TORONTO, Australia — Amaresh Tesfamariam's heart stopped beating several times over the past three and a half years.
There were numerous "code blues," too many for her family to remember, with staff rushing to bring her back to life at the hospitals she stayed at ever since becoming one of 26 people run down in Toronto’s horrific van attack.
But Tesfamariam returned again and again to her bedridden life. Each time she had to relearn how to speak through a ventilator valve, a process made difficult by her paralysis from the neck down.
Yet she kept smiling, her family said, and even filled the room with a booming laugh when she could.
On Oct. 28, her heart beat for the final time in the intensive care unit at Michael Garron Hospital. She died from massive bleeding in the lungs due to being on a ventilator for years, her family said.
"Her life was beautiful, then the attack happened," her sister Azeb Tesfamariam said in a phone interview from Eritrea, where the 65-year-old was buried last week.
"She never complained, she never cursed," her brother Belay Tesfamariam said from Washington, D.C.
Amaresh Tesfamariam's life changed in an instant on April 23, 2018.
At 1:20 p.m., she called her sister to chat. The two spoke many times every day. Tesfamariam told her sister she wanted to soak in the sunshine on the unusually warm day before heading underground to take the subway to Fudger House, the long-term care home where she worked as a nurse.
About 10 minutes later, Tesfamariam, then 62, walked northbound on the sidewalk of Yonge Street as Alek Minassian sped toward her in a rented van. She stopped at the sight of the van and tried to get out of its way, his murder trial heard, but she was hit and thrown to the ground, suffering catastrophic injuries. Ten people died that day and 16, including Tesfamariam, were injured.
She would spend the rest of her life in hospital, first at Sunnybrook hospital, where she was rushed immediately after the attack, then at Michael Garron Hospital.
"She really fought for three and a half years," said her niece, Luwam Ogbaselassie, one of several family members in Toronto who helped care for her. "I'm overwhelmingly sad, but there's also a real sense of relief that she's finally able to rest."
Tesfamariam was born on March 12, 1956, in Ethiopia, the third oldest of four brothers and five sisters.
She became an elementary school teacher and in the 1980s moved to Eritrea to be with her parents, who had moved there earlier, her family said.
When the Eritrean-Ethiopian war escalated, Tesfamariam left for a new life in Canada. She settled in Montreal, where she lived for nearly a decade.
She struggled to find meaningful work in the city, bouncing from job to job, and eventually moved to Toronto in search of new opportunities, her family said.
In 1999, at age 43, Tesfamariam went back to school to become a nurse.
She met Elena Benito on her first day of class at George Brown College in Toronto. Benito had recently arrived from Eritrea herself and the pair bonded quickly.
It was Tesfamariam's smile that caught Benito's attention, she said.
"Even though she was old for school, we became friends," Benito said. "She was so happy to be joining the program and we helped each other a lot – but she helped me more."
Tesfamariam eventually found her calling as a nurse at Fudger House. Benito later joined her there.
"She's a good model for me and for other nurses," Benito said. "I was serious, but I start to smile because she always smiles."
Tesfamariam would always show up at least an hour early for her 3 p.m. shift and always stayed late, Benito said. Her big laugh made her a favourite with the home's residents, whom she always advocated for, Benito added.
"All the residents who knew Amaresh, they miss her," Benito said.
Tesfamariam told others she was close to retirement, with plans to step away from the job in September 2018 and travel the world, Benito said. She had a large family she wanted to see, with loved ones in Eritrea, Ethiopia, Germany, Italy and throughout Canada and the United States.
Those family members came to visit her in hospital instead.
"She was special, she kept the family together, especially after our parents died," her brother said. "Now that she's gone, we are empty."
Benito visited Tesfamariam every Tuesday and said her friend would grill her about the care residents were receiving at the nursing home where she used to work.
"Elena, make sure all the residents, they take the right medication," Benito recalled Tesfamariam telling her.
Doctors told the family they didn't expect Tesfamariam to live for more than a few months after the attack, but she was determined to live.
"She would say, 'I'm going to go home, it might be in a wheelchair, but I'm going to go home,'" said her niece.
The family brought her body home to Asmara last week. A large contingent showed up at the airport in Eritrea's capital to welcome her home.
Now her family is left with quiet, along with the memory of Tesfamariam's bright smile.
"I miss my best friend," Azeb Tesfamariam said through tears. "She should still be here with me."
This report by The Canadian Press was first published Nov. 17, 2021.
Liam Casey, The Canadian Press