As House tells Wilson about the gifts he received from the secret Santa, he mentions "a second edition Conan Doyle." Sir Arthur Conan Doyle is the creator of Sherlock Holmes, whom House is loosely based on.
This episode was voted the "Worst TV Show of the Week" by the Parents Television Council the week of its airing because of House's sexual discussions with the patient's daughter, his method of proving his diagnosis, and his interactions with the clinic patient.
In the opening, a mother belays her daughter; however, as her daughter falls, the rope runs through the mother's hands before the girl hits the ground. This would never happen as the rope is always at least twice the height of the wall.
In the opening, the indoor rock climbing scene is filmed at Boulderdash Indoor Rock Climbing in Thousand Oaks, California (the tallest indoor climbing gym in Southern California). The girl climbs on "The Prow," a 45' slightly overhanging wall with lead and top-rope routes ranging from 5.6 to 5.12.
When House is seeing his clinic patient for the second time, he mentions being shot with a Red Rider BB gun. This is a reference to the movie A Christmas Story, where the main character Ralphie wants a Red Rider BB gun and the running joke is "you'll shoot your eye out!"