Arlene has been Richard's primary caretaker since his surgery for brain cancer, which left him uncommunicative and unable to walk. When he drove his wheelchair into a pool, she accompanied him to the hospital.
Gregory House was curious about why Arlene insisted on keeping Richard at home instead of putting into a long term care facility. She told House it was her responsibility to take care of Richard.
House first started by addressing Richard's symptoms, but convinced Arlene that he might be able to get Richard to communicate again. He started a series of risky procedures, and Arlene went along. When she was asked why she was risking her husband's life with an increasingly lower chance he would recover, she countered that it was better than letting him live the way he was.
Cuddy eventually ordered Richard discharged. However, House had convinced her he might have Addison's disease. Against her better judgment and contrary to her direct orders to House that he not try it, she injected Richard with cortisol. Within a minute, he had gotten out of his wheelchair and stumbled over to his overwhelmed wife and son.