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Every Note Played 
Lisa Genova, 2018
Gallery/Scout
320 pp.
ISBN-13:
9781476717807


Summary
From neuroscientist and 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. (From the publisher.)


Author Bio
Birth—November 22, 1970
Where—N/A
Education—B.S. Bates College; Ph.D, Harvard University
Currently—lives on Cape Cod, Massachusetts


Lisa Genova is an American neuroscientist and author of fiction. She graduated valedictorian, summa cum laude from Bates College with a BS degree in biopsychology and received her Ph.D. in neuroscience from Harvard University in 1998.

Genova did research at Massachusetts General Hospital East, Yale Medical School, McLean Hospital, and the National Institutes of Health. She also taught neuroanatomy at Harvard Medical School fall 1996.

Genova married and gave birth to a daughter in 2000. Four years later she and her husband divorced, and Genova began writing full-time. To hear Genova tell it:

When I was 33, I got divorced. I’d been a stay-at-home mom for four years, and I planned to go back to work as a health-care industry strategy consultant. But then I asked myself a question that changed the course of my life: If I could do anything I wanted, what would I do? My answer, which was both exciting and terrifying—write a novel about a woman with Alzheimer’s (Cape Cod Magazine.).

In 2007 she self-published her first novel, Still Alice, which went on to became a major best seller and award winning film. Since then, Genova has written three other fictional works about characters dealing with neurological disorders.

Still Alice
Genova's debut novel follows a woman suffering from early-onset Alzheimer’s disease. Alice Howland, a 50-year-old woman, is a cognitive psychology professor at Harvard and a world-renowned linguistics expert. She is married to an equally successful husband, and they have three grown children. The disease takes hold swiftly, changing Alice’s relationship with her family and the world.

Self-published, Genova sold copies of the book out of the trunk of her car. The book was later acquired by Simon & Schuster and published in 2009. It appeared on the New York Times best seller list for more than 40 weeks, was sold in 30 countries, and translated into more than 20 languages.

The book was adapted for the stage by Christine Mary Dunford and performed by Chicago's  Lookingglass Theatre Company in 2013.

A 2014 film adaptation starred Julianne Moore as the lead and co-starred Alec Baldwin, Kristen Stewart, and Kate Bosworth. Moore won an Oscar for Best Actress.

Other books
Left Neglected (2011)
Genova's second novel tells the story of a woman who suffers from left neglect (also called hemispatial or unilateral neglect), caused by a traumatic brain injury. As she struggles to recover, she learns that she must embrace a simpler life. She begins to heal when she attends to elements left neglected in herself, her family, and the world around her.

Love Anthony (2012)
Offering a unique perspective in fiction, this third novel presents the extraordinary voice of Anthony, a nonverbal boy with autism. Anthony reveals a neurologically plausible peek inside the mind of autism, why he hates pronouns, why he loves swinging and the number three, how he experiences routine, joy, and love. And it is the voice of this voiceless boy that guides two women in this powerfully unforgettable story to discover the universal truths that connect us all.

Inside the O'Briens (2015)
In her fourth novel, Genova follows Joe O'Brien, a middle-aged Boston policeman diagnosed with Huntington's. There is no cure, and the disease is progressive and lethal. The story revolves around the fallout on Joe's family, including his daughter who is at risk for carrying the genes.

TV and film
Since her first novel was published, Genova has become a professional speaker about Alzheimer's disease. She has been a guest on the Today Show, Dr. Oz, CNN, PBS News Hour, and the Diane Rehm Show. She appeared in the documentary film To Not Fade Away. It is a follow-up to the Emmy Award-winning film, Not Fade Away (2009), about Marie Vitale, a woman who was diagnosed with Alzheimer's disease at the age of 45. (Adapated from Wikipedia. Retrieved 4/6/2015.)


Book Reviews
What’s amazing about her newest novel, Every Note Played, is what is amazing about all of Genova’s books. She is both the neuroscientist and the actor when she writes. She tells not only the story of a person struck down by some disease. She tells the story of the disease, too. And you learn this way. But it never feels like learning.
Boston Globe


[Lisa Genova] delivers another gripping journey through a dread disease in Every Note Played. This time she trains her masterful storytelling skills on ALS as it plays out in a fractured family... deft phrasing eases the reader’s passage through a story that can’t end happily.
Minneapolis Star Tribune


An expertly written depiction of the toll a ravaging disease takes on both the body and the heart.
Marie Claire


[A] gripping novel.… Unsparing in her depiction of the disease’s harrowing effects, neuroscientist Genova also celebrates humanity and the rewards of asking for, and offering, forgiveness.
People


This book is especially remarkable because as a neuroscientist, author Lisa Genova has keen insight into the realities of ALS.
Bustle


Genova captivates with [her] painful but unflinching story…. [The characters'] harrowing journey, though it lacks any true narrative surprises, is both substantively informative about ALS and an emotionally wrenching psychological portrait.
Publishers Weekly


Genova expertly details the devastation ALS wreaks on Richard, and though her latest is a sometimes difficult read, she finds hope in the opportunities Richard has to repair his relationships with his daughter and brothers before it’s too late.
Booklist


While undeniably formulaic, Genova's latest is one of her strongest—more internalized, sometimes slow, but an eloquent and touching imagining of how a peaceful terminal place might be reached.
Kirkus Reviews


Discussion Questions
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? If so, why? 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.
(Questions issued by the publisher.)

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