One Flew Over the

Cuckoo's Nest

(1962) is a novel written by Ken

Kesey. Set in an Oregon psychiatric hospital, the narrative serves as a study of the institutional
processes and the human mind as well as a critique of behaviorism and a celebration of
humanistic principles. Published in 1962, the novel was adapted into a Broadway play by Dale
Wasserman in 1963. Bo Goldmanadapted the novel for the 1975 film directed by Milo Forman,
which won five Academy Awards.

Plot
The book is narrated by "Chief" Bromden, a gigantic and docile half-Native American inmate
who is thought to be deaf and mute. Bromden focuses on the antics of the rebellious Randle
Patrick McMurphy, who faked insanity to serve his sentence in the hospital, rather than in prison,
for battery and gambling. The head administrative nurse, Mildred Ratched, rules the ward with a
mailed fist and with little medical oversight. She is assisted by her three black day-shift orderlies,
and her assistant doctors.
McMurphy constantly antagonizes Nurse Ratched and upsets the routines, leading to constant
power struggles between the inmate and the nurse. He runs a card table, captains the ward's
basketball team, comments on Nurse Ratched's figure, incites the other patients on the ward to
conduct a vote on watching the World Series on television, and organizes an unsupervised deep
sea fishing trip. His reaction after failing to lift a heavy shower room control panel (which he had
claimed to be able to) "But at least I tried." gives the men incentive to try to stand up for
themselves, to do their best instead of allowing Nurse Ratched to take control of everything they
do. The Chief opens up to McMurphy and reveals late one night that he can speak and hear. A
disturbance after the fishing trip results in McMurphy and the Chief being sent for electroshock
therapysessions, but even this experience does little to tamp down McMurphy's rambunctious
behavior.
One night, after bribing the night orderly, McMurphy breaks into the pharmacy and smuggles
bottles of liquor and two prostitute girlfriends onto the ward. McMurphy persuades one of the
women to seduce Billy Bibbit, a timid, boyish patient, with a terrible stutter and little experience
with women, so that he can lose his virginity. Although McMurphy plans to escape before the
morning shift arrives, he and the other patients fall asleep instead without cleaning up the mess
and the staff finds the ward in complete disarray. Nurse Ratched finds Billy and the prostitute in

each other's arms, partially dressed, and admonishes him. Billy asserts himself for the first time,
answering Nurse Ratched without stuttering. Ratched calmly threatens to tell Billy's mother what
she has seen. Billy has an emotional breakdown and, once left alone in the doctor's office,
commits suicide by cutting his throat. Nurse Ratched blames McMurphy for the loss of Billy's
life. Enraged at what she has done to Billy, McMurphy attacks her and attempts to strangle her to
death and tears off her uniform, revealing her breasts to the patients and aides watching. He has
to be dragged away from her and is moved to the Disturbed ward.
Nurse Ratched misses a week of work due to her injuries, during which time many of the patients
either transfer to other wards or check out of the hospital forever. When she returns, she cannot
speak and is thus deprived of her most potent tool to keep the men in line. Most of the patients
leave shortly after this event. Later, after Bromden, Martini, and Scanlon are the only patients
who attended the boat trip left on the ward, McMurphy is brought back in. He has received
a lobotomy and is now in a vegetative state, silent and motionless. The Chief smothers
McMurphy with a pillow during the night in an act of mercy, before throwing the shower room
control panel, the same one McMurphy could not lift earlier, through a window, and escaping the
hospital.

Background
One Flew Over the Cuckoo's Nest was written in 1959 and published in 1962 in the midst of
the Civil Rights Movement [3] and deep changes to the way psychology and psychiatry were
being approached in America. The 1960s began the controversial movement
towards deinstitutionalization,[4][5] an act that would have affected the characters in Kesey's novel.
The novel is a direct product of Kesey's time working the graveyard shift as an orderly at a
mental health facility in Menlo Park, California.[6] Not only did he speak to the patients and
witness the workings of the institution, but he voluntarily took psychoactive drugs, including
Mescaline and LSD, as part of Project MKUltra;[7]
In addition to his work with Project MKUltra, Kesey experimented with LSD recreationally. He
advocated for drug use as a path to individual freedom,[8] an attitude that was reflected in the
views of psychological researchers of the time.[9][10] In the 1960s LSD was thought to offer the
best access to the human mind. Each individual's experiences were said to vary; emotions and
experiences ranged from transformations into other life forms, religious experiences, and
extreme empathy.[9] It was Kesey's experience with LSD and other psychedelics that made him
sympathetic toward the patients.[11]
The novel constantly refers to different authorities that control individuals through subtle and
coercive methods. The novel's narrator, the Chief, combines these authorities in his mind, calling
them "The Combine" in reference to the mechanistic way they manipulate and process

individuals. The authority of The Combine is most often personified in the character of Nurse
Ratched who controls the inhabitants of the novel's mental ward through a combination of
rewards and subtle shame.[11] Although she does not normally resort to conventionally harsh
discipline, her actions are portrayed as more insidious than those of a conventional prison
administrator. This is because the subtlety of her actions prevents her prisoners from
understanding that they are being controlled at all. The Chief also sees the Combine in the
damming of the wild Columbia River at Celilo Falls, where his Native American ancestors
hunted, and in the broader conformity of post-war American consumer society. The novel's
critique of the mental ward as an instrument ofoppression comparable to the prison mirrored
many of the claims that French intellectual Michel Foucault was making at the same time.
Similarly, Foucault argued that invisible forms of discipline oppressed individuals on a broad
societal scale, encouraging them to censor aspects of themselves and their actions. The novel
also criticizes the emasculation of men in society, particularly in the character of Billy Bibbit, the
stuttering acute who is domineered by both Nurse Ratched and his mother. These and other
interpretive threads are synthesized and analyzed in Peter Swirski's "You're Not in Canada until
You Can Hear the Loons Crying or Voting, People's Power and Ken Kesey's One Flew over the
Cuckoo's Nest".[12]

Title
The title of the book is a line from a nursery rhyme:
Vintery, mintery, cutery, corn,
Apple seed and apple thorn,
Wire, briar, limber lock
Three geese in a flock
One flew East
One flew West
And one flew over the cuckoo's nest
Chief Bromden's grandmother sang this song to him when he was young. The absurdity of the
poem is in the fact that a joined "flock" of geese cannot fly in separate directions at once, as well
as the fact that the cuckoo does not build a nest of its own. However, the poem can also be
interpreted as one goose flying east, one flying west, and one flying over the cuckoo's nest.

Main characters

Chief Bromden: The novel's half-Native American narrator has been in the mental hospital
since the end of World War II. Bromden pretends to be deaf and mute, and through this guise
he becomes privy to many of the ward's dirtiest secrets.[11] As a young man, the Chief was a

high school football star, a college student, and a war hero. After seeing his father, a Native
American chieftain, humiliated at the hands of the U.S. government and his (white) wife,
Chief Bromden descends into clinical depression and begins hallucinating. Soon he is
diagnosed with schizophrenia. He believes society is controlled by a large, mechanized
system which he calls "The Combine."
Richard Gray, author of A History of American Literature, said that Bromden "supplies"
the novel's "vision."[13] Gray explains that Bromden's "eye" "sees the inner truth" and that
Bromden "is an outsider, an innocent eye in a way like Huck Finn, but what he sees is far
stranger, far more surreal."[13] Gray explained that Bromden's vision "may not be literally
true but it is symbolically so because, to quote Emily Dickinson again, 'Much madness is
divinest sense.'"[13]
Randle McMurphy: A rebellious convict sent from a normal prison. He is guilty
of battery and gambling. He had also been charged with, but never convicted of, statutory
rape. McMurphy is transferred from a prison work farm to the hospital, thinking it will be an
easy way to serve out his sentence in comfort. In the end, McMurphy turns violent against
Nurse Ratched, costing him his freedom, his health, and his life.

Staff
Nurse Ratched (also known as "Big Nurse"): The tyrannical head nurse of the mental institution,
who exercises near-total control over those in her care, including her subordinates. She will not
hesitate to restrict her patients' access to medication, amenities, and basic human necessities if it
suits her whims. Her informant is the timid Billy Bibbit, whom she coerces into divulging the
unit's secrets by threatening to complain about him to his mother. McMurphy's fun-loving,
rebellious presence in Ratched's institution is a constant annoyance, as neither threats nor
punishment nor shock therapy will stop him or the patients under his sway. Eventually, after
McMurphy nearly chokes her to death in a fit of rage, Nurse Ratched has him lobotomized.
However, the damage has already been done, and Nurse Ratched's rule is broken after
McMurphy's attack leaves her nearly unable to speak, which renders her unable to intimidate her
patients, subordinates and superiors.

The "Black Boys" Washington, Williams and Warren: Three black men who work as aides in
the ward. Williams is a dwarf, his growth stunted after witnessing his mother being raped by
white men. The Chief says Nurse Ratched hired them for their sadistic nature.
Dr. Spivey: The ward doctor. Nurse Ratched drove off other doctors, but she kept Spivey
because he always did as he was told. Harding suggests that the nurse could threaten to
expose him as a drug addict if he stood up to her. McMurphy's rebellion inspires him to stand
up to Nurse Ratched.

Nurse Pilbow: The young night nurse. Her face, neck and chest are stained with a
profound birthmark. She is a devout Catholic and presents symptoms of peccatophobia(fear
of sinning or imaginary crimes). She blames the patients for infecting her with their evil and
takes it out on them.
Mr. Turkle: An elderly African American aide who works the late shift in the ward. He
agrees to allow McMurphy to host a party and sneak in prostitutes one night.

Acutes
The acutes are patients who officials believe can still be cured. With few exceptions, they are
there voluntarily.

Billy Bibbit: A nervous, shy and boyish patient with an extreme speech impediment, Billy
cuts himself and has attempted suicide numerous times. To alleviate Billy's fear of women,
McMurphy sneaks a prostitute into the ward so Billy can lose his virginity. The next
morning, Nurse Ratched threatens to tell his mother; fearing the loss of his mother's love,
Billy has an emotional breakdown and commits suicide by cutting his own throat.
Dale Harding: The unofficial leader of the patients before McMurphy arrives, he is an
intelligent, good-looking man who's ashamed of his repressed homosexuality. Harding's
beautiful yet malcontent wife is a source of shame for him.
George Sorensen: A man with germaphobia, he spends his days repeatedly washing his
hands in the ward's drinking fountain. McMurphy manages to persuade him to lead a fishing
expedition for the patients after discovering that he had captained a PT boat during World
War II. Afterward, the staff forcibly delouse him, knowing the mental anguish this causes
him.
Charles Cheswick: A loud-mouthed patient who always demands changes in the ward, but
never has the courage to see anything through. He finds a friend in McMurphy, who's able to
voice his opinions for him. After McMurphy loses his confidence when he learns that his
stay in the ward is indefinite, Cheswick drowns himself in the swimming pool.
Martini: A patient who suffers from severe hallucinations.
Scanlon: A patient obsessed with explosives and destruction. He is the only other nonvegetative patient confined to the ward by force aside from McMurphy and Bromden; the
rest can leave at any time.
Sefelt and Fredrickson: Two epileptic patients. Jim Sefelt refuses to take his anti-seizure
medication, as it makes his teeth fall out (gingival hyperplasia is a known side
effectof phenytoin). Bruce Fredrickson takes Sefelt's medication and his own because he is
terrified of the seizures, and loses teeth due to the resulting overdosage.

Max Taber: An unruly patient who was released before McMurphy arrived. The Chief later
describes how, after questioning what was in his medication, Nurse Ratched had him "fixed."

Chronics
The Chronics are patients who will never be cured. Many of the chronics are in vegetative states.

Ruckly: A hell-raising patient who challenges the rules until his lobotomy. After
the lobotomy, he sits and stares at a picture of his wife, and occasionally screams profanities.
Ellis: Ellis was put in a vegetative state by electroshock therapy. He stands against the wall
in a disturbing messianic position with arms outstretched.
Pete Bancini: Bancini suffered brain damage at birth but managed to hold down simple jobs,
such as a switch operator on a lightly-used railroad branch line, until the switches were
automated and he lost his job, after which he was institutionalized. The Chief remembers
how once, and only once, he lashed out violently against the aides, telling the other patients
that he was a living miscarriage, born dead.
Rawler: A patient on the Disturbed ward, above the main ward, who says nothing but "loo,
loo, loo!" all day and tries to run up the walls. One night, Rawler castrates himself while
sitting on the toilet and bleeds to death before anyone realizes what he has done.
Old Blastic: An old patient who is in a vegetative state. The first night McMurphy is in the
ward, Bromden dreams Blastic is hung by his heel and sliced open, spilling his rusty visceral
matter. The next morning it is revealed that Blastic died during the night.
The Lifeguard: An ex-professional football player, he still has the cleat marks on his
forehead from the injury that scrambled his brains. He explains to McMurphy that, unlike
prison, patients are kept in the hospital as long as the staff desires.
Colonel Matterson: The oldest patient in the ward, he suffers from severe senile
dementia and cannot move without a wheelchair. He is a veteran of the First World War, and
spends his days "explaining" objects through metaphor.

Other characters

Candy: The prostitute that McMurphy brings on the fishing trip. Billy Bibbit has a crush on
her and McMurphy convinces Candy to sleep with him.
Sandy: Another prostitute and friend of McMurphy. She and Sefelt sleep together. Sefelt has
a seizure while they are having sexual intercourse.
Vera Harding: Dale Harding's wife.