What makes one person survive a difficult life and another, with seemingly more gifts, feel the need to end it? Toews' latest novel tells a tale of two sisters raised in a family of outliers in a strict Canadian Mennonite community. The older sister, Elfrieda, a world-famous concert pianist married to a devoted, brilliant husband, has attempted suicide many times. Yolandi is a mess, with two children born out of wedlock, no substantive career, and a pending divorce, yet she manages to soldier on with a fierce sense of humor and hope. Yoli tries oh, how hard she tries to keep her sister alive. Much of the story has Elf in the hospital recovering from various attempts to kill herself, while Yoli pleads with her, badgers the staff, and tries to plan for a future.