Lisa Genova, novelist and neuroscientist, has a gift for telling accessible stories about complex maladies and their victims. Still Alice explored early-onset Alzheimer's; in Left Neglected, a high-achieving woman suffers a brain injury. In Every Note Played, celebrated classical pianist Richard denies his diagnosis of ALS, until he sits at his Steinway and "the keys want to be caressed, the relationship ready and available to him, but he can't respond, and this is suddenly the cruelest moment of his life." Having chosen performing over his marriage and his daughter, Richard's tragedy is multiple; he suffers alone. Genova alternates Richard's chapters with Karina's, his ex-wife who sacrificed her rising career as a jazz pianist and deferred to Richard's relocations and touring. Richard is unfaithful; Karina grows bitter and vindictive.
Three years after their separation, as he becomes too disabled to live alone, she reluctantly takes him into her home. Their relationship is frosty; she cares for him but both rue their situation. However, as they each reflect on what led to their estrangement, the reader learns that Karina is not blameless. As Richard moves toward his inevitable death, they both hope for forgiveness and redemption.
Genova unsparingly details the tragedy of ALS. But she includes the beauty and joy of Richard and Karina's lives in music, balancing the horrific with the uplifting. Every Note Played is the story of a marriage, as well as a hard-hitting primer on a disease. She includes links to her website and "Readers in Action: ALS," and urges readers to learn more. --Cheryl Krocker McKeon, manager, Book Passage, San Francisco