Elfrieda Von Riesen’s suicide attempt by overdose brings her family face to face with the clarity of her wish to die and the difficulty of answering it. Discovered unconscious at home, she survives and wakes in hospital, where her humor and familiar bond with her younger sister persist amid psychiatric care. The attempt does not end the question of assisted death: it sharpens the conflict over whether love means accepting Elfrieda’s request, refusing it, or finding a way to remain beside her without deciding for her.

The attempt and the note

After an earlier attempt to die by refusing food, Elfrieda uses pills. The source of the medication remains unknown; when Yolandi Von Riesen asks her mother, Lottie, where the pills came from, Lottie can only speculate that Elfrieda might have called a pill-information line. The uncertainty offers no explanation that would make the attempt easier to contain or understand.

Elf leaves a note on yellow lined legal-pad paper, the same kind she had used years earlier to devise her distinctive AMPS signature. The page brings together several different registers: a hope that God will receive her, a recognition that there is no time left to make her mark, and the names of the people she loves. She writes those names in green marker, and her family members are all included. Alongside the list, she asks to be understood and allowed to go, while affirming her love for them. Her mother also recalls an unreadable quotation attributed to David Hume. The note therefore does not present the attempt as a rejection of the family; it sets her request against a plainly stated attachment to them. Its religious reference leaves Yolandi wondering whether Elfrieda believes in God, without resolving the question.

Discovery and hospital aftermath

Lottie finds Elfrieda unconscious in bed at home. By the time Elfrieda regains consciousness in the hospital, Yolandi has flown from Toronto, where Yoli makes her home, to be at her bedside. Elfrieda greets her with a slow smile and a joke about the sisters meeting this way too often. She introduces Yolandi to the nurses and to the woman assigned to watch her, adopting the formality of a diplomatic gathering even in the emergency ward.

With her hands restrained, she points her chin toward her sister and calls her Yoyo. Yolandi corrects the name, and the small exchange restores their characteristic familiarity within a setting organized around observation and risk. Elfrieda says she has been discussing Thomas Aquinas with the woman watching her. The watcher responds that medication remains in Elfrieda’s system; Elfrieda answers with another joke, then tells Yolandi she is kidding. The scene holds two realities together: the seriousness of her condition and the wit through which the sisters continue to recognize one another.

After Elfrieda is transferred from the emergency ward to the psychiatric ward, Yolandi learns from Janice at the front desk that Elfrieda has fallen in a washroom. A nurse says she needs to start eating, regain strength, and become more aware of her surroundings. Yolandi wants to bring the nurse’s remark back to Elfrieda as a chance for them to share an eye-roll, and also imagines introducing her to a patient who dislikes television. But Elfrieda has asked her to leave. Yolandi decides that honoring this request matters: even as a psychiatric patient, her sister remains someone whose wishes deserve to be heard. The attempt thus leads not only to surveillance and medical instructions, but also to a test of whether care can include respecting a boundary.

The Swiss question

Elf’s survival does not settle what should happen next. When she asks Yolandi to take her to Switzerland, Yolandi refuses, resisting the phrase one last thing as too final. Later, learning that Swiss law permits assistance in dying for a person with mental illness under conditions that include the absence of selfish motivation, Yolandi understands why Elfrieda has made the request. That knowledge changes the refusal from a simple answer into an ethical and practical problem.

Yolandi weighs a possible plan involving Nembutal in Mexico against a trip to Zurich and a legal process there. The first option would involve obtaining the drug and making sure Elfrieda opened it herself; Yolandi recognizes that the meaning of encouragement in such circumstances would be uncertain. The Swiss option could depend on doctors judging whether Elfrieda’s suffering qualified, and either course would require Nic and Lottie’s agreement. Yolandi is also troubled by what telling Elfrieda might do: even a small wish to live could disappear if a route to death became newly available. Her deliberation is not presented as a decision already made, but as a changing understanding of the request and of her own responsibility.

The possibility later reaches a conversation with Julie. Yolandi has searched for the cost of a Swiss clinic in Zurich; Julie doubts that such a clinic is for someone who is not already dying. Yolandi answers that Swiss law also recognizes mental illness and weariness of life. Their exchange leaves the question open rather than converting legal possibility into consensus. The law gives Yolandi a framework for thinking, but it cannot decide for her whether taking Elfrieda there would be an act of care, nor whether refusing would protect her sister or deny her request.

Aftermath and the limits of rescue

The overdose is one episode in Elfrieda’s continuing suicidal despair, not a resolution of it. She later dies, and the family’s arrangements for her ashes show how her stated wishes remain part of the aftermath. Nic rejects dividing the ashes, and also refuses Lottie’s suggestion that Elfrieda be buried with her father in East Village, because Elfrieda had expressly said she did not want to be buried there. Her ashes are buried under a large tree at Elmwood Cemetery in Winnipeg, where Elfrieda and Nic live.

Looking back, Yolandi wonders whether Elfrieda would have died peacefully and not alone if she had taken her to Zurich. She describes herself as having failed, while Nic tells her that no one is to blame and that both of them did everything possible. The attempt’s lasting consequence is therefore not a settled verdict on the family’s choices. It leaves a question that the later death intensifies: how to honor a loved one’s stated wishes while remaining responsible to the life that has not yet ended.