Harmonic Dissonance is about two married couples -- (straight) Elle and Patrick and (gay) Corey and Noah. Patrick and Noah have dementia and are at the same Memory Care facility. During their stay, Patrick and Noah form a sexual relationship even though Patrick is straight. Both no longer recognize their spouses. The novel explores the impact on Elle and Corey as they confront the impact of Alzheimer's on their marriages; the way their roles have changed. Elle and Corey are forced to form a bond with each other-as a coping mechanism. Elle ponders whether her husband has been a closeted gay man during their marriage. Corey and Noah's adopted son is missing in Afghanistan, making Corey deal with another potential loss in his life without the support of his husband, Noah. Music is used as a backdrop because the auditory system of the brain is fully functional at 16 weeks. We appreciate and understand music before anything else. With dementia, music is the last brain function to die. In other words, first in and last out.