Some physicians are very arrogant and with relatively poor bed side manners. Still, they may have good clinical skills and responsibility. You may be right not to trust him as your long-term physician. You may also be surprised in a second visit (some physicians need time to adjust to their patient or possibly you may have happened to see him on a less good day). Either way he seems to have seriously thought about your relatively complex illness and possibly be on the right track to figure it out. Even if you end up going else-where and finding a more pleasant neurologist, it will make your (and his) life easier if you have a clear-cut diagnosis from a place like Mayo. It sounds like you have a pretty severe illness and not receiving any treatment at the moment, so this Mayo doc is understandably concerned. I think you have nothing to lose (apart from a bit of your pride) by going to see him again. And I think there is (potentially) a lot you can gain. If he only wanted to "cover his ***" he had to contact you once or twice and then document it on your chart as "non-compliant patient". It sounds that he really cares.