The title of this episode refers to a line from William Shakespeare's Hamlet: "I am but mad north-north-west. When the wind is southerly, I know a hawk from a handsaw."
Dr. Pearson is one of many series characters whose names refer to Canadian historical figures. Fraser is startled to hear that her first name is "Esther" because it echoes Lester Pearson, a prime minister in the 1950s and 1960s. That's why he asks "Are you related..." and she seemingly understands his reference and says no.