Ellen Pompeo looks about eight months pregnant in this episode (as episodes are filmed a while in advance of the air date. She had her first baby in September 2009, and this episode aired in October 2009) and at the beginning of the episode, you can clearly see her very pregnant belly as Meredith and Christina walk out of the the trauma room, before Ellen Pompeo had a chance to duck behind the ER desk.
In the episode, guest star James Frain's character is scared of the number 5 hinting at the actors famous movie "Where the Heart Is". In the movie, co-star and love interest Natalie Portman is also terrified of the number 5 because horrible things always seem to happen when the number is involved.
Every episode of the show is named after a famous song. "I Always Feel Like Somebody's Watching Me" is a song by Rockwell.
Cristina: She looks like a Stepford Wife, you've gotta tell her.
The Stepford Wives is a 1975 film, remade in 2004, and also a book. The story concerns Joanna Eberhart, a photographer and young mother who begins to suspect that the frighteningly submissive housewives in her new idyllic Connecticut neighborhood may be robots created by their husbands. The term Stepford Wife is usually a reference to a submissive and docile housewife.