Every Note Played

Three days after Karina leaves for New Orleans with Elise, Richard sits at his computer playing recordings of jazz music, finding them jarring and aimless. Although Grace is available to help Richard, she stays mostly in her room, studying, and Richard generally avoids asking her for help, instead waiting for his aides to help him. Earlier, Richard invited Grace to watch a movie or go for a walk with him, but she made excuses.

Feeling restless, Richard wanders the house, wondering how to set things right between himself and Grace. Stopping at Karina’s piano, he spots the sheet music for “Für Elise” by Ludwig van Beethoven, which was his favorite piece when he was 11 years old. Lost in memory, he cries as he longs to play again. Wandering to the kitchen, he sees leftover pizza and coffee and recalls the pleasures of eating and drinking. His thoughts wander to a passionate encounter with Maxine, a former lover.

A few minutes after nine o’clock at night, Richard begins making his way back to the den but stumbles and falls due to his weakened right leg. His nose bleeding, Richard tries to call Grace but loses consciousness. A while later, Grace discovers and rouses him; she considers calling for help, but Richard assures her that he is okay. After cleaning away his blood, she makes him comfortable on the floor since she can’t move him on her own. She attaches his BiPAP and then lays out a bed for herself to sleep next to him on the kitchen floor. Richard says he is sorry for everything and tells Grace that he loves her; she says she loves him, too.

At a bistro in New Orleans, Karina, Elise, and Elise’s students attend a performance by rising jazz pianist Alexander Lynch. Karina is relieved to have a break from caring for Richard but feels out of place among Elise’s students. She thinks back to her time at the Curtis Institute, where it initially appeared her career would be more promising than Richard’s; Karina’s playing demonstrated an emotional maturity that Richard would only gain later. At the time, Richard felt threatened by Karina’s success.

As Alexander plays, Karina is transported through memories and emotions. Karina recognizes that she has been living in fear. Following Grace’s birth, Karina used the responsibilities of motherhood as an excuse not to play jazz; later, when she discovered that Richard was having affairs, she retreated into the safety of her routine as a classical piano teacher. Now, she admits the truth: that she put limits on herself because she was afraid of failing to measure up to Richard’s success. As the show ends, Karina resolves to take initiative in her life.

Following his fall, Richard begins using the wheelchair he purchased months earlier. He opts not to buy any of the several expensive devices that would allow him to control the wheelchair, instead relying on others to help him move. With money from the sale of his condo, he has a ramp constructed at one of the entrances to Karina’s home. Meanwhile, Bill starts working two shifts each day to help Richard into and out of bed, pending the arrival of a hydraulic Hoyer lift, which will allow others to perform this otherwise challenging task.

One afternoon, Richard wakes up in front of the TV. His head leans forward, but he is too tired to lift it, as is often the case nowadays. Bill and Karina arrive a few minutes later, announcing a surprise. Richard is stunned and moved to see his grand piano. He asks Karina to play some jazz, and she accompanies Bill in a “restrained and romantic” rendition of “Somewhere Over the Rainbow” (252). As she plays, it occurs to Richard that the time has come to set Karina free.

A few days later, the hydraulic lift has not yet arrived, so Bill puts two gait belts and a cervical collar on Richard before maneuvering him into bed for the evening. Once Richard is settled, Bill helps him urinate into a bottle. After he leaves, Karina administers Richard’s evening meal through his feeding tube.

Richard notes that Karina has been happier since returning from New Orleans. Tonight, as she cares for him, he is both aroused and regretful of the way he treated her throughout their marriage.

One morning, Richard sits in his wheelchair as Karina, who has a cold, cooks breakfast. Salivating at the smell of bacon he cannot eat, Richard ponders his past and future. He moves his head from side to side, testing the limits of his ability to move. Even though breathing is becoming increasingly difficult, Richard refuses to ask for the BiPAP to be attached 24/7. Now, he musters all his strength to keep breathing.

When Karina finds Richard struggling to breathe, she calls 911, and an ambulance soon arrives and takes him to the hospital. There, he is put on a ventilator that pumps air through a tube that runs down his windpipe; an X-ray reveals that he has pneumonia.

Richard and Karina meet with Kathy, Richard’s care coordinator. Richard communicates solely through blinking to signify yes or no. Kathy explains that Richard now faces a choice: First, he can have a tracheostomy, which involves cutting an opening in his windpipe so that he can enter long-term care, supported by a ventilator. This option is extremely expensive and involves a minimum of two full-time, highly trained caregivers. Second, Richard can choose to be “terminally weaned” from the ventilator, effectively ending his life due to respiratory failure. Leaving Richard and Karina alone with a letter board to communicate, Kathy asks them to think it over and give her their decision tomorrow.

Karina leaves without asking Richard what he wants, afraid of the answer he might give. The next morning, in the hospital cafeteria, she reflects on her relationship with Richard. When Grace was three, not wanting any more children, Karina got an intrauterine contraceptive device without telling Richard, who wanted to have more children. Over the next decade, Karina lied to Richard, giving false causes for her apparent infertility. When Karina went to have the device replaced, she learned that it would require surgery to do so. Terrified, she confessed the truth to Richard, who was furious. The two separated within a year and divorced two years after that. Now, Karina wonders if she should continue to care for Richard as penance for her deception.

Before noon, Karina returns to Richard’s room, planning to wait for Kathy to ask him what he wants. Richard, however, gets her attention and reveals, through the spelling board, that he wants to return home without undergoing surgery. Both cry, and Karina thanks him.

After her flight, Grace goes directly to the hospital to meet Richard, Karina, and Bill. A doctor explains that Richard will transition to a BiPAP before returning home; should he prove unable to breathe with the BiPAP, he will die.

Refusing the offer of a music therapist, Karina instead plays a recording of Richard playing Schumann’s “Fantasie in C Major” on her phone. After Grace expresses her love to Richard, the doctor removes the ventilator tube and attaches the BiPAP.

Arriving back home, Bill and Karina move Richard’s bed next to his piano. After a day back in Karina’s home, Richard stops using the BiPAP or receiving food. Over the next two days, he breathes naturally, and a nurse supplies sedatives and painkillers. Karina and Grace wait patiently, wanting to be present when Richard passes. When Grace leaves to shower, Karina takes the opportunity to apologize to Richard for lying to him. She suggests that they each did their best, even if she wishes she did better. When Grace returns, Karina plays “Nocturne in E-Flat Major” by Chopin. When she finishes the piece, she turns to find Grace crying and Richard no longer breathing.

Eight days later, Karina cleans out Richard’s belongings, most of which she intends to donate. Thinking about the future, she briefly considers moving back to New York. Sitting at Richard’s computer, she checks her email and finds a message from Dr. George, which contains a legacy message that Richard recorded for Karina. In the message, Richard apologizes for cheating on Karina, stopping her from playing jazz, and treating her poorly. He also encourages her to go to New York and play jazz. As she listens to Richard’s message again and again, Karina feels a new sense of hope and forgiveness, both for Richard and herself.