RAI - Just a couople of thought for you. Have you read the 5 Love Languages (Chapman) yet? I'm not sure it would immediately help with your wife- but there is a book specifically geared towards speaking the correct love language with your children and doing that might be a very visible change for your wife to notice, not to mention being a great thing for your kids at this challenging time.
Also - and I offer this from a place of great respect - you mentioned that you are a physician? IRL, I am a Quality Analyst for a large healthcare group and I have learned that in order to be effective in my job, I have had to tailor my communications to the doctors. Namely, I am deferential, I constantly acknowledge the difficulty of practicing medicine, I constantly reassure that I am not telling anyone how to practice medicine and I dispassionately present a lot of facts. Possibly - you may look at having to do the inverse. Is it at all possible that when you converse with your wife, you are at least partially using your clinical Drs voice? If there is any chance that you are doing this, you will want to be aware of it and learn to address her more as a peer. I mention this because my STBX is a deputy sheriff and throughout the years he did sometimes slip into using his "cop voice" (emotionless and just the facts) and I can tell you that while its understandable that we can carry these tones over from our working life, it did not go over well with me.
With 5 kids and your profession, I am sure you are busy, but what have you considered in terms of GAL?
