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Dear Cali Chica:
Excellent job yesterday, an A+ if I may grade your performance. All that you wrote in your post today reads reasonable, insightful, fair and wise.
This is what I see this morning: the major, key element in your future with your husband is his stress level. As you proceed, keep this major element in mind every single day, no exceptions. You do not have.. the luxury of expressing any aggression at all against him. You do need to be honest with him, of course, be true to yourself, be assertive, yes, but never, ever aggressive.
Have his stress level in mind at all times and choose your words and behavior so to not increase his stress level, and whenever possible, decrease it, and be true to what you value, not to undisciplined anger and frustration.
I know you care about his well-being, you are a loving wife (I am so glad that I am able to state this!), but think of it for just a moment from a financial perspective: you worked so hard and so has he, to become medical doctors, so much time, work, resources invested, and a significant motivation was to be making significant income, wasn’t it. If you invest in being as patient as you have been with him yesterday, calm and collected, every day, that is likely to bring about a huge increase in your joint income: less stressed, he may choose the private route in SD and that may mean a whole lot more money coming in for years, than if he remained an employee. Same true for you, less stress for you, better chance you make more money, and experience more professional satisfaction otherwise.
Having invested so much professionally, it makes a whole lot of sense to not mess it up by having a draining, miserable relationship.
His stress level is key at this point. Once you allow him the option to stay in nyc, he is more likely to consider SD, because he feels less stressed, less trapped in having-to go to SD. He needs wiggling room, when stressed, an option for an out. So give him that, go easy with him, give him space to go back and forth, don’t force him to go one way or the other. Allow him to take the lead, to experience a sense of power and freedom to choose, and he will be less stressed and he will choose one way or the other on time.
Also, show him, over time, that you are calm and collected in different scenarios, no matter what, and he will learn to trust you to remain calm (and you will trust yourself as well, Self Trust and all).
Do keep your sister in your outer circle- this is a no brainer as far as it being advantageous to you, husband and your sister, no disadvantage at all (other than that subjective feeling of guilt on your part, which is not congruent with reality).
anita