I think the Judge had an affair with the missing midwife, and the doc who was killed 12 yrs. later was trying to stop the judge from getting on the CA supreme court, so he died--Trudy knew about the affair too--thought she might have been pregnant when she died and that was why she was in contact with the clinic and stumbled onto the affair.
In her tape to Adrian, she made a point of telling him again that she had to get an RX for Ambrose--Ambrose was always jealous of his brother--especially when he was out in the world and went to college and met/married Trudy.
Therefore--Ambrose made the Judge aware of what Trudy knew, to wreck Monk's life by making sure Trudy was gone from his life. Can't say Ambrose did it, as he doesn't have six fingers !!!!!

Trudy is not dead. She's in witness protection. They found Monks antidote, but want people to think he is dead too, so that he can enter witness protection with Trudy. Monk doesn't know this, but medicines are keeping him sick.

Finally Monk will solve the mystery and no witness protection.

There was an episode where Monk recognized Trudy's eyes in a cab driver lady. It was revealed she had recieved the corneas from Trudy after her death meaning she must be dead for the story line to make sense. I also had a fealing when I first saw X-mass gift box earlier seasons that a clue if not a tape was in the box. Despite Monks problems I think he would have been so obsessed with the murder he would opened the box for a possible clue even for one that was oblique.

I love Monk because I he is still feels so much love and pain for Trudy after the many years. I lost someone I loved to an accident and I hope I will never grow dull to the love and pain. What better ending than for Monk to die
catching Trudy's killer and being with her again. That would be the way I would want to die.

Thanks for bringing that up. I forgot about that episode. You have just knocked out most of the theories on Trudy being alive and it's very feasible it could be Monk waking up from a coma, then seeing Trudy. I like that ending. Good detective work.

How can Trudi still be alive??? There was that episode where Monk "recognizes" Trudi's eyes in a transplant patient.... he follows the women with her eyes everywhere, then learns that the woman received Trudi's corneas. So are we to believe that Trudi is alive, and blind?

I'm wondering if Monk has dreamed everything, that perhaps he was the one hurt in the blast, and not Trudi. Trudi says in Monk's "real" dream, it's almost over.... does that mean he is about to awake from a long coma? Also, Randy says, out of nowhere in the recent episode, "I'm going to miss all this." Why?? Why does he suddenly say that? I think Monk has been dreaming all along.

What if because of some unknown chemical reaction the only thing that could keep Monk from being killed by the poison is milk! haha!

I think Monk will live. I also think the birthing place, the midwife's death and the doctors death is all connected with a black market baby selling ring that Trudy uncovered after she had a baby out of wedlock as a teenager and gave her baby away for adoption. That's the awful thing she said she did in the tape. Monk will come face to face with Trudy's daughter who will be the exact likeness of Trudy. Let's give Monk a happy ending, he deserves it.

I don't think Monk will die. In the beginning of the episode, Trudy told him it was time to let her go. I think that he will realize, in a very painful way, that he has been wrong all these years. Before Trudy died, he wasn't as bad. He withdrew totally. Natalie has done a lot to help him. I think the poison is in the wipes, and combined with the gift, he will realize that he could have solved the murder twelve years ago. He already told Dr. Bell that he has wasted so many years. I believe this is all a part of the ending. Randy will go to New York, big mistake, and Monk will let Trudy go.

DanMan: I don't find ambiguous endings "offensive" the way people seem to feel violated at the notion of Monk dying at the end of the show. I just hate endings that are actually non-endings. It's lazy. They act like it's all creative and artsy, and that's what the defenders of such lame endings will say, but no, it's just lazy and indecisive.

It's okay to leave some things up to the viewer/reader... in fact that's to be expected. But not the climax of the story. Not knowing if the protagonist, placed in mortal danger, lives or dies is simply unacceptable in a series finale (whether it be a tv show, movie, or series of books). "Is he dead or alive" is a great cliffhanger until the next season/book/sequel. But it's absolutely unacceptable when it's intended to be the end of the end.

Also I agree with those who said it's Monk's hand wipes that were poisoned. Though you'd think they'd check everything that Natalie bought at the grocery store that day, including hand wipes. But they were probably just dumb and assumed it must have been a food product. Can ricin even be absorbed through the skin? I thought it had to be ingested or injected. I also doubt that there are 4,000+ different types of ricin poison. Isn't ricin made from castor beans? I thought ricin was a specific type of poison, not a general class of poisons like "nerve gas" but I'm no expert and I'm too lazy to look it up on wikipedia.

We think that the poison wasn't through a food, but his hand wipes. They were poisoned in the grocery store and Monk brought them up 2 or three times in this episode. He keeps using, making him sicker and sicker.

And I think he will die, and see Trudy finally, right after solving her murder. That's all- we just have to wait 5 more days to find out who's right.