Introduction

“Unsparing in her depiction of the disease’s harrowing effects, neuroscientist Genova also celebrates humanity.” —People

“Sometimes it’s easier to tell truth in fiction…And she tells it with heart and hope.” —NPR

“Her juxtaposition of scientific detail with compassionate, heartfelt storytelling is unparalleled.” —Bookreporter

“Every Note Played will grip and gut you.” —The Boston Globe

From neuroscientist and New York Times 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.

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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? Explain your answer. 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.

Enhance Your Book Club

1. When Richard first listens to jazz, “The compositions are scribbles, run-on sentences without proper grammar and no punctuation.” (p.224-225) Listen to jazz, including some of the artists that Richard does, such as Miles Davis, Herbie Hancock, and John Coltrane, with your book club. Did you like what you heard? Discuss your thoughts with your book club.

2. Karina bakes makowiec for her family’s Christmas Eve dinner. Find a Polish recipe and try it with your book club. What do you think of it? Do you have any culinary traditions associated with the holidays? Share them with your book club. Why do you think Richard asks Karina to feed him some of the makowiec?

3. Listen to Maurice Ravel’s Piano Concerto for the Left Hand with your book club. Did you enjoy it? Why is this musical composition particularly meaningful to Richard? Are there any musical compositions that hold a special place in your heart? What are they?

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