Dear Margo: For more than 20 years, my extended family has been putting up with my brother's wife. She's a negative, nasty, miserable person who blames everyone else for her problems. Lots of drama has been created time and time again because everything is about her. She's managed to alienate everyone in the family — some, including myself, permanently. And I used to be one of her staunchest defenders in the interest of family harmony. Obviously, she has "issues," but she won't deal with them. Doing so would be admitting she wasn't perfect.

Recently, this woman left a longtime job and went to work for a hospital — the hospital my mother, my other relatives and I have been going to for years. We are concerned about the access she will have to our medical records. Not to sound paranoid, but is there anything we can do to protect ourselves? Is there any way to ensure she doesn't see our records? Do we call the hospital and fill them in? We honestly believe this woman is capable of justifying anything she does — with 20-plus years of experience to back us up. — On Edge

Dear On: I don't know what this troublesome s-i-l would gain by viewing everyone's medical recs, but I suppose anything is possible. The way you'll know, however, is if she casually brings up, say, Uncle Albert's vasectomy, in which case she will have breached HIPAA regulations and can be fired. Several hospital personnel recently were sacked for snooping in celebrities' records in California hospitals. So I guess you all just wait for her to drop something into the conversation that you believe to be medically privileged. There really is no phoning the hospital to say you have a wretched relative who will probably snoop in the records. — Margo, vigilantly

Life Is Choices

Dear Margo: Almost everything about my four-year relationship is perfect. But the one thing that's not is a big one: He is two decades older than I am and already has a kid who has a teenager of her own. I had always been on the fence about having a child, but I feel the pull more as I approach my late 30s. Now he has told me he's 100-percent sure he doesn't want to do the daddy number again. I don't want to pressure him into anything, but I can't help but wonder if I'll regret not being a mom. I know I'd be a good one. He wants me to be happy, which, ironically, only makes it harder to imagine giving him up. What I want is to raise a child with him. I feel no real desire to be with someone new. How do you even do that when you're already in love? I'm drawn to adoption and have considered single motherhood. He's made it clear what he wants. How do I proceed? — Betwixt and Between

Dear Be: Carefully. And you are smart to think and talk about this now. That issue has wrecked more than one marriage. When you say you want to raise a child with him, you must deal with the fact that he's said he doesn't want to raise another child, period. He's done that; now he wants another kind of life. He is already Gramps — which is what he would be taken for if the two of you had a child. Don't bank on getting married and him changing his mind. (Though that has been known to happen.) Your choice now is motherhood or the guy.

I do think you're one step ahead of the game by being inclined toward adoption. In the case of any unforeseen end to the relationship, you would not be burdened by a biological clock that had stopped ticking. Because this needs to be a personal decision, your decision, you might try my old standby: The List. Identify the pros and cons, and try to gauge the strength of your feelings in both directions. Life is choices, my dear, and some situations require us to choose. — Margo, introspectively

Dear Margo is written by Margo Howard, Ann Landers' daughter. All letters must be sent via the online form at www.creators.com/dearmargo. Due to a high volume of e-mail, not all letters will be answered.