D: What would you like to know about this game?
G: Everything.
D: Great. First thing to know is, this game is one that is primarily played in the context of comedy improv, that is, theatrical improvisation.
G: No!
D: Oh yes!
G: So how do you play?
D: You present a scene in which the last letter of the last word of one actor's line of dialogue becomes the first letter of the first word of the next actor's line. Hence the name, "last letter, first letter."
G: Right. So if I'm an improviser, and I end a sentence with a hilarious word like "proctologist," which ends in a "t," you have to start your next sentence with the letter "t"?
D: That's it.
G: This game sounds simple enough. Is it hard to play?
D: Yes, it can be. It requires good listening skills (and as such, is an excellent training game) but focusing too much on playing the game correctly can sap a scene of any vitality. Three minutes of non-sequiturs might fulfill the rules of the game but it won't make for a very interesting scene.
G: Elephants ate my pajamas!
D: See what I mean?
G: "Now is the time for all good men to come to the aid of their country!"
D: You can stop now.
G: Where did this game come from?
D: Maybe from Spolin. Possibly from Johnstone. Improv troupes from both philosophies of improvisation have been known to include it in their repertoire.
G: Er, what happens if you're a bad speller, and don't know the last letter of a word like "repertoire?"
D: ...
G: why aren't you-- oh, I see. You could keep quiet and let the previous speaker continue...
D: ...
G: as technically, they're not bound by the rule, until they finally end a sentence with a word you are familiar with.
D: Ha! You've got it!
G: Thanks. One more question: are there any other contexts in which this game might be useful?
D: Learning a new language-- this game can be used to review vocabulary, although you might want to limit it to just words, instead of full sentences. And as I said before, it's a useful exercise for practicing listening skills.

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