Thank you so much for letting us know how your son is doing. Poor little guy! Had a similar situation with my first child and didn't realize how quickly they could get into some serious trouble.
I don't know what to tell you about W taking son out of state. If you feel comfortable about his welfare, then maybe you could just talk to a lawyer to see what other alternatives there might be to protect your rights as his father. For example, knowing where he's living and the daycare, etc.
I agree that it would be putting a nail in the M cofin to prevent her pursuing her medical career. (Does she have to move out of state to become a doctor?)(Never mind)It's best to keep a good cooperated R with the mother of your child, but I think you should know all of the options available.
I'm concerned that when she moves off into another state, the chances to R will lessen. That's why it's so important to be able to move on and focus on a life without her in the center of it.
It is not about what you feel should work in your M. It is about doing the work that gets the right results. Do what works!