AUBURN, Maine - Doctors who prescribe a healthy dose of humor for patients seldom get enough of it themselves.
That's not the case with the family physician who publishes the Placebo Journal, a bimonthly magazine he hopes will help doctors keep a sense of humor while battling what he calls the Medical Axis of Evil: drug companies, HMOs and medical malpractice insurers.
The December edition featured on its cover "It's a Wonderful Physician's Life" and offered a different spin on a memorable line: "Every time Daddy's pager goes off, an angel gets his wings."
Other features included "Stupid Pharmaceutical Tricks" and the "X-ray Files," featuring unusual X-rays.
Dr. Doug Farrago started the magazine in 2001 to point out what's wrong with medicine and have a few laughs along the way. "I'm doing this absolutely out of fun. This is my therapy," he said.
Farrago, who has 2,500 patients, understands the need physicians have for some levity - he diagnoses a terminal cancer case each month.
"You have to be Robo-Doc to deal with it," he said. "The only way to re-humanize yourself is to laugh and vent."
He also believes, "A doctor who's relaxed and has a sense of humor gives better care."
Much of the humor in the Placebo Journal is dark, focusing on pharmaceutical companies, the threat of lawsuits, narcotics-seeking patients and endless paperwork for insurers. Farrago strikes back by making fun of it.
Few topics are sacred, but there are some ground rules: Stories must be true, patient confidentiality cannot be violated, and no story can involve harm coming to a patient.
Issues have included parodies including "Nordart," a contraceptive dart doctors can use on patients who have children but shouldn't; "Cyanara," a weight-loss drug that's 80 percent cyanide and "Indifferex," a mediocre anti-depressant.
It has phony ads, like one for "OxyCotton Candy," which takes a poke at OyxContin, a painkiller that has been abused by some patients.
The magazine, which has a circulation of 5,000, has no real advertising. It's funded through subscriptions and profits from a device Farrago invented to reduce stress on baseball catchers' knees.
Humor is also evident in the practice Farrago shares with three other docs, Ray Stone, Carolyn Kase and John Comis.
The four are reminiscent of the "Seinfeld" cast. At a recent lunch, talk of the popular Atkins diet turned into a spoof called the "Fatkins Diet" - all-fat, of course. They also had suggestions for "Trading Cases," a parody on The Learning Channel's popular "Trading Spaces."
Signs of Farrago's wackiness also abound in his office: a golden bust of Elvis, a Three Stooges cookie jar and a crown made from medical instruments. And there's the journal's mascot, a skull with Groucho glasses.
Dr. Amber Tyler, a resident at the University of Nebraska Medical Center, said the Placebo Journal hits upon the realities of doctoring.
"I'm six to seven months into my residency and I'm already fried. It's a great thing to sit down and read and laugh and realize that you're not alone," she said.
Another fan is Tess Gerritsen, M.D., author of medical thrillers including "Harvest" and "The Surgeon."
"It's almost a guilty pleasure," Gerritsen said. "I feel a little bad about it because some of the humor - it's the kind of humor you don't want your patients to know you're reading."
Some doctors are offended, but Farrago makes no apologies.
"We've been called sophomoric," he said. "I'm proud of being sophomoric."
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