Monk is called to Mexico by a bizarre case — a young skydiver whose autopsy found that his lungs were full of water. Monk must hunt down the truth behind this odd turn of events while dealing with the lack of help, his own anxieties about local amenities, and the still-uncaught culprit, who seems more than willing to kill again.
This episode includes examples of the following tropes:
- Friendship Moment: Despite often being exasperated with Monk, Sharona is in tears when she thinks he's been killed and euphoric when she figures out that the dead man could not have been her boss.
- Kick the Dog: When Monk pleads a college kid to share his Sierra Springs water (the only brand Monk drinks), he obliges Monk...By pouring some on a college girl. Justified, as the kid might've been too drunk out of his mind to realize Monk was serious.
- Out-of-Character Alert: Sharona thinks a recent hit-and-run victim was Monk until the person telling her about it says the man crawled through a very dirty place before dying, something the germaphobic Monk would never do.
- Platonic Declaration of Love: When Captain Stottlemeyer gets the (erroneous) report that Monk's been killed, he tells Randy that he will resign if Monk doesn't get a police funeral with full honors (despite having been discharged from the force) and declares, "I'm going to tell you something, Randy, and I'm not ashamed to admit it. I loved that man." A few minutes later, he gets the news that it was a lookalike and not Monk who was killed, and his mood flip-flops:Stottlemeyer: I hate that man!
- Run for the Border: Monk is lured to Mexico by a corrupt doctor who wants to kill him in revenge for Monk testifying against him in an insurance fraud case. Said doctor jumped bail, fled to Mexico and changed his name, and did so by committing two bizarre murders (a wild lion attack, and then a boy who drowned in mid-air while skydiving).
- The Coroner Doth Protest Too Much: The reason Monk is there is because the son of a friend of San Francisco's mayor had died while skydiving but the coroner determined that he had actually drowned — in mid-air. Monk is called in to investigate how such a bizarre murder cover-up might have happened, but it turns out that the coroner is lying, and tampered with the body after death to support his story in case anyone checked. The staging is because he's got an old score to settle with Monk and wants to lure him in with an unusual death. He had in fact attempted the same thing several times before with various other bizarre deaths (most notably a wild lion), but this was the first one that the local police didn't just write off as related to the Mexican drug trade.
- Translation Convention: The Mexican cops converse in perfect English even in the cold opening.