The Thunderbird Bowling Center, where the bowling alley scenes were filmed, insisted that the bowling surfaces be preserved. To comply, the production staff were forced either to wear bowling shoes or to wear makeshift "paper booties" on their feet.
In between takes, David Duchovny and director Jim Charleston would bowl against each other, to the extent that Duchovny found his muscles ached from all the exercise.
John Shiban was inspired to write this episode after his wife's father, who was dying, professed to see visions.
Sydney Lassick plays someone similar to his memorable role of the unstable but good-hearted inmate of a mental institution that he played in One Flew Over the Cuckoo's Nest (1975), here as Chuck Forsch, then as Charley Cheswick. Notably, he's the fourth and last actor who played a patient in Milos Forman's movie who also performed in "X-files," after Brad Dourif, Vincent Schiavelli and Michael Berryman.
One of the female Day room patients is the daughter of actor Tom Braidwood, who plays Frohicke, one of the Lone Gunmen.