All My Puny Sorrows, originally published in Canada in 2014, is a work of fiction by Canadian author Miriam Toews. Since its publication, the novel has won the Rogers Writers’ Trust Fiction Prize and been shortlisted for the Scotiabank Giller Prize, the Folio Prize for Literature, and the Wellcome Book Prize. In 2021, Michael McGowan directed and produced the novel’s film adaptation. All My Puny Sorrows is in large part inspired by autobiographical events from Toews’s life. It is written from the third-person point of view and toggles between the past and present.

The novel tells the story of sisters Yoli Von Riesen and Elf Von Riesen’s relationship. They grew up in the Mennonite community (a Christian denominational sect) and have been close since childhood. However, Elf has depression and Yoli often feels desperate to keep her sister alive. After Elf attempts to die by suicide for a third time, Yoli and her family band together to help Elf recover. Yoli’s concern for her sister inspires the novel’s explorations of the Enduring Strength of Sibling Bonds, the Impact of Mental Health on Family Dynamics, and the Importance of Art and Creativity to Survival. 

This guide refers to the 2014 McSweeney’s hardback edition of the novel.

Content Warning: The novel and this guide discuss death by suicide. The text uses potentially triggering or stigmatizing terms for death by suicide that the guide reproduces in quotation only.

Plot Summary

Yoli Von Riesen (Yolandi) lives with her teenage daughter Nora in Toronto where she works as a writer. One day Yoli gets a call from her mother, Lottie Von Riesen, informing her that her sister Elf Von Risen (Elfrieda) has been hospitalized. Elf has depression and was admitted to the Winnipeg psychiatric ward after she attempted to die by suicide. Yoli’s son, Will, flies to Toronto to stay with Nora while Yoli travels to Winnipeg to be with Elf.

Upon her arrival, Yoli and Elf’s husband, Nic, send Lottie on a cruise to give her a break. In the meantime, Yoli devotes her time to visiting with Elf. During some visits, Yoli tries to share happy memories with Elf. She offers anecdotes from their childhood in East Village, their former Mennonite community, hoping that Elf will remember some pleasant moments from her past. Elf repeatedly begs Yoli to stop talking about childhood and to tell her about her life in Toronto instead. Yoli offers up a few anecdotes about her two lovers, Finbar and Radek, updates Elf on her impending divorce from Nora’s father, Dan, and shares stories about Nora and Will, too.

When Yoli isn’t at the hospital, she either visits Radek or her best friend, Julie. Julie also grew up in East Village, and she and Yoli have been close since they were young. The friends spend time smoking, drinking, and talking openly together.

Yoli and Nic also try to devise a plan for Elf’s future together. Elf is a famous pianist and has a world tour in two weeks. Nic doesn’t want to cancel it because he hopes that Elf will change her mind about performing and that it’ll make her feel better. Yoli isn’t sure but goes along with Nic’s plan.

Throughout Yoli’s time in Winnipeg, her mind often drifts into memories of the past. The narrative presents various flashbacks to Yoli and Elf’s childhood. Yoli particularly remembers how spirited Elf was and how quickly she proved her musical talent. She began performing in Europe when she was just 17.

In the present, Yoli collects Lottie from the airport when she returns from her cruise. They go to visit Elf, who announces that she’s ready to leave the hospital and wants to tour after all. Yoli and Lottie are anxious but hopeful. After Elf’s discharge, Yoli flies home to be with Nora. Just a few weeks later, however, Lottie calls to say that Elf attempted to die by suicide once more. Yoli arranges for Will to stay with Nora again and flies back to Winnipeg.

During this visit, Yoli is less patient with Elf. Whenever the sisters are alone together, Yoli bluntly accuses her of being selfish and failing to consider how she’s hurting her and the rest of their family. Elf argues that Yoli knows nothing about empathy or despair. Yoli insists that Elf should want to live for her, the way she lives for Elf. Finally, she races out of the hospital. Once in the lot, however, Yoli regrets what she said and races back to apologize to Elf.

Lottie’s sister, Tina, comes into town to support Lottie. Not long later, Tina passes out multiple times while she and Lottie are out. She’s admitted to the hospital, where the doctors discover that she needs open-heart surgery. They’re confident that the operation will be routine and Tina will be fine. However, Tina passes away shortly after the procedure. During this time, Nic is traveling in Spain. Yoli contacts him and begs him to come home to be with Elf, as she has to go to Vancouver for Tina’s funeral services. When he gets back and before Yoli leaves, she begs the nurses not to discharge Elf while she’s away even if Elf tells them that she’s okay.

After Tina’s funeral, Yoli returns to Toronto to see Nora. One day, Lottie calls to say that the hospital is letting Elf go home for her birthday. Yoli is worried but tries to focus on enjoying the day with her daughter instead. After they play tennis and eat ice cream, Nic calls Yoli to say that Elf died by suicide.

Yoli and Nora fly to Winnipeg where they convene with the rest of their family. Afterward, Yoli inherits money from Elf, which she uses to buy a new house in Toronto. After Yoli finishes the repairs on the house, Lottie moves in with her and Nora. The three create a new family life together. Meanwhile, Yoli writes letters to Elf, updating her on her life. She often has dreams about Elf, too.