I cannot say enough good things about this episode. It was touching, relatable, realistic, absolutely, get-burtingly hilarious, and full of some of the best characterization any episode has ever boasted. If only Homer was written this way all the time, I would die in peace. This is a classic, THE classic, example of The Simpsons taking a heartfelt, emotional issue that many, many people could symapthize with, and pull it off with a zany twist in such a way that it leaves you howling with laughter, but still has time for a few serious moments. Somehow, the idea of Homer having a heart problem just clicks together with Homer's character so perfectly that you start to wish they would show it in more episodes (even though that would ruin it). Dr. Nick as well was simply at top form: at his stupidest and most appalling ever. He kept me in stitches whenever he was on screen. Full of classic quotes "Bed goes up, bed goes down", "Cloud goes up, cloud goes down", "Whew! I though it was my tranmission!", "Oh I thought it said brain hemorhages!", "No sir. I discussed this with the authorities, they consider it murder.", "I made an H!", etc., etc.
On the other hand, this episode could have easily sunk in the hands of anyone but Dave Silverman. It could have been disjointed, awkward, and insensitive, but my oh my, he pulled off the direction so well he deserved an Emmy, if there was such a category. The scene where Homer keels over in Burns's office remains among my top favorite scenes in the Simpsons, heck, in all animation. I especially love this episode because of it's quiet moments in between scenes: Homer praying in his hospital bed (a perfect example of the Simpsons soft spot for religion). Bart and Lisa's messages to each other, which I thought felt Brooksian ever before I found out that Brooks wrote it. Marge and Homer trying to figure out their finances, which I'm sure almost everyone could relate to. Homer's characterization really does hold this episode together, he is perfect: sweet, stupid, bumbling, slightly pathetic, the whole gamut. This episode has a very special place in my heart, but even if it didn't, I would still give it the highest A+ ranking.