#LiteraryWives: Every Note Played by Lisa Genova

Literary Wives is an on-line book group that examines the meaning and role of wife in different books. Four times a year, we post and discuss a book with this question in mind:

What does this book say about wives or about the experience of being a wife?

Don’t forget to check out the other members of Literary Wives to see what they have to say about the book!

Every Note Played by Lisa Genova

Goodreads Synopsis: 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. 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.

Warning: Contains Spoilers!

I enjoy reading Lisa Genova’s books. I think mostly for the medical information I learn, in the context of people’s lives rather than from a text book (or the internet equivalent of a text book). Every Note Played is about a man with ALS–which is heartbreaking enough, but made even more so by the fact that playing the piano is his whole life and the first to go are his arms. I think the scariest thing about this disease is how fast it all happens.

The story is set up to make Richard unlikable, but we can’t help but feel sorry for him when he’s diagnosed with ALS. And his ex-wife feels the same. Despite how they feel about each other, Karina takes pity on Richard and lets him come home so she can help take care of him.

What does this book say about wives or about the experience of being a wife?

Karina and Richard were both talented pianists when they met and got married. But two things happened that made Karina resentful and ultimately led to their divorce. While the couple were living in New York, Karina fell in love with jazz and began a promising career as a jazz musician, but the couple moved to Boston for Richard’s career, leaving the jazz scene behind. Then, when their daughter Grace was born, Karina took on parenthood practically alone. Richard was too busy with his career and travelling the world to spend a lot of time with his family. Karina had to content herself with giving piano lessons to students who didn’t really want to be there.

Karina’s experience of being a wife seems to involve resentment, jealousy, and feeling ‘less than’. And why wouldn’t she? While she was keeping the home fires burning, Richard was living his dream and sleeping with other women.

She retreated into the intensity, responsibility, and loneliness of full-time motherhood, resigning herself to living in Richard’s immense shadow, darker, lonelier, and far more inescapable than the pre-dawn sky of a grim November morning.

When Karina looks back on their relationship, she remembers that Richard was always a bit of “a narcissist, a fragile egomaniac, a selfish prick. She naively thought these were the character traits of any talented, ambitious man. The price of admission. She respected his dedication to piano and admired his confidence. Looking back, she can see that his dedication was desperation, his confidence was arrogance, that he was always a house of cards.”

Is Richard fully to blame? He certainly didn’t make it easy on her – he definitely failed in the supportive husband department. But she was so wrapped up in her resentment of him that she failed to see her own role in things, and to admit that, more than anything, she was afraid of failing.

Richard is sick and dying, and she still can’t let him off the hook. Making him wrong allows her to feel right, and feeling right is her drug of choice.

Karina is not blameless – we eventually learn that she had been taking birth control all the years that Richard thought they were trying for another child. She had her reasons; she felt as though she had lost control of other parts of her life and she blamed Richard for it. But you can’t expect to have a good marriage with that kind of deceit going on.

They never talked about any of it. They were complicit in their mutual silence.

By the time they divorce, Karina believes it is too late for her to chase her dreams – that she’s been out of the game too long. And now she has taken on the job of providing intense homecare for her ex-husband. Because how can she not take him in when he has no where else to go? (Learning where Richard came from and how he was brought up shone new light on his personality.)

In the process of caring for Richard–and in Richard’s experience of losing control of his body and having lots of time to think about his life, mistakes, and what is really important–Karina and Richard begin to reconcile with each other. And Karina starts to see the possibilities of what her life can still be.

He wants to tell her that he’s sorry that she’s so tired. He’s sorry he has this and had nowhere else to go. He’s sorry he’s become such a burden to her. And then suddenly, strangely, for the first time, he wants to tell her that he’s sorry for all of it.

One last big test of what they had both learned during this experience was the question of whether or not Richard was going to choose to be put on a ventilator to prolong his life (and need around-the-clock care); he still had the power to put her career on hold with this decision. He chooses not to.

Have you read any of Lisa Genova’s books?

Join us in June for Monogamy by Sue Miller!

29 thoughts on “#LiteraryWives: Every Note Played by Lisa Genova

    • Naomi says:

      She does a good job of showing you it’s like to be the one with the disease and the one caring for the person with the disease. Both are heartbreaking.
      Looking forward to Monogamy!

  1. Eva @ The Paperback Princess says:

    It’s so true about the foundation of their marriage – they both made decisions that led them to this point, neither was blameless. I was glad that they had a chance to reconcile even if it was because of such a devastating disease.

    I hadn’t realized until your post that each kind of lose control over their lives (albeit in very different ways); Karina because of Richard’s decisions and the care of their child, and Richard obviously because of his disease. Richard really makes the ultimate decision to give her another chance at her life.

    • Naomi says:

      I wonder if that final decision that he makes would have made sense – or might have been different – if they hadn’t had that chance to reconcile…

  2. Lynn @ Smoke & Mirrors says:

    I was surprised at the speed with which this disease progressed as well!

    I am always interested in “end-of-life” decisions made by people. I have always said I would not want to endure much “life” (if you can call it that) beyond when I can communicate and take care of myself. Keeping a body “alive” is not necessarily “living,” in my opinion! Though I have known people who went ahead with toxic treatments and surgeries even though they knew it was basically hopeless. I’ve always wondered if I’ll be able to stick with my intentions if put in a similar situation. I thought that was one of the best aspects of this book, witnessing Richard’s ambivalence as he had to make decisions.

    • Naomi says:

      That was one of the best parts of the book, for sure. He had some huge decisions to make and not much time to make them!
      It must be so frustrating to have something to say and not be able to say it. 😦

  3. Lynn Gerrard says:

    I did appreciate the fact that Richard chose to participate in clinical trials for medication. As he stated, he felt he could at least do his part to help others in the future.

  4. Rebecca Foster says:

    I enjoyed Still Alice — like you say, it’s neat to see how the medical situations play out in fiction (although I also read a lot of medical nonfiction). I’m interested in this one, too, and actually would have joined you this month had my library owned a print copy. (They do have the e-book, but, alas, downloading something to my Kindle these days is a recipe for it sitting there unread for months or years!)

    Like Susan, I’ll be looking forward to your thoughts on Monogamy; it was a joint favourite of ours last year.

    • Naomi says:

      Ooo… That’s good to hear!

      One of the reasons I like reading about it in fiction is because I don’t read enough nonfiction – so I get to feel like I’m still learning something! 🙂

  5. wadholloway says:

    I’m excited to have actually read the book you are discussing – 2 and a half years ago, which means a) that the audiobook must have been released simultaneously; and b) that I remember very little.
    I’m interested that you are all discussing Richard’s problems which I saw as just a vehicle for the discussion of Karina. You write: “While she was keeping the home fires burning, Richard was living his dream and sleeping with other women.” but the sleeping with other women is if not irrelevant, then at least not the main point. Whether or not we get a bit on the side, us men just steam ahead with our careers, and our ‘partners’ get to do whatever they can in the space that is left.
    If in the next book Karina gets the disease I’m willing to bet that Richard phones the nursing home matron once a week to make sure she’s ok. That’s what this book is about – men work and women care (and don’t we love it).

    • Naomi says:

      Thanks for the juicy comment, Bill! Let’s
      see… I agree that in a lot of cases (especially historically) “men work and women care”, but I’m not convinced that’s what this book is about. If the story involved several couples living under that same idea, then maybe one could say that’s what it was about, but in this book there is only one couple. You’re right, though, that Richard’s womanizing is not the point. I’m not really sure what the book is about (living with ALS?), but I do know that if Karina had decided to continue with her career despite the lack of support from Richard, it would have been a whole lot more work for her. So, even though in some ways the book is telling us that maybe the real reason Karina chose not to follow her dreams was because she was afraid of failing, I might argue that the amount of work it would have been for her to do so would have felt very overwhelming. Not to mention guilt – she would definitely have felt the mother guilt of leaving her child in someone else’s care while she was working. It’s not hard to see why so many women choose to put things on hold after having a child/children.
      If Karina had been sick, Richard might have put her in a home, but I would like to think most men wouldn’t. Am I wrong to think that??

    • Naomi says:

      Eva said the same thing (which we didn’t know when we put it on our list)! I can see why you would be, but I find it interesting!

  6. annelogan17 says:

    I love reading your literary wives posts Naomi, and this was no exception. It sounds great! I know what it feels like to sometimes live in your husband’s shadow, he’s a very successful businessman, but I’m lucky in that he supports my career too, and places importance on it as well, even though I make (way) less money than him. haha

    • Naomi says:

      Things are similar here. We have a pretty traditional marriage (he’s the main breadwinner), but he has always supported the stuff I’ve wanted to do! (Including stay home with the kids!)

  7. Karissa says:

    I’ve heard (not sure how accurate it is) that in couples where one person requires long term care, the divorce rate is much higher when it’s the wife who needs care. Meaning that women will more likely stay and care for their partner while a man will decide it’s too much and leave. Interesting that here that even extends to after a divorce.

    • Naomi says:

      That *is* interesting! And sad!
      I wonder, too, if women are more likely to be frowned upon if they choose not to be the caregiver…

      • Karissa says:

        I wouldn’t be surprised if that was part of it. I wonder too if, for many women, caring for a spouse is one more (big) thing to take on on top of everything else like running a household and caring for small children. Whereas some of these husbands are maybe taking on the care of a spouse plus all the quiet labour they didn’t realize their wives were doing.

  8. Care says:

    I wondered, too and did some quick searching on the question about divorce rates; an article popped up right away: Yes, “When a wife falls ill, there is a 6 percent greater chance that a later-life marriage will end in divorce than there is if she remains healthy. When a husband becomes sick, there is no impact on the odds that the couple will divorce. Mar 6, 2015”


    Interesting post, great review. I’ve read 3 of Genova’s books. All informative and well written, good stories, recommended.

      • Lynn @ Smoke & Mirrors says:

        I’m gonna butt in here, Naomi! How cool that you found this article. I am rather shocked that the divorce percentage is not higher when the wife/female falls ill. (And what about same-sex married couples?!? LOL) But, I also wonder how much higher the percentage would be for an ill wife/female to be in an institution for care as opposed to being able to remain at home. I can imagine many more wives care for their husbands longer if not until the end than do husbands caring for their wives. If that makes sense…

  9. buriedinprint says:

    What an interesting discussion! I’ve not read her books, and I don’t really feel pulled in their direction, but I do enjoy the kind of dilemmas that arise out of these situations in fiction. It’s one thing to read statistics in non-fiction about ailments and death/dying, quite another to have the human experience, even if it is fictionalized!

    • Naomi says:

      I find that in fiction you can learn about some of the things not covered in non-fiction, like the decisions that have to be made about health care. And how it affects everyone around them.
      I keep wondering what disease she’s going to write about next…

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