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First a Tremor, Then a Wheelchair, Then Some Tougher Choices

In “You’re Not You,” Hilary Swank’s portrayal of Kate, a gifted concert pianist with amyotrophic lateral sclerosis, is so intensely persuasive that once you’re engaged by her wrenching ordeal, you mostly forgive the movie’s emotional manipulation.

As everyone surely must know, thanks to the widely publicized ice bucket challenge to raise money for A.L.S. research, this progressive ailment — also known as Lou Gehrig’s disease — affects nerve cells in the brain that control voluntary muscle movement. As their condition worsens, patients have increasing difficulty walking, talking and breathing. Many die from respiratory failure. Ms. Swank’s meticulous, unsparing depiction of the symptoms, which can be excruciating to observe, seems to come from deep inside.

You’re Not YouOCT. 10, 2014
“Oh, no,” you may say to yourself. “Another disease-of-the-week tear-jerker!” But in its forthright honesty, “You’re Not You,” directed by George C. Wolfe from Shana Feste and Jordan Roberts’s adaptation of Michelle Wildgen’s popular novel, belongs to the upper ranks of a genre whose modern prototype remains James L. Brooks’s 1983 blockbuster, “Terms of Endearment.”

“You’re Not You” doesn’t have the feisty, larger-than-life vitality of a character like Aurora Greenway, who was played to the hilt by Shirley MacLaine in “Terms of Endearment.” The closest equivalent is Bec, Kate’s unlikely caretaker (Emmy Rossum). A hard-drinking, drug-taking, promiscuous college student and aspiring singer-songwriter, Bec reflexively rebuffs romantic overtures once sex is over. Many of the characters in the film, set in Texas, have a Lone Star swagger, but Bec is the most combative.

“Let’s get one thing clear,” she declares to a man she picked up in a bar the previous night and pounced on voraciously. “I’m not girlfriend material!”

The movie’s central relationship is the fraught bond between Kate’s demure classical musician and the tempestuous Bec. Ms. Rossum’s performance is equal in power to Ms. Swank’s. The movie pointedly contrasts Kate’s upper-class decorum with Bec’s rowdiness. And when the film brings in Bec’s mean, disapproving mother (Marcia Gay Harden), who sneers that her daughter squanders her time and energy on projects doomed to fail, you understand why Bec is driven by self-loathing rebellion.

“You’re Not You” begins with Kate’s 35th-birthday party. She and her husband, Evan (Josh Duhamel), are blissfully in love and surrounded by friends. When Kate sits down at the piano to play Chopin’s Polonaise in A flat major, she notices a tremor in her fingers. Wasting no time, “You’re Not You” leaps ahead a year and a half. Kate, no longer able to play the piano, is feeble and uses a wheelchair. Her enunciation is beginning to be garbled.

Ms. Swank registers every subtle change in Kate’s body and mind as her condition worsens. You feel the despair of a musician whose abilities are taken away and her rage and humiliation when she discovers that Evan has betrayed her. That is followed by her guilt and sorrow over “what I did to your life,” as she tells him later.

Staying loyal to “You’re Not You” requires a huge leap of faith early in the movie, when Kate overrules Evan’s choice of a caretaker and insists on hiring Bec, who is clumsy, can’t cook and has no nursing experience beyond some volunteer work while in high school. An indication of her domestic ineptitude is the mess she makes by packing vegetables in a blender, then running the machine without putting on the lid. Despite her mother’s scorn, Bec sticks to her job, learns how to cook and becomes Kate’s medical advocate. But why Kate chose Bec remains a mystery.

The story doesn’t politely halt as Kate’s death approaches. There are heated arguments about whether to follow her end-of-life wishes. Despite holes in the storytelling, Ms. Swank and Ms. Rossum keep it real.