All My Puny Sorrows, written by Canadian Mennonite author Miriam Toews, was published in 2014 by Alfred A. Knopf Inc. It is her sixth novel. Her other works have received much acclaim, particularly A Complicated Kindness (2004) and Women Talking (2018). Women Talking was adapted for the screen in 2022, just as All My Puny Sorrows was in 2021. Toews has received numerous literary awards, such as the Governor General’s Award for A Complicated Kindness, as well as multiple Canadian honours, including receiving an honorary Doctor of Literature degree from Brandon University and appointment as an Officer of the Order of Canada. Toews most frequently writes realist fiction inspired by her own life experiences growing up in a conservative Mennonite community and dealing with the mental health struggles of her father and sister. All My Puny Sorrows is no different; it is grounded in Toews’ familial past to the point that it borders on autobiography. Due to the weighty subject matter, the novel is likely intended for adults and should be approached with caution by those with a history of mental illness and suicidal ideation.

The novel follows sisters Yolandi (Yoli) and Elfrieda (Elf) from their childhood in an isolated Mennonite community to their adulthood in their careers as a supposedly failing author and a world-famous pianist, respectively. Despite her successful life and loving husband, Elf is chronically depressed and suicidal, as was her late father who died by suicide via a train. After Elf’s most recent suicide attempt, Yoli must either support her sister through her recovery and attempt to convince her that life is worth living or heed Elf’s wishes to fly to Switzerland for a medically-assisted suicide.

I found myself feeling very empathetic towards both Yoli and Elf.  Both women are incredibly realistic, three-dimensional characters—perhaps due to their autobiographical influence—and their tight sisterly bond carries All My Puny Sorrows forward through its quieter scenes. While the novel feels as if it were written in a single sitting, it is evident how much thought was put into every page as Toews skillfully moves between the past and present with ease, every past detail bringing the reader back to the main conflict between Elf’s desire to die and Yoli’s desire to keep her alive.

Toews weaves together literary allusions and philosophical reflections without coming across as pretentious and offers an ethical conclusion without straying into sermonic territory.

On multiple occasions, I was brought to tears by the frank yet devastating displays of grief Yoli experienced after Elf’s death, specifically Yoli’s final look at her sister’s body where she thinks: “I felt a powerful, oceanic feeling of gratitude towards the funeral director who had tried so hard to restore my sister’s beauty for one last look from her mother” (271).

At its core, the novel tells two stories. The first is the universal struggle of life. All the members of the Von Riesen family deal with suffering caused by both external and internal forces associated with the sorrow of their wronged Russian ancestors, and inherited like original sin. Much like the struggle of Sisyphus described by Camus in The Myth of Sisyphus, the question of life’s meaning and thoughts of ending it are explored through Elf’s mental health crises and through Yoli’s struggle to decide whether or not to “kill” her sister by taking her to Switzerland. These philosophical questions are not new in literature. In the past decade alone, novels such as Jay Asher’s 13 Reasons Why and Hanya Yanagihara’s A Little Life have captured the public’s attention with their narratives surrounding suicide, specifically in connection with teens and young adults. 

The themes of mental health and medically-assisted suicide in All My Puny Sorrows are even more relevant now than they did when the novel was published in 2014, as Canada has since legalised Medical Assistance in Dying (MAID), and is currently considering mental illness alone as a qualifying condition. However, unlike these other works, All My Puny Sorrows delivers a far more nuanced depiction of mental health and the tragedy of suicide, balancing sympathy for Elf’s situation with the intense grief that her suicide causes her family and friends. Elf does not want to die because of any explicit traumatic event, but because of a deep-seated, unexplainable mental illness. It is not only Elf who is suffering from her suicidal ideation and attempts, but her entire family and community, who have to put aside their lives to fly across the country and visit her in the hospital, and plan how to watch her constantly when she is let out.

On one hand, as the story unfolds, Toews appears to support medically-assisted dying by seeming to suggest that some individuals—such as Elf and their father—have a “deadline” on their life before they self-implode, illustrated by the imaginary fragile “glass piano” that resides in Elf’s stomach. Yet Toews makes no attempt to diminish the agonizing aftermath of a family member’s death by suicide, medically assisted or not. Yoli, her mom and the rest of her family are still devastated and tormented by Elf’s suicide many months after it has happened, Yoli descending into alcoholism and harassing the hospital she believes failed to save her sister’s life.

And yet, Yoli—and Toews, through her—concludes that medically-assisted suicide in her sister’s case would have been the better of two evils because, while it would not have prevented the pain of losing Elf, it would have offered her a more peaceful, dignified death.

Although mental health and suicide are the main themes of All My Puny Sorrows, another is the love between two sisters. Elf and Yoli’s bond speaks to the complexity and power of sibling relationships, and how they often overshadow other forms of connection. While Elf has a loving husband, it is her sister whom she trusts with the secret of her desire to go to Switzerland. And while Yoli states she “lives hopefully” for the “completely unattainable” desire for “true love,” the narrative implicitly suggests that Elf herself is the love of Yoli’s life (164). However, like most siblings, they also spend a lot of their time together arguing and even insisting they hate one another due to their fundamental disagreement over Elf’s desire to commit suicide: “She wanted to die and I wanted her to live and we were enemies who loved each other” (37-38).

Despite the anguish I felt when reading the novel, I would recommend All My Puny Sorrows to others. Its accessible yet profound prose, realistic familial relationships and reflections on universal questions about life and death delivered through a narrative of the lives of one Canadian family make it an extremely emotional but rewarding read.