Smithers takes Mr. Burns to Mayo Clinic in Rochester, Minnesota. Mayo Clinic has been ranked number one in the United States for seven consecutive years and has maintained a position at or near the top for over 35 years.
Paintings seen at the Burns' manor include parodies of:
Mr. Burns has a collection all Nancy Drew Mystery Stories. The controversial book Lisa highlights, Clue in the Clock, is fictitious but references how many of the Nancy Drew Mystery Stories are titled starting with "The Clue in...".
While racing with a bicycle, Bart calls himself "Al Unser Jr.", referring to American retired racing driver. Lisa, who is riding a horse, calls herself "Princess Margaret". Margaret was known to enjoy horseback riding, though it was not as prominent a part of her life as it was for other members of the royal family, such as Queen Elizabeth II, Margaret's older sister.
The "got tumor?" sign at the Mayo Clinic is a reference to "got milk?", an American advertising campaign encouraging the consumption of milk and dairy products.
US president Franklin D. Roosevelt had a social security number one position before that of Mr. Burns'.
Marge mentions Bill Cosby and David Letterman (she incorrectly calls them "Crosby" and "Letterson") as examples of famous comedians who smoke cigars while reprimanding Bart for doing so.
Homer finds American actor Jimmy Smits attractive.
When Homer wants to buy expensive beers, Moe offers him the famous Danish beer Tuborg.
The Tyson vs Secretariat fight features former professional boxer Mike Tyson and Secretariat, who was a champion American thoroughbred racehorse and the ninth winner of the American Triple Crown.
The Mayo Clinic diagnoses Burns with "Three Stooges Syndrome", meaning that he has a multitude of medical conditions, but because they all cancel each other out, they can't harm him. The doctor likens the situation to The Three Stooges all trying to go through a doorway at the same time.
After watching a knife-fight between two monkeys, Moe comments "He ain't pretty no more!" This is Nicholas Colasanto's line in the 1980 American biographical sports drama film Raging Bull.
The Coast Guard officer gets Homer's party going by sounding out the opening guitar riffs to the The Doobie Brothers' song "China Grove".
The monkey named Furious George is a parody of Curious George, a fictional monkey who is the title character of a series of popular children's picture books written and illustrated by Margret and H. A. Rey.
