Natalie, on the brink of taking a test for her private investigator's license, attends a retreat run by her and Ellen Morse's favorite self-help guru Miranda Bigley. Natalie's relaxing experience gets derailed when Monk tracks her down to rescue her from the "cult", but not even Monk's interference can rival the disruption when Miranda jumps off a cliff in full sight of everyone. Natalie, a fan of Miranda's work, can't believe it's just suicide, but Monk and Stottlemeyer aren't convinced and would prefer to focus on another case — a blackmailing clown who was poisoned through the mail. Will Monk and his erstwhile assistant ever come to an agreement, or is the partnership over before it's even begun?
This book includes examples of the following tropes:
- Absurd Phobia: As the book opens, Monk discovers he has a fear of aardvarks.
- Afraid of Clowns: When Monk walks onto the latest crime scene, he starts off as his usual brilliant self...until he realizes that the victim worked as a clown. Suffering a breakdown, he refuses to return, even when Lt. Devlin threatens to cut his retainer if he doesn't come back to work. Eventually, Natalie convinces him to come back on the proviso that the police remove or downplay all references to clowns. However, partway through the case, he ends up mistaken for the dead clown by a suspect and forced to pose as said clown to find evidence.
- Blackmail Backfire: The clown, Dudley Smith, found evidence that his current customers were involved in a medicine poisoning scheme like the Tylenol incident and demanded hush money. He found out the hard way why it's a dangerous thing to blackmail a murderer when the "victim" sends him poison-tainted cash.
- Canary in a Coal Mine: When Monk panics about the poison that killed the clown potentially being airborne, Stottlemeyer points out the victim's pet canaries, namedropping the trope.
- Death by Materialism: Two workers on the clown case come down with symptoms of poisoning and have to be rushed to the hospital. Monk eventually figures out that the poison was on the blackmail money and the techs tried to take it for themselves, thus exposing themselves to the toxin.
- Death of a Child: An open case that echoes the Tylenol murders comes up. Before anyone knew about the contaminated painkillers, two children took some of the pills and died. Luckily, the clown murder turns out to be related, allowing the children's families to achieve some closure.
- Deceased Fall-Guy Gambit: Miranda's company was legitimately involved in shady things, so Miranda and her husband Damian came up with a plan to pin the blame on her and have her fake her death and meet up with Damian later. However, Damian was having an affair with the company massage therapist, and he decided it would be better if Miranda's death was a little more realistic than she planned.
- Footsie Under the Table: A variant; during Miranda's memorial service, her husband Damian and his mistress are sitting prim and proper in their chairs...and playing footsie below everyone's line of sight. Natalie is infuriated by the lack of respect. She accidentally catches their attention and makes them stop.
- Get Out!: Ellen orders Monk out of her shop after he's too insensitive while she's having a breakdown.
- Hapless Self-Help: Miranda Bigley is a very successful self-help author who commits suicide while on a retreat in full view of the other guests. Due to her teachings, Natalie can't believe it was suicide. She's right, it wasn't. But Miranda's company was still involved in very shady things and Miranda faked her death before being killed by her cheating husband.
- Hollywood Psychology: Averted; Natalie wonders several times if Miranda could have been hypnotized into jumping off the cliff, but Monk points out that hypnotism can't make people act against their wills.
- I Ate WHAT?!: While she and Natalie are trying a Peruvian restaurant's food, Ellen warns Natalie against eating the dish known as cuy. When Natalie asks why, Ellen explains it's guinea pig. Natalie, who had a pet guinea pig at one point, is aghast and totally agrees with Ellen's recommendation.
- Laser-Guided Karma: Natalie finds out that Monk bought a limousine company using the reward money from a previous case that was supposed to go to Natalie’s bonus without telling her. At the end of the novel, Natalie uses the reward money from the insurance company to fund Monk and Teeger, Consulting Detectives, with the other half going to Ellen Morse, without telling Monk until he brings it up.
- Medals for Everyone: After solving the clown murder (and a national outstanding case as well), Stottlemeyer and Lt. Devlin receive public commendations. Monk and Natalie get theirs in the mail.
- Noodle Incident: Natalie vaguely mentions several previous cases that weren't covered in the episodes or books, such as one when Monk tried to take a bullet for her but the killer's gun jammed and another when Monk tried to have a gold grill put in his teeth while on a case involving gangsta rap.
- O.O.C. Is Serious Business: Ellen Morse also has OCD but with far greater control than Monk, in part thanks to self-help guru Miranda Bigley. After Bigley dies, Ellen relapses. While still nowhere near Monk's level of compulsiveness, she is caught vigorously cleaning her store and becomes far less tolerant of Monk's antics.
- Prefer Jail to the Protagonist: After kidnapping Monk, the villains of the clown case race off, leaving their Bulgarian housekeeper to mind all the children from their daughter's birthday party. When Stottlemeyer, Lt. Devlin, and Natalie arrive on the scene, she offers to be arrested, given that it couldn't be worse than things are now.
- Shout-Out:
- Take a Moment to Catch Your Death: Miranda Bigley faked her death, then was murdered by her husband.
- Went Crazy When They Left: Downplayed. Ellen has OCD, though she has better control of it than Monk does. She credits this at least partially to Miranda Bigley, whose advice was very helpful and who even sat on the phone with her in the middle of a breakdown. When Miranda dies, Ellen's OCD reasserts itself.
- You Called Me "X"; It Must Be Serious: As part of asserting her new role as Monk's partner, Natalie starts calling him "Adrian" rather than "Mr. Monk". He's extremely rattled, and she uses it several times to distract him.
