After experiencing a setback due to his condition, Monk decides to take medication that alleviates his symptoms. Unfortunately, it also impairs his ability to solve crime.
This episode includes examples if the following tropes:
- Absence of Evidence: Once Monk is back to normal, he realizes the suicide note Marlene Highsmith "left behind" is a fake, as it was written in red marker when there was no such marker in the apartment.
- Artistic License – Medicine: The medication Doxinyl seems to work overnight. They usually take days or weeks to show any effect. The dosing is also suspect since Dr. Kroger puts Monk on half a dose when usually a psychiatrist would probably start a patient on the lowest dose to monitor his reaction. Also, rather than giving him a prescription to have filled at a chemist, Dr. Kroger just pulls a random (seemingly unmarked) bottle from his cupboard and hands it over without giving Monk any information about what it is, what frequency to take it, or any possible side-effects.
- Driven to Suicide: Marlene Highsmith felt guilty over the death of an armored car guard whose truck Lester had robbed before. When he plans a repeat performance, she throws herself off a ledge, but not before leaving a suicide note explaining Lester's current robbery.
- Goodbye, Cruel World!: As stated above, Marlene Highsmith leaves a suicide note to warn the police of Lester's next robbery. Lester destroys it once he can get into the apartment.
- Heel Realization: "The Monk" acts like an immature and obnoxious teenage frat boy, even to other teenagers. So they invite him to play Marco-Polo. After a while of playing, he realizes they all ditched him. This is the wake-up call Monk needs to realize he's being exceptionally annoying to everyone around him.
- I Never Said It Was Poison: Subverted, Monk attempts to catch a suspect out but actually he had given the suspect the information and forgot about it because the medicine made him so loopy.Monk: How did you know she was wearing a bathrobe? No one said anything about a bathrobe!
Lester: You did! Two minutes ago! - Inside Job: Lester Highsmith works as an armored transport guard to give him access to a truck to rob.
- Irony: Monk has a very sobering paradox.Monk: I'm afraid of change, and I'm afraid of not changing.
- I Want My Beloved to Be Happy: When Monk talks to the vision of Trudy and how conflicted he is about taking the medication, she assures him that no matter what he chooses, she wants him to be happy.
- The Last Straw: It's one thing for "The Monk" to be unable to solve cases like he used to or to alienate everyone around him. It's another thing when the medicine renders him unable to invoke the strong memory of Trudy when he smells the pillow. This is what finally convinces Monk that the medicine isn't worth him "being normal".
- Never Suicide: Subverted. Lester is accused for his ex-wife’s death, but it’s revealed Marlene really did kill herself. He was responsible for switching her suicide note since she confessed to helping him with a crime.
- O.O.C. Is Serious Business:
- Randy, usually pretty carefree and goofy, becomes very businesslike and focused when the shooting begins. This continues after he sees Stottlemeyer has been shot, forcing him to take over.
- Stottlemeyer fears he's dying when Monk hugs him. Both Stottlemeyer and Sharona are shocked to see Monk eat a sandwich off of Stottlemeyers plate. This is when they start seeing the side-effects of the medication.
- Put on a Bus: This is Bitty Schram's final episode as Sharona Fleming. Well, until season eight, anyway.
- Shout-Out: To The Mask especially the end where Sharona tosses the medication in the trash.
- Smokescreen Crime: Two years prior to the events of the episode, Marlene helped her husband Lester commit a robbery, during which a driver of the armored car they targeted was killed. Racked with guilt, Marlene killed herself and left a suicide note that not only confessed to the crime but also stated when and where a new robbery by her husband and his accomplice. Lester shot Stottlemeyer which resulted in all available police officers giving chase, including the police officers that were in the apartment from which his wife had jumped out of. This allowed Lester to sneak into the apartment, steal the wife's suicide note and leave a fake one that made no mention of the robbery.
- Took a Level in Jerkass: The medication makes Monk act like an obnoxious frat boy, to the point where he starts dressing in Hawaiian shirts, referring to people as "L7s" (squares), and calling himself "The Monk".
- We Need a Distraction: Lester couldn't walk right into his apartment to get Marlene's suicide note because cops were outside the building. To get around this, he drove around the block and shot Captain Stottlemeyer.
- We Want Our Jerk Back!: Despite showing exasperation at Monk's idiosyncrasies and neuroses, the SFPD and Sharona want Monk to return to his old self after seeing him on medication. Monk decides to give up the medication when he realizes that the medication made him lose his connections to Trudy.Sharona: Where's "the Monk"?Monk: Trudy didn't like him.
- Writing Indentation Clue: Monk suspects that something is wrong with Marlene Highsmith's suicide note. At first, he doesn't seem to know or care what is wrong because he is on Dioxynl, but when Monk goes off the drug, he realizes that the note was not Marlene's because it was written with a red pen, and there is no red pen in the kitchenette the note was written in. Monk takes the writing tablet the note was written on and uses chalk rubbing to reveal Marlene's actual suicide note - a confession that her ex-husband Lester Highsmith is staging an armored car robbery, that happens to be going down right at the moment Monk and Sharona discover the note. Lester had written the suicide note the police found and staged a drive-by shooting a few blocks away to keep the cops away while he switched out notes.
