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Doug had told the doctors he was single when he was admitted, and they were surprised when Franni showed up claiming to be his wife. It was clear that they were estranged. Franni was upset that Doug was always away from home and spent little time with her and their son. Doug was upset that Franni didn't understand that Doug's welfare was just as important as everyone else's and saving the environment would be in his best interests too.
Gregory House suspected that Doug had sporotrichosis, but it can only be transmitted through contact with roses, and Doug despised cultivated flowers because of the chemicals used to grow them. Franni denied that they had ever had roses in their garden, but House finally got Doug to admit he bought cultivated roses as a peace offering, but Franni had left the house before he could deliver them.