Letters to the Editor
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Plan, plan, plan
I think you should sit down with your wife and discuss scenarios. What support does Mom need? Does she need someone to keep an eye on her finances? Does she need someone talking to her doctor on a regular basis? Does she need some family presence?
What can you do? My list might be Sunday dinner once a month, look over her bills and bank statements once a month, help her find a social group. Maybe it's just signing her up for Senior Bingo. Check with her doctor about treating her depression.
What can't you do? My list includes turn your house into a private nursing home. Provide a social life for someone who isn't doing a damn thing to find it on their own.
What don't you want to do? Be the guy they call when the light bulb burns out or the driveway needs shovelling. Be the lender of last resort for family who can't manage their own finances.
Once you've set the right boundaries, you might end up with a geographic radius. Or maybe you'll have figured out how to meet your duties from the other end of the continent.
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Don't do it!
Your first obligation must be to your wife and son, and any future children you have. If you move to Denver, your mother, sister, and their families could become like parasites, sucking not only your time and money, but your emotional energy as well. Serving spiritual vampires sucks you dry of the energy you have to serve those who really need you. You can serve not only your immediate family (wife and son), but your patients much better if you are not sucked dry by those needy women from your birth family.
Listen, there will always be needy people who will take as much as they can possibly get from you. No matter how much you give them, it will never be enough. That feeling you feel when you are near them that makes you want to get away is there for a reason -- it is your spirit telling you that you need to limit contact with these people. Yes, they are your birth family, but you can serve them by hiring caregivers. If you try to help them yourself, you will always feel that you have not done enough for them, they will stay in pain, and your family and patients will suffer. Please don't fall for this.
Another truism, which you probably already know by now as a doctor, is that virtually every family that has someone over the age of 40 (and many families with younger people as well) has some kind of physical illness -- cancer, heart disease, multiple sclerosis, etc. Your mother and sister are not unique. Some day it will be you or your wife who has the physical challenge. In the meantime, your mother could live another 30 years and your sister could outlast you!
Are you prepared to spend 30 or more years serving these needy women who suck so much out of you? What will this do to your marriage?
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Will you regret your decision when they're gone?
At 22, I moved in with my grandfather both for my convenience and his (as my grandmother died a year earlier.) My grandfather was a reserved man with whom I had no particular bond other than familial obligation. His children talked about how hard and uncaring a father he was. Fortunately as time passed, he wasn't that way with me and I got to know a different man than his children did--but I didn't know that moving in.
At 25, I took on responsibility caring for my grandfather with increasing dementia, and ended up being the one who got to suffer the rages he had when he didn't get his way, or he was trying to cover for something he couldn't remember. When I was 27 my grandfather went into the hospital and has required more nursing care than can be provided in a home setting.
My grandfather has two children, my mother who is a doctor, and has now taken over managing his care since he will never be able to leave a nursing home. My uncle live on the opposite coast and has chosen never to be involved in his care. Had my uncle been in charge and were it not for my willingness to take on the responsibility, my grandfather would have spent 3 years in a nursing home--years that he didn't need to be in an institutional setting. My uncle talks to him maybe once a year and I resent the hell out of the fact that he just doesn't care about the man.
As a single twenty-something did I resent the rages, having to clean up after his incontinence, the need to cook and drive him everywhere? Of course. Did it make me unhappy? OF COURSE!!! Being a caretaker is hard, family obligations are hard, frustrating and things we wouldn't choose for our lives.
During the last year my grandfather has lost all knowledge of who I am. When I think about the time I spent taking care of him, how miserable I was, how nasty to me he was, and how I felt dragged down by the whole situation when I should have been enjoying life and a new career(I'd just finished a new graduate degree)--honestly now I don't regret a damn thing.
Sometimes the things we do out of duty just plain suck. They don't fit in with our grand plan, they are inconvenient, and not the choice we'd make. But there's a reason we do them.
I knew that if I abandoned my grandfather, moved out and decided to live my life for me, I'd never be able to live with myself knowing that my action put him in a nursing home, a place he'd hate.
So what I say to the LW is this: if you can live with yourself, if you won't regret not being there for your mother after she's gone, by all means go elsewhere. But if you feel familial duty (which it sounds like you do) you need to be there for your family, maybe not in the same city, but within driving distance, with firmly established boundaries, so you don't regret it when it is too late.