i think it's vital that you're on the same page in terms of the marriage being at the top of the list  however there are times y ou may need to go to an emergency surgery, etc.  if you're on call etc, then i get that for sure.  but once you're home, you're home.  once you're with your spouse, you're with your spouse. minus of course emergencies that are somewhat out of your control but how you respond to them is under your control.  i would have an open dialogue with your spouse that looks like "how can i make you feel safe at all times....how can i make you safe when there is an emergency?  how can i help you feel like the biggest priority in my life?"  then, i would also do this with a safe expert third party when life allows it.  perhaps if there is an unrealistic expectation by your spouse, the expert third party can step in and help them see the truth of what needs to happen and can happen.  maybe even adjust your thinking as well.