By Heather Holm, from the GoFundMe campaign launched for Pamela on September 3, 2019
Here is the summary. For the daily updates and photos, read below.
Pamela Holm (my sister) went to Vancouver, BC, for a training program in August, and health issues that she was starting to have investigated got worse, and she was in a lot of pain. After her course was finished, she flew to from Vancouver to Calgary to spend Labour Day weekend with our sister Carol, where she was definitely unwell. While flying back to Ottawa on September 2, an undiagnosed tumour in her liver erupted, causing massive internal bleeding. Her blood pressure plummeted and she fought to stay conscious. Upon arrival, she was taken by ambulance to Emergency at Ottawa Hospital, where the tumour was found to be occupying 2/3 of her liver. That night an interventional radiology procedure was done to stop the bleeding and she received a unit of blood.
Four days later, still in hospital, she had a stroke which paralyzed the left side of her body.
She had the best medical intervention available anywhere. Within minutes of the stroke, a world-class stroke team was with her. She had several more interventional radiology procedures (using a small incision and working through the blood vessels): one that removed most of the blood clot in her brain, a second liver embolization, and one to insert a filter in a vein to prevent clots in the legs from moving to the major organs.
However, her condition continued to be very serious. No metastasis was found, but the tumor (HCC, hepatocellular carcinoma) was in some of the blood vessels of the liver, ruling out surgery or transplant.
Options were considered and then ruled out, as Pamela was in too fragile a state. Doctors had a difficult time juggling the contradictory needs of her conditions. The liver was throwing blood clots which showed up in her brain (the stroke), lung (pulmonary embolism) and legs (thrombosis). But anti-coagulants could not be given in any large amount because of the liver bleed. It was a perfect storm that left her vulnerable to any sudden, potentially fatal, thrombosis event.
Pamela had worked hard at building up her Music Therapy practice and establishing her credentials, and in the last couple of years she had moved a tiny bit away from the stress of living on the financial edge. Being self-employed, however, she had no sick pay and no benefits. She also did a lot of volunteer work, and often took care of herself last.
So we launched a GoFundMe campaign for Pam right away so that she wouldn’t have to worry about covering her rent and basic expenses for a while. For that, it truly worked, and she was most grateful. It really allowed her to relax about her major source of stress, and be present with the day-to-day demands of her body. And for a while after the stroke, we hoped that she would be able to rehabilitate somewhat, which would require paraphernalia and professional support.
More importantly, the GoFundMe campaign gave her a giant “group hug” so that she really understood that she was loved, and not alone in the world. She felt held up by her community and family near and far. She could feel the love, and spoke of it repeatedly, even in her last conversation before she fell into an unresponsive state and could no longer speak.
She got wonderful palliative care, accompanied by family and friends every step of the way.
Pamela died peacefully on Monday, September 23, 2019.
Funds raised are going into paying bills and final expenses.
Please know that the financial support she received uplifted her and eased her mind, and also that of her family.
After launching the GoFundMe campaign on September 3, I made almost daily updates.
September 4, 2019
The tumor is involving most of Pam’s liver, extending into blood vessels, and is not operable, nor is a transplant an option. Doctors are waiting on a biopsy to confirm, but they think it’s hepatocellular carcinoma (HCC), which usually comes from cirrhosis or Hep B or C, and only rarely from unknown causes as in this case. They plan to again embolize a weak spot to forestall bleeding, and are looking into a short course of low-level radiation and immunotherapy (a kind of chemo, more easily tolerated) to reduce the size of the tumor. These treatments are not curative, but intended to prolong life and manage symptoms. She is seeing various support teams in the hospital, from social to spiritual. She may be discharged in a few days, and get these treatments over the next few weeks.
Pamela and her family are reeling from the swift developments, and talking about ways to support and accompany her in the next few weeks and months.
September 5, 2019
Pam is feeling the love coming her way, and basking in it. The messages on GoFundMe are a big part of that. Our sister-in-law, Dorcas, arrived in Ottawa this evening. She has deep knowledge about things medical, as well as being a great person, so Pam will feel very much supported by her presence. Earlier in the day she had a biopsy. And she has composed a new body-affirming song to sing to herself and the nurses.
September 6, 2019
Pam had a stroke this morning. She has been moved to Ottawa Civic Hospital to have an emergency procedure to try and fish out the clot. It’s on the right side of her brain. Please send her love, light, reiki, healing thoughts, peace; visualize her facing the future with acceptance and gratitude. My husband and I are about to get in the car to drive from NS to Ottawa. [2-day trip]
September 8, 2019
Steve and I arrived in Ottawa yesterday (Saturday) to find Pam in the ICU at Ottawa Hospital, Civic Campus, with Dorcas at her side and brother Mike keeping their dogs company somewhere nearby.
She is getting world-class medical care. On Friday, a stroke team was with her in minutes. Anticoagulants (clot-busting drugs or blood thinners) would likely increase bleeding of the tumor so options are limited. A highly trained team accessed the clot in her brain through a blood vessel in the groin, and were able to fish out 80% of it. While she was still under anesthetic, another team did an angiogram (to visualize the blood vessels) then a second embolization procedure in her liver, with the goal of cutting off blood flow to the tumor tissue without damaging still healthy parts of the liver which are needed to sustain life. All state-of-the-art, minimally invasive surgery. I’m in awe.
She is still in the ICU, where each nurse monitors a single patient. Brain and liver functions are being monitored to assess level of recovery. There is pain, and there is medication for that. She has fancy stockings massaging her shins at intervals to prevent clots in her legs [and edema]. Vital signs are on a screen, blood pressure is controlled if necessary, and as of this afternoon she has a tube up her nose delivering liquid food directly into her stomach, bypassing her tastebuds, which disappoints her, as she hasn’t been able to eat anything for quite a while. Her ability to swallow is not reliable enough to have more than a couple of ice chips at a time.
She can manage a crooked smile, and one side of the mouth does most of the talking, which can make it hard to understand. The lack of facial expression leaves her eyes doing a lot of the communicating. She is fully aware and as awake as she can be, though she falls asleep intermittently. She has some movement on the left side, still not much. When she’s not asleep, her right hand is often busy with her phone, holding someone else’s hand, giving a thumbs up of approval, conducting or playing air piano to music. Staff is learning that this woman needs music.
She called for a Reiki practitioner friend, who was welcomed by staff. One of the chaplains is a Buddhist monk who has a singing bowl. Family is welcomed as part of the care team, except when direct care is underway.
What is it like to find a loved one felled by a stroke? Heartbreaking. Then you get on with the details. Then you cry again. Then you stay present with her. Then….
Last night Pam asked me to read from A Course in Miracles. It was for me as much as for her, I think. Miracles ‘R Us. But we don’t control the outcome, and the meaning only becomes apparent as we go through the experience.
Thank you for sharing our journey.
September 9, 2019
Pam had a very busy day today – for anyone, let alone someone in her condition.
A fellow Music Therapist came in to work with her on professionally handing over her client files.
A physiotherapist got her sitting up and working on proprioception and coordination.
A speech therapist tested her swallowing ability. She passed with flying colours, and now she is allowed to eat! She really enjoyed her supper. Hopefully that nasal feeding tube will soon be gone.
We found her more alert than yesterday. They’re planning on moving her when they can to a “step-down unit” where the care is a bit less intensive than ICU.
September 10, 2019
Another busy day with Pam in the ICU – scopes and prods and procedures, some of them rocket science, others decidedly not, but we need not go into those details. Three highlights, I’d say:
1. Her friend Jonny’s visit with 6-lb Charlie, who snuck into the ICU in a backpack. We drew the curtains and they had some sweet time together (see photo). Pam misses her little dog Winnie, who died in 2017.
2. Getting transferred from the bed to a wheelchair in a hoist. This is probably the most fun you can have in ICU, and Pam clearly enjoyed her high-flying act.
3. Getting out of ICU into the Neuroscience Acute Care Unit down the hall this evening. Now she has a little more privacy, a little more quiet, and hopefully better sleep. But even that was tiring, and I stayed a little later to help her get adjusted.
But there’s pain and fatigue, uncertainty and dependence, having to trust other people when you’re quite helpless… it isn’t fun and games, but the good moments will be remembered.
September 11, 2019
Several people have asked whether Pam is up for visits. In yesterday’s update, I shared some of the lighter moments in a difficult day, and some of the more flattering photos I’ve taken.
But the truth is that Pam cannot entertain, nor does she need entertainment. She is a high-needs patient right now. Like a newborn. She needs ice chips fed to her at regular intervals and on demand. She needs help eating, drinking, doing number 1 and number 2, shifting position, pain relief. She needs sleep, which is hard enough to get in the hospital, and she often dozes off in mid-stream. With her limited facial expression and intonation, she needs attentive listening, even telepathy at times. Patience and presence.
She is not usually responding to texts and emails herself. We help her with that if necessary, and have not been completely on the ball because interruptions are constant so please don’t be concerned if no one has answered you. She is not watching videos or reading things people send to cheer her up, or looking at Facebook. I read her most of the GoFundMe donors’ names and comments today, which pleased her greatly. But we didn’t get to finish the job.
She welcomes distance healing, and certain practitioners would be welcome to come in and treat her in the hospital. In addition, there’s room for people who can spend 2 or 3 hours with her quietly, responding to her needs and staying out of the way of the nurses and doctors when asked. I would like to set up an online calendar to organize that.
She’s sinking into the experience of just being in a painful, paralyzed body, which needs feeding and watering. She needs to let go of her busy “life” and just be in the Now. Some of us are in a position to interface with the outside world so she can get down to that basic self-care and healing, but another part of the job is just being there with her while she labours to give birth to herself.
September 12, 2019
Again today we saw the difficulty of balancing the liver tumor’s tendency to bleed and what the other organs need. Normally, a stroke patient would be given drugs that inhibit blood clotting, but they have to tread carefully with Pam so that her liver doesn’t start bleeding again.
This morning, her nurse noticed things were not going well. The resulting CT scan of her upper body showed a pulmonary embolism – i.e. a blood clot in her lung.
She also had an ultrasound to locate blood clots in her legs, which have been quite swollen.
Meanwhile, doctors (specialists in things like thrombology and interventional radiology) descended to announce that they wanted to put a filter in her vein to catch any blood clots moving up from the legs which could have potentially fatal results. And they wanted to do it now. So they did. Nice birthday present.
So it was another challenging day for her, in addition to rather a lot of visitors bearing birthday cards and good wishes.
My big accomplishment today was getting her car’s license sticker renewed online at the last minute, due on her birthday – so that I can drive it around town, without her having to show up in person, and explaining to her that she personally won’t be driving that particular standard shift again.
Oh, and she got the feeding tube removed from her nose, which hurt. But it’s easier to swallow now.
I hope she has a quieter day tomorrow. She needs it.
September 13, 2019
Visits: After talking with Pam and her nurse, we’re asking visitors (other than family or practitioners who are there to do a session as arranged) to keep to the following hours, and to not stay very long – e.g. 15 minutes – as Pam gets tired.
There are no formal visiting hours on the floor. Best times to visit are mealtimes, which are 8:30, 12:30 and 5:30. Pam needs some help eating, so you may be useful in reaching for the things she wants.
She needs her naptime between 2 and 5 pm. So do others on the floor. No visitors then, please.
Mornings between 10 and 12 are for physio, etc. Not a good time for visitors. She needs to work on her own healing.
After 7 pm, she is getting ready to sleep for the night, so please don’t come later than that, and be ready to leave at 7.
Also, be prepared to leave if there are medical or nursing procedures going on.
We are trying to reduce external stimulation for her. Keep your personal energy quiet, not just for her but for the other patients on the floor who are all very sick. Be conscious of whether you are giving energy to her, or wanting something from her, even subconsciously. She is so used to giving out energy to others, but she has to give it all to herself now.
Remember that her facial expressions and voice are flat because of the stroke. However, she is very aware of the people and vibes around her. She hears everything. If she drifts off to sleep while you are talking, it’s ok.
It is very difficult to see someone you know as sparky and animated be so sick, so be prepared to deal with your own feelings. When you leave the floor, let yourself cry if you need to. I do, every day.
Healing for Pam may or may not mean getting “better” – we hope her body will get better, of course – but she is on a journey into the depths of her being, and will emerge transformed, different, but still our beloved Pam, whatever happens.
I hope the updates will satisfy your need to know the latest of how she’s doing. We don’t have time to respond to all the individual messages we receive. Pam really does appreciate the love and community around her, and she knows it is part of her healing.
September 14, 2019
Blessed is young Gabriel, also called Archangel, who bathes patients in their beds and who massages their heads with shampoo, and deals cheerfully with the indignities of their infirmity, for he doth give much comfort.
Blessed is the young nurse who hoists her bedridden patient high in the room and turns her to face the trees and the fields before lowering her into the wheelchair, for she gives great joy in a painful day.
Blessed are weekends that many hospital staff spend with their families so patients can have peace from procedures, for they provide much quiet healing time.
Blessed are the nurses attuned to beeps and buzzes who do not startle at the penetrating tone of the singing bowl at the end of the day, for it is doing their work.
Blessed are the shamanic poets and those who hear their words and find much depth of meaning within, for they are true healers.
Blessed are the Beatitudes, set to music and sung by a choir and uploaded to YouTube, for they transform a chamber of pain into a healing yurt.
(Pam’s fellow GIM students will catch the last reference.)
September 15, 2019
The weekend has been gentler, not just for Pam but for Steve and me: less traffic, easy parking around the hospital, less of a buzz going on inside the hospital. We bring Pam some of whatever we cook for ourselves, and she enjoys it. We’ve been able to have some quiet, healing times with her. Funny to call it that in a hospital; they can do procedures and monitor vital signs, and I’m very grateful for the personal care she gets, but the integration of it all and the emotional/spiritual part of the experience is what we and her various friends are better able to help with.
Now we’re bracing ourselves for a busy week. The doctors will be looking at how she’s doing and deciding the next steps. Sister-in-law Dorcas has come back from Toronto to accompany us on this next part of the journey, and we are very happy to have her here. She has had a career in medical research and teaching, understands the system and comes up with good questions. Even more importantly, she has a steady, solid and compassionate presence, as we learned during the last days of both our parents.
And in Pam’s neighbourhood of New Edinburgh, they’re holding their annual garage sale next weekend, and Stacie is organizing a bake sale to raise more money for Pam! Check it out if you’re in the area. Maybe there will be some campaigning politicians hobnobbing with the local folks. It’s very close to 24 Sussex and Rideau Hall.
September 16, 2019
All hearts on deck. Prayers, candles, reiki and love.
Pam went into an unresponsive, sleeping, snoring state this afternoon. A hurried CT scan, which the neurologist expected to show a massive bleed in the brain, did not show such. They are trying to figure out what the problem is.
Because of the liver cancer, Pam’s liver is forming blood clots. One caused the stroke, one went to her lung the other day, and there are others in her legs. The filter they put in place is to prevent clots moving to the organs. Another clot could threaten a major organ anytime. So that was the first guess.
But maybe it’s medication-related. Maybe something else.
And/or maybe at some level, Pam is deciding whether she wants to stay with us or not. Just before this incident, she was telling a doctor that she had to be able to play guitar, and showed with a ukulele how limp her left hand was. Who is she if she can’t play guitar?
Letting go, letting go.
A few hours later, she is breathing more easily. GIM* music is playing on shuffle on her phone. We talk to her assuming she can hear us, and she has moved her left foot at appropriate times in the conversation often enough to convince us that it was her current equivalent of a “thumbs up”. So we wait, and keep vigil.
As I post this, she is moving more. Legs, arms, neck, right hand. Hope blooms.
*GIM is Guided Imagery and Music, a beautiful therapeutic modality that she has been studying. It does not, in fact, require the playing of any instrument. Rather it uses careful selection of classical music to bring forth imagery from the subconscious, which the therapist can then explore with the client.
September 17, 2019
Dorcas and I slept, sort of, in Pam’s hospital room last night. Pam has not regained the ability to communicate since yesterday’s event. Over the night, her pulse has crept upward. Her right hand moves a bit from time to time. She has an oxygen mask on with a constant hiss, and I played a Tibetan singing bowls video that sort of cut through the noise and provided some small distraction from the drama in the semi-room next door.
Today, I am struck with the similarity between Pam’s condition and that of our mother in her last days. Mom also had liver cancer and didn’t know it until the week before she died. She didn’t have cirrhosis or hepatitis either, the most common predisposing factors to this kind of cancer. She also responded to music – especially the songs we sang – through the comatose state with arm movements and light hand squeezes.
I’m unbelievably sad. Fuck cancer.
But I have to accept. Why should Pam want to stay with a body that will at best need a lot of healing and will never be able to do the things she came to do, that she was wired to do, to sing and encourage and play music, be creative, help others, and live an independent life? Even now, her body is vulnerable to sudden further blockages in the organs and the brain. It’s a lot to expect a person to embrace that as a new experience unless it was part of their original life plan.
There has been much healing for her in the last 2 weeks – learning to trust, finding the caring and love throughout the healthcare system – doctors, nurses, orderlies, support workers etc., and especially feeling carried by the love of so many, and surrounded by family. Those are the main things she has talked about since being in the hospital, aside from her intense physical needs.
More family members are arriving today. What remains is the vigil, love and prayers. That matters too.
September 18, 2019
Keep holding Pam in the Light; keep your reiki, love, prayers etc. coming in. A bunch of relatives (Mike, April, Alexandre) came in last evening and Pam’s bed was surrounded, then Pam’s entire community of friends in Perth arrived (in Spirit) with a friend, so the room was “crowded” even more. Cousin April was with Pam when her more-than-a-chiropractor and friend came in. Pam started doing thumbs-up again for “yes” – e.g. to have April read from A Course in Miracles.
Then at 5 a.m. another crisis. She was having trouble keeping her airway open, and a breathing tube was inserted. Mike and Dorcas arrived at 6 a.m. to find the medical team hovering around her. We’ll be gathered around her again today.
Some medical details so you can focus your efforts: Heartrate has been increasing steadily over the last few days, and is now over 140. So it’s like she is running a marathon and can’t stop. EEG yesterday did not show seizures, and CT scans did not show clots in brain or lungs, so doctors’ best assumption is that she is dealing with an an infection, which happens easily when you’re using a catheter. They are giving her the best antibiotics but she hasn’t (yet?) responded. Raising her consciousness level (that’s a medical term, not an indication of spiritual ability!) would help her body clear the infection, but pain would also increase the heartrate, and she hasn’t been able to communicate about pain effectively. She is getting 50% oxygen which is as much as they can give her. She is back to just a mask as she didn’t like the tube in her mouth (it wasn’t intubation; just a smaller thing to keep the passageway open). So she’s breathing on her own with a mask.
As next of kin, when she is unable to give consent herself, I have to approve certain interventions, including pain medication that would dull her awareness, and I have to think about what I would want. I give more of a priority to being conscious in a crisis than some people would, and I believe Pam would too. I value having a conscious death (if I can’t ascend, ha ha,) myself. But I can’t measure her pain. If her heart rate is partly due to pain, some medication would reduce the stress. She can’t keep running a marathon forever.
September 19, 2019
Today the bells and whistles got turned off and the palliative care team got fully involved. No more monitoring every heartbeat, no more alarm beeps going off over Pam’s head, indicating that her heart rate has again gone over a previously reasonable limit (must be so annoying for a musician), and the comfort medication is helping her relax. Pam had a crisis at 5 this morning which woke up both Steve and Dorcas from sleep in their beds with her telepathic call for help. Mike and Dorcas arrived at the hospital at 6 to find staff hovering over Pam and the oxygen in her mask turned up to 50% which was as high as it could go.
Later, around noon, I finished singing a song with some silliness, and thought at first that she was laughing, but no, it was trouble breathing. The nurse put a 100% oxygen mask on her. I shall not look for laughs from her again.
The pain medication is helping her relax somewhat. It’s all about comfort now, not to “snow” her with medication (a doctor’s word for over-medicating) but to quieten her body’s need to put all her effort into breathing.
Two music therapist friends came by to sing to her, beautifully and so lovingly. Once I asked Pam how she sings when she’s really emotional, and she said, “You dig deeper.” So today I dug deeper to sing along. Pam was my first singing companion, and I will miss that so much.
It’s unbelievable that our singing bird is leaving us. Just makes no sense.
When you’re really focussed on wellness, whether you have a healing practice or you’re a therapist, or you try to take care of yourself as Pam did, it’s hard to believe that someone could get so sick, so fast. Cancer is like that. What is it teaching us?
An awful lot about our desire to control our lives and what it is to let go, for sure.
The vigil continues.
September 20, 2019
The experience of being with Pam on the 5th floor is a lot less hectic than it was in ICU or NACU. And if I feel that way, imagine what the patient’s experience is. Fewer intrusions, less activity.
Pam continues to be in the mostly unresponsive state that she entered 4 days ago. We know that it was not induced by medication; she was on minimal painkillers at the time. It came on in the middle of a conversation. It wasn’t caused by another stroke. It’s a state familiar to those who work with dying cancer patients, and to us because our mother was in it for a couple of days before she died.
But it’s strange if you don’t know about it. Once visitor today saw her sleeping peacefully and didn’t want to wake her up. But there’s no waking up from this state. Whether she’s off in a dream, or present and aware of her surroundings, we cannot tell by looking at her. But the more sensitive intuitives among us tell us that she knows who is there.
She is getting pain relief now but the drugs are not causing the “coma”. The coma came first. And I feel that it came on with her realization of how her limited her activities would be if she recovered, and the choice she made at that point to move on.
The body is gradually shutting down. This is a natural process of “active dying”, a dry death, and pain is somewhat curtailed by endorphins produced in the brain. No IV fluids are given, as that would cause pain and prolong the process.
The hearing is the last of the senses to go. So we continue to talk to her, sing, play her favourite recorded music, read to her.
Our sister Carol arrives tomorrow from Calgary, and Pam’s godson will visit on Sunday, as we remind her. She’s still breathing.
She had a lovely visit today with two friends who took the Music Therapy course with her at Capilano College around 1990. They knew how to include her in the conversation very naturally as they chatted about memories and told stories, sang her some songs, and gave us, her family, a picture of Pam’s life in those days when we didn’t see her often. And she did appear to be smiling (see picture).
A few others have come with their energy work, sound healing, and presence, and the room feels wholesome and calm for their efforts.
We’ve also heard from her music students and their parents, families whose lives she has touched deeply.
This is a real perk of being here at this time: getting to know our Pammie through these people who also love her.
September 21, 2019
Pam is in much the same state as yesterday: breathing slowly, peacefully. Some of our conversations around the bed go deep very quickly, as if she’s participating in, facilitating the conversation. Which she is, I am very sure. She hears everything, and those who can pick up her telepathic communication confirm that she is present and aware. She is helping us draw closer together and get to know her through meeting her friends.
Today we had some visitors from the Unitarian Universalist Fellowship which she has attended for years – and sometimes led services. They showed us some video from a singing circle she animated; you can hear her voice leading the rest while she played her guitar. She just loved – loves – to sing and get others singing.
To update a previous post about visitors: it’s OK to come by for a short visit if you feel you have energy to give and stories to share. The former issue about optimal visiting hours was to accommodate her need to eat and sleep. Her present state is not structured with the same needs. There is almost always a family member with her, sometimes several.
Pam’s street was alive with yard sales this morning. Stacie’s bake sale in front of Pam’s apartment building was a great success, and more importantly than the money raised, which was impressive enough, she helped Pam say goodbye to the community, and it gave us an opportunity to hang out and talk with the neighbours. Thanks, Stacie.
Our sister Carol, who arrived today, last saw Pam on Labour Day weekend in Calgary. She was pretty sick then: not sleeping, in a lot of pain, waiting to see her doctor back in Ottawa to figure out what was wrong but resisting being sick. She couldn’t afford to be sick.
It’s wonderful to have a medical system that supports people when they’re acutely ill, and Pam has truly had the best of the best.
But how many people ignore their own health needs while they are barely supporting themselves and their families? Our individualist culture forces us to be self-sufficient and competitive. But not everyone thrives in such a system. How do we redesign a society that allows everyone to shine their unique light in service to the whole?
September 22, 2019
It was a quiet family day around Pam’s bed, with a few visitors. A highlight for us, and no doubt for Pam, was when her godson (and 2nd cousin once removed) Emmanuel Holm, a talented musician, played for her, making do with the quiet tenor ukulele that we keep handy. Pam encouraged him when he was younger and starting to show talent. His mother and I are wishing we had a recording of them playing and singing Jobin’s “Wave”. Pam loves Emmanuel and his older brother so very much, and helped raise them, as they say.
Not much change with Pam today. She is being kept comfortable with medication, and we’re doing our best to watch out for her neck which had repeated whiplash in the last few years. Immobile patients must be turned regularly for comfort and to prevent bedsores, and watching out for her neck adds a degree of difficulty to the routine. However, the neck pain was bad enough to distract her from what was going on in her liver, and delayed the diagnosis. So her neck needs to be treated gently; the vulnerability is still there.
The fact that she is still breathing away is giving us time to gather around her and have those rare and meaningful conversations with family and friends. I like to think that it is a useful for her, too, on her inner journey. It won’t last much longer.
September 23, 2019
Pam died peacefully this afternoon. Elegantly, beautifully, just slowly enough for me to realize it was happening.
She had waited for sister Carol and godson Emmanuel to come, and had the grace to wait until the day after Dorcas’ birthday. Dorcas had spent much of the day and the night with her, and counted it a very good birthday.
A few details about Pam’s dying, which I share with love and to make this unbelievable event a little more real: On Monday afternoon, Pam seemed a little uncomfortable so I plugged in her earbuds and put on a favourite CD of hers, a compilation of relaxing classical pieces entitled “Berceuse”. Halfway through, her breathing changed. She made it to the last piece on the CD, breathing her last while listening to Ravel’s “Pavane pour une infante défunte” (Slow dance for a dead princess). She knew the CD well, so I can only imagine that she waited for it.
We stood around the bed, holding hands with hers, and listened to the video of her singing “Another Bright Star … Going Home” at our mother’s funeral 5 years ago, while the doctor waited respectfully to pronounce death.
Staff said we could take our time, so we did. When it came time to wash the body, I put lavender oil in the warm water, and Valérie, who is a midwife by profession, honoured Pam’s body at the end of its life with love and tenderness and poetry, the voice of Mother Gaia acknowledging her child with sweet words and caresses.
Pam has joined another choir, and there is great rejoicing.
We wish to thank everyone who supported her journey in so many ways.
September 25, 2019
We met with the Ottawa Funeral Cooperative to make arrangements. While there, we decided we would like to shroud the body in the way of ancient tradition, which the funeral director kindly allowed us to do. Valérie bought a large piece of unbleached cotton and a piece of beautiful lavender organic cotton which we tore into strips. Pam’s friend Kathleen happened to connect with us at that moment and brought a bundle of sacred herbs, and I found frankincense and acorns in Pam’s apartment, acorns being a symbol of our mother’s family name which means “oak wood”. A sign for the ancestors. After a final, loving goodbye, we wrapped Pam’s body in the shroud, and tied it closed with the lavender strips. Carol has to return to Calgary on Saturday, so it was good for her to have the chance to participate in this ritual.
Pam’s body will be cremated next Monday, September 30 at 8 a.m. in Gatineau. If anyone wants to join us there to witness the cremation, please contact me for details. There will be no viewing of the body, and the shroud will be inside the cremation container which will not be opened.
We have set the date for what I want to call a “Memorial Service and Celebration of Life”. We need a major event to remember her together, friends and family, so we can move towards acceptance of the unacceptable fact that she is quite suddenly on the other side of the Veil from us. We will share stories, song and food and then give an opportunity for the musicians among us to shine as she would have done herself.
It will take place at the Universalist Unitarian Fellowship, 400 McArthur St., Ottawa, on Saturday, October 12. The main event will start at 4 pm, to be followed by pot-luck supper and an open mic. Watch for further details. Hopefully we can use Facebook Live to enable people who can’t be there to watch.
A gathering will be held in Mahone Bay, NS, after Steve and I return (October 26).
October 1, 2019 – Cremation
Most people let the professionals take care of the cremation and just pick up the ashes afterwards. But I see it as an opportunity to honour the body, the vessel of the deceased, to engage with the Mysteries, and to help make the death “real” for myself and other mourners – which ultimately helps us deal with grief and loss.
Steve and I were joined by Dorcas, Valérie, and four of Pam’s friends to witness the cremation. This is an extra service offered by the crematorium, and is always done first thing in the morning so that it can be scheduled with certainty. It’s in a beautiful facility near the Gatineau Park, and Eric, the funeral director there, was sweet. He made coffee for some of us while we waited.
There is a small room which we filled, with a window looking into the workspace. He gave us a candle. Somehow I found some good words about the contrast between Pam’s presence and her absence, wherein lies the Mystery, and how the cremation of the body gives expression to that, and lit the candle. Then I opened at random Richard Wagamese’s book, Embers, and read the page. He’s always appropriate.
Eric then maneuvered the cremation box into the furnace as we watched, and sang – mostly the chorus of Pam’s own song, Another Bright Star, which is quickly becoming a classic, with lots of harmonies. Eric was very impressed.
Afterwards, he explained the cremation process. Their computer-monitored system is more sophisticated than the one we know in Bridgewater, NS.
We all went to a breakfast restaurant after that, and brought the candle in, and lit it again.
Steve, Dorcas and I spent the rest of the day in the Gatineau Park. It was good to be outside and walking.
I found the cremation tougher this time than it was for either of my parents. Actually, everything about this experience is much tougher.
October 4, 2019
Harvesting my sister’s garden
Today I visited the community garden bed that Pamela nurtured over the last 3 or 4 years. Her gardening buddy, Evaa, said it was always one of the nicest. Even though a beautiful orange squash had been pilfered by an anonymous harvester who hopefully knew how to cook it, and the Swiss chard had been chopped, there was an abundance of arugula, white Russian kale, and even a Chinese salad mallow, reminding me that I’d given her some seeds a while back. Plus some beans and carrots. We’ll make a nice soup with all that.
I’m missing my own garden back home, though I hear the deer got a lot of it. So now I’m harvesting my sister’s garden that she put her loving effort into. It’s actually a metaphor for what’s happening here now; we are being embraced by the love that Pam’s friends have for her. We’re staying at one friend’s house, which makes it much easier to work on emptying Pam’s apartment – both logistically and emotionally. We’re finding the songs that she wrote, the treasures she bought, the work she did on ancestral stories, not to mention the very personal journals, rich in emotional compost which produced a fertile soil for her creativity.
This is an important time for me; I’m still getting to know my sister even though she is physically gone, through her gardens of song, of friends, and of kale.
October 10, 2019
We’re busy preparing for the memorial service in Ottawa on Saturday. If you’re coming, please note that it’s at the Unitarian FELLOWSHIP in Vanier (400 McArthur Ave, west of St Laurent), not the Unitarian CHURCH in Westboro. From the outside, it looks more like a storefront than a church. There is parking behind and around the neighbourhood.
It’s going to be a beautiful service, with gifts of music from the Cantata Singers, which Pamela sang in, and a group of Ottawa area music therapists. There will be an opportunity for anyone who wishes to share special memories of Pam. You’re encouraged to stay afterward for food and an open mic, the kind of scene in which Pamela would have enjoyed and shone.
As for us, our son Malcolm (19) joined us last night and we’re very happy to see him. We’re still staying with Pam’s friend and mentor, Nicola Oddy, which has been a great blessing for us for many reasons. The main work continues to be to go through everything in Pam’s apartment, deciding what to keep and by whom, and what to sell or donate. Because people ask, the best way to help is to come and take away things that will be useful to you or someone else.
The main task falls mostly to me, however: going through all her meticulously kept files and random unfiled papers, and deciding what to toss, shred, offer to other music therapists, or keep for either bookkeeping or personal reasons. It’s deepening the conversations we had and revealing those parts of her life that she necessarily pursued independently of her big sister.
October 13, 2019
Yesterday’s Memorial and Celebration for Pamela went really well; I’m feeling very satisfied with the event. About 140 people showed up (guessing from the number of printed programs left), an interesting cross-section neighbours, choirs, colleagues, Unitarians, and even surprise relatives. We live-streamed too, on Facebook, and relatives in Calgary and friends elsewhere but the video feed ended up sideways. (Sorry about that; the previous day’s test had worked well. It’s the first time doing FB Live.) So I’m attaching a horizontal video below – our backup. There was no chance for fancy camera work. The sound is good, anyway, on both versions.
October 17, 2019
Mahone Bay service postponed
For medical reasons, we need to postpone the Mahone Bay service planned for October 26. Watch for updates.
October 18, 2019
Selling stuff secondhand is hard work. Giving it away is definitely easier, but still takes time and work. Clearing Pam’s apartment has involved some of the former and a lot of the latter. And now we’re getting close to the end. Whatever’s left after tomorrow will have to get delivered to an agency, or a particular person we’ve identified.
Many of the people who’ve responded to the local “Buy Nothing” group I joined on Facebook (“local” meaning a very small area of the city) are young families, often immigrants, who live in sparsely furnished apartments and can really use things. There’s the Algerian woman who has been here with her family for just a year, who brought us a freshly-baked loaf of bread when she came back the second day. She was delighted to find Pam’s fishing tackle box full of useful hardware items, the sort of thing that takes decades to collect.
There’s the beautiful young couple with two kids. The man had actually talked to Pam a few times on the phone, as he realized in our conversation. His partner is the kind of person Pam would have mentored in vocals and sound healing.
There was the immigrant who was thrilled with the wood carving tools. The older woman who works part-time translating for patients in the hospital (so she’s heard some stories), who just buried her brother in Poland (he died 2 days after Pamela), who wanted herbal teas and the half-empty bottles of cleaning products. The neighbour who is active with a Steiner-inspired church who took Pam’s hymnbooks. Stacie of the bakesale, who is moving to a little house in the country, took the bed –something that’s hard to donate. And Nigel has carted carloads of books to a local library booksale and arranged for Pam’s bike to go to another neighbour whose bike was just stolen.
Finishing up here feels like when I was finishing my thesis. I knew I was near the end, but there were always more details, and it had to be done properly, and for years I had dreams that there was still more to do. But we’re in the home stretch, and really looking forward to heading back.
Yesterday we finally saw the surface of Pamela’s dining table. I could feel her say, “Whew, that’s good.” Kathleen and Steve and I sat at it for lunch. The photo looks towards the last intact corner of the apartment: her desk. I’ve painted myself into that corner. Time to finish it up. I hope to get it right and not miss any important papers. Hope I won’t be dreaming for years of almost finishing the job.
So many thank you’s, particularly to music therapist friends Kathleen and Patricia, who have helped in the apartment, and the aforementioned Nigel, a good friend of Pam’s and the convener of the neighbourhood with his BBQ. And a big Thanksgiving heap of gratitude to Nicola and Chuck. Steve and I, and other relatives as they came and went, have been staying at their Ottawa house since we got here. It has made things much easier for us emotionally, practically, and especially health-wise as the dust in the apartment got stirred up. It’s past time for us all to return to our normal lives, when looking back at this will seem like a dream, hopefully not just a recurring nightmare. For now, though, the intensity of the experience has not quite let up.
October 22, 2019
I’d just like to remind everyone in Nova Scotia that the Memorial for Pamela originally scheduled for Oct. 26 in Mahone Bay (as mentioned in the published obituaries) has been postponed to a later date for family medical reasons. Please pass on this information to anyone you know who might have attended. Thanks.
November 1, 2019
I left Ottawa last Saturday, Oct. 26, and got home late the next night. My husband Steve flew home the previous Tuesday, as his sinus infection had become incapacitating. So I had more room in the car to pack Pam’s things in.
If not for the help of Sherry and Kathleen, I’d still be there. They were whirlwinds of cleaning and sorting, and Kathleen took some things to store until my brother can bring them down to Nova Scotia.
Speaking of Mike, he has an unusually intense kidney stone issue. We are still not ready to set a date for our Mahone Bay memorial service.
The night before I left Ottawa, four of us went to a favourite spot of Pam’s on the Rideau River nearby, where she used to walk Winnie. We took her collection of pebbles from the east coast and the west coast, and threw them in one by one, sharing memories and wishes. It was a sweet moment.
Once home, the fatigue and the sadness caught up with me. I’m still in semi-retreat mode, working at taking care of myself, concerned about not getting sunk in grief, nursing my continuing cough with herbs (though I may need antibiotics), accessing the healing resources available to me here, napping and sleeping in. I crave this cocoon. I’m also slowly starting to work through the chaos of the house and garden after 7 weeks of absence, and Pam’s papers, and getting back in touch with my work clients. I’m trying not to push myself however, and to take the time to rest when I need it.
A pet project of mine, however, is archiving Pamela’s creative output, especially songs, on her website at www.PamelaHolm.ca [this one]. I’m just getting started, but you are welcome to check it out. The video of the Memorial Service in Ottawa and the photo gallery of Pamela can also be found there under “In Memorium”.
December 11, 2019
Thoughts about Pamela’s Nova Scotia Celebration of Life are evolving. It makes sense to hold it in the spring when the weather is better and safer for travelling.
My wish is to give people an opportunity to get to know Pamela better from what she has left behind, as it has been a profound experience for me to discover more about my sister.
I’m envisioning honouring Pam by sharing her music, poems and other writings, performed and read by different people (contact me if you’d like to be involved), including some of her singalong songs and chants for all to join in. There would also be time for personal sharing of memories. We would livestream and record the event.
The event would be followed by the scattering of ashes, which will probably involve a hike. I don’t remember ever discussing specifically with Pam what she would have wanted, but she left a couple of clues:
- the chorus of her song Take Me Back
“Take me back to that down home country/ Wild rocky coastline and waves crashing o’er/ …Back to the Maritime shore”
- from a 2018 poem called “Will”:
…I will until
The time when life
Has lost its thrill
Then cast my ashes
To the krill….”
Meanwhile, I’ve been taking much pleasure in working on this website. It’s a great antidote to dismantling her apartment, which felt rather brutal under the circumstances. I’m so glad to be able to assemble her creative output – the tangible remains of her presence in the world – in a way that can be shared.
As for me, I’m back working from home, practicing for the annual Christmas choral concert, going to the weekly farmers’ markets and occasional social events, starting a new fitness class (Nia), living my life with Steve. Pamela is never far from our minds and hearts. My guitar playing is improving as I learn her songs, and together we’re exploring her singing bowls which we will be taking back out into the world in our own way.
I’m always happy to hear from Pam’s friends.