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The Note in the Culvert: How a Surgeon Stole Her Body · Why Humans Lie

0:03
Speaker 1: The note was circled twice in red ballpoint seven words,
0:09
Speaker 1: she will agree if you tell her the nerve damage
0:11
Speaker 1: is progressing. It sat beside a surgical file for a
0:14
Speaker 1: procedure performed in two thousand seven, one procedure, a procedure
0:19
Speaker 1: a second radiologist would later review and find no evidence
0:23
Speaker 1: ever justified. That note was not in any official electronic record.
0:28
Speaker 2: It existed only in.
0:30
Speaker 1: A private accordion folder, annotated in a second hand, kept
0:34
Speaker 1: outside the system that was supposed to protect the patient
0:36
Speaker 1: whose name was on every page. The folder was found
0:39
Speaker 1: in a culvert, not in a filing cabinet, not in
0:43
Speaker 1: a safe, behind Elmhurst Medical Plaza, wedged between a concrete
0:48
Speaker 1: lip and a tangle of roots, water damaged but intact.
0:53
Speaker 1: Discovered on a Tuesday morning in May of two thousand
0:56
Speaker 1: nine by a dog named Pepper and the woman holding
0:59
Speaker 1: his leash. By noon that day, the folder was in
1:03
Speaker 1: an evidence bag. By November, a surgeon named Craig Foster
1:09
Speaker 1: was under arrest, and by the time Rebecca Hamilton sat
1:12
Speaker 1: in a court room in the spring of twenty ten,
1:16
Speaker 1: she had already lived through seventeen surgical procedures, two mortgage draws,
1:21
Speaker 1: and five years of being told methodically that her body
1:25
Speaker 1: was failing her. The question was never whether it had happened.
1:29
Speaker 1: The records made that undeniable. The question was how how
1:34
Speaker 1: one person could so completely dismantle another's relationship with her
1:38
Speaker 1: own body, her own judgment, her own sense of what
1:41
Speaker 1: was real, and do it inside an examining room, wearing
1:45
Speaker 1: a white coat and calling it care. Rebecca Hamilton was
1:49
Speaker 1: forty four years old in May of two thousand and nine.
1:53
Speaker 1: She had taught art at Elmhurst High School long enough
1:57
Speaker 1: that former students had graduated, moved away, and come back
2:01
Speaker 1: to tell her what her class had meant to them.
2:03
Speaker 1: She was the kind of teacher who remembered which student
2:06
Speaker 1: preferred charcoal, who kept extra supplies for the ones who
2:10
Speaker 1: couldn't afford them, and who arrived early enough on Wednesdays
2:15
Speaker 1: to claim the corner booth at Millbrook Diner on Prospect
2:19
Speaker 1: Street before any one else did. Joanne Platt, the waitress
2:23
Speaker 1: who had worked that booth since two thousand three, filled
2:27
Speaker 1: Rebecca's standing order without being asked. According to her primary
2:31
Speaker 1: care physician, doctor Marcus Webb, Rebecca had no clinical history
2:36
Speaker 1: of anxiety, no hypochondria, no documented pattern of health seeking
2:42
Speaker 1: behavior that was out of the ordinary. She was not
2:45
Speaker 1: a person who catastrophised. She was organized, grounded, and by
2:50
Speaker 1: all accounts, deeply tethered to her routines. Her morning jog
2:54
Speaker 1: along Riverside path, her Wednesday booth, her class room. She
2:58
Speaker 1: jobbed the same path every morning. That detail matters. Riverside
3:03
Speaker 1: path runs past Elmhurst Medical Plaza, the parking structure adjacent
3:08
Speaker 1: to that path. The parking structure adjacent to that path,
3:13
Speaker 1: the one you'd use if you wanted to watch someone's
3:16
Speaker 1: routine without looking like you were watching, appears in records
3:20
Speaker 1: from March of two thousand and five, three parking validations,
3:25
Speaker 1: three separate days, all linked to doctor Craig Foster. Foster
3:30
Speaker 1: was forty one that spring, board certified orthopedic surgeon Elmhurst
3:35
Speaker 1: Surgical associates. Colleagues described him as methodical, unhurried. He had
3:41
Speaker 1: a habit of sitting during consultations rather than standing, a
3:46
Speaker 1: posture one patient advocate would later describe as deliberately leveling,
3:50
Speaker 1: a way of seeming less clinical, more conversational, more like
3:55
Speaker 1: someone on your side. In spring of two thousand and five,
3:59
Speaker 1: Rebecca's prime Mary care physician referred her to a specialist
4:03
Speaker 1: for a hand complaint. The referral was intended for doctor
4:07
Speaker 1: Linda Oxner. According to the intake log reviewed by investigators,
4:11
Speaker 1: there is no documented reason why it was routed instead
4:14
Speaker 1: to doctor Craig Foster. Front desk coordinator Paula Kim's records
4:20
Speaker 1: show the deviation, they do not explain it. Rebecca's first
4:24
Speaker 1: consultation with Foster lasted approximately one hour. He performed a
4:29
Speaker 1: carpal tunnel release. That procedure, reviewed later, was clinically defensible.
4:34
Speaker 1: It was the last one that would be b There
4:38
Speaker 1: is something about the architecture of what followed that a
4:41
Speaker 1: single number captures better than any description. Seventeen seventeen procedures
4:47
Speaker 1: over five years. Hand, then shoulder, then cervical spine, then
4:53
Speaker 1: left knee, each one arriving at a moment when Rebecca's
4:56
Speaker 1: uncertainty about her own body was highest, Each one framed
5:00
Speaker 1: as the logical next step, necessary, urgent, what any responsible
5:04
Speaker 1: patient would choose. In two thousand six, Rebecca voiced doubt twice.
5:09
Speaker 1: Both times Foster pressed back, using the history of her hand,
5:13
Speaker 1: the thing he had already fixed, the thing that had
5:16
Speaker 1: proven him right.
5:17
Speaker 2: Once.
5:18
Speaker 1: According to testimony later given a trial, he did not
5:22
Speaker 1: raise his voice, He did not threaten. He simply redirected
5:26
Speaker 1: her attention to the evidence. She already trusted her own
5:29
Speaker 1: prior pain, her own prior relief. By two thousand seven,
5:34
Speaker 1: he was performing eight surgeries in a single year. That
5:37
Speaker 1: same year, he annotated her imaging with notes claiming her
5:41
Speaker 1: condition was progressing. Doctor Sandra Holt, an independent radiologist who
5:46
Speaker 1: reviewed that two thousand seven imaging after Foster's arrest, found
5:52
Speaker 1: no progression none. The annotation that would end up circled
5:56
Speaker 1: in red ball point was written that year. Rebecca did
6:00
Speaker 1: not know about it. She would not see it for
6:03
Speaker 1: two more years. In the meantime, her emergency savings were
6:07
Speaker 1: gone by February of two thousand eight. She drew a
6:10
Speaker 1: second mortgage in May of that same year, and she
6:13
Speaker 1: kept going back because Craig Foster had spent three years
6:17
Speaker 1: making sure she believed, down to the level of physical
6:20
Speaker 1: sensation that if she stopped, something irreversible would happen to
6:25
Speaker 1: her body. That is not a metaphor. That is what
6:29
Speaker 1: the evidence shows. He built, piece by piece inside a
6:32
Speaker 1: patient who had no clinical reason to be afraid her
6:36
Speaker 1: sister Diane visited in the summer of two thousand eight.
6:39
Speaker 1: What she saw alarmed her enough that she began quietly
6:43
Speaker 1: looking for help, not for Rebecca's body, but for what
6:46
Speaker 1: was happening around it. That thread, once pulled, would not stop.
6:52
Speaker 1: Diane Hamilton was not a medical professional. She was a
6:55
Speaker 1: sister who had not seen Rebecca in.
6:57
Speaker 2: Almost a year.
6:59
Speaker 1: She walked into the house in the summer of two
7:01
Speaker 1: thousand and eight and understood, without meeting a chart or
7:03
Speaker 1: a diagnosis, that something was deeply wrong. Rebecca was not sick.
7:09
Speaker 2: She was diminished.
7:10
Speaker 1: Diane noticed the way Rebecca moved through her own kitchen, cautious, apologetic,
7:16
Speaker 1: as though her body had become a thing she no
7:18
Speaker 1: longer trusted to behave. She noticed the stacks of billing
7:23
Speaker 1: paperwork on the table. She noticed that Rebecca could recite
7:26
Speaker 1: Foster's recommendations from memory in the exact cadence Foster used
7:30
Speaker 1: to deliver them. What Diane did not know yet was
7:34
Speaker 1: that her sister had been operated on eleven times in
7:37
Speaker 1: three years, and that the man who had performed every
7:40
Speaker 1: one of those surgeries had once parked three times in
7:44
Speaker 1: a single month beside the path where Rebecca jogged. She
7:48
Speaker 1: hired John Mercer six weeks later. Mercer was a patient advocate.
7:53
Speaker 1: His job was paperwork, billing codes, facility fees, the fine
7:58
Speaker 1: print that most patients need ever see because they are
8:01
Speaker 1: too busy trying to recover. He came in expecting administrative disorder.
8:06
Speaker 1: What he found was something that did not look like
8:09
Speaker 1: disorder at all.
8:11
Speaker 2: It looked intentional.
8:12
Speaker 1: The first anomaly was a facility fee charge for.
8:16
Speaker 2: A surgical suite.
8:17
Speaker 1: The date matched one of Rebecca's procedures, but the suite itself,
8:21
Speaker 1: according to internal booking records, had been assigned to a
8:24
Speaker 1: different patient that day. The fee had been billed to
8:27
Speaker 1: Rebecca anyway. The funds, once traced, led not to Elmhurst's
8:32
Speaker 1: Surgical Associates operating account, but to a personal account that
8:37
Speaker 1: was not a billing error. One billing error is a mistake,
8:41
Speaker 1: but Mercer kept pulling the thread. Ted Horner, the records
8:45
Speaker 1: manager at the practice, later confirmed something that had struck
8:48
Speaker 1: him at the time as unusual but not alarming. Foster
8:52
Speaker 1: had requested that patient summaries be printed in a non
8:55
Speaker 1: standard format physical binders, what Foster called called continuity of
9:01
Speaker 1: care documents. These binders were not part of the official
9:05
Speaker 1: electronic record. They existed on paper only, and the paper
9:10
Speaker 1: at some point had ended up in an accordion folder,
9:14
Speaker 1: which had ended up in a culvert picture.
9:16
Speaker 2: What that means.
9:18
Speaker 1: Every clinical justification Foster built, every note explaining why the
9:23
Speaker 1: next procedure was necessary, why Rebecca's condition was advancing, why
9:28
Speaker 1: waiting would be dangerous, existed in a document that was
9:32
Speaker 1: never formally logged. The official record was clean. The working record,
9:37
Speaker 1: the one with the red ball point annotations, was portable, deniable,
9:42
Speaker 1: and someone had tried to make it disappear. The annotation
9:46
Speaker 1: circled twice, the one that read, she will agree if
9:49
Speaker 1: you tell her the nerve damages progressing. Doctor Sandra Holt
9:53
Speaker 1: had reviewed that same twenty seven, imaging no progression. The
9:58
Speaker 1: annotation was not a clinical observation. It was a script.
10:02
Speaker 1: Here is where the case turns. Not because of the
10:05
Speaker 1: billing records, not because of the folder. Those things confirmed
10:09
Speaker 1: what Mercer suspected. But confirmation is not the same as pattern,
10:14
Speaker 1: and pattern was what prosecutors needed if they were going
10:17
Speaker 1: to argue this was not negligence, not a series of
10:21
Speaker 1: clinical misjudgments, but something that had been constructed deliberately over time.
10:27
Speaker 1: Ten days after Foster's arrest in November of two thousand nine,
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Speaker 1: a woman named Connie Marsh called the investigative team. Marsh
10:35
Speaker 1: had been Foster's patient in Dayton late nineteen nineties. She
10:39
Speaker 1: had undergone five procedures under his care. She had not
10:43
Speaker 1: come forward before because she had not known there was
10:46
Speaker 1: anything to come forward about. She had relocated. That was
10:50
Speaker 1: the only reason she had left his orbit. Not a confrontation,
10:54
Speaker 1: not a warning from any one, not a moment of
10:57
Speaker 1: clarity about what had been done to her. She had
11:00
Speaker 1: simply moved, and Foster had simply moved on. What Connie
11:05
Speaker 1: Marsh did when she testified in the spring of two
11:08
Speaker 1: thousand ten was provide something Rebecca's records alone could not
11:12
Speaker 1: a before, a proof that the pattern did not begin
11:15
Speaker 1: with Rebecca Hamilton and had not been improvised around her
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Speaker 1: particular vulnerabilities. Foster had done this before Rebecca's hand began
11:25
Speaker 1: to ache, before he saw her on the path, before
11:29
Speaker 1: he intercepted a referral meant for a different doctor. The
11:32
Speaker 1: financial subpoena issued in the fall of two thousand nine
11:36
Speaker 1: found billing discrepancies across six other patients over a nine
11:40
Speaker 1: year period, six others nine years. Rebecca was not an exception.
11:46
Speaker 1: She was a continuation picture the referral. One more time,
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Speaker 1: Doctor Marcus Webb writes a name on a slip of paper,
11:54
Speaker 1: doctor Linda Oxner. That name never arrives at Oxner's office.
11:59
Speaker 1: Paula Kim's intake log shows no documented reason for the deviation.
12:04
Speaker 1: It simply does not happen. Rebecca walks into Elmhurst's Surgical Associates. Instead,
12:09
Speaker 1: she sits down across from Craig Foster, who is already sitting,
12:14
Speaker 1: a detail noted by multiple people who knew him, a
12:17
Speaker 1: habit of leveling the room, of making the space feel
12:20
Speaker 1: collaborative rather than hierarchical. The first consult lasts close to
12:25
Speaker 1: an hour. The carpal tunnel release that follows is clinically defensible.
12:30
Speaker 1: Doctor Webb confirmed it. There is no disputing that that
12:35
Speaker 1: fact matters. It matters because the first procedure, being legitimate,
12:39
Speaker 1: is not incidental to what came after. It is load bearing.
12:44
Speaker 1: A surgeon who botches the first operation loses the patient immediately.
12:48
Speaker 1: A surgeon who gets it right earns something far more
12:51
Speaker 1: durable than satisfaction. He earns trust and trust inside a
12:56
Speaker 1: medical relationship is not an emotion. It is a cognitive
13:00
Speaker 1: frame book. It changes how the patient interprets subsequent information.
13:05
Speaker 1: It makes doubt feel disloyal. Foster's written statement to the
13:10
Speaker 1: Ohio Medical Board, submitted in mid two thousand fifteen, three
13:14
Speaker 1: months after his second appeal failed, described the process in
13:19
Speaker 1: his own language. He wrote about identifying Rebecca on the path.
13:24
Speaker 1: He wrote about engineering the referral. He wrote about calibrating
13:28
Speaker 1: his recommendations in his own words, to arrive just at
13:31
Speaker 1: the edge of what she could refuse. He called it
13:34
Speaker 1: a system. Nancy Stevens, Rebecca's therapist, read that letter. She
13:39
Speaker 1: found no legible remorse in it. What she found instead
13:44
Speaker 1: was the same structural logic Foster had used in the
13:48
Speaker 1: exam room, a framing designed to position the writer as
13:51
Speaker 1: the most rational person in the room.
13:53
Speaker 2: Even in confession.
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Speaker 1: He never addressed a single word of it to Rebecca.
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Speaker 1: The letter is in the record. The folder is in
14:01
Speaker 1: the County Evidence Archive, preserved in a sealed plastic sleeve.
14:05
Speaker 1: The annotations are still legible. Rebecca returned to teaching in
14:10
Speaker 1: the fall of two thousand ten. On Wednesday mornings, she
14:14
Speaker 1: still holds the corner booth at the Millbrook Diner. Joanne
14:18
Speaker 1: Platt still fills her standing order without being asked. Some things,
14:22
Speaker 1: once taken do not come back intact, but some things,
14:27
Speaker 1: the small, stubborn.
14:29
Speaker 2: Ordinary ones hold.
14:30
Speaker 1: The folder found its way into the record, The letter
14:33
Speaker 1: found its way into the record. But the case did
14:36
Speaker 1: not end with a document. It ended with a woman
14:39
Speaker 1: standing at the front of a classroom in the fall
14:41
Speaker 1: of two thousand ten, holding a piece of chalk, deciding
14:45
Speaker 1: to go back. Craig Foster was arrested in November two
14:49
Speaker 1: thousand nine. The charges were insurance fraud, medical fraud, and
14:54
Speaker 1: three counts of felony assault procedures performed without medical.
14:58
Speaker 2: Necessity and tied to specific patients.
15:01
Speaker 1: That third category is worth sitting with not now practice,
15:06
Speaker 1: not negligence assault. The trial ran in the spring of
15:10
Speaker 1: twenty ten. Rebecca Hamilton testified for four days, four days
15:15
Speaker 1: of sitting across from the man who had mapped her
15:18
Speaker 1: threshold and stayed just inside it. Her testimony was detailed, chronological,
15:23
Speaker 1: and by every account in the record, devastating. She did
15:27
Speaker 1: not reconstruct a crime, She reconstructed a logic. She explained
15:31
Speaker 1: methodically how each procedure had been made to feel inevitable.
15:35
Speaker 1: Connie Marsh testified two she came forward ten days after
15:40
Speaker 1: Foster's arrest, a prior patient from his date and practice
15:43
Speaker 1: in the late nineteen nineties, who had undergone five procedures
15:47
Speaker 1: before relocating, and by accident of geography, escaping his orbit.
15:52
Speaker 1: She was not targeted a second time. She was simply
15:55
Speaker 1: moved out of range. Her testimony established what the billing
15:59
Speaker 1: records alone could not, that the pattern had a history,
16:03
Speaker 1: that Rebecca was not the beginning, that nine years of
16:06
Speaker 1: financial subpoena records pulled in the fall of two thousand
16:10
Speaker 1: nine showed similar discrepancies across six other patients. Foster was
16:16
Speaker 1: not a surgeon who made one catastrophic error in judgment.
16:20
Speaker 1: He was a surgeon who had built a repeating architecture
16:23
Speaker 1: and run it across multiple people over nearly a decade.
16:27
Speaker 1: In June twenty ten, the jury returned guilty verdicts on
16:31
Speaker 1: eleven of fourteen counts. Foster was sentenced to sixteen years.
16:37
Speaker 1: He filed appeals in twenty twelve and again in twenty fourteen.
16:42
Speaker 1: The second appeal failed in March two thousand fifteen, three
16:45
Speaker 1: months later, in a move that investigators characterized as a confession,
16:49
Speaker 1: he submitted a written statement to the Ohio Medical Board.
16:53
Speaker 1: He described identifying Rebecca on the riverside path. He described
16:57
Speaker 1: engineering the referral away from doctor Linda Oxner. He described
17:02
Speaker 1: calibrating his recommendations to arrive, in his own phrase, just
17:06
Speaker 1: at the edge of what she could refuse. He called
17:09
Speaker 1: the whole operation a system. Nancy Stevens, Rebecca's therapist, read
17:14
Speaker 1: that letter. She did not find remorse. She found the
17:18
Speaker 1: same architecture she had identified in Foster's exam room behavior,
17:22
Speaker 1: a prose structure designed to make the writer appear as
17:25
Speaker 1: the most rational person in the room, even while describing
17:28
Speaker 1: what he had done. The language of the letter mirrored
17:31
Speaker 1: the language of manipulation. Even in confession he was framing.
17:36
Speaker 1: He never directed a single word of it toward Rebecca.
17:39
Speaker 1: The annotated folder remains in the County Evidence Archive, preserved
17:43
Speaker 1: inside a sealed plastic sleeve. The red ball point annotations
17:48
Speaker 1: are still legible. The note circled twice. She will agree
17:52
Speaker 1: if you tell her the nerve damage is progressing. Sits
17:55
Speaker 1: beside imaging that an independent radiologist found showed no progression
18:00
Speaker 1: at all, the document that cracked the case open was
18:03
Speaker 1: not generated by an investigator.
18:05
Speaker 2: It was found by a dog.
18:07
Speaker 1: There is a specific kind of damage this case produced
18:10
Speaker 1: that does not appear in any charred sheet. It does
18:13
Speaker 1: not appear in the sixteen year sentence. It does not
18:16
Speaker 1: appear in Foster's written statement to the medical Board because
18:20
Speaker 1: Foster never acknowledged it at all. Rebecca Hamilton was forty
18:23
Speaker 1: four years old in May two thousand nine. She was
18:27
Speaker 1: an art teacher. She had no clinical history of anxiety,
18:31
Speaker 1: no history of hypochondria. Her own primary care physician, doctor
18:36
Speaker 1: Marcus Webb, confirmed that on record, she jogged the Riverside path.
18:42
Speaker 1: She had a Wednesday booth at the Millbrook Diner and
18:45
Speaker 1: a standing order Joanne Platt had been filling since two
18:48
Speaker 1: thousand three. She had a life with a specific shape.
18:51
Speaker 1: Between two thousand five and two thousand nine, seventeen procedures moved.
18:58
Speaker 2: Through that life.
19:00
Speaker 1: Her emergency savings were gone by February two thousand eight.
19:05
Speaker 1: She took a second mortgage draw in May of that year.
19:08
Speaker 1: She was exhausted by the summer. Her sister Diane noticed
19:11
Speaker 1: it and did not know what she was looking at,
19:14
Speaker 1: only that something had been slowly removed. What had been
19:17
Speaker 1: removed was not just money or physical capacity. It was
19:21
Speaker 1: epistemic ground. Foster's system worked by making Rebecca doubt her
19:27
Speaker 1: own perception of her body, her own memory of what
19:29
Speaker 1: she had been told, her own sense of whether her
19:32
Speaker 1: doubt was legitimate or just fear. By the time doctor
19:36
Speaker 1: Pamela Voss told her in the summer of two thousand
19:39
Speaker 1: eight that the last three procedures had no clinical basis, Rebecca.
19:43
Speaker 2: Did not act on it.
19:45
Speaker 1: She had been so thoroughly repositioned inside Foster's interpretive frame
19:50
Speaker 1: that even a clear second opinion did not break through.
19:53
Speaker 1: Nancy Stevens named what Foster had done. He had weaponized doubt.
19:58
Speaker 1: He had taken the ordinary, very human anxiety of receiving
20:02
Speaker 1: a medical opinion, the vulnerability of sitting across from someone
20:06
Speaker 1: with institutional authority over your body, and he had used
20:10
Speaker 1: it as a control mechanism. The system ran on trust,
20:14
Speaker 1: trust that was legitimate at the start, because the first
20:17
Speaker 1: procedure was legitimate. That is the architecture. You have to
20:21
Speaker 1: build something real before you can dismantle something real.
20:25
Speaker 2: This is not a story.
20:26
Speaker 1: About a patient who was deceived by a charismatic stranger.
20:30
Speaker 1: Rebecca Hamilton was not naive. She was a person operating
20:34
Speaker 1: in good faith inside a system that was supposed to
20:36
Speaker 1: protect her, overseen by a man who had spent years
20:39
Speaker 1: learning exactly how much pressure a person's good faith could
20:42
Speaker 1: absorb before it collapsed. The question this case leaves open
20:46
Speaker 1: is not whether the system was dismantled. The conviction established that.
20:51
Speaker 1: The question is how many iterations of the same architecture
20:55
Speaker 1: are running right now inside institutions that have every structural
20:59
Speaker 1: reason to trust the person at the center of them,
21:02
Speaker 1: because that person, at least once was trustworthy. Connie Marsh
21:06
Speaker 1: came forward ten days after the arrest.
21:10
Speaker 2: She had spent years not.
21:11
Speaker 1: Knowing that what had happened to her had a name.
21:14
Speaker 1: She had simply moved, and moving had saved her. Rebecca
21:18
Speaker 1: did not move. She testified for four days and watched
21:22
Speaker 1: a jury return eleven guilty verdicts. She returned to teaching
21:26
Speaker 1: that fault. She still holds the corner booth on Wednesday mornings.
21:31
Speaker 1: Joanne Platt still knows the order some things Craig Foster
21:36
Speaker 1: could calculate. He calculated the referral, the annotations, the edge
21:41
Speaker 1: of what she could refuse. He could not calculate what
21:44
Speaker 1: she would do after. This show is made by Obo
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Speaker 1: Media