The interesting thing about this episode is that it reverses and mirrors many of the standard episodes, showing things into sharp highlight.
The first important thing when watching this episode is to observe how the writers handle Monk's OCD properly and in an entertaining manner. In this case we're not forced to or watch characters suffer through Monk's obsession - "...Airplane" and "...Theater" are two examples here). Instead the writers reverse things as we see how Monk's OCD causes _him_ to suffer. This is something they should do more often - it makes Monk a far more sympathetic rather then occasionally tiresome character with Tony Shalhoub resorting to schtick. The writers and Shalhoub have great fun with this - again and again they dangle deliverance before Monk and then snatch it away from him ("reversal of fortune," as it were). One gets the impression Monk almost doesn't care whether the murderer kills him or not - he's dying anyway. Ironically, it's played like his desire to leave the country is what drives him to figure out who is trying to kill him, rather then any desire to save his own (suffering) life. His line from the premiere, "I am in Hell," is never more appropriate then here and kudos to Tony Shalhoub for conveying how Monk is suffering.
The episode also reverses expectations since we soon find out that who the murderer's target is isn't who we're initially lead to believe but rather Monk himself. It's particularly ironic since as noted above, Monk doesn't really care.
This episode does an odd reversal on Sharona as she reverts briefly to her former "wild" life. It's a little unclear why she cuts loose - this can't be the first time she's had a chance to drink and party ("...Vacation"). It does seem a bit odd to see her abandoning Monk to party and get drunk - she is his (occasionally) paid nurse, right? Still, this lets her see the kind of person she used to be and her "skills" do let her find a clue or two. Note how the writers reverse things again - it's Sharona who almost gets them killed in the hotel room since she's the one who straightens the picture rather then Monk when the murderer and the audience expect Monk to do so.
The most amusing thing about this episode to me is the Alameda/Plato equivalents to Stottlemeyer/Disher. It's actually a clever little ploy, particularly since a) it's pretty subtlety done, and b) the writers don't make the characters reverse things. Plato is much more suave then Disher (and Sharona seems mildly interested in him). Stottlemeyer isn't quite as...obsessed with a particular solutionas Alameda is. Alameda seems much more forthright in eventually stating his respect for Monk, who we see occasionally backsliding due to his more complex relationship. Although Stottlemeyer's reaction to the news of Monk's death neatly demonstrates the seesaw nature of his feelings toward his friend and the guy who eventually solves crimes for him. The catch is that while Stottlemeyer and Disher aren't on screen a lot, you feel like they are since Alameda & Plato are around in their place and are kind of mirror images of them in some ways.
On other matters, this is another episode that gives us a focus on "minor" characters. The hotel owner is a laugh - both trying to cover up the flaws of his cheap hotel ("Don't eat the mints!") while proudly boasting of his three-way light (which neatly becomes a clue for Monk to avoid death). The border guard forced to deal with Monk and the murderer also have some nice moments.
The murder mystery is actually pretty interesting - particularly the subtle clue over measurement conversions which does give the audience a fair chance at trying to figure out the killer. The only inconsistent element is that the murderer, for all his cleverness, seems curiously incompetent when it comes to trying to kill Monk himself. Both times he's foiled by a reversal - a "mirror image" of Monk rather then Monk himself, and Monk not adjusting the picture and so being in a position to spot the bomb before Sharona gets them both killed.
Overall, this is about the most subtle episode they've done in the series - deliberately or not, this episode is about reversals of all sorts and you can catch them throughout.