova has wowed me before with her books, and I am happy to say she has done it again with Every Note Played. In this book Richard, a concert pianist, is diagnosed with ALS. The disease progresses quite rapidly, and soon he cannot manage on his own. He is forced to accept his ex-wife’s offer of a home and her care. This book is fairly graphic, but it is also ripe with emotion. Told in alternating chapters from Richard’s and Karina’s points of view, the reader learns of their early relationship as well as Richard’s declining health. I appreciated the honest portrayal of this disease. The circumstances in this book are horrific, and it was truly thought provoking. My favorite character in this book was Richard’s home health aid, Bill. His endless optimism provides needed hope in this rather dark story. He’s always singing while helping Richard, and he becomes a true friend to both Richard and Karina. We need more people like him in this world. I understand that this type of book might not be manageable for some readers, but for me it was a very engaging story. I struggled to rate this book. It was very nearly a perfect read for me.
Valerian70 More than 1 year ago
Every Note Played is a very difficult book to read, dealing with the effects of ALS on the human body and so on to the relationships between the sufferer and their families and friends. The descriptions of how the disease works on the muscles of the body are thorough (to the point where I would not recommend anyone with hypochondriac tendencies picks this book up) and graphic. None of this I have an issue with. I will note that I did become confused by the early references to Stephen Hawking so I had to go a-googling and discovered that ALS is a form of Motor Neurone Disease so that would explain why I could not make the connection (I am British and we generally use MND). My issues came with the characters that the book is about. Richard is that stereo-typical classical musician who cares for nothing and no-one outside his selected oeuvre. Strangely he reminded me of Jilly Cooper's Rannaldini in his selfishness and high opinion of himself - very odd comparison to make I know. Although he does achieve some sort of personal epiphany as the disease progresses through him and laying his body waste it felt, to me, rather forced and at odds with what little we know of his personality. His ex-wife Karina is similarly unappealing and I just could not get on board with her actions in the book and her internal monologues did little to make me warm to her. That said, this is a very sensitive subject and it is dealt with very well. I appreciated the author's attention to the detail of how being a Carer is completely and utterly relentless and how you may harbour "bad" thoughts towards the patient. The way the patient interacts with the variety of carers is also well-wrought with some being taken for granted and others appreciated - sadly (as is the case in this book) it is usually the main carer who is taken for granted and seen as no more than an extension to the machinery keeping the patient alive. I feel a little mean only giving the book 3 stars but the lack of connection between myself, as the reader, and the characters meant that I could not mark it any higher. The writing itself is adequate and does become a little hectoring about what a vile illness MND is in places which did serve me to back off a little bit - we know it is horrendous and not something we would wish on our worst enemy. This book will garner a slew of praise and a lot of 5 Star reviews I am sure and, never forget, everyone is entitled to their opinion. I RECEIVED A FREE COPY OF THIS BOOK FROM READERS FIRST IN EXCHANGE FOR AN HONEST REVIEW.
Anonymous More than 1 year ago
Beattie’s “The New Yorker Stories” is a pretty good collection of slice-of-life stories that begin in the early 1970s and cover a span of 32 years. My favorite story was “Shifting,” which features a disabled Vietnam veteran who is a friend to the protagonist. I also especially appreciated that in a good number of the stories, dogs are integral characters. I do wish that there were a copy right date for each story.
brf1948 More than 1 year ago
I loved Still Alice, and have gifted it to all of my contemporaries facing alzheimer's themselves or within their families. Every Note Played is a fiction based on fact novel that brings home the horror of Lou Gehrig's disease. Seen through the eyes of Richard, a 45 year old world class concert pianist who can not visualize himself as anything more or less, we see how both Richard and his family are affected by his diagnosis and the progression of ALS. We also get to meet some very exceptional caregivers in this novel. (There are a lot of them out there. I've been blessed to meet a few.) I am so grateful that Ms. Genova has tackled ALS, in her inestimable way making it better understood by lay persons. She has been a true gift to our generation, giving us the tools necessary to empathize and assist those friends and family members facing first Alzheimer's and now ALS, or amyotrophic lateral sclerosis. This is a disease that was not recognized in the US much before the 1939 death of Lou Gehrig, but it is increasingly seen as time goes by. Finding a cause and a cure is imperative. In the afterward Lisa Genova gives us web sites to increase our knowledge of and places to donate to assist those suffering with this death sentence. Steven Hawkins is an extreme example to us all of what great good luck, remission, and science is capable of - he was first diagnosed with early onset, slow progression ALS in 1963 and died March 14, 2018 at 76. 90 to 95% of folks diagnosed in the US today with ALS (or MND - Motor Neuron Disease) live an average of only 2 to 4 years from diagnosis to death. The Ice Bucket Challenge was a good start. We need to pick up the baton again now, and carry it on to a cure. I won a free paperback copy of this novel from Goodreads, Lisa Genova and Allen and Unwin Publishers in exchange for an honest review. Thank you all for sharing your hard work with me.
CLynnT More than 1 year ago
Richard owns the world. He is a renowned pianist; booking sold old concerts all over the world. He’s a man-about-town, a most-wanted bachelor, and rarely sleeps alone after each of his outrageously perfect concerts. He’s divorced with one daughter, has a dad and brothers who always laughed at him for playing piano, and he works tirelessly to prevent that baggage from slowing him down in his ambitions and quests. Without warning, Richard can’t control his hand. Richard has ALS and is terribly, sadly alone. Karina had a great shot at jazz; she was a natural and in her element. Until her then-husband, Richard insisted they move in order to further his own career. She never found a jazz niche in New York. It simply didn’t exist. As their daughter, Grace grew; Karina’s career and desires fell by the wayside while Richard’s career took off. Karina, in her anger and determination to keep one personal desire to herself, the desire to have no more children, lies to Richard until they’re finally divorced and free of one another. How do these two people, each with so much pride, guilt and deep-rooted anger, end up together three years after their divorce when Richard needs help so badly? These undertones of human error and forgiveness are overshadowed by the cruel, relentless and uncompassionate symptoms of ALS. Each day, each hour is a new loss, each remaining ability, simple motor skills, such as breathing, swallowing, talking, become a cherished function that is on its way out. So sets the stage for Every Note Played. It’s a realistic glimpse into the lives of one family affected by the disease with no cure. As Richard’s health fails, Karin and Grace’s ability for compassion and forgiveness strengthens. The author, Lisa Genova, is an amazingly accomplished person. I respect her tremendously and am always eager to read her works. Her personal history and education are so impressive, and her compassion that comes thru in her writing is sobering. She accomplished that with Still Alice and has opened my eyes to the slow, steady decline of ALS with this new novel. Ms. Genova’s notes from the author at the end of the book really add such a personal touch to her writing. She is sincere. This comes thru so strongly in her characters. Although it is a sobering subject, I thoroughly enjoyed reading this book. It reveals so much about the disease, compassion, forgiveness and basic humanity. (I received an advance copy of this book from NetGalley in exchange for an unbiased review. Thank you to Gallery / Scout Press and NetGalley for making it available.)