Elfrieda attempts suicide by starving herself after withdrawing from food and asking her family not to call a doctor. The episode forces Yolandi to choose between honoring Elfrieda’s immediate refusal of medical help and acting to preserve her life. That intervention saves Elfrieda from remaining alone with the crisis, but it also exposes the central divide between the sisters: one wants to die, while the other cannot agree to let her go.

Background and Crisis

The attempt is recalled as the last time Elfrieda tried to kill herself in this way. Lottie phones Yolandi in Toronto to tell her that Elfrieda is not eating and is pleading with both Lottie and Nic not to summon medical help. They are desperate, and Yolandi comes to the family home. She goes directly from the airport to Elfrieda’s bedroom, where she kneels beside her sister and says that she has come to call a doctor.

Lottie had apparently promised not to call one. Rather than choose between her daughters’ opposing wishes, she stays in the dining room with her back to them. Her withdrawal leaves the decisive action to Yolandi, who tells Elfrieda that she will call despite her pleas. Elfrieda promises that she will eat and continues begging her sister not to act. Yolandi nevertheless tells her that an ambulance is coming. The open screen door and the smell of lilacs outside mark the ordinary domestic setting in which the emergency unfolds; they do not soften the urgency of the decision.

Intervention and Separation

When Elfrieda calls to Lottie for support, their mother says nothing and does not turn around. Yolandi tells Elfrieda that she has to go with the paramedics. Elfrieda uses what little strength she has left to make a rude gesture as they load her into the ambulance. The detail conveys the anger between the sisters without changing what Yolandi has decided: she will not treat Elfrieda’s request to be left alone as a reason to withhold emergency care.

At the hospital, Yolandi stands beside Elfrieda’s stretcher in the emergency room, crying and moving her hands along the steel railing. Elfrieda takes her hand weakly and tells her that she hates her. Yolandi bends to kiss her and answers that she knows; she also says that she hates Elfrieda. The exchange does not establish a simple reconciliation. Instead, the sisters hold each other tenderly and awkwardly while still confronting the disagreement that brought them there.

The Sisters’ Conflict and the Hospital Encounter

Yolandi recognizes this exchange as the first time they have partly articulated their main problem. Elfrieda wants to die; Yolandi wants her to live. They are enemies in the immediate dispute, yet they love one another. The physical closeness of holding hands and embracing exists alongside the disagreement, not in place of it. Their attachment therefore makes the intervention more complicated than a contest between indifference and care: each sister’s position is bound up with a relationship neither can simply set aside.

The episode also introduces Janice, whom Yolandi first meets beside Elfrieda’s stretcher. Janice wears a small furry creature on her belt loop and asks to speak with Yolandi privately. In a beige family room, she gives Yolandi a box of tissues and reassures her that calling the ambulance was the right thing to do. She separates Elfrieda’s hatred of being saved from hatred of Yolandi herself, suggesting that the feeling can be understood in parts. Yolandi thanks her. Janice hugs her firmly, and, after Janice leaves, Yolandi tears at her fingernails and cuticles until they bleed. The sequence shows that reassurance reaches her in a moment of acute strain, but does not make the burden of the decision disappear.

Later Consequences and Ethical Stakes

When Yolandi returns to Elfrieda, her sister reports overhearing a doctor speak dismissively about her intelligence because she is not grateful that her life was saved. Elfrieda describes the encounter as an interrogation, and Yolandi responds with anger at the doctor. This detail extends the scene beyond the sisters’ disagreement: after the ambulance has brought Elfrieda into emergency care, the hospital encounter also leaves her feeling judged for not welcoming the intervention. The narrative does not equate a desire to live with intelligence or present gratitude as a condition of deserving care.

The memory later forms part of the background to Yolandi’s consideration of assisted death. After learning that Swiss law allows assistance for a mentally ill person under certain conditions, she weighs whether to take Elfrieda to Zurich, considers an alternative in Mexico, and thinks about the consent and practical arrangements such plans would require. When she tells her friend Julie about the Zurich clinic, Julie questions whether it is intended only for people who are already dying. These later deliberations do not undo the earlier emergency decision; they show Yolandi continuing to confront the same conflict under different circumstances, between Elfrieda’s wish to die and the responsibility Yolandi feels toward her.

Yolandi ultimately refuses Elfrieda’s request to take her to Switzerland. After Elfrieda’s death, Yolandi wonders whether she failed by not helping her die peacefully and accompanied, while Nic tells her that she did everything she could. That later uncertainty gives the starvation attempt lasting weight: the ambulance intervention is neither presented as a resolution of Elfrieda’s despair nor treated as proof that the sisters’ competing claims can be reconciled. It remains the first explicit scene in which their love and their incompatible wishes are voiced together.