Is life worth living if you lose the desire to go on? This is one of the questions raised in Miriam Toews' autobiographical novel. "All My Puny Sorrows" follows a suicidal concert pianist, Elf, and her sister, mother and aunt. They are Mennonites who live in Canada, and suicide runs in their family. Elf's father killed himself, and the aunt lost one of her daughters. Elf is determined to kill herself, too. She wants her sister, Yoli, to take her to Zurich so she can die peacefully. Assisted suicide is legal there as long as a person is mentally or physically ill.

"She told me she'd never adjusted to the light," Yoli says of Elf. "She'd just never developed a tolerance for the world, her inoculation hadn't taken. Reality was a rusty leg trap."

Elf has a brilliant career as a talented musician. Yoli, on the other hand, isn't as successful. She's going through a divorce and trying to be a good mother and sister. A writer who pens rodeo stories featuring sad teen heroines, Yoli is dealing with her own sense of loneliness and despair while trying to be there for her sister. Elf is supposed to go on a major tour, but she's fragile and deeply depressed. She tells Yoli that she has a "glass piano inside of her that she worries will break."

Elf has always been the precocious one. When they were kids, she came up with a symbol she left all over town that incorporated her initials and the letters AMPS — All My Puny Sorrows. A line from a Coleridge poem:

I too a sister had, an only Sister —

She lov'd me dearly, and I doted

on her!

To her I pour'd forth all my

puny sorrows

But literature can't save her, and neither can music. "Was she cursed genetically from day one to want to die?" Yoli wonders. "Was every seemingly happy moment from her past, every smile, every song, every heartfelt hug and laugh and exuberant fist-pump and triumph, just a temporary detour from her innate longing for release and oblivion?"

At times Toews' book falls into clichéd territory, with such statements as, "Because to survive something we first need to know what it is we're surviving." But at its heart, "All My Puny Sorrows" is a bittersweet story about those who survive and those who can't fight the current.

Michele Filgate is a writer in New York.