What Do You Think?

10/11/13 4AM
I am thinking about yesterday's visit with my, now former, Johns Hopkins Derm Doc.  I may not have made it clear, but she more or less resigned, saying I could come back at any time.  That is fine with me as at this point I see nothing to gain for either of us continuing the relationship.  What I would be interested in knowing is how you feel about what happened.  These are the questions I have.  Assuming I gave you an accurate portrayal of the conversation (I really think I did), and I realize your answer has to be based on that assumption and might otherwise change.

1. Did she deal with the issue of whether I had gotten better  appropriately?
2. Should she have allowed that maybe she was wrong in the face of the patient's insistence and the other Derm Doc's strong position and photo evidence (easily verifiable with a phone call)?  I can believe she might honestly have not seen the difference since she sees lots of different patients and had to rely on memory of what she saw 2 weeks before.
3. The cause and the cure for this rare disease are both unknown according to her, and Conventional Medicine. Here she has a case with "Dramatic Improvement".  Should she have been more interested in learning in fact whether such improvement was occurring and why?
4. And if she verified the progress with the other Doc, should she have then accepted continuing to monitor as previously agreed or was it OK for her to push me to change course to the risky drug Methotrexate?

Note: this from the National Institutes of Health site:

Methotrexate SHOULD BE USED ONLY IN LIFE THREATENING NEOPLASTIC DISEASES, OR IN PATIENTS WITH PSORIASIS OR RHEUMATOID ARTHRITIS WITH SEVERE, RECALCITRANT, DISABLING DISEASE WHICH IS NOT ADEQUATELY RESPONSIVE TO OTHER FORMS OF THERAPY  (my emphasis).
DEATHS HAVE BEEN REPORTED WITH THE USE OF Methotrexate IN THE TREATMENT OF MALIGNANCY, PSORIASIS, AND RHEUMATOID ARTHRITIS.

Or maybe these are the wrong questions.  Please, if you can, just take a quick moment to tell me your reaction as brief or detailed as you wish.  I really want to know if I'm right on this or missing something.

My view is she should have been interested in finding out if I had achieved "dramatic improvement" as my other Doc observed and verified the photographic evidence.  To tell a patient he is not improving when he indeed is, I think, is very destructive. And, you know what I think about going on drugs unnecessarily, especially this one.  And finally, given that Johns Hopkins is known for its expertise in rare diseases for which  people come from all over the world for treatment, shouldn't she want to refer me to someone else in the institution who would be interested in following my case even if she weren't.

I am also wondering. Should I follow up with Johns Hopkins to see if they would be interested in following this.   If Johns Hopkins reputation for expertise with rare diseases is deserved as well as its ranking as the best hospital, and its top tier ranking for their school of medicine isn't it likely there is someone there who would be interested in following this case? Should I follow up with this institution so others might benefit, or just steal away quietly into the night?

Please tell me what you think!  And, as always, thanks for reading!