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.


My Thoughts: With every new book by this author, I am hesitant to start turning the pages. The books are all so powerful and poignant, beautifully written and well-researched, and so emotional that I know I will soon be immersed in the tragedy that besets the characters. The same was true with Every Note Played, a story of a once-happy couple, with everything ahead of them. Broken by anger and the irretrievable destruction of their marriage, they couldn’t be more distant from one another when Richard receives his terrifying diagnosis.

Alternately narrated by Richard and Karina, we feel the depths of their individual pain as they tell their story, beginning with the happier days in the past and leading up to the momentous incident that decided their future: we feel the total helplessness Richard confronts on that defining day, and what it took for Karina to step up to help.

This book was one I had to set aside periodically, as I couldn’t take in the details of their lives without wanting a break. It is impossible not to experience their challenges with them, as the characters’ vivid descriptions leave nothing to the imagination. I learned more than I could have anticipated about the disease that took over their lives, and with each page, I felt a part of their suffering. A story that kept me turning the pages, I give this latest by Genova 5 stars.



  1. So glad you loved it. I believe it was one of her best books. So tragic and heartbreaking to actually feel what it would be like to have ALS and be a caretaker. The devestation was almost unbearable. I know I finished reading the book with tears pouring down my face. Lovely review.

    Liked by 1 person

    1. The descriptions of the symptoms made me feel as though I might be coming down with the disease! That’s how realistic were the descriptions. Thanks for visiting, Susan.

      I loved Still Alice, too, of course; I have that one on DVD as well.


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