The work was commissioned by the Pittsburgh Symphony Orchestra and is dedicated to the composer's brother, who suffered from a debilitating stroke in 2008.
She wrote in the score program notes:The horrific journey of the aftermath of a serious stroke consists of many different emotional stages: crying, anger, anxiety and depression.
Inside a dramatic and often loud steady beat (of the heart) surrounded by waves of fast notes (which veer between "anxious" and "joyful"), there are five slower (and "softer") solos for horn, bassoon, violin, clarinet and trumpet where more "peaceful" surroundings come forward.
[1] Reviewing a recording of Stroke, the music critic Leslie Wright called it "a very well constructed piece that grips one throughout its nearly 20-minute length."
"[4] The Nashville Symphony launched a Kickstarter campaign on August 23, 2013, to raise $15,500 for a recording of Stroke, in addition to Tower's Chamber Dance and her Violin Concerto, to commemorate the composer's 75th birthday.