THE DOCTOR WILL GET BACK TO YOU

I always tell people they should get in touch with the doctor when they are worried. I know that doctors are far from infallible, but until recently, I thought they at least cared enough to make an effort to keep you from dying.

A few days ago, it felt like something was stuck in my gum in back of my mouth near one of the big molars. I brushed. I flossed. After a while, it was still bothering me, but I was turning my gums into hamburger, so I quit.

Yesterday, I took a flashlight and looked. Nasty. The gum is eroded and puffy, slightly grey. Not pretty. Too late to call the dentist, but I had an appointment next Wednesday and had prophylactic antibiotics in hand.

I had a mitral valve replaced last year, among other heart-related surgeries. Oral infections are particularly dangerous for heart patients. They will spread quickly from mouth to heart valve.

waiting for

I followed my own advice.

This sort of thing can be scary. Fast as a speeding bullet, I could be dead — which is why I take antibiotics before I have dental work done. It’s also why I have to be ultra careful about infection in general.

Not knowing what else to do, I starting taking the antibiotics. I figured taking antibiotics I might not need would be safer than doing nothing. I would be upset and depressed if I died before I got to the dentist.

As it turned out, my dentist doesn’t have hours on Friday. He works alone — no associates — so there was no one I could talk to until Monday.

I called my cardiologist. Talked to the nurse. Explained I’m taking clindamycin which I got from my dentist just yesterday. It’s not a full prescription, but more than the amount I normally get before a dental appointment — 16 pills. Pharmacy error? If so, it was a fortunate one. I looked up dosage information on-line, and started taking it last night.

72-Dana-Farber_053

I explained all of this to the nurse. She assured me the doctor would get back to me. It took a couple of hours, but he did.

Until other circumstances I would have  called my “primary care doctor,” but he has never bothered to read my medical history. He understands nothing, doesn’t listen, dismisses me as a weird, old hypochondriac. My cardiologist, on the other hand, is one of the good guys.

I like to think they balance each other out. Does medicine work that way?

So, here’s my advice. Talk to your doctor. But maybe you need to start by finding a doctor who cares. Shows compassion. Who will get to knows you well enough to recognize you if he bumps into you on the street.

Because mine wouldn’t.



Categories: Medical, Personal

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73 replies

  1. We don’t get many things right over here in the UK but Primary Health Care is one we do get right. I was a Primary Care doctor for 30+ years – now retired. You get to know people in a smallish community, the patients get continuity of care, and the doctor’s care is holistic and across the board. Plus we are the gatekeepers to all the secondary care specialists locally who we actually know. It’s a good system.

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    • I wish you lived around here. You are exactly what I need and can’t find, at least not locally. And primary care really needs to be local.

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      • Local is best, but the politicians are obsessed with ‘economies of scale’ and want to create large primary care polyclinics serving far larger populations – the death of a personal service where the patient develops a longitudinal relationship with the doctor that is so beneficial for both parties.

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        • There are lots of local doctors — if you live in the city or suburbs. Not around here. The way it has worked out around Boston is the hospitals are the backbone affiliation, but doctor groups set up shops all over the place forming lots of small clusters, often in medical buildings so one building houses a bunch of different specialties and practices. The problem for me is we live out in the country, far from Boston. No big hospitals and a small population. We don’t have a lot of doctors of any kind, but especially primary care. There’s a shortage of primary care doctors all over the country, but it’s worst in rural areas. Clinics are not popular in the U.S. Very UNpopular, I would say.

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  2. why do my comments here keep showing up at the top? =(

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  3. At the time I think TV didnt know what to do with itself, and most of the performers were old vaudeville/ stars that had gone on to movies and radio: Durante, Jack Benny, Bob Hope, even the Marx Brothers. I loved the old westerns (which I didnt know WERE old westerns at first) with Gene Autry, a much younger Roy Rogers, Tom Mix, Hoot Gibson. ( In those days of course, we were allowed to endanger our health with cap pistols…)

    One of my recurring memories is that of my Dad sitting on the porch reading, listening to the radio broadcasts (Red Sox, all the way) with the drone of the occasional passenger plane overhead.

    What’s nice about being spoiled by all that, is that we were. No one younger has that same communications history on such a personal level, do they. I wouldnt dare try to explain Pinky Lee or Soupy Sales to anyone who hadnt experienced it personally, they’d think I was nuts. =) then again, Im not sure I could explain Pinky Lee.

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  4. An important post Marilyn, thanks for sharing. Many don’t realize the importance of taking antibiotics for dental woes when one has undergone heart surgeries. And sadly, there are many doctors who don’t give a damn past the mighty dollar. I spent a lot of searching about a decade ago for my personal arsenal of doctors. I got rid of a few and tested a few others, and happily I’m content with my team. I also like to live holistically as best I can, that is avoid pharmaceuticals as much as possible, and having a doctor who understands and can work with me and my naturopath alternatively when necessary. It’s up to us to be proactive. Incidentally, I also underwent open heart surgery 8 years ago. I had a tumour removed that was hanging from my mitral valve. 🙂

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    • I’m very happy with my cardio people and they are the most critical members of my team right now. They are smart, responsive, and vigilant. I wish I could say the same of my PCP. I too am proactive on my and my husband’s behalf. if you have serious medical problems, you really need to stand up for yourself and be smart about medical stuff.

      It’s hard to find a good PCP here. There aren’t a lot of doctors in the country. The shortage of primary care doctors has gotten serious. But I’m looking for someone who is willing to take on a high-risk patient with multiple, overlapping problems. A lot of doctors don’t want to be bothered with complicated people, especially if you are on Medicare and there’s no money in it.

      This is one of the times when living far outside a city is a serious disadvantage. If I lived in Boston, I’d have no problem. My cardio team is in Boston, but a family doctor needs to be accessible. Hence the problem.

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  5. When I was 11 I had a chance to see “Gone With the Wind”, which was shown annually at the Oak Birch Inn on Lake Winnepesaukee. Mother felt I was old enough, so we invited my best friend to see it too. She was exactly a year older than I was. At the end of the movie, when Rhett walks out, I felt so SORRY for Scarlett (I’d never read the book), and said so. Annie looked at me and said, ‘you wait a year. then see the movie again.” Damn, what a year can do to a kid. Poor Rhett…

    And of course, if Heathcliff had sat down and talked to Cathy, there goes your drama…conflict, conflict…

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  6. Garry – what did John Wayne call doctors – quacks. Actually I have finally found a really good doctor. Actually it is a clinic – if I am sick and can’t see my doctor I can just walk in and see another one. But that is only the hours of 8 AM – 8 PM. Some doctors shouldn’t be doctors. Some are just so arrogant and full of themselves. I have a few stories to tell about some doctors I have seen over the years. And I used to be a nurse. But now Dr Google is great too for background information about drugs. Talking about drugs – don’t get me started on the kickbacks the quacks receive to promote their drugs as well.

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  7. Good advice! Our PCP is a-OK. We traded the old one in several years ago. Hope you get that tooth fixed and so glad you had antibiotics on hand. The docs don’t like to hand them out anymore, but they seem more than willing to hand out Rxs for pain meds. Go figure???? Thoughts and prayers for you and yours. ❤

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    • When you have a replacement mitral valve, they absolutely INSIST you take antibiotics for anything that even might become infected. Apparently a heart valve is an infection target.

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  8. I really have nothing to add to the comments chain, since fortunately I have very, very good doctors who respond really quickly when I need them. I’m only here right now to tell you that I hope you can get in to see your dentist first thing Monday and that it turns out to be something relatively minor and easily fixable.

    Feel better, Marilyn.

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  9. Doctor.., just another word for “mechanic”.., they’re mostly guessing at the size of the wrench needed for your particular bolt…

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    • In this case, it’s even more complicated because I need a REAL mechanic — the dentist — and he won’t be in until Monday. The doctor is just my holding action. The dentist has the artillery.

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  10. Dental pain is the worst! not to mention your complications… I hope the antibiotics help. I can’t imagine going the whole weekend with mouth pain. Bleh.

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  11. Doctors are not infallible, but they know more about what ails us than we do.

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  12. I think I should listen to your advice and go to doctor for my proper check up. As I mentioned in my post that I ‘m suffering from severe migraine for last two days. This is longest attack I have had in four years. Sorry for the missed posts. I will make up for those once recovered.

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    • I spoke to my cardiologist and got more antibiotics to keep me going until I can get to the dentist, presumably on Monday.

      I get migraines too. Cluster migraines, which sounds like what you are getting, eventually stop by themselves. The only thing that really helped me for a very long time were ice packs. I used to freeze wet washcloths and apply them to my head. Not a cure, but at least some relief. Stay out of bright sun, if you can!

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      • Thank you so much. It is such a relief to get a piece of advice from you. I was missing you all so badly that I switched on my laptop despite Tarun told me not to do so. I will try ice packs. Regards.

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  13. I think I would have had a few sleepless nights. Not a problem I would have here, the specialists can’t wait to have a patient willing to pay (although we have an insurance, but the till rings all the same). I hope you have found some sort of solution to your problem. I should be more careful with my diabetes, as slowly but surely I am getting more problems with my feet/legs in connection with circulation, although I regularly take a Vitamin B table on a metal basis. There again, I cannot get them in Switzerland for some strange reason, so my drug store has to get them from German and they are not paid for by my insurance, although perscribed by the ober diabetes guru doctor where I live. Anyhow at the moment no big problem, the Swiss franc is strong, the € is weak so they are cheaper.

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    • Garry needs a bunch of vitamins, none of which are covered by insurance. You wouldn’t think folic acid could cost so MUCH, but it does. And I can’t afford my asthma medicines at all. I have noticed that preventative medicines are mostly NOT covered by insurance, but “cures” are. Antibiotics are cheap and inhalers for asthma are almost affordable, but the medicine that keeps asthma from occurring are insanely expensive. Narcotics are relatively cheap, but lidocaine patches that work really well for pain and are not addictive are not covered by insurance. Ten lidocaine patches (prescription grade) are nearly $500. Health care for seniors is such a problem. It’s probably less so in a small country like Switzerland, but here, the problem just keeps getting bigger as the population ages and there are more and more seniors with lots of health problems to be cared for. It’s only going to get worse.

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      • Marilyn, we are certainly on a roll right now. Did you check with Dr. (“Marathon Man”) Ed? He might’ve squeezed you in.
        Here’s hoping you can make it to our scheduled dental appointments next week in minimal “discomfort”.

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        • I think by the time Wednesday rolls around, that particular appointment may well be redundant. But who knows, right? It’s been a hell of a summer. And it only just started.

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  14. you lucked out, and you had the sense to know who to call.

    If I see an emergency building, we’re lucky in that we live within range of the local hospital, and thats where we head.

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    • I knew there was no point calling my “PCP.” He’s a lost cause. But my cardiologist has a really on-the-ball front office AND he is a nice guy who apparently cares … so I figured he would understand the problem (he understands the issue of mouth infection and mitral valve replacements) and he would actually call me back. And I notice the pain in my mouth is diminishing. Maybe by the time I get to the dentist on Monday, the infection will be under control and he can just fix the tooth — or gum — or whatever is going on back there.

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  15. DON’T get me started at “Doctors”, “Healthcare”, “Medicine”. I had my appointments last week and I am still so bloody mad that I haven’t found the right tone to write about it. I am foaming, smoke is coming out of my nostrils and I would like to verbally hit one of them really hard.

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    • Same here–you have to wonder if there isnt something in their training that dismisses females as all “nervous old ladies” with not much else to do but take their own pulse six times a day…

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      • I had a really good one — a woman, of course — but her organization refused to contract with BCBS Senior Care, so I had to find another doctor. This guy has the compassion of a garden tractor and needs a serious (preferably painful) attitude adjustment. It’s the first male (older) PCP I’ve had in a very long time and it reminds me why I hate them. Arrogant assholes, the lot of them.

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        • Yeah, garden tractor compassion rules, especially with specialists–the only part of your health they are even slightly concerned with is that teeny part they spent years studying in med school. the rest can wait outside the door, tyvm…One positive thing, though–it forces us to take charge of our own health, in many ways, rather than docilely playing “trust the doctor he knows best” which my mother’s generation used as a mantra for everything…

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          • Agreed! I’ve been lucky enough to have very good heart specialists, even if my general doctor is a dud. But I still have to stay on my toes because one doctor never knows that the other is doing and these days, no one seems to see “me” as a whole, so i have to be the “me” specialist. And the Garry specialist, though his doctor (who used to be my doctor too) is much better about noticing what’s going on than most. Even the ones I like, I still watch carefully. Even the best make mistakes and I don’t want to be one of them.

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      • I have the opposite problem, I am tired of being over medicated.

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        • Oh, I refuse medication unless I’m convinced it’s something I really need. The asthma stuff, though, I actually DO need … I’m taking a lot fewer meds than I used to and that’s just fine.

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          • i have a doctor now that admits dialogue in the examining room. We talk. We discuss. We argue. sometimes I even win, lol.
            One doctor totally ignored my lifelong anemia/poor reaction to iron listing on the chart, and prescribed a huge iron dosage for my ‘pernicious anemia.” I took two pills and both legs swelled up like balloons. lol
            so much for that.
            A surgeon blew off (if he ever read it) my osteo, and prescribed Prevacid for GERD. turns out its the last thing you want to take for osteo, but I didnt know that until it was too late. Good surgeon, but a bit of a dud in the meds department. Same guy told me to take Zantac. I said, I take ranitidine. He smiled and said, you need Zantac. Yes sir. =)

            You really do need to pay attention to what they’re giving you, and why. Google is my friend in that regard. As is my own common sense. I take what I need, no more.

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            • A surprising number of physicians are stupid about medications. They don’t recognize generic names. Even otherwise smart doctors don’t often know the generic names of drugs they prescribe. Maybe they can’t keep up. My current PCP has a great front office. He himself is a jerk, but at least his backup people are on the ball. My previous doctor was great, but her office staff stinks.

              I guess you can’t get it all. If I didn’t have so many different conditions to keep track of, it would be a lot easier.

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              • I guess I’ve been lucky to get progressive doctors who bring their laptops into our appointments and look that stuff up. If I tell them I’m taking this medicine and they think I need to take something else, they look it up to see if there’s a reaction, etc… They’ll also look it up to see if my insurance covers it, because why waste everyone’s time if it doesn’t?

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                • My doctors have laptops, but they never seem to know if the insurance covers it or not. Maybe that’s something of a moving target. We are on Medicare plans and each plan has its own schedule. It gets ridiculously complicated.

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                • yep, even I have to ask which medicare plan we’re on, since we also have Anthem. confusing isnt even close. there are hundreds of plans out there now, hundreds of combinations, and im always grateful to those doctors whose staff does the hunting.

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                • That’s why it’s so hard to figure out whether you are more dependent on the doctor or his front office. I think I have more interaction with the office than the doctor. They are the ones who work out the prescriptions, the payments from which of the plans and who to bill for what. It’s insane … and this is better than the old days where they just sent a bill and YOU had to figure it out.

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    • Touched a sore spot, huh. Don’t get ME started. That’s just the leading edge of my issues with medical providers. There ARE good ones … but there are so many bad ones. So many. And a terrible shortage of primary care doctors.

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    • Lady Bug, I’ve been watching re-re-re repeats of “The Untouchables”. It would be great to have Ness and his guys take these doctors into an alley way for “tuneups”. Or, as Ness puts it after punching a guy out, “Take THAT, you punk!”
      You think Capone would’ve taken this crap from his doctors? They’d be eating lead..

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      • Yep, my friend Eliot would have taken care of them…or at least would have give them a fair warning. Why don’t they show this show anymore. I loved it.

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        • They do show it, sometimes. On the various oldies channels on cable and satellite.

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        • Lady bug, if you have cable. Ness and all those oldies are around on obscure channels. You have to patiently surf. I dvr’d a bunch of “Untouchables” on our bedroom TV. I usually watch an episode a night before fading to black (blatantly racist?). I usually feel a rush of something when Ness (don’t need no stinkin’ warrant or PC policy) screams at a villain and then beats hell out of him for info.
          Reminds me of my early working years working crime stories. No damn coddling of perps!

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          • I need to look for it. I haven’t seen an episode of the Untouchables in years. Thank you for letting me know. We do have cable, or some cable left…I will search for it. Thanks a bunch. No comment on “fading black” just loud laughter.

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          • Yessir =)

            Dragnet was fun, too. All that laconic stuff, sort of a modern day Watson and Holmes. Ill bet a lot of that stuff is on YouTube if you do a bit of surfing.

            Actually…youtube.com/eliot ness episodes or…

            http://www.bing.com/search?q=youtube.com%2F++eliot+ness+episodes&src=IE-TopResult&FORM=IETR02&conversationid=

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            • Judy, the new “entertainment” is so “blah” that I cannot imagine who watches. I don’t think it’s an age thing. It’s about taste and intelligence. I know I am generalizing. I am not one of those PBS elitists. So, yes, some of the old stuff is entertaining. And, some of it doesn’t stand the test of time. You just have to surf for interesting things, new or old. Here endeth my sermon for the day.

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              • I tend toward animation, both online and off, Garry, and one thing I notice is the amazingly awful animation offered today, for kids. They didnt cut their teeth as we did on Bugs Bunny or the really good disney movies, so there is no standard for them. Even as a teenager I was bored with DeputyDawg, although UnderDog relied on silly, which helped. But now what is touted as excellent animation (from disney no less) for kids is dreadful.
                And I no longer watch TV anyway. We can’t get cable and really dont care about a dish which would be our only option out here. Reality shows leave me cold, I havent a clue what the fuss is all about with sitcoms and I now lose patience when someone says they can’t come to visit, Jeopardy is on…

                Frankly the day I went online nearly 20 years ago was the last day I really sat down and watched TV…I remember I Love Lucy and the Honeymooners, both touted as funny. I found Ralph Kramden boorish, sullen, and dim. These days he’d be in counseling. Lucy and Desi, I now realize, exemplified the 50s standard of marital manipulation (she cajoles and whines and he scowls and then gives in…) and for me, none of it is funny.

                The only shows I really recall with any fondness were the Frasier and the Michael J. Fox seriesesses =)

                Beyond that, I much prefer the computer, where people actually communicate. Much more fulfilling.

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                • You and I share the same taste. We watch a lot of movies. Old and medium. Some of the things we like best is “direct to DVD” stuff because that’s where the people we know and like seem to wind up. Neither Garry nor I has ever made it all the way through a reality show. Early on, we thought we’d try to see what the fuss was about and all these years later, we still don’t have an answer. The oldies channels aren’t just “old” oldies.

                  We watch NCIS because Garry was a Marine and Semper Fi to y’all. Castle because it may not be realistic, but at least it’s witty. Garry is an effective seeker-outer of all kinds of stuff that he records and we watch, at least for a while. Sometimes, we don’t make it more than a few minutes into it before he looks at me and says “Is this doing anything for you?” which means it isn’t doing anything for him. We rarely disagree, though he will sit through things that I wouldn’t watch past the credits.

                  I never liked the Honeymooners or Lucy and oddly, neither did Garry, though apparently we are very much in the minority. Even when I was a little kid, I found most sitcoms embarrassing and I hated watching people be humiliated. It still bothers me. We don’t watch sitcoms, for the most part. Every once in a while, there’s one, but we usually tire of it quickly. It’s always about kids and their trivial bullshit problems.

                  That Garry is a very serious movie buff and has an encyclopedic knowledge of movies from silent through approximately the 1970s, then it gets a little bit less complete, but still far better than mine ever will be … it helps. He has read reviews, knows back stories, recognizes directors, writers, cinematographers. And he has pretty good taste, except that he is much fonder of 1930-40s comedies and film noir than I am.

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                • I seriously believe that as a kid I watched probably every movie ever made up to maybe 1950–that was the heyday of old movies, and I watched em all. No one knew what to do with the silent films, so soupy sales and other kids programs ran them as filler. No one knew what to do with all that space, so we got early felix, Inkspot, those dreadful early porky pig type cartoons…I even sat through Froggy plunk your magic twanger because there was the promise of a movie in there, whether it was Lassie come home or Jungle Book with Sabu (which scared the pants off me), it all went in and stayed there.

                  Know who I despised? Sid Cesar and Imogene Coca. there was something cruel about his face, I had to leave the room they showed up. And yeah, I was a fan of those early comedies too. Didnt always understand them, but they were fun. My favorite movie (which seems terribly hammy now) was The Women

                  Humiliation is supposed to be funny. I never understood why. Banana Peel humor always left me cold. I did like Danny Thomas, his monologues were priceless and gentle , as were those of Jack Benny. Different times, different perspectives I guess.

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                • It’s always interesting to me how movies I loved when I was young — books too — don’t stand up to time. Things I thought romantic just seem stupid to me now. I always wonder why Heathcliff didn’t sit and talk to Cathy before charging off to ruin everyone’s life. Stuff like that. Times change. We change. The movies and books and television shows stay the same.

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                • I should add radio to this conversation. I grew up as a “radio days” kid. “Superman”, “The Lone Ranger”, “Sgt. Preston” and LOTS of the old soaps. I also remember listening to radio drama like “The Lux Radio Theater” (They used to run condensed versions of theatrical movies featuring the original stars), “Suspense”, “Gunsmoke” (w/ William Conrad as Matt Dillon), “Have Gun, Will Travel” (John Dehner as Paladin”), “Gangbusters”, “My Favorite Wife” (forerunner to “I Love Lucy”). Sunday nights were great with Jack Benny, Burns and Allen, Phil Harris and Alice Faye, etc.
                  I also began my life long love affair with baseball listening to the Brooklyn Dodgers games on radio. My sportscaster idol, Hall of Famer Vince Scully, was just a kid out of Columia University doing his first year as the “kid” on the Dodgers broadcasting staff. Vin is now in his 80’s and still the best. A guy who easily slips Shakespeare into his broadcasts.
                  I guess we were spoiled by growing up with all these legends on radio and early television.
                  I agree about “humiliation comedy” being despicable.
                  Hi-Yo, Silver!

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