For the first time in the series, Monk does not appear in the closing scene. It's also the first time Captain Leland Stottlemeyer cries.
This episode reintroduces Glenne Headly, who first played Captain Stottlemeyer's "hippie wife," Karen, in "Mr. Monk and the Very, Very Old Man (2003)." The Stottlemeyers' older son Jared, played by an uncredited Cameron Kush in "Mr. Monk Goes to the Ballgame (2003)," is played by fourteen-year-old Jesse James. In Mr. Monk Goes to a Rock Concert (2006), Jared is played by Jon Kyle Hansen. We also meet the Stottlemeyers' second son, Max, briefly alluded to in "Mr. Monk and the Very, Very Old Man (2003)," and played here by Connor Carmody - and whose first name is misspelled as "Conner" in the ending credits.
Ileane Meltzer, who plays Evan Coker's cranky neighbor -and who chews Monk out twice for adjusting her sundial -is a costume designer for the series. She also played an angry neighbor in Love at Large (1990), a romantic comedy/detective story in which Ted Levine plays a bigamist with two names and two lives.
The union strike was filmed at the same intersection as the T-1000 arrival in Terminator 2: Judgment Day (1991). See filming locations.
When the Captain first arrives to the hospital and gets updated by the doctor, the doctor states they will operate if the swelling goes down. When the doctor says who will operate, Sharona verifies that "they are good" and states that she is an "RN" and did her training in the facility 7 years ago. In the Dale the Whale episode, Sharona says she is a "practical nurse" and has maintained her licensure. California uses vocational nurses (LVN), not practical (LPN). A practical/vocational nurse (LPN/LVN) is not the same as a registered nurse (RN). An LPN/LVN would work under a RN, whereas the RN can work independently under their own license.