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My uncle is slowly killing himself -- and dragging us down

I'm stuck in a fateful spiral like something in a Faulkner novel

My uncle is slowly killing himself -- and dragging us down
Salon/Zach Trenholm

Dear Cary,

I can't say how glad I am to see your byline again after such a serious illness. I hope you're taking the return to work just a bit more slowly than you think you can stand — don't let us letter writers use up all the energy you need to heal!

With that said, I'm hoping you can help me help my family stay together after my uncle finishes the process of self-destruction he has dedicated himself to for the past 40 years. I suppose in an average family, one in which the parents were not alcoholics, one in which the mother did not commit suicide at 52, one in which the father was able to survive his wife's death by more than four years, the daughter — my mother — might have been able to stand up to her brother without feeling she had broken her promise to take care of him.

Perhaps she wouldn't have called her daughters in tears, over and over, about him and his disregard for her property, her reputation in the neighborhood, and her marriage. Perhaps the cycle would have been broken by her refusal to participate in it, or instead of breaking his promises, he would have stopped collecting broken-down cars and parking them closer and closer to her; he would have paid rent, or at least utilities, for his use of the property; he would at least have given the mange treatments and vitamins to the dog he couldn't take to the vet himself, leaving his sister to watch the veterinarian use his hands to read the story of the Chihuahua's broken teeth and mysterious back fractures. He would have cleared up the area around his motor home, washed his piles of untreated laundry, gotten mouse traps, stopped dumping his sewage tanks in the creek behind her home.

Perhaps he would have made it possible for her to talk about his drinking and abuse of prescription narcotics, to express her support, suggest a treatment program, do something about it without fearing his anger and insanity. In this imaginary family, when he sat at the table and made sparkling conversation on holidays, or when he charmed her friends with tales of his latest trip to an exotic locale, his niece could be full of admiration every year, never going through the disillusionment of knowing he would never change and that her mother would never stop tearing herself apart expecting him to do so.

Our family not being this average family, my uncle continues to use and drink, has never stopped taking emotional and financial advantage of my mother, and he has just had his second heart attack since March. His uncontrolled diabetes has damaged his foot, which is now infected with MRSA, and it looks like there is finally nothing she can do to prevent him from killing himself this time. He always threatened suicide in a roundabout way whenever she tried to make him leave her property (he came for a visit in the late 1980s and got sucked into the family web of enabling and abuse). Somehow it got written into their relationship that his job was to destroy himself, and her job was to do everything possible to stop him from doing that, often at great personal cost. She is already devastated, and of course she will be after his death, and she will probably want to continue to call and lament with me for hours at a time about this sad loss.

My question is, I've always resisted her attempts to make me pretend he is a father figure to me (she used to nag me about sending him a Father's Day card), but what can I do to help them heal once he is gone? There's no longer any benefit to me in refusing to play the family game, but I'm strangely attached to my role as the "Don't let him take advantage of you, and you'll both be healthier" jerk in the family. Would it be better for me to act like my sister? When Code Enforcement laid down the law about the abandoned vehicles, cargo container and general litter on my parents' property, she offered to take my uncle in, which we all know would have been a 30-year commitment, even though all of the junk was his and would probably come with him. Sometimes I feel like we're living in a Faulkner novel. Are we?

Well, hopefully you can show me the way forward so that we don't end up hating each other. ("Dad" is likely to say some pretty uncharitable, but true, things, and I'll be willing to bite my tongue if it helps everyone hang on.)

Thanks for your help and good luck with this one!

Anse Bundren's Niece

Dear Niece,

"I'm strangely attached to my role," you say. And that, I would say, is the place for you to start unraveling the knotted ropes that bind you.

No matter the circumstance and history, no matter the right and wrong of it, no matter the promises made: You are more important than this postage stamp of land you come from; your mission is larger, your spirit is fresher, your purpose here on earth far different from this collection of characters. Your assignment, should you choose to accept it, is to become unattached to your role.

This means, in a sense, becoming naked; it means walking away from everything that clothes you in pity and self-denial, in self-righteousness and toughness, in being the knowing one, in being the one who broke the chain or led the family out of its chaos or rescued her mother. It means stepping out of the narrative, if you will. The narrative is powerful, but it is not everything. It is not the spirit. You have a mission apart from your involvement in this family. I suggest you turn your attention to your own personal mission.

I often suggest to people not that they change their lives wholesale but that they make small adjustments in emphasis. I do this because I have observed that change is a slow process. We are like huge ocean liners at cruising speed; we cannot turn on a dime. When we commit to making changes, we find many, many ongoing processes resist the change. We are like factories or cities; there is a lot going on behind the scenes. We meet resistance. We are like presidents who would like to decree and find their decrees obeyed. There are entrenched forces, committees, whole armies working silently against us when we decide to change. So it does not happen fast. So we begin by shifting our emphasis.

I suggest you shift your emphasis from what to do about your family, and how to do it, to what to do. Ask yourself what you want to do. Not what must be done or should be done but what do you want to do. What is it that's been nagging at you? And you might even ask yourself what great but daunting task or adventure you have been using your family to avoid. If your family went away, what would you do with your time? Find this thing, or if you know what it is already, then simply admit it to yourself wholeheartedly: This is the thing that gives me happiness and meaning! This is the thing I was put here to do!

Then do that thing. Accept the torment and brokenhearted outrage that your movement out of the stifling circle of family dependence will spark. Move out of this cycle of violent degradation. Accept that you cannot fix these people or change these people or rescue these people. Accept that life goes on. Find your path and walk it.


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Study: Breast-feeding would save lives, money

A new study shows that hundreds of babies and billions of dollars would be saved each year if women breast-fed more

The lives of nearly 900 babies would be saved each year, along with billions of dollars, if 90 percent of U.S. women breast-fed their babies for the first six months of life, a cost analysis says.

Those startling results, published online Monday in the journal Pediatrics, are only an estimate. But several experts who reviewed the analysis said the methods and conclusions seem sound.

"The health care system has got to be aware that breast-feeding makes a profound difference," said Dr. Ruth Lawrence, who heads the American Academy of Pediatrics' breast-feeding section.

The findings suggest that there are hundreds of deaths and many more costly illnesses each year from health problems that breast-feeding may help prevent. These include stomach viruses, ear infections, asthma, juvenile diabetes, Sudden Infant Death Syndrome and even childhood leukemia.

The magnitude of health benefits linked to breast-feeding is vastly underappreciated, said lead author Dr. Melissa Bartick, an internist and instructor at Harvard Medical School. Breast-feeding is sometimes considered a lifestyle choice, but Bartick calls it a public health issue.

Among the benefits: Breast milk contains antibodies that help babies fight infections; it also can affect insulin levels in the blood, which may make breast-fed babies less likely to develop diabetes and obesity.

The analysis studied the prevalence of 10 common childhood illnesses, costs of treating those diseases, including hospitalization, and the level of disease protection other studies have linked with breast-feeding.

The $13 billion in estimated losses due to the low breast-feeding rate includes an economists' calculation partly based on lost potential lifetime wages -- $10.56 million per death.

The methods were similar to a widely cited 2001 government report that said $3.6 billion could be saved each year if 50 percent of mothers breast-fed their babies for six months. Medical costs have climbed since then and breast-feeding rates have increased only slightly.

About 43 percent of U.S. mothers do at least some breast-feeding for six months, but only 12 percent follow government guidelines recommending that babies receive only breast milk for six months.

Dr. Larry Gray, a University of Chicago pediatrician, called the analysis compelling and said it's reasonable to strive for 90 percent compliance.

But he also said mothers who don't breast-feed for six months shouldn't be blamed or made to feel guilty, because their jobs and other demands often make it impossible to do so.

"We'd all love as pediatricians to be able to carry this information into the boardrooms by saying we all gain by small changes at the workplace" that encourage breast-feeding, Gray said.

Bartick said there are some encouraging signs. The government's new health care overhaul requires large employers to provide private places for working mothers to pump breast milk. And under a provision enacted April 1 by the Joint Commission, a hospital accrediting agency, hospitals may be evaluated on their efforts to ensure that newborns are fed only breast milk before they're sent home.

The pediatrics academy says babies should be given a chance to start breast-feeding immediately after birth. Bartick said that often doesn't happen, and at many hospitals newborns are offered formula even when their mothers intend to breast-feed.

"Hospital practices need to change to be more in line with evidence-based care," Bartick said. "We really shouldn't be blaming mothers for this."

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