Paging the Holistic Doctor

Most interesting patient encounter today: 50 something year old caucasian woman for "thyroid problem". Patient (upon me entering the room): I thought you would be Asian. Me: Well, I get that a lot. That, and "I thought you would be an African man." (this honestly has been said to me more than once here) Patient: I'm looking for a holistic doctor. I've been seeing an esoteric practitioner and taking a lot of holistic remedies, you know, the ones in the small blue containers. Me: Why don't you tell me what a "holistic" doctor means to you? (and PS, what is an esoteric practitioner?! I kept this thought to myself.) She goes on to describe her long struggle with hypothyroidism (as well as history of abuse and homelessness - isn't the story always more complicated than it seems?) and how she hasn't been taking medication for a very long time. Her last allopathic doctor got frustrated with her and refused to see her any longer. She believes in the mind body connection and has been trying diets, yoga, and other alternative therapies, including lots of herbs. She wants a practitioner that supports this, though she realizes she may need actual thyroid hormone, but wants to take the "natural" kind (made from pork thryoid instead of synthetic hormone). I listen to this (all the while mentally drafting this blog entry), and then explain that while I support alternative treatments and certainly believe in their effectiveness for certain aliments, I was trained in an allopathic medical school. I, therefore, can not advise her on holistic treatment for thyroid disease, as this is not my area of expertise. I can, however, check her thyroid hormone levels and advise her in which pharmacotherapies would be best for her. She marinates in these concepts for awhile, then proceeds to tell me other tidbits about herself, and her beliefs. A few examples: "I don't care what anyone thinks, I felt that radiation when it hit over here from Japan. Can you prescribe me potassium iodine?" and "I once went on a diet where I could only heat hot foods, which really helped my thyroid. I may try that again." and "I used to work as a nurse." (!@#$%^!!!) I wrap up our most fascinating session by telling her, in an attempt to speak her language, that it seems she needs to fully accept her disease process before she can actually be successfully treated. I suggested she stop trying to fight her body and its aliments, accept the state that her health is currently in, and only then will she fully be able to heal. Oh yeah, and take your thyroid meds. See you in 6 weeks!