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Prine explained in an interview with Performing Songwriter: "The studio version of that was cut with a band, and it was real stiff and humorless. We cut it once, live, and that was it. That was the power of the song, in the way people would turn their heads the minute I'd get to the first verse, the first chords. That was the reason we used the live version." Prine found inspiration when he happened upon a "Dear Abby" column while on a trip to Rome, Italy. He said:
"I was in Europe and my first wife and I stopped in Rome for the day. I wanted a newspaper and all they had was the International Herald Tribune which is all the tragic news in the world crammed into six pages with no sports results and no comics. And yet here’s 'Dear Abby.' She was the only relief in the whole paper. and that’s where I wrote most of the song - in Rome, Italy that is."
"Years later somebody took the verse about the guy whose stomach makes noises, wrote it just out of kilter enough so it didn’t rhyme, and send it to 'Dear Abby.' And she answered it in her column. She suggested that he seek professional help. She got loads of letters from people who knew the song and told her she’d been had."
****REVISED April 22, 2019 - SR****