Wow! what a book. Following Richard's battle with ALS was heartbreaking. The fact that his ex-wife took him into her home to care for him speak volumes about a woman who gave up her life for her husband's career. The progression of the disease was certainly eye-opening. Combining Richard's music with the disease was unique, especially when one can almost hear the music. From beginning to end the characters grew and changed and were lucky enough to have time to forgive each other.

Genova takes readers on another journey of a character struggling with an incurable, irreversal disease. While early onset Alzheimer's was relatively tidy, ALS is gross and messy. Genova spared no detail from diagnosis to the inevitable demise. A painful truth of how one's past "comes home to roost," will get all readers to consider past choices, decisions, and make plans for making amends. Thoughtful, emotional, and informative.

This was an emotional book written unemotionally. It was excellent. Heartbreaking, frustrating but ever so true. I love the way the author writes and her knowledge is first hand. Just a beautiful story. Live your life because we only have one!

I love how much can be learned by reading the books of Lisa Genova. In this case, while fascinated by the disease, I found I had to scan through much of the second half of the book, partly because I wasn’t interested in the musical aspect of the story and partly because I was getting tired of the repeated interactions. All this said, I cried my way through the ending and into the author’s notes. . What a horrifying disease and a terrible, fearsome way to live. I sincerely hope that the recently approved medication that Lisa Genova talked about will prove to be a magic bullet.

Every Note Played is somber, but never morbid despite the omnipresence of an unwelcome mien. Richard, a fragile artist, and a selfish prick. Karina on the first meet is dejected and miserable. Their divorce is typical of a couple who had so much in common but couldn't find some common ground. One of their joint successes is their daughter, but her departure for college leaves Karina and Richard with no reason to interact. Until ALS. Obligation, resentment, and regret dot their new normal. Their reconfigured relationship may seem like an odd place to find, kindness, redemption, and if not love, then empathy, but if you're not getting a little misty by this time you may want to check your faculties.
Every Note Played educates more than any ice bucket and moves you in a way that is sad, but also sanguine. Let the characters acknowledgements, revelations, and amends motivate you to act. The power of confession is incredibly freeing no matter the destination.

Lisa Genova gives the reader a front row seat on the progression, treatment, and heartbreak of ALS.

Whenever Lisa Genova releases a new novel, it is automatically my must read book of the season before I've even read the first line. Each of her books focus on a neurological disorder and the emotional impact of the disease on the patient and those close to them. A PhD neuroscientist, she uses her thorough knowledge of the brain to enrich and fill out her novels while also creating interesting and complex characters and compelling storylines. I have loved every one of her books and this one is no exception.

Every Note Played centers on Richard, an accomplished classical pianist, his ex-wife, Karina, and his estranged daughter, Grace. When Richard first notices clumsiness is his fingers, he tries to ignore it and even allows his manager to write it off as a case of tendonitis. But when his symptoms worsen, he is forced to seek medical attention. The diagnosis, ALS, also known as Lou Gehrig's disease, shocks and devastates him. He is forced to rely on strangers to care for him and eventually on Karina, who makes the incredibly generous offer of allowing him to move back in to their family home so she and Grace can help care for him. Richard is a self-centered, rude and not very likable man, but as his condition inevitably worsens, his humanity shines through and he manages to repair some of the damage he has caused to those closest to him.

While I adore all of Genova's books this one hit particularly close to home for me. My husband's spunky and adorable grandmother died of the the bulbar variant of the disease a few years ago, and completely lost the ability to speak for the last several years of her life. One of my closest friends lost her father to the disease when he was in his early sixties. ALS affects people of all races, ages and walks of life, but even if you've never witnessed the disease up close, you're sure to be moved by this deftly told and emotional story. Just keep the tissues easily accessible.

And for bonus material, her TED talk on things you can do to prevent Alzheimer's disease is fascinating and educational.

https://ed.ted.com/featured/JbufIwmt

There will be #nochill in this review. If this book doesn't win all the awards, I don't know what those people are thinking. I haven't been so emotionally affected by a book in a long time (maybe ever?). I cried for about an hour after I finished reading and it was not a pretty cry (My mascara was halfway down my face.). Every Note Played by Lisa Genova is a beautiful, complicated, wonderful story. I will get more into how the story affected me personally, but let's get into the review.

Synopsis (from Goodreads):
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.

Richard is kind of an ass. His life is playing the piano. He is so focused on his career as a pianist that he completely forgets about his family and it ends up being one of the factors that leads to his divorce. Richard's life solely involves the piano and the women that move in and out of his life. That is, until he finds out he has ALS. Then all that disappears. Richard's hands are the first thing to go and he has to give up the piano entirely. When he can't take care of himself, he begrudgingly moves in with his wife, Karina and they learn to live with each other after hating one another for so long. Richard is an incredibly well-developed character and he goes through every emotion as he struggles with this disease. Richard is aggravating and stubborn and sweet and vulnerable and a thousand other adjectives throughout this book and it felt really special to be able to go along with him on his journey. Also, he has a home-health aid named Bill who is a pure joy! You will love Bill.

Karina has had a rough life and it didn't get much easier after Richard and her divorced. She misses her daughter, Grace immensely when she goes away to college. She also is still living with a lot of anger toward Richard. He blames him for abandoning her for his career, while she felt she had to let go of hers to be a mother. She teaches piano from her house and besides a few friends and her daughter, she doesn't get out much. But when a friend tells her that there are rumors that Richard has ALS, she is determined to find out for herself. While their first meeting leaves much to be desired, eventually Karina comes to see that Richard is declining rapidly and he is going to run out of money sooner rather than later. So, to probably both of their surprises, she allows him to move in with her. And needless to say, it is not easy. Not anywhere close to it. Karina becomes stuck in her house taking care of Richard at all hours of the day. She had just felt like she had gotten her independence back and now she is back to taking care of her ex-husband. But as his illness becomes worse and worse, Karina starts to understand that he was not the only one at fault for the problems in their relationship. Karina also comes to realize that maybe it's not too late for her to restart her career and go back to the things she loved that she let go of so long ago.

Richard and Karina have quite a complicated relationship (if you couldn't tell that by now). There is a lot of hatred between the two of them and a lot of unspoken words, but they also have a very intense history of similar interests and love. They grew apart, stopped talking to each other, neglected each other, and then grew to dislike each other so much it turned into hatred. But then they are presented with this tragic situation. Richard gets ALS and has no one to take care of him or at least no one he isn't paying. At first, he doesn't tell anyone. But once people find out, specifically, Karina, the ex-couple have to live under the same roof and Karina becomes the prime caregiver. While she never refuses to do the work, she comes to resent it (which, from my experience, seems to be a common part/stage of being a caregiver to someone, even if you love them). While they end up coming to a place that is much better than where they started, the disease is always prevalent in their relationship.

While there are other characters I could talk about, I really want to talk about Richard's relationship with ALS. The disease felt like another character, like the antagonist almost. While Richard isn't always the most likable character, I always felt like shit everytime the disease takes something else from him. And with the way the story is written, switching between Richard and Karina's point of view, by the time we get back to Richard's POV he has lost another part of his body to the disease. It is purely astonishing how Lisa Genova shows us the deterioration of the body through this character. Each time we get back to Richard's POV is like a shot to the gut because you don't want him to lose anymore, you don't want him to die. We meet Richard when he is just beginning to feel the symptoms of ALS. His right hand doesn't work anymore. And going through everything on both sides of that journey, Richard's and Karina's, makes you feel a small part of what it must be like for people and families to go through this every day. It's really fucked up that anyone has to go through this.

I have never really had a reaction to a story like I had with this one. Like I said, I sobbed for about an hour. The story deals with forgiveness and that is something I have been trying to figure out myself for the past year. How to forgive, what to forgive, if I should. This story put that into a different light or maybe just made it clearer for me, and that caused all the emotions to come up. Of course, I was crying for the characters and the situation they were in, but I think I was also crying for loss, and heartbreak, and all the things in life that are unfair. Lisa Genova's story really made me think about things that I usually keep on the back burner in my mind. She has written such a beautiful, bittersweet story.

If it wasn't obvious by now that I am in love with this book, I don't know what more I can say. On a scale of 5 stars, I am giving Every Note Played 5 stars. It was brilliantly written with expertly developed characters that I connected to almost immediately. Please go buy this book when it comes out. And, if you can, please donate to ALS ONE.They are an organization looking for a cure to ALS and trying to give people with ALS better care. 

Every Note Played by Lisa Genova comes out March 20, 2018.

Thank you, NetGalley and Gallery/Scout Press for this ARC in exchange for my honest review.

Lisa Genova is a brilliantly talented author, always bringing beautiful and heartbreaking stories to life. I enjoyed this book, as I do each of her thought-provoking and engaging books. I was caught up in Richard and Karina's story and was left thinking long after I finished the book

Fabulous book following the journey of a man with ALS from beginning to end and the complex emotional toll it has on self and family. Written with a certain rawness as a man with full intellect intact, yet a body that won't move, and essentially unable to communicate. Poignant scene where he desires a sexual experience, yet cannot communicate it.

This is Genova's best book yet, not a light accomplishment. Her research, her skill in showing us the devastation of ALS, the courage of those who have ALS, their families, their caregivers, as ALS makes its relentless journey to death, is unmatched.

For those who have lost a loved one to this disease, this book will resonate. For those of us who have watched a loved one die, the decisions to be made, the longing for it to be over, to never end, all the unspoken words...this will speak to you as well.

Faces Behind ALS

I adore Genova’s books. The illnesses she writes about are deeply complex serious, and frightening however in her hands, they are honestly humanized, poignant, and truthful. Every Note Played is no exception as she draws from a wealth of knowledge and research to bring us a story of a forty-five year old celebrity pianist who is diagnosed with ALS.

As Richard navigates the cruel trajectory of this motor neuron destroying disease, he learns to become humbled in a way he hasn’t had to in years. His armor breaks down bit by bit along with his body as new opportunities are presented to him in ways they would not have had he remained healthy. This reconciliation with one’s misfortune, especially one as grave as this one, as not being all bad and providing those unique opportunities to live a better life in the short time one has left create an interesting paradox and one Genova handles very well.

Richard and his ex-wife Karina had built an acrimonious relationship before and after their bitter divorce on heartbreaking resentment on both sides. Each justifies in his own right, Karina and Richard’s daughter side with Karina as Richard continues to lead a life of a celebrity muscician. After Richard’s diagnosis, Karina steps in as his primary caregiver and both begin to face their part in their marital demise.

Told with honesty and stark brutality as the indignities of this illness are illustrated in such a way to honor the victims and caregivers by refusing to gloss over just how harsh the day to day elements of the disease are and how overwhelming they can be and how they can exact their toll. Resiliency is built brick by brick and even in the face of such dire circumstances, healing and forgiveness can still take place.

BRB Rating: Read It.

Tears and more tears. I loved the brutal honesty of this book. It accurately conveys the horrible disease of ALS. I loved the omniscient viewpoint. It helped me understand more fully what this disease does to all who are involved. It was heartbreaking as is the awful and cruel disease of ALS.

I absolutely loved this book from beginning to end. Lisa Genova has a way of catching me right at the start of a book and holding me until the last word. This is a beautifully heartbreaking book about a disease I knew little about. Her characters feel like real people, someone from my neighborhood.

Lisa Genova conducts yet another virtuoso performance as the author of this latest true-to-life sage that documents the devastating impact that a terminal illness brings to a family. In this novel Richard is a divorced concert pianist who is diagnosed with ALS, aka Lou Gehrig's disease. His bitter divorce from ex-wife Karina, a former jazz pianist, has left him estranged from his college student daughter.

The diagnosis of ALS comes as a shock to a man whose whole identify in life has been tied to his piano playing, the one thing he can no longer do as first his right, and then his left arm becomes paralyzed. As the disease spreads, so does word of his illness which eventually reaches Karina who can't reconcile this ill, lonely and needy man with the selfish one whose ambition and arrogance ground her career to a halt. As Karina becomes Richard's reluctant nursemaid, moving him into her living room, hospital bed and all, this novel becomes not only an examination of a cruel disease wreaking havoc on a body, but also how impending death can also bring introspection, forgiveness and newfound hope.

Neither of these protagonists are particularly likeable people, both overly consumed with their own selfish needs. That Genova can craft a story that makes one want to look past their personalities and still see their humanity, pain and emotion is a tribute to her talent. Her detailed and riveting description of living and dying with ALS is eye opening, gripping and gut wrenching, yet one you can't stop reading. As a reader, it made my heart ache for all the patients and families that have or will lose their loved ones to this dreadful disease. Every Lisa Genova book has been a must read for me and this one didn't disappoint.

Another winner by Lisa Genova. With each book Genova writes, I learn something. This time she takes us into the world of a concert pianist who has ALS and the impact his illness has on himself and his family. A beautifully written story about life, love, forgiveness, and dying -at times emotionally draining but such a touching story. Highly recommend.

I have some mixed feelings about this book. The main characters held a love/hate relationship for me. They were both so angry for so much of the story that I was praying there would be some kind of redemption. I won't spoil anything though.

It was a very thorough look on the effects of ALS to a body and to the caretaker. I was a caretaker for 4 years, not to an ALS patient, but I do know the toll it takes on a person. Richard goes through the gamut from learning he has it, which destroys his soul because he is a pianist, to reaching the end of life and all the messiness that brings. He was easier to figure out than Karina. I wondered why she stayed so long and stayed in her rut even after their divorce. But we do what we need to.

I was in tears at the end of the book. The ending was beautifully written. It made my heart smile. This is another very good read by Ms. Genova.

Thanks to Netgalley and the publisher for the copy.

I must begin by thanking NetGalley and the publisher for letting me read an advanced copy of this wonderful book by Lisa Genova.
I have read and enjoyed and learned from “Still Alice”, “Anthony” and “Left Neglected”. When I learned that this author had a new book coming out, I knew I just had to read it. However, I was also not sure I wanted to read it because of the subject matter, ALS. My wonderful brother was a victim of this horrendous disease a few years ago and I was not sure if I should put myself through the emotional experience of reading a novel about it. Well, since I had the book and liked everything written by this author I decided to read it and if it got to be too much for me, I’d stop.
I am so glad I read it! Yes, I thought often of my brother (as I normally do) but I also appreciated that he did not have to suffer as much as some people do with ALS. And, my brother was nothing in personality like Richard, which helped. I appreciate all the research that the author did and it helped me understand the disease a little more.
I also found myself going to my computer to listen to some of the classical music mentioned in the book and references to pieces of music and art.
Be forewarned, however, and have a couple of tissues handy later in the book.
I wanted to think about this a couple of days before writing a review. It is very rare for me to give any book 5* but I cannot think of any reason for not doing so in this case.
I now have “Inside the O’Briens” the only Lisa Genova book I’ve not read on my Kindle and hope to get to it sooner rather than later.

Oh my! I felt completely enveloped in this story. "Every Note Played" by Lisa Genova gives powerful and vivid insight into the devastating affliction and reality of ALS. I loved "Still Alice" by this author, and was looking forward to reading another realistic, honest and well researched novel. ALS is an aggressive degenerative disease, and the main character Richard, along with his family, face a terrible reality of gradual and permanent loss, while trying to find forgiveness and make a mends. This is an irresistible story of a heartbreaking spiral, difficult, but really amazing. Thank you NetGalley, the publisher and author for this early edition copy. I highly recommend it, and all opinions are my own.

Lisa is writing with her usual understanding of factors that don't have a cure. Her characters are believable. Richard with ALS and his mental anguish as he loses the ability to continue his career as a concert pianist. The anger of his x-wife and her disappointments with her life...not what she had planned. It was hard to put down.