Production Code: AABF04\\
Premiere Date: December 6, 1998

While driving home from a Old West tourist trap, Homer ignores Grampa Simpson's pleas to let him use the bathroom, which causes the old man to blow out both of his kidneys. With Grampa at death's door, Homer decides to give a kidney to his father -- then runs off when he becomes afraid of what being an organ donor will do for him.
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!!This episode contains examples of:

* ArtisticLicenseBiology: A "kidney blowout" due to holding in urine for a long time is physically and medically impossible, as the kidneys (much like the liver) is just a filter that makes body waste. If any organ in the urinary tract was going to suffer from having too much urine in it, it would be the bladder (and he would have pissed himself before dying of sepsis). And if Grampa's urinary system was compromised and Homer didn't want to donate a kidney, couldn't they have put Grampa on dialysis until a donor could be found? You know "urine" trouble when SethMacFarlane can realistically portray the trials and tribulations of dealing with kidney failure (as seen in "[[FamilyGuy New Kidney on the Block]]" and "[[WesternAnimation/AmericanDad The Kidney Stays in the Picture]]".
* ChristianityIsCatholic: When Marge asks Reverend Lovejoy to perform the last rites for Grampa, Lovejoy retorts, "Marge, that's Catholic. Why don't you ask me to do a voodoo dance?"
* ContinuitySnarl: Grampa is said to have two functional kidneys, but in [[Recap/TheSimsponsS2E17OldMoney "Old Money"]][[note]]the season two episode where he dates a woman named Bea who dies and leaves him all her money, which he uses to make the Retirement Castle a better place[[/note]], he told Bea he had one kidney (unless he meant one that was functioning).
* EvenEvilHasStandards: The Frenchman may have stolen his accordian (actually a concertina) from a blind monkey, but, he (and the other passengers on the ''Ship of Lost Souls'') would never dream of leaving their fathers to die in the hospital after promising them a kidney.
** Neither would Bart, a boy once hailed as "America's Bad Boy."
* {{Jerkass}}: A lot of viewers hated this episode, as it showed Homer at his most selfish (bailing during his father's kidney transplant operation). Even the other characters said so.
** JerkassHasAPoint: His fear were pivoted by the fact Dr. Hibbert (and everyone else) outright lied to him about the dangers of the operation so he'd agree. When they can't make him donate willingly, he outright steals his kidney while he's unconscious. While it's DirtyCowardice at its finest, would you trust your body in the hands of a quack that deceives and outright mutilates you without your consent?
* LaserGuidedKarma: Homer getting crushed by a car.
* MorallyAmbiguousDoctorate: Homer's cowardice is partially pivoted by the fact Dr Hibbert lied about the dangers of the operation to make him go through with it. When he fails to get Homer to willing go through with it, he outright ''steals'' the kidney from him while he's unconscious.
* NoodleIncident: A whole Ship of Lost Souls full of them, barring the French man with the accordion (see EvenEvilHasStandards above).
* PottyEmergency and PottyFailure: PlayedForDrama; because Homer wouldn't stop to let Grampa use the bathroom, Grampa's kidneys exploded and is now near death.