Sean, who is pretending to his wife that he cannot perform sexually because he is recovering from a vasectomy, is seen in bed reading the book "The Sun Also Rises" by Ernest Hemingway, a novel told from the point of view of a character who has been emasculated because of a wound received in World War One.
Loudon Wainwright III has a cameo as the doctor, his third time playing a doctor, after M*A*S*H and Knocked Up.
The episode title is a reference to "Cuts Like A Knife", released in 1983 by Bryan Adams.