Squidward is playing his clarinet when SpongeBob goes outside to do some gardening. He think Squidward went to an Italian restaurant called Mario's. Suddenly, SpongeBob notices two construction workers putting up a billboard. Thinking Squidward's music is flatulence, SpongeBob becomes noisy to cover it up, until Squidward alerts him to stop. Getting mad at the billboard workers, he then discovers the Bikini Bottom Symphony Orchestra is holding a competition for an original score. Following a series of events starting with Patrick breaking his butt, Squidward tries not to get distracted by SpongeBob's home doctoring. After turning in his score, he finds that he wrote down all of SpongeBob's doctoring. He finds SpongeBob squeezing a rubber duck and Patrick going "Woo!" and SpongeBob is on a seat, bashing Patrick's brain, causing a farting noise and making his eyes pop out.
The audience gave a round of applause to Squidward. SpongeBob says to make sure Squidward doesn't get a "swelled head". The camera cuts to only Squidward, whose head inflates due to Patrick squeezing the pump of the blood pressure, and the episode ends by the screen blacking out as an explosion is heard.
( ‣ ) Associated production music
( • ) Original music
( ◦ ) SpongeBob music
• ? - Sage Guyton, Jeremy Wakefield [title card] • ? - Nicolas Carr, Barry Anthony [Squidward playing clarinet] ‣Dramatic Impact 3 - Ivor Slaney ["Those construction workers!"] ‣ ? ["I'll cover for him."] ‣Comic Walk - Sidney Torch ["SpongeBob, can you keep it down?"] ‣Playful Bridge 5 - Harry Bluestone ["Original compositions wanted?"] ‣Big Show Theme - Robert Sharples [Squidward imagines himself in a limo] ‣Piano Concerto No. 1 - Peter Ilyich Tchaikovsky [Squidward conducting] • ? - Jeremy Wakefield [Squidward melts] ‣Chase Cue 1 - Sage Guyton, Jeremy Wakefield [Squidward runs outside, kisses construction workers] ‣ ? [Squidward puts his game face on] ‣Dramatic Impact 6 - Ivor Slaney ["Due tomorrow?!"] ‣Drama Link (g) - Hubert Clifford [Squidward screams] ‣ ? ["Don't worry, Squidward, we'll do it together."] ‣Seaweed - Steve Belfer [Patrick broke his butt] ‣Monocle and Pocket-Watch - Brian Douglas Gulland [SpongeBob taking Patrick's blood pressure] ‣ ? ["Come on... be inspired."] ‣Wild Eyes - Ronald Hanmer [brainstorm] ‣Heavenly Voices (c) - David Farnon [rainbow appears] ‣Piano Concerto No. 1 - Peter Ilyich Tchaikovsky [Squidward starts writing] ‣Steel Licks (b) - Jeremy Wakefield [rainbow melts] ‣Goofy Conversation - Nicolas Carr, Barry Anthony [SpongeBob doing tests on Patrick] ‣Abject Terror - Paul Lewis [Squidward still writing] ‣ ? [Squidward's finished] ‣Film Fanfare (a) - Dick Stephen Walter ["I did it! I did it! I did it!..."] • ? - Nicolas Carr [conductor looking at sheet music] ‣ ? [choir] ‣The Suction Cup Symphony - Gary Stockdale ‣Hawaiian Link (b) - Richard Myhill [Squidward starts to walk away] ‣Take a Bow 1 - David Lindup [everyone cheers] •Hawaiian Sting - Nicolas Carr [ending]
When Squidward finally finishes writing his song, he has that same look on his face that he had in the episode Squid's Day Off, when he locked himself in his house. However, sand was added into his eyes in this episode.
The machine that Patrick was in was exactly like the one SpongeBob was dreaming about the laughing machine in "Funny Pants".
When "The Splinter" premiered, this episode also aired along with it.
In "Suds", and "The Splinter" Patrick pretended to be a doctor and treated SpongeBob. This time, the tables are turned: SpongeBob pretends to be a doctor and treats Patrick.
It is not known because if Squidward needed silence to concentrate, it never occurred to close the window.
The first time SpongeBob puts on a rubber glove and makes that squeaky sound and Patrick goes "Woo!", may have implied that SpongeBob was giving Patrick a prostate exam. However, he was just playing with a rubber duck that amused Patrick.
Dish Network calls this episode "Suctioncup Symphony".
The symphony the orchestra plays may have been from Heroes of the Bible: Lions, Shepherds and Queens (Oh My!)
Squidward would have seen "Bikini Bottom Symphony Orchestra" on the billboard since "Original Compositions Wanted" was the part that wasn't visible.
All the music players still continued playing their instruments after the music ended.