How do you answer the questions, “What do you do?” [7:43] What does the first meeting look like for a new patient at the Zen Hospice Project? Coming close to death and dealing with pain and disability inspired him to go into medicine and the field of disability rights. A place where people prepare to die on their own terms. So the fear of dying, the fear of the dying process. "There was a big explosion, a big flash of light, and I was thrown ... quite some distance," Miller says. He is also a triple amputee, co-founder of a tea company, owner of a farm in Utah and a newlywed who still looks like the Ivy Leaguer he once was. Currently an assistant clinical professor of medicine at UCSF, BJ served as executive director of Zen Hospice Project for several years. Among the various awards received, BJ won the William Osler Distinguished Teaching Award as well as the AAHPM/Project on Death in America Palliative Medicine Community Leadership Award. BJ Miller, MD, is the executive director at the San Francisco Zen Hospice. In his work in end-of-life care, he seeks to connect art, spirituality and medicine. And then, over time, from the early '80s on, it's just been a very slow decline to the point now where she really requires an electric wheelchair, has a little bit of ability to stand, but not for very long, etc. Zen Caregiving Project is a non-profit organization based in San Francisco, California with over 30 years of experience in practicing and teaching mindfulness-based, compassionate caregiving. Dr. BJ Miller is one of the pre-eminent speakers on patient-centered care, palliative and end-of-life care. Miller is cultivating a model for palliative care organizations around the world, and emphasizing healthcares quixotic relationship to the inevitability of death. Dr. BJ Miller Miller, executive director of the Zen Hospice Project in San Francisco, is using his experiences as doctor and “one who suffers” to fix the “badly designed” health care system for those nearing death. BJ Miller is an American physician, author and speaker. On palliative care and the treatment of suffering. “For most people, the scariest thing about … BJ is also an Assistant Clinical Professor of Medicine at the University of California San Francisco (UCSF), and is an attending specialist for the Symptom Management Service of the UCSF Helen Diller Comprehensive Cancer Center, one of the country’s very first outpatient palliative care clinics. BJ Miller is a titan in the field of palliative care. Currently an assistant clinical professor of medicine at UCSF, BJ served as executive director of Zen Hospice Project for several years. So instead the compulsion was to work with it — in a professional way that I could make a living. On how he helps his patients with both their fear of dying and their fear of being dead. For many, it’s simply comfort, respect, love. As executive director at Zen Hospice Project in San Francisco, BJ Miller helps patients face their own deaths realistically, comfortably and on their own terms. In his work in end-of-life care, he seeks to connect art, spirituality and medicine. That zone, it helps me imagine what my patients are going through, being close to death. I can't overcome this; it's my daily experience. For more than a month, operations at the guesthouse have been suspended due to lack of funding.. A Good Life And A Good Death: What Is Palliative Care? It felt like such a rich, rich place that I had been forced into. The project runs largely on donations, which have diminished in recent years as donors have chosen to direct their money to social justice issues threatened under the Trump administration. Miller is a hospice and palliative medicine physician, author, speaker, educator, and founder and President of Mettle Health.He was formerly executive director of the Zen Hospice Project and an assistant clinical professor of medicine at the University of California, San Francisco. But anyone who's dealt with pain — chronic pain — when the clouds part even for a moment and you have the absence of pain, it's a stunning feeling. Drawing on his expertise as a physician, former Executive Director of Zen Hospice Project, and as a patient, he is an advocate for a healthcare system that maximizes quality of life and that minimizes unnecessary suffering. November 3, 2015. We Insist: A Timeline Of Protest Music In 2020. For Dr. BJ Miller, a palliative care specialist at UCSF and executive director of San Francisco's Zen Hospice Project, it can be a spiritual calling as well as a medical one. Articles about BJ Miller on LionsRoar.com. Drawing on his expertise as a physician, former Executive Director of Zen Hospice Project, and as a patient, he is an advocate for a healthcare system that maximizes quality of life and that minimizes unnecessary suffering. ... We understand that process pretty well, and there's a lot we can do. It's a multiheaded entity. He sees patients and caregivers through his online palliative care service, Mettle Health. His new book, A Beginner’s Guide to the End, is a practical guide for preparing for death. After several years working in both the art and disability-rights non-profit communities he enrolled at UCSF where he completed his MD as a Regents’ Scholar in 2001. BJ Miller, MD Executive Director, Zen Hospice Project. Dr. BJ Miller is only 40 but he thinks about death a lot. I'm afraid of being in the ground. So, it gets at your desire, it gets at your longing, it gets at what you're lacking. Browse more videos. And when we push on that one, I think most of us can get to a place where we realize that we're not just our bodies — and our bodies, once they're dead, aren't likely to be feeling anything. I remember feeling that I really wanted to stay close to that interface between joy and sorrow, between pain and pleasure, between life and death. "If I'm honest, there's a little bit of pride. I've come to understand suffering as a wedge — a gap that opens up in you. Dr. BJ Miller is a palliative care physician at UCSF, the former executive director of Zen Hospice, and a leading voice reframing society’s discourse on death and dying. Now, some of my patients will say, "That's one thing. Oct 29, 2018-- Oncologist and Executive Director of the Zen Hospice Project, B. J. Miller is a practitioner who is part of a Buddhist-informed, humanistic approach to care. Help Zen Hospice Project show its expression of positive end-of-life experiences. An electrical shock sustained while a Princeton undergraduate nearly cost him his life. There's all sorts of things to do, so suffering is not necessarily part of the dying process. Show Notes. ... People say, "Actually I'm afraid of the pain I imagine is going to happen during the dying process." Disability is not something to be ashamed of. His expertise includes symptom management for patients with cancer. It's not something to overcome, to put behind you — it's something to work with. A leading voice in reimagining the end of life experience, BJ Miller, MD is a palliative care physician at University of California, San Francisco and former Executive Director of Zen Hospice Project. We offer courses, workshops, and training for professional, family, clinical, and volunteer caregivers. He spends nearly 75 hours a week directing the hospice project, working in an outpatient clinic at UCSF and visiting those receiving home-hospice care. All rights reserved. That's very often at the heart of people's fear of being dead — like all that they're going to miss. His new book, with co-author Shoshana Berger, is A Beginner's Guide to the End: Practical Advice for Living Life and Facing Death. Creative Director/Founder HD360 Tours, LLC July 2015 – Present 4 years 3 months. It's not something to overcome, to put behind you — it's something to work with. On how growing up with his mother, who had polio, influenced him. So death is close by, pain is close by — so is the rest of life. That's knowable. And that to me has felt like a kind of a dexterity or an agility, something very good. Since he had looked death in the eyes, it changed the way he looked at life. Dr. Bruce (BJ) Miller Jr. is a hospice and palliative care specialist who treats hospitalized patients with terminal or life-altering illnesses. © Copyright 2020 Minnesota Network of Hospice and Palliative Care. Oprah Winfrey speaks with Dr. BJ Miller, hospice and palliative care specialist at the University of California in San Francisco, who shares his revelations about a subject that is often taboo in our culture – the experience of death. What really matters at the end of life | BJ Miller. It’s something I’ve been thinking a lot about since having this epic conversation with BJ Miller: oncologist, palliative care specialist, educator, thinker and all-round amazing human. He sees patients and caregivers through his online palliative care service, Mettle Health. It's helpful when patients will confess some fear to me. He is the Dream Foundation Honorary Medical Chair, the only national dream-granting organization for terminally-ill adults. Miller, a doctor and triple amputee, used his own experience to pioneer a new model of palliative care at a small, quirky hospice in San Francisco. Dr. BJ Miller brings unique experience to his role as Executive Director of Zen Hospice Project in San Francisco. BJ Miller, MD, talks with Michael Lerner about his life, his disability, and his role as executive director at the Zen Hospice Project in San Francisco. He is a hospice and palliative medicine physician and sees patients and families at the UCSF Helen Diller Family Comprehensive Cancer Center. Informed by his own experiences as a patient, BJ powerfully advocates for designing better endings. BJ Miller is a hospice and palliative medicine physician who thinks deeply about how to create a dignified, graceful end of life for his patients. Be sure to subscribe for daily interviews and content with our experts! Drawing on his expertise as a physician, former Executive Director of Zen Hospice Project, and as a patient, he is an advocate for a healthcare system that maximizes quality of life and that minimizes unnecessary suffering. Death is an uncomfortable topic. Take the time to savor this moving talk, which asks big questions about how we think on death and honor life. Click here to learn more. BJ Miller is now director of the Zen Hospice in San Francisco. To grow up around disability from a young age, to have that carved into your worldview was, you can imagine, hugely helpful for me as a 19-year-old kid with ostensibly everything going for him. Palliative care aims to ease the suffering of patients and their families. In my early childhood, she used crutches and a brace and was extremely physically capable. A leading voice in reimagining the end of life experience, BJ Miller, MD is a palliative care physician at University of California, San Francisco and former Executive Director of Zen Hospice Project. Neither of them is accurate. BJ was Executive Director of Zen Hospice Project from 2011- 2016 where he helped develop and share a pioneering model of human-centered end of life care. The organization, based loosely on Buddhist principles, offers care that helps patients embrace the spiritual side of death. Dr. BJ Miller is only 40 but he thinks about death a lot. Fear is a big important subject and really requires and demands looking at. ... To know in your bones that you're on borrowed time with being "able-bodied" — I knew that. BJ Miller is a titan in the field of palliative care. That's why I think hospice and palliative medicine is so interesting. The Zen Hospice, where Miller was executive director, suspended activities last year due to a lack of funding, but Miller remains on a public mission to “depathologize death.” “I think my silhouette, the shape of my body, is of comfort to my patients on some level, ” BJ Miller says. Of course, those two responses are related. Palliative care physician at UCSF and senior director and advocate at Zen Hospice Project, BJ Miller looks into the changes faced by the conquerors of cancer and what to do with them. "My body was literally smoking.". Miller, senior director of the Zen Hospice Project in San Francisco, knows most people regard hospice and palliative medicine with a … Bridget Bentz, Molly Seavy-Nesper and Deborah Franklin adapted it for the Web. On finding the balance between life and death, and joy and sorrow. It is important to live so that you're preparing for a good death." BJ Miller is poised to deliver it. We offer courses, workshops, and training for professional, family, clinical, and volunteer caregivers. He is the new executive director of the Zen Hospice Project in San Francisco and a palliative care specialist at UCSF Medical Center. 19:08. Since he had looked death in the eyes, it changed the way he looked at life. Miller’s own life was profoundly reshaped at age 19 by an accident that involved the live wires of a parked commuter train. The gap between the world you have and the world you want. The Zen Hospice Project is a place where medical staff and volunteers practice love, compassion, and empathy. Greater Minneapolis-St. Paul Area • Our HD360 Tours are an excellent way to showcase any space beautifully. At first, he became right-hand man to the executive director at the time, BJ Miller, a doctor and a charismatic visionary who put the Zen Hospice Project in the national conscience through a high-profile New York Times interview and a TED talk that’s been viewed more than 7.5 million times. BJ MILLER,Zen Hospice Project: When people find out I'm in palliative care, first of all, many people — you start with, well, oh, well, what is that? The guesthouse of the Zen Hospice Project in San Francisco saw its last patient in June. And then that becomes a nice compass for our way forward, how we're going to live until we die. He is a powerful advocate for the role of our senses, community and presence in delivering palliative care and for ushering in a new perspective on living with death. The Symington Foundation Conference on New Dimensions in Integrative Cancer Care was … It affects your identity. To Die At Home, It Helps To Have Someone Who Can Take Time Off Work, A Nurse Reflects On The Privilege Of Caring For Dying Patients. Dr. BJ Miller's new project, the Center for Dying and Living, is a website designed for people to share their stories related to living with illness, disability or loss, or their stories of caring for someone with those conditions. Connect with BJ Miller and Zen Hospice: ZenHospice.org | Facebook | Twitter. Presley Baldwin. I knew how to read that, thanks to my mother. Dr. BJ Miller: Zen Hospice Project. Dr. BJ Miller brings unique compassion to his role as Senior Director and Advocate of Zen Hospice Project. The Zen Hospice Project guesthouse opened in 1990, during the height of the AIDS epidemic. Playing next. The guesthouse of the Zen Hospice Project … While a sophomore in college, Dr. Miller suffered a devastating electrical shock throughout his body. He is a practicing hospice and palliative medicine physician and is best known for his 2015 TED Talk, "What Really Matters at the End of Life" BJ has been on the teaching faculty at UCSF School of Medicine since 2007. But if you go there, then what has that done? Dr. BJ Miller (far right) on the stoop of the Zen Hospice Project with (from left to right) Mary Knopt, Nurse Manager, Jeff Leaver, Resource Nurse, and Maysie, BJ’s dog. That has pointed us very squarely to all the things we love and care about. And lean in he has: Miller’s 2015 TED Talk on the subject of death garnered over 9 million views, and as the former executive director of San Francisco’s Zen Hospice Project, Miller confronted death on a daily basis. BJ MILLER, Zen Hospice Project: When people find out I'm in palliative care, first of all, many people — you start with, well, oh, well, what is that? Miller survived that 1990 accident but lost both legs below the knee and half of one arm. 2:57. As a palliative care physician at the University of California San Francisco's Cancer Center, Miller draws on his own experiences to help people with their physical, emotional and spiritual pain at the end of their lives. Our work, drawing from over 30 years of experience in hospice and end of life care, is grounded in the expression of the universal values of compassion and service. We have ways of being with each other. They treat you like you've got special knowledge, or they treat you a little bit like Frankenstein. Dr. Bruce (BJ) Miller Jr. is a hospice and palliative care specialist who treats hospitalized patients with terminal or life-altering illnesses. How B.J. I'm afraid of what comes next or whatever else." BJ Miller is a hospice and palliative care specialist on a quest to reframe our relationship with death. That's an important distinction, because any hospice and palliative medicine team can do a lot to quell the pain and the sorrow that happens during the dying process. That accident took most of his limbs, but the event and his recovery inspired him to pursue a career as a palliative care physician. Preparing for Death: A Spiritual Approach. Fear helps point to the things that you care about, the things you love, the things you're afraid to lose. He completed his internal medicine residency at Cottage Hospital in Santa Barbara, California, where he served as chief resident. Many people felt it got demonstrably worse when Dr. Miller left and George Kellar, a … We teach caregivers to use mindfulness-based tools to improve well-being, and through conversation, we inspire each other to live fully in the face of the universal experience of loss. The work and values of the Zen Hospice project are what drew Miller to the organization.. I had to hang out there for a while, but I became a little enamored of it, because from there I could just as easily get to sorrow as I could get to joy. Miller’s revolutionary Zen Hospice after stopping dialysis; and Pat, whose womb is a “cancerous mess.” Well, suffering, there's a lot of different ways to define it. Join us for a life-affirming conversation between two of the leading voices in health care today about how we can learn to live well not in spite of death but because of it. B.J. ... People think you're Jesus because you've gone through something special. B.J. ... Grief does this. Doctor Q&A: BJ Miller Palliative care aims to ease the suffering of patients and their families. Miller is the senior director and advocate of the Zen Hospice Project and we at WYD are big fans—mainly because of how he’s cultivating a richer dialogue about death and dying that is so needed in our time. Miller is a hospice and palliative medicine physician, author, speaker, educator, and founder and President of Mettle Health.He was formerly executive director of the Zen Hospice Project and an assistant clinical professor of medicine at the University of California, San Francisco. So it didn't teach me to cling to life with my fingernails, that that was the way through. Show Notes. The Zen Hospice Project works to bridge medical and social models of care in effort to provide the finest palliative care available. And it seems like many physicians, hospice workers, and others who work with people who are dying find spiritual insights. That's pretty concrete. Today, BJ is a physician as the University of California, San Francisco (UCSF), and the executive director of the Zen Hospice Project in San Francisco. About BJ Miller. ... [What] I'm a little proud of is the decision to work with this experience over time, to dig into it, to mine it, to find a creative energy in it. The fear there, the things we are afraid to miss, are the things we really should uptick in terms of our attention now. In an interview with the UCSF Medical Center, Miller said, “I’ve been interested in the project since I first learned about it in medical school because it’s a place that’s fueled by kindness and compassion, rather than invention and resources. His expertise includes symptom management for patients with cancer. At the end of our lives, what do we most wish for? In 1990, BJ Miller was hit with 11,000 volts of electricity. At first, he became right-hand man to the executive director at the time, BJ Miller, a doctor and a charismatic visionary who put the Zen Hospice Project in the national conscience through a high-profile New York Times interview and a TED talk that’s been viewed more than 7.5 million times. Zen and Buddhism offer so much in response to this situation. Dr. BJ Miller Dr. BJ Miller is one of the pre-eminent speakers on patient-centered care, palliative and end-of-life care. In contrast, this is a focal point for BJ Miller, palliative care physician and executive director of the Zen Hospice Project, a San Francisco-based nonprofit that’s focused on improving our experience of death. And this idea that the world is going to continue on without them, all the things they're not going to get to see, etc. The internal culture at Zen Hospice Project became notoriously toxic in recent years. Laurencelenhardt13. Dr. BJ Miller (far right) on the stoop of the Zen Hospice Project with (from left to right) Mary Knopt, Nurse Manager, Jeff Leaver, Resource Nurse, and Maysie, BJ’s dog. "I'm more afraid of not living a full life. And I had seen that. Zen & the Art of Letting Go Dr. BJ Miller Helps Create a Caring Circle at Zen Hospice Project by David Rosenberg. Drawing on his expertise as a physician, former Executive Director of Zen Hospice Project, and as a patient, he is an advocate for a healthcare system that maximizes quality of life and that minimizes unnecessary suffering. As executive director at Zen Hospice Project in San Francisco, BJ Miller helps patients face their own deaths realistically, comfortably and on their own terms. But that's the kind of vibe you can get — a lot of us who have disabilities know very well. But let's think about it. So is the good stuff. Today, BJ is a physician as the University of California, San Francisco (UCSF), and the executive director of the Zen Hospice Project in San Francisco. Zen Caregiving Project is a non-profit organization based in San Francisco, California with over 30 years of experience in practicing and teaching mindfulness-based, compassionate caregiving. Register for What Matters Most at the End of Life. Then my response, of course, is, "Well, gosh, I don't know what that's like either. Essentially Zen expresses the need for being with whatever is happening. Dr. BJ Miller is one of the pre-eminent speakers on patient-centered care, palliative and end-of-life care. Your purchase helps support NPR programming. Zen Hospice is a natural fit for Miller. ... Basically palliative care is the treatment of suffering, versus the rest of medicine as the treatment of disease. But after recovering, Miller became a doctor, joined the faculty of UCSF, and is now leading a conversation about patient-centered care and redesigning the experience of how we die. And there's a lot of reassurance. We have medications. He is the new executive director of the Zen Hospice Project in San Francisco and a palliative care specialist at UCSF Medical Center. BJ Miller Understands Mortality. In film, Miller is the subject of Netflix's Academy Award-nominated short documentary, End Game by veteran directors Rob Epstein, Jeffrey Friedman and executi… His new book, A Beginner’s Guide to the End: Practical Advice for Living Life and Facing Death is out now. "I'm more afraid of not living a full life. So that's an important distinction. Raised in Chicago, BJ studied art history as an undergraduate at Princeton University. It doesn't go away. For Dr. BJ Miller, a palliative care specialist at UCSF and executive director of San Francisco's Zen Hospice Project, it can be a spiritual calling as well as a medical one. He spends nearly 75 hours a week directing the hospice project, working in an outpatient clinic at UCSF and visiting those receiving home-hospice care. Memorial Service will be held Thursday, June 16, 2016, at 11:00 A.M., at Swedlanda Lutheran Church in Palmyra Township, rural Hector, Minnesota. Watch BJ Miller, executive director of the Zen Hospice Project, describe his mission to reimagine death in the TED Talk below. But I'm actually afraid of being dead. He is a practicing hospice and palliative medicine physician and is best known for his 2015 TED Talk, "What Really Matters at the End of Life" BJ has been on the teaching faculty at UCSF School of Medicine since 2007. Palliative care specialist BJ Miller helps patients face their own deaths realistically, comfortably, and on their own terms. Coming out of the back side of the experience of my own injuries, my own brush with death, etc., I came out of there eventually holding life much more loosely. ", Practical Advice for Living Life and Facing Death. Simon & Schuster Let's talk about it." Dr. BJ Miller, a palliative care doctor and Executive Director of San Francisco’s Zen Hospice Project, shares insights about end-of-life care in the recent TED Talk “What Really Matters at … "I'm not afraid of death," he says. BJ heads up the Zen Hospice Project in San Francisco, a not-for-profit dedicated to changing the way we think about death. Cicely Saunders, the grandmother of hospice work, she called it "total pain." Miller says it's hard for him to regret the accident that changed his life. BJ Miller is an American physician, author and speaker. And medicine lit up, theoretically, as a way where I could use these experiences and pay them forward in some way or draw from them — not overcome them and put them behind me. Zen Hospice, volunteers, spirituality and BJ Miller The US hospice system, which could be described as an alternative funding option for people at end of life to the regular Medicare/Medicaid system, is increasingly populated by the entry of large health facility operators. He completed his fellowship in Hospice & Palliative Medicine at Harvard Medical School, with his clinical duties split between Massachusetts General Hospital and Dana-Farber Cancer Institute. Dr. BJ Miller also speaks to the therapeutic potential of aesthetics, and how to design for life. It taught me some adult trick of simultaneously holding on to opposing emotions. When BJ Miller was a sophomore at Princeton University, he climbed atop a commuter train that had been parked for the night. "I'm not afraid of death," he says. But when you push on that one, you can open up [about] what is known as [the] modern acronym of FOMO — fear of missing out. ... Dr. BJ Miller knows what it feels like to be near death. Sam Briger and Joel Wolfram produced and edited this interview for broadcast. About BJ Miller. The Zen Hospice Project guesthouse opened in 1990, during the height of the AIDS epidemic. He is also a triple amputee, co-founder of a tea company, owner of a farm in Utah and a newlywed who still looks like the Ivy Leaguer he once was. Awareness of death is a practice in many spiritual traditions. For the past two years, he has overseen patient care in the facility’s six beds; all of … I didn't have to learn that, and that was a huge advantage. He miraculously survived but lost both legs below the knee and half of one arm. 8:26. BJ Miller is now director of the Zen Hospice in San Francisco. We have ways of positioning your body. "So much has flowed from it," he says. Suffering is a multiheaded beast. I started doing a little work [in] arts advocacy and disability rights. You don't just treat pain. In this episode, BJ begins with how his own brush with death radically shifted his perspective and ultimately forged his path towards palliative care and helping patients integrate and understand their life in a meaningful way. What began as a lark took a tragic turn when 11,000 volts of electricity suddenly surged through his body. The Zen Hospice Project guesthouse. That [it has] a physical component, a psychological and emotional component, a spiritual component. On deciding to pursue palliative medicine. Screenshot from “The Art of Mindful Caregiving” by Zen Hospice Project on Vimeo. One might say it affects how you see yourself. Dr. BJ Miller, a palliative care doctor and Executive Director of San Francisco’s Zen Hospice Project, shares insights about end-of-life care in the … So what is suffering? Connect with BJ Miller and Zen Hospice: ZenHospice.org | Facebook | Twitter. Wise words and solid advice from BJ Miller, who thinks deeply about the end of life as head of the Zen Hospice Project. But basically ... thanks to the disability rights movement, I realized that disability is not something to be ashamed of. Zen & the Art of Letting Go Dr. BJ Miller Helps Create a Caring Circle at Zen Hospice Project by David Rosenberg. Hospice Champion Project with Peace Hospice Care, Hospice of St Francis and West Herts NHS Trust. The sooner we do, the better, because oftentimes it's not so darn scary. Dr. BJ Miller is one of the pre-eminent speakers on patient-centered care, palliative and end-of-life care. Report. How? A place where people prepare to die on their own terms. Zen Hospice Project was the subject of the Netflix 2018 Academy Award-nominated short documentary End Game, about terminally ill patients in a San Francisco hospital as well as at the Zen Hospice Project house, featuring the work of palliative care physician BJ Miller and other palliative care clinicians. Hughes-Hantge Funeral Chapel - Bernice Christenson, age 95, of Gaylord, formerly of Hector, passed away Wednesday, June 8, 2016, at Oak Terrace Health Care Center in Gaylord. An electrical shock sustained while a Princeton undergraduate nearly cost him his life. Among the patients we meet: Thekla, a terminally ill senior anxious about life after death; Bruce, a severely underweight man who enrolled in Dr. B.J. Post cancer treatment, the body is in physical, metabolic, emotional and even spiritual fall-out. His TED Talk, “What Really Matters at the End of Life,” about keeping the patient at the center of care and encouraging empathic end-of-life care, and has garnered over 6 million views to date and ranked among the most viewed talks. hide caption. You treat suffering. How do you answer the questions, “What do you do?” [7:43] What does the first meeting look like for a new patient at the Zen Hospice Project? It is …

bj miller zen hospice

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