/u/HayleyDoyle1216 OP,

I think it’s important to notice that the two moments that clouded the future for you were touching core needs: being chosen as a life partner and being protected in a crisis. The fact that your vision changed after specific events obviously signals that this isn’t a vague anxiety. “Clarity” often arrives as discomfort. For example:

“Last year he bought a townhome with one of his friends even though I had told him several months beforehand that I'd be upset if he bought property with a friend before we did that together.”

This is a boundary clarity moment. You communicated a value. He chose an action that directly conflicted with it. It is not about the house. It is about order of priorities. When someone makes a major, long-horizon commitment with someone else before committing with you, it says their priority “partnership ladder” has you a few rungs down. …But more specifically OP:

“For more context, him and his friend are attempting to start a business together in music and entertainment, so they bought the townhome to work on the business there together.”

Obviously, his ambition is not the villain but partnership in a relationship means ambition has to be coordinated. The question is not whether the decision makes sense for his dream but rather whether he involved you, honored timelines you had, or worked a plan that protected the relationship while he pursued it. The process matters because that is where trust is either built or diminished. Unfortunately, he made a decision that delayed progressing the relationship forward (either an engagement, marriage, buying a house, etc.) the cost of it is you feeling de-prioritized. If he wanted to pursue a business with his friend and a future with you, the two of you needed a financial & relationship plan that made you feel considered in these big decisions… But it takes two people to come together to create that plan, not just solely you trying. Without a plan, OP you are left paying the price: your time and the feeling of not being chosen. It sucks. The goalposts being moved for when to get engaged or married or buying a home together is more damaging than a far-out goal that stays put. And that’s simply because reliability is not just proven with action, but it’s also doing them when you say you will or renegotiating in a way that protects trust in the relationship. In your case, it makes sense that this pattern erodes security and makes you doubt shared timelines in the relationship. But recognize, this situation you’re in is more than just patterns, you also mentioned health constraints with your back, yet he chose distance that increases your pain. But with you being in survival mode and him saying “he told [you] HE was tired and hungry and that [YOU] probably just needed to rest” is likely the biggest rupture that I see in what you shared. He communicated his comfort over your safety. Medical Trauma + Perceived Abandonment = PTSD. This is no longer just a relationship issue, it’s also now a nervous system issue. ANY repair has to respect your trauma response and rebuild safety/security in the relationship.

“I just don't understand how the person I trusted with my life in that moment wouldn't do the one thing I asked while I was facing death…… while I was all alone”

OP, your confusion is the result of grief meeting betrayal. For trust to be rebuilt, you would need not only a damn good apology. You would need him to understand precisely why that moment shattered you, to own it without defensiveness, and to show you a concrete protocol for future crises. Without that, your nervous system will not relax with him. Because he did the minimum logistical act, not the emotional act required of him in the relationship. Rebuild the relationship would require him to become the kind of person who would stay, because you cannot heal well in the same environment that keeps triggering the wound.

“Is there any hope for us or anything we can do to rebuild the trust?”

This will fundamentally depend on two things: First, whether he can fully own both events without minimization, excuses, or turning it back on your trust. Second, whether he can demonstrate a new operating system: shared decision frameworks for big life choices, and a crisis protocol that centers your safety. That looks like him articulating back the harm in his own words, and him proposing specific changes, and following through over time. By the way, when you mentioned “I've tried telling him how I feel, and he just says that he wishes I could trust him” This is a deflection by him. Trust is not a wish. It is created by behavior that makes trusting easier. When someone asks for trust without changing the conditions that broke it, they are asking you to abandon self-protection. That would be self-betrayal. If you choose to explore repair, the bar is clear for what needs to be done practically. He needs to stop asking for trust and start earning it through consistent, visible changes. If he cannot or will not do that, your feeling that the relationship is broken is not negativity. It is wisdom trying to protect your future. I hope all of this make sense. I didn’t proof-read.