Monk is pulled into using his skills on a very personal case when Captain Stottlemeyer's wife, Karen, is gravely injured in a collision with a tow truck after its driver is sniped. Can Monk crack the case before Stottlemeyer cracks under the pressure?
This episode includes examples of the following tropes:
- Adult Fear: Karen is hospitalized with severe injuries after a car accident, leading to the possibility of Stottlemeyer losing his wife and their two sons losing their mother.
- Check, Please!: Monk takes Stottlemeyer's children out to lunch at a diner. Naturally, he's uncomfortable in the surroundings. So when the staff break into a dance routine to one of the songs on the jukebox, he says the line when the microphone is held out in front of him. Then one of the waitresses bumps the table, giving him his Eureka Moment to solving the case.
- Give Me a Reason: After finding out that Coker is responsible, Stottlemeyer grabs him and pins him against his car, asking him to put up a fight so he'll have an excuse for the violence he wants to inflict on him. Luckily, Sharona and Randy are there to talk him down.
- Hollywood Law: Captain Stottlemeyer is in charge of the investigation into the shooting of a tow truck driver, during which Stottlemeyer's wife Karen collided with the tow truck and was knocked into a coma. Although Leland has an interest in finding the man responsible, it's a severe conflict of interest to investigate matters than even tangentially have to do with a close relative like a spouse.
- Implied Death Threat: When the subject of Karen's injuries comes up while the police are searching Coker's house, Stottlemeyer says that the doctors healed her, and that Coker needs to call and give them his thanks for saving him.
- Lack of Empathy: Evan Coker shoots a tow truck driver with a hunting rifle in order to retrieve a pistol from his repossessed car. The driver's truck then promptly swerves in front of Stottlemeyer's wife Karen, causing her to crash and get knocked into a temporary coma. In the ending, while being arrested by the police, Coker is shown chuckling and smiling after Stottlemeyer almost goes ballistic and beats him down because of this.
- Meaningful Echo: Early on, Monk's watch is several minutes slow because he hasn't messed with or replaced it since Trudy died. Stottlemeyer suggests that it's been long enough and Monk should let go and move on. Later, after spending most of the episode worried sick about Karen, Stottlemeyer tells Monk he understands now; he can't just let go.
- Mood Whiplash: In the beginning, Monk and Leland are outside Monk's apartment, conversing, as Monk exasperates the substitute garbagemen with how to load his garbage. That part of the scene itself is pretty amusing. Just as the garbage truck is beginning to drive away, a very distraught Randy arrives to inform Leland that his wife Karen has been in a car accident and has been hospitalized.
- O.O.C. Is Serious Business: Monk chases down a garbage truck and jumps onto it to retrieve the bag containing the evidence that Coker was trying to get rid of.
- Percussive Therapy: Midway through the episode, Stottlemeyer is beating on a vending machine in the hospital. Eventually, a chocolate bar with nuts comes out. Stottlemeyer offers it to Monk, saying he hates nuts and he just wanted to pound something.