Lisa Genova specializes in novels featuring protagonists with neurological disorders. She has previously published Still Alice, Left Neglected, Love, Anthony, andInside the O’Briens. In her latest work, Richard is a concert pianist and he has ALS, the best know form of motor neuron disease. He needs to be able to use his body for his work, but his body is gradually starting to fail, meaning that he has to give up the one activity that has given his life most meaning. He is also recently divorced from Karina, after he has had many affairs and has neglected her and their daughter Grace, who is around college age, and there is plenty of bad feeling between him and them. Karina had talents equal to his when they met, but she sacrificed her career for the marriage and to be a mother, while he made no sacrifices at all. So Richard, for all his talent, isn’t a likeable character. Or at least he wouldn’t be if he didn’t have ALS. The disease brings him down physically but makes him regret his former arrogance and he makes efforts to reconnect with his daughter.

There are not many plot twists here: Richard’s decline is linear and straightforward. Its inevitability is crushing. The main question is how long can he hold on to various important abilities: playing the piano with his left hand, being able to live on his own, being able to stand up and walk on his own, being able to swallow, being able to breathe. With each loss, he relies more on other people. The central development in the novel is when Karina sees how Richard can no longer cope on his own and tells him to move in back with her, in the house where they used to live together. One might judge that this is such a ridiculous plot move that it undermines the rest of the story, but Genova makes it work, exploring the reasons why Karina makes the offer and how she comes very close to regretting it. The resentments she had resulting from failed their marriage haven’t gone away, and the only way she can continue in a healthy way is to work out how to forgive him.

The book does especially well in conveying information about ALS, its treatment, and what it takes to care for someone with the condition. The most charismatic figure in the story is Bill, a gay man who has seen many people die, and who now works as a professional, helping people with serious illnesses in the declining stages of their lives. Bill has seen it all and maintains a sense of humor and humanity. He’s the most reliable person in the story, and he always lightens the mood. Other carers have a harder time working out how to keep their patience with Bill or to sustain the energy it takes to help him. Richard meets with a variety of doctors who tell him what he can do to prepare for the coming problems, and much of this will be helpful to people wanting to learn about living with the disease.

Every Note Played is a good read with plenty of characters, and despite the sad story it has enough subplots for the reader to maintain enthusiasm. It should help educate people about ALS and also about both classical and jazz music.

© 2018 Christian Perring

Christian Perring teaches in NYC.