The garbage collectors have been holding a strike, causing San Francisco to be covered with trash and Monk to slowly lose his sanity. What's worse, the union's head has been found dead of what appears to be suicide, which means unless Monk can solve his death, the strike will continue indefinitely. Can he solve this before he loses his mind?
This episode involves examples of the following tropes:
- Brick Joke: At the start, Monk packs up all his trash and ships it out, giving a delivery address only when pressed for one. Later, during a therapy session, it turns out that Monk sent the trash to Dr. Kroger.
- Call-Back: While in the clean-room with Monk, Stottlemeyer starts playing with the yo-yo he got during his anger management classes in "Mr. Monk and the Captain's Marriage".
- Corrupt Politician: Subverted. Monk's first proposed solution is that Mayor Nicholson murdered Cusack. However, he later says that this is the wrong solution.
- Didn't Think This Through: No one brings it up, and Monk is obviously not in a good state of mind when he explains it, but his plan to drive the garbage trucks into the bay when they get full would massively pollute the bay. He'd also run out of trucks long before he could get all the trash.
- Insane Troll Logic: Monk's theory about Alice Cooper being the murderer runs on this. How does Monk figure this? Cooper was performing a show on the same night as the murder. Why on Earth would Cooper do this? Cooper was insanely jealous of Jimmy. Why, you ask? Because Jimmy had an antique wingback chair in his office, and rock stars collect antique wingback chairs, of course! Disher tries to cut through this, but to no avail.Disher: Why didn't he take the chair?
Monk: Hello? It had a bullet hole in it, it had blood on it. He didn't want it anymore.
Disher: He could have washed it.
Stottlemeyer: Randy, I don't think we need to stand here and pick apart the "Alice-Cooper-wants-an-antique-chair" theory. - Mistaken for Evidence: Monk finds scuff marks on the edge of Cusack's desk and cashew fragments on a chair. When he sees that Mayor Nicholson eats cashews and likes to put his feet up on his desk, he becomes sure that Nicholson killed Cusack. Later, though, he realizes that Nicholson had visited Cusack earlier that same night and was secretly trying to negotiate an end to the garbage strike.
- Never Suicide: Much to Monk's displeasure, he finds evidence that Cusack didn't kill himself, prolonging the investigation and the strike.
- Oh, Crap!: Monk, Natalie, Stottlemeyer and Disher move away from eavesdropping reporters to discuss the mayor being a suspect. They don't realize the spot they're standing in bounces echoes to the other side of the room until after the reporters hear everything. Stottlemeyer defeatedly moans, "Oh, hell."
- Sanity Slippage: If Monk was unhinged before, then this episode makes his state worse. Stottlemeyer has to take him to a sanitized clean-room in order to get him to start thinking straight and solve the case.
- Secret Relationship: Of the professional type. Publicly, Cusack and Mayor Nicholson are adversaries in the strike negotiations. Privately, Nicholson went to Cusack's office on the night of the murder for a secret bargaining session. Nicholson couldn't admit to being there because it would have ruined his career, but Monk figured it out from shoe scuff marks and cashew residue at the crime scene.
- Stealing from the Till: The union's accountant had embezzled over $300,000 from the pension fund. Knowing that he would be caught when the financial records were checked as part of the strike negotiations, he killed Cusack and staged the death as a suicide.
- Trademark Favorite Food: Cashews, for Nicholson. After finding fragments of them on a chair at the crime scene, Monk suspects him of killing Cusack.
- White Void Room: Monk is so overwhelmed by trash piling up all over the city in that he has a dissociative break and begins speaking, and writing, only gibberish. Cpt. Stottlemeyer takes him to a clean room in a microchip plant to settle his nerves. The walls, floor, ceiling, a table and two chairs are all solid white. The two men even wear hazmat-type white coveralls, complete with hoods, over their clothes while there.
- Why We Need Garbagemen: San Francisco is covered in trash due to a sanitation workers' strike and Monk is losing his mind from all of it.
