The series follows Adrian Monk (Tony Shalhoub), a private detective with obsessive–compulsive disorder and multiple phobias, and his assistant Natalie Teeger (Traylor Howard).

In a flashback to December 14, 1997, Trudy Monk asks her husband about his latest investigation, the disappearance of a midwife named Wendy Stroud.

Monk concludes that the murder was committed by a professional hitman, and the police soon find a partial fingerprint that identifies the suspect as Joey Kazarinski.

When attending a dinner the following day at Natalie's house, Monk is poisoned with a powerful synthetic toxin based on ricin.

Monk discovers a videotape recording made by Trudy before her death, where she confesses to having had an affair with Rickover when he had been a law professor at Berkeley.

Twelve years later, Dr. Nash came across references to the child when digitizing the birthing clinic's patient records, and thus suspected what had happened to Stroud.

A few days later, Monk finds an old newspaper article concerning Stroud's disappearance, and discovers that Trudy's child did not die, but was adopted.

A final montage shows flashbacks from throughout the series, before cutting to clips of the main characters in the present day: Stottlemeyer getting ready for work and embracing his wife, Randy setting up his desk in Summit, and Monk and Natalie arriving at the crime scene.

Club's Emily VanDerWerff called it "a surprisingly sweet ending to a show that I haven't watched regularly in a few years", and gave it a "B+".

Tony Shalhoub was nominated for the 2010 Primetime Emmy Award for Outstanding Lead Actor in a Comedy Series for this episode.

Additionally, Randy Newman won the 2010 Primetime Emmy Award for Original Outstanding Music and Lyrics for the song "When I'm Gone".