Mary Ann's dream of being in the hospital is an allusion to the popular 1930s and 1940s M.G.M. Dr. Kildare movie series. In the series, Lew Ayres played Dr. James Kildare, and Lionel Barrymore played Dr. Leonard Gillespie, Dr. Kildare's older advisor and confidant. In Mary Ann's dream, Mr. Howell plays Dr. Zorba Gillespie (a combination of Barrymore's Dr. Leonard Gillespie and Sam Jaffe's Dr. David Zorba - from the TV series Ben Casey (1961)).
Gilligan mentions that he has a sister for the first time.
Mr. Howell tells the Skipper that he is as big as the Ponderosa. Alan Hale appeared in one episode of the series Bonanza.