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I honestly never noticed anything wrong with him, but if it was a heart attack I wouldn't think one would show any outside abnormalities until just before the attack?
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The final cause of death may have been an MI, but that could have been brought on by any number of health problems that would have shown signs much earlier, including various kinds of cardiovascular disease, but also including bacterial and viral infections that can attack the heart valves and trigger heart attacks.
I've also noticed that he has not been looking well for the past season and noticed that he didn't seem to be getting as much screen time, and have frankly been a little concerned. So the sad news comes as a surprise, but not a total bolt from the blue. RIP Mr. Kamel. And Doctor Kroger. (I don't believe for one second that they will try to recast the role. Most shows don't unless there is a compelling reason either in the storyline or the format of the show itself why a given character
has to stay around when the actor is no longer available, regardless of the reason.
The obvious example is replacing Sharona with Natalie - which was a much more risky move in terms of the show's chemistry. If they didn't recast
that role, but instead went with a new character and a new relationship between Monk and his assistant, I can't see them hiring a new actor to play Dr. Kroger - especially given that the actor didn't quit, but rather passed away. The fans wouldn't stand for it.
Nor do I think that Elizondo would consent to just continue playing a character created by another actor.
Regards,
Joe