Summary:
This is a
dramatic and moving story about a concert pianist who, at 45 years of age,
suddenly and inexplicably, has ALS, and also equally about his ex-wife Karina,
who takes on his care throughout his slow, inevitable, and lethal decline. As
many readers know, ALS (Amyotrophic Lateral Sclerosis). or “Lou Gherig’s
disease,” hardens the motor nerves so that, progressively, there is no more
control of muscles throughout the body. Not many readers know, however, the
difficult path such patients and their families must pursue. This sensitive and
detailed novel takes readers powerfully into the world of ALS, a disease for
which there is today no cure.
Obsessed with
his musical career and international travel, Richard has paid little attention
to Karina and their daughter, Grace, and he has had affairs with other women. Karina
has deceived him about her inability to bear more children. Because of their
move from New York City to Boston, Karina, also a gifted pianist, has lost a
possible career in jazz and now gives piano lessons to unpromising
students.
The first
several chapters alternate between Richard and Karina. Although divorced from
him, she brings him, now an ALS patient, back into the home they once shared.
Various nurses, doctors, and other specialists try to explain the difficult
future that includes certain loss of body functions, but Richard and Karina are
slow to comprehend these. Despite their denial, they are forced to come to terms
with Richard’s progressive decline and, finally, death.
Richard loses
the ability to use his hands, then his arms. He needs a special machine to
breathe at night. Soon he has paid caregivers for parts of the day; these
include a cheery and admirable man named Bill. No longer able to eat, Richard
has a feeding tube. Later he needs a hospital bed. Also a Head Mouse to work
his computer. Also an elaborate wheelchair. With unresolved issues in the past,
Richard and Karina are emotionally apart—even with feelings of hate and
rage—even while she cares for him.
Karina’s walking
partner Elise, a teacher, helps her stay sane. Karina travels to New Orleans
with Elise and her class and finds her interest in jazz reawakened.
No longer able
to breathe even with assistance, should Richard go on to mechanical ventilation
that will require 24-hour care at enormous expense? A choice is made.
Richard dies,
with various resolutions before and after his death.
View full annotation