Darlene Kegan

Meredith grows increasingly dissatisfied with the unknown details of Derek's life. Meanwhile, Alex treats Devo, a patient whose religious beliefs jeopardize her chances for recovery; Izzie contemplates reconnecting with her estranged mother; Zoey, a pregnant woman in her 40s who's been diagnosed with cancer, disagrees with Cristina's medical advice; and the interns are mystified by Cable, a patient who's being treated for seizures and who thinks he's psychic.

Monk is distraught when the garbage collectors go on strike and San Francisco is buried in trash.

Late at night, a young woman named Vickie frantically buzzes the intercom of a palatial beach house, imploring the owner to let her in. She's holding a manila envelope. Vickie turns around to find someone she recognizes wielding a knife at her. The unseen individual chases Vickie down a steep embankment behind the house and stabs her to death beside a rundown trailer on the beach -- a nude beach. The killer proceeds to take the envelope from Vickie's dead hands. At the crime scene, Natalie, Capt. Stottlemeyer, and Lt. Disher attempt to distract Monk from seeing the naked bystanders. They're temporarily successful, and Monk is able to deduce that Vickie was clutching something when she died...