What’s It About

Elf is a brilliant pianist who performs internationally in front of sellout crowds.  She has a wonderful marriage with a husband who loves her deeply. And she also desperately wants to die.

Yoli is Elf’s younger sister, recently divorced, who is living off her savings and is struggling to finish her first literary novel.  When Elf tries again to take her own life, Yoli is the first one there to support her.

And then one day Elf asks Yoli if she’d like to accompany her to Switzerland. A country famous for its armed neutrality, its watches, its chocolate and its legalisation of assisted suicide.

Should I Read It?

It’s very hard to describe All My Puny Sorrows without making it sounds like the sort of book that will darken a sunny day and put a frown on a clown.  While it’s absolutely about mental illness, about the right to live and the right to die, it’s also one of the most life affirming novel’s I’ve read.  This is because Miriam Toews understands that the line between soul shredding grief and laugh out loud comedy is incredibly thin.

All My Puny Sorrows is an astonishing novel.  And you should most definitely read it.

Representative Paragraph

Elf’s description of her depression to her sister (and first person narrator) Yolanada (AKA Yoli):

Then Elf tells me that she has a glass piano inside her. She’s terrified that it will break. She can’t let it break. She tells me that it’s squeezed right up against the lower right side of her stomach, that sometimes she can feel the hard edges of it pushing at her skin, that she’s afraid it will push through and she’ll bleed to death. But mostly she’s terrified that it will break inside her. I ask her what kind of piano it is and she tells me that it’s an old upright Heintzman that used to be a player piano but that the player mechanism has been removed and the whole thing has been turned into glass, even the keys. Everything. When she hears bottles being thrown into the back of a garbage truck or wind chimes or even a certain type of bird singing she immediately thinks it’s the piano breaking.


When as a society we debate the merits of assisted suicide, we generally envisage it applying to someone who no longer has any quality of life due to terminal illness or some other sort of disability such as a brain injury.  We rarely consider those with a mental illness because we believe that a person’s state of mind is treatable with therapy and drugs.  And generally that’s the case.  I’m an example of someone who suffers anxiety and depression and treats it with medication (and therapy a couple of years back),  But Miriam Toews’ asks us to consider those who, for whatever reason, no longer see the traditional approaches, the drugs and the counselling sessions, as useful.  People like Elfrieda, a world renowned pianist, who can no longer accept the darkness in her life.  Does someone like Elf, Toews’ asks, deserve the right to take her life in a controlled, pain free and legal manner?

When Elf asks her sister Yoli to accompany her to Switzerland where euthanasia is legal (not that Elf is that explicit but her sister reads between the lines) Yoli is faced with that very question.  Should assisted suicide apply to people with an extreme forms of mental illness?  To the credit of both Yoli and Toews, the novel doesn’t become bogged down in ethical questions on euthanasia and the right die.  In fact Yoli makes the decision to help her sister relatively quickly even if early on she ruminates that:

[Elf] wanted to die and I wanted her to live and we were enemies who loved each other.

But in spite of her desire to fulfill her sister’s wishes, Yoli spends most of the novel trying to save her sister’s life.  While there’s a comedic / fanciful element to some of her ideas (dropping Elf into North Korea where she’d be forced to survive on her own, thus ultimately cherishing each day), mostly her efforts are marked with frustration and anger. She berates Elf for her selfishness —

Has it occurred to you ever in your life that I’m the one that’s colossally fucked up and could use some sisterly support every once in a while?…  Has it ever occurred to you that I’m not okay, that everything in my life is embarrassing, that I got knocked up twice by two different guys and had two divorces and two affairs that were—are—not only a nightmare but also a cliché and that I’m broke and writing a shitty little book about boats that nobody wants to publish and sleeping around with men who … fucking ooze nicotine into their sheets from their entire bodies…

— and blasts Elf’s Doctor for his lack of care —

After just one visit with her you’re refusing to help? I said. You’re some kind of esteemed psychiatrist. You’re just fucking dismissing her out of hand right in front of her? My sister is vulnerable. She’s tortured. She’s your patient! She’s begging for help but wants to assert one small vestige of individual power over her life. Surely even a first-year psych student would understand the significance of that stance. Are you not … do you not have any professional curiosity, even? Are you alive or what the fuck?

It’s these angry, raw outburst that bring home the message of this novel, that as a society we still struggle to deal with those who suffer from mental illness.  Yes, there’s greater awareness with more treatments and resources available to help those who are sick, but they’re all directed at keeping the patient alive, at making them recognise the value of life.  Even Yoli’s attempt to have Elf acknowledge that she isn’t the only one suffering is just another way of avoiding the elephant in the room – that Elf’s urge to die isn’t a whim or a phase, but a real and tangible thing.

As uncomfortable and confronting as this might all sound Toews has written a book that’s not only very funny – even if it’s a laugh tinged with sadness – but life affirming.  Much of this has to do with Yoli, our point of view character, who faces a mounting level of shit and yet muddles her way through it, though not always successfully.  I could describe her as engaging or believable, clichéd descriptors that I often fall back on, but what I really want to say is that I loved Yoli because there was something genuine and real about her frustrated anger, her fears and her deep unquestionable love for her family.

Yoli’s love for her family – in particular her mother and father – remains strong and steadfast even though both Yoli and Elf rejected the Mennonite faith they were brought up with.  Toews could have very easily put the sisters at odds with their parents while using the tragedy of mental illness as a springboard for discussions about the soul and extreme forms of religion.  But other than one scene where a Church elder comes unannounced to Elf’s hospital bed in an attempt to save her, Yoli looks back fondly on her quirky upbringing.  Her mother also happens to be a delight, a religious woman who takes very little shit from anyone, including and especially her daughters.  The final third of the novel – which I won’t spoil here – has some lovely mother / daughter moments.

I know it’s been a long review.  I’ve gone well over my nominal word limit of about 900 words.  But sometimes I need to explain – even if it’s mostly a ramble – why I loved a book so much.  Or to put it another way: Miriam Toews has written a beautiful novel dealing with an uncomfortable and tough subject with great humour and humanity.