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Literature / One Flew Over the Cuckoo's Nest

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"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."

One Flew Over the Cuckoo's Nest, a 1962 novel by Ken Kesey, takes place in an insane asylum run by Miss Ratched, the Big Nurse, who rules over the patients with an iron fist... and her machines, of course, according to narrator Chief Bromden.

She has so much power over them that no one dares to stand up to her, until one day when Randle Patrick McMurphy swaggers into the ward, and things are never the same again as he takes everything the Big Nurse stands for and slowly destroys it right before everyone's eyes.

Was adapted into a 1963 Broadway play starring Kirk Douglas as McMurphy, as well as a critically-acclaimed 1975 movie directed by Miloš Forman, starring Jack Nicholson as McMurphy and Louise Fletcher as Nurse Ratched. The 2020 Netflix series Ratched is a prequel starring Sarah Paulson as the eponymous character.

This novel provides examples of:

  • Alliterative Name: Billy Bibbit, Charles Cheswick.
  • Ambiguously Gay: Harding at first. It's confirmed when his wife shows up. He admits it, by way of euphemisms, to McMurphy prior to the story's climax.
  • Anti-Hero: McMurphy is an Unscrupulous Hero. He's racist, sexist, loud, rude, and scams the other patients out of their money regularly. He originally got busted for statutory rape. But he's the only thing that can get them out of their shells and remind them that they're not a bunch of worthless rabbits. Eventually, he genuinely cares about them in spite of himself.
  • Battleaxe Nurse: Ratched, who rules over the ward and controls the patients' and staff's every move.
  • Bedlam House: The novel is set in one of these, albeit one which maintains an outward appearance of being a modern, progressive facility.
  • Beginner's Luck: Despite knowing nothing about fishing, the guys who go on the boat trip reel in a good haul, including a halibut estimated at 200-300 pounds. They do have an advantage in that George Sorensen used to work as a commercial fisherman.
  • Beware the Quiet Ones: The aides take some lumps because they underestimate quiet patients. The first is Pete Bancini, an aging patient with the mental capacity of a toddler, who has a brief moment of lucidity that results in him attacking an orderly.
  • Big Brother Is Watching: Through her glass window... Appropriately, the Big Nurse's nickname is an allusion to Big Brother. Chief believes that The Combine is the actual Big Brother, while the nurse is just its high-ranking officer.
  • Big "NO!": Billy's reaction to Nurse Ratched threatening to tell his mother about how he had sex with Candy is to plead for her to not do it by shouting "No!" multiple times, before he decides to commit suicide.
  • Bittersweet Ending: McMurphy wins the fight against Ratched, but at the cost of part of his brain, which ultimately forces Chief Bromden to euthanize him by smothering him with a pillow before finally escaping to his ancient tribal lands.
  • Blaming "The Man": Bromden refers to "the Combine", an all-encompassing, mechanized Mind-Control Conspiracy that represents systems of social control and conformity. The Combine's chief representative in the story is not a man but a woman — specifically, Nurse Ratched.
  • Blithe Spirit: McMurphy. He's definitely a flawed guy, but still teaches the patients not to fear Nurse Ratched or her arbitrary rules.
  • Boisterous Bruiser: McMurphy. In his introduction alone, he laughs and greets everyone at the ward, telling them how he got committed. This becomes the plot foundation for the story, as McMurphy inspires the other patients to come out of their shells and become more confident.
  • Butt-Monkey: Harding and Mr. Turkle, the night orderly.
  • Chekhov's Gun: The Hydrotherapy Console. McMurphy tries to lift it in one scene in an attempt to throw it through the window and escape with the other patients, but finds that it is too heavy for him. Later in the novel, in his conversation with Chief, McMurphy points out the console and wonders if Chief can lift it. At the end of the novel, Chief manages to successfully pick up and throw the console out of the window and escape the ward himself.
  • Cure Your Gays: Given that Harding doesn't show any signs of mental illness but is more-than-ambiguously gay, this could very well be why he's in the institution - especially since homosexuality was still considered a mental disorder when the book was written.
  • D-Cup Distress: Nurse Ratched resents having large breasts and tries to hide them.
  • Deadpan Snarker: Harding. He surpasses deadpan so well that it's hard to tell that's what he's doing at first, but after the fishing trip it becomes much more clear.
  • Death of Personality: As a result of McMurphy's lobotomy.
  • Depraved Dwarf: Williams the orderly has dwarfism, and is one of Nurse Ratched's enforcers.
  • Dirty Kid: McMurphy apparently was one as a child, judging by his story he tells about how he first had sex at the age of 10.
  • Doomed Moral Victor: McMurphy's attack on Ratched leads to his death but also to her downfall and improved conditions for his fellow inmates.
  • Dragon-in-Chief: Nurse Ratched has authority over her asylum that is unchecked even by her superiors.
  • Driven to Suicide: Poor Billy Bibbit and old Charles Cheswick. From earlier in the book, the minor character Rawler is also mentioned to have killed himself.
  • Electricity Knocks You Out: Discussed. While the two are discussing electroshock therapy, McMurphy asks Harding if it's painful, but Harding claims that people who undergo EST go unconscious immediately after being shocked once.
  • Electroconvulsive Therapy Is Torture: In real life, electroshock therapy is mainly painless and quick but with varying results. For a short time after the treatment, the patient may have trouble forming new memories, but the vast majority of patients feel better and are able to use a wider range of treatments. In the past the shock could damage the body through the reaction to the shock, but modern electroconvulsive therapy is done with a muscle relaxant and a short-acting anesthetic, making it mostly painless. In this book, however, it's... well, Electric Torture (although it DOES mention a few times that the shock itself is quick and practically painless) and that portrayal had a worrying amount of impact on medicine. Doctors were shamed out of using ECT for decades after the release of Cuckoo's Nest, despite its generally positive results.
    • The book was written during the 60s when anesthesia was starting to be used with ECT. But considering that this is Nurse Ratched we're talking about, it is likely that she chose not to use it for the purpose of making him suffer.
  • Empty Shell: Patients who are lobotomized become this. It's most prominent when McMurphy is lobotomized, leading the patients to believe that it isn't even him at first, and Chief finally giving him a Mercy Kill by smothering him with a pillow in the end.
  • Epigraph: The nursery rhyme that gives the book its title.
    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.
  • Even the Guys Want Him: Bromden momentarily questions his sexuality when contemplating McMurphy's magnetism. However, he also points out that if he were really gay, he would want to do "other things" to McMurphy.
  • Evil Is Deathly Cold: Subtly invoked the white-clad, emotionless Big Nurse, in contrast with the friendly, redheaded McMurphy. Both are usually described in terms suggesting winter and summer, respectively.
  • Fan Disservice: Nurse Ratched is described as having a large set of breasts...but she herself doesn't like them very much. Not to mention her abusive behavior destroys any attraction one could feel toward her.
  • Fiery Redhead: McMurphy is a redhead whose string of convictions includes a number of assaults.
  • Fighting Irish: Which makes McMurphy's aforementioned Fiery Redhead characterisation into a Phenotype Stereotype.
  • First-Person Peripheral Narrator: "Chief" Bromden, who takes center stage over the hero McMurphy because his hallucinations highlight the symbolism of the book, and because we have to look up to McMurphy. We can't be him.
  • Fun with Acronyms: Randle Patrick McMurphy, R.P.M., is in constant, often circular (metaphorical) motion.
  • Gentle Giant: Bromden measures at a staggering 6 ft, 8 in. (203 cm), but is as timid as the other inmates. Until he apparently finishes MacMurphy's "training program".
  • Go Among Mad People: McMurphy feigned insanity and got himself sent to the asylum thinking it would be an easy way out from his prison sentence. He was dead wrong.
  • Groin Attack: Rawler, one of the patients on the Disturbed Ward, does this to himself and bleeds to death.
  • Hate Sink: Nurse Ratched is meant to embody all that is wrong with the ward's treatment of the mentally ill.
  • The Hero Dies: McMurphy himself at the end.
  • Hidden Buxom: Nurse Ratched resents having large breasts and tries to hide them.
  • Hidden Depths: George Sorensen captained a PT boat during World War II and was awarded the Navy Cross.
  • Hooker with a Heart of Gold: Candy and Sandy, the two prostitutes that McMurphy hires, are very friendly. They listen to what the other patients have to say, and Candy even helps Billy gain a little confidence.
  • Hospital Hottie: The inmates comment that Nurse Ratched would be quite attractive if she weren't so emotionless and intimidating.
  • Insanity Defense: McMurphy claims he's insane to get transferred to the institution to serve out the rest of his sentence in cushy surroundings, and is more than a little alarmed when he realizes that 'the rest of his sentence' is no longer the few months he thought it was, but when the doctors decide that he's no longer a threat to himself or others — which, considering he's pissed off the evil Nurse Ratched, could mean an indefinite stay.
  • Intimate Psychotherapy: McMurphy brings prostitutes onto the mental ward to make the other patients into men. After sleeping with one of the prostitutes, Billy Bibbit becomes confident enough to finally stand up to Nurse Ratched. This all goes down the toilet once Nurse Ratched threatens to tell Billy's mother about what happened, which drives poor Billy to suicide.
  • Irony:
    • The entire plot is a large-scale example of situational irony. McMurphy cons his way into being committed because he's too lazy to serve out a light sentence on the work farm for statutory rape. The fact that McMurphy knows he doesn't belong there makes him chafe with the staff, which leads to him not only getting labeled genuinely insane, but also lobotomized... and then dead. It really hits home for him when he asks about the end of his prison sentence, only to find that, because he's been involuntarily committed, the length of his stay is now entirely up to the medical staff.
    • Patients in the Disturbed Ward, which houses patients with violent or self-harming tendencies, are treated much more humanely than the ones in Nurse Ratched's ward. The nurse in the Disturbed Ward actually tries to keep patients there longer to keep them away from Ratched.
  • Jailbait Taboo: Why McMurphy was incarcerated to begin with.
  • Jaywalking Will Ruin Your Life: McMurphy got into this whole jail to mental hospital to lobotomy and ultimately to death situation because he committed statutory rape on a fifteen-year-old girl. At the time of the book's publication (1962) statutory rape of the kind involving an adult and a teenager was considered to be less of an issue than it is considered to be today.
  • Karmic Trickster: Deconstructed with McMurphy, since he lacks the usual Karmic Protection.
  • Last-Name Basis: Compare: The patients all call each other by the last names, while the Big Nurse has them on a first-name basis.
  • Least Is First: Charles Cheswick is the only man who is initially enthusiastic for McMurphy's scheme to change the ward schedule.
  • Lobotomy:
    • Ruckly, the patient who was an angry lunatic before he undergoes the procedure, becomes an empty shell after his lobotomy. His eyes are described as being like burnt-out lightbulbs.
    • After McMurphy attacks Ratched, he is lobotomized and left in a vegetative state. Bromden mercy kills him.
  • Mad Bomber: Scanlon. We're never told whether or not he has ever acted on his urges, but he is the only Acute patient other than McMurphy who is committed involuntarily.
  • Madness Mantra: Ruckly, one of the Chronics, responds to everything by mumbling "Fffffuuck da wife".
  • Malicious Misnaming: Nurse Ratched calls McMurphy "McMurry" as a power play. McMurphy lets her know (without stating it straight out) that he knows it's intentional, and at one point he returns the favor by calling her "Nurse Rat-shed."
  • Mercy Kill: After McMurphy gets a lobotomy, Bromden decides to put him out of his misery by suffocating him with a pillow.
  • Meaningful Name: Bromden, related to bromide, a tranquilizer.
  • Messianic Archetype: McMurphy. Lampshaded when he and 12 other guys all go fishing. Harding compares the EST victim to Jesus on the cross. McMurphy is also friends with a prostitute called Mary. Bromden describes McMurphy as a "giant sent from the sky to save us." Billy Bibbit commits suicide after betraying him.
  • Mind-Control Conspiracy: Chief Bromden vs. the Combine.
    • Then, at the end of the book, just before McMurphy tries to strangle Nurse Ratched, Chief Bromden has a terrifyng moment of clarity and realizes the true Mind-Control Conspiracy:
    First I had a quick thought to try to stop him, talk him into taking what he’d already won and let her have the last round, but another, bigger thought wiped the first thought away completely. I suddenly realized with a crystal certainty that neither I nor any of the half-score of us could stop him. That Harding’s arguing or my grabbing him from behind, or old Colonel Matterson’s teaching or Scanlon’s griping, or all of us together couldn’t rise up and stop him.
    We couldn’t stop him because we were the ones making him do it.
    It wasn’t the nurse that was forcing him, it was our need that was making him push himself slowly up from sitting, his big hands driving down on the leather chair arms, pushing him up, rising and standing like one of those moving-picture zombies, obeying orders beamed at him from forty masters. It was us that had been making him go on for weeks, keeping him standing long after his feet and legs had given out, weeks of making him wink and grin and laugh and go on with his act long after his humor had been parched dry between two electrodes.
    We made him stand and hitch up his black shorts like they were horsehide chaps, and push back his cap with one finger like it was a ten-gallon Stetson, slow, mechanical gestures - and when he walked across the floor you could hear the iron in his bare heels ring sparks out of the tile.
  • Mind Screw: Sometimes Bromden will go off on bizarre tangents that can make things very difficult to follow if you aren't paying attention.
  • Modesty Towel: McMurphy greets Nurse Ratched wearing one on his second day at the hospital, as he had just showered. When she says he can't walk around like that, he threatens to take it off. He's actually wearing boxer shorts underneath.
  • My Beloved Smother: Billy Bibbit is terrified of his mother, though we never learn why as we don't even hear from her or see her. It is briefly mentioned that she won't let him find a wife or go off to college due to him supposedly having his whole life ahead of him, despite Billy being 31.
  • Nom de Mom: The Metis narrator is named Chief Bromden. He inherited "Chief" from his Indian dad, Chief Tee Ah Millatoona, but "Bromden" from his white mom. In fact, when his parents got married, his father took his mother's name instead of the other way around.
  • No Medication for Me: It is mentioned that the anti-seizure medication causes your teeth to fall out, which is a good reason why some of the patients don't want to take it.note  One gets the unfortunate side effect mentioned above, and decides he'd rather have the seizures; the other is terrified of having a seizure, and takes both men's doses just to be safe.
  • Obfuscating Disability: Chief Bromden. To clarify, he IS insane, just not deaf or mute.
  • Obfuscating Insanity: Adopted by McMurphy to get transferred to the hospital from the work farm he was originally sentenced to. It soon enough becomes clear that he's actually put himself in a worse spot.
  • Only Sane Man: McMurphy, literally.
  • Orderlies are Creeps: The orderlies act as Nurse Ratched's enforcers. The patients consider it a victory when one of them gets his nose broken in a basketball game, and again when McMurphy beats him up in a fistfight.
  • Order Versus Chaos: With chaos portrayed as good.
  • Politically Incorrect Hero: McMurphy is both racist and sexist (although some of this can be attributed to Values Dissonance). He repeatedly calls the black orderlies "coons," and at one point he claims that women who aren't sex objects are oppressive to men. When he first arrives at the mental hospital, before he knows any of the real reasons to object to Nurse Ratched's reign, his initial objection to her power is that it's "unnatural" for men to be so completely under the authority of a woman.
  • Porky Pig Pronunciation: Billy.
  • Prison Rape: Not exactly prison, but the orderlies at the Pendleton insane asylum love to give patients showers. They always check the patient's temperature at the same time they shower the patient, and they go down to Miss Ratched beforehand to get a rectal thermometer and a bottle of Vaseline. She admonishes them to use the minimum amount of Vaseline necessary, but they take the whole bottle inside with them, and they turn up the water pressure till the noise makes it impossible to hear anything that's going on inside...
  • Psycho Psychologist: The actual doctors are sane if ineffectual, but then there's Miss Ratched, and the orderlies who may need help a lot worse than the patients.
  • The Quiet One: Bromden. Until later.
  • Rage Breaking Point: McMurphy hits his when Billy Bibbit commits suicide after the ward party, blaming Nurse Ratched for shaming him into it.
  • Real Men Wear Pink: Contrast the closeted homosexual Harding (who fears showing signs of weakness) with the straight, boisterous McMurphy who isn't afraid to express his softer side once in a while.
  • Reasonable Authority Figure: Dr. Spivey. Unfortunately, he has no real power.
  • Room 101: The Disturbed Ward subverts this. Despite the electroshock therapy and lobotomies performed there, it's actually a refuge from Nurse Ratched's tyranny, and the staff will often try to prolong a patient's time on the Disturbed Ward because Ratched is just that nasty.
  • Sadist: Nurse Ratched is a coldly vindictive and utterly hateful Control Freak who uses her position to bully, intimidate, torture and lobotomise the patients in her care. She accepts no challenge to her authority. She is perfectly capable of intentionally driving her patients to suicide out of petty revenge. In addition, she allows the orderlies to rape the inmates in order to break them further and cement her own power.
  • Scary Black Man: The three daytime orderlies, Warren, Washington, and Williams, are horribly abusive to the patients.Williams at least has the excuse of having seen his mother raped by whites as a child. Averted with Geever, a night-shift orderly who removes the used chewing gum from the underside of the Chief's bunk, and Turkle, another night man who lets the patients have their party before McMurphy's self-foiled escape.
  • The Schizophrenia Conspiracy: "Chief" Bromden isn't given an explicit diagnosis but is usually interpreted as schizophrenic. One of the main themes of the novel is the patients' struggle against the "Combine", a vast force trying to control all of society through forced conformity. Not that this was Kesey's commentary on The '50s in any way...
  • Sesquipedalian Loquaciousness, Spock Speak: Our garrulous friend, Harding.
  • Sex Is Liberation: Billy, who becomes far more confident after spending a night with Candy. Unfortunately, Nurse Ratched threatens to tell his mother, which ultimately results in him being Driven to Suicide.
  • Shameful Strip: Inflicted upon Nurse Ratched by McMurphy when she finally pushes him over the edge. It completely obliterates the aura she had cultivated of being "above sex and everything else that's weak and of the flesh", freeing the ward from its terror of her and leading to all but the Chronics and a handful of Acutes voluntarily leaving her care.
  • Shown Their Work:
    • Kesey worked at the Oregon State Hospital's mental ward (then and still notorious for its poor quality) as an orderly and stated that the Big Nurse is based off an amalgamation of several nurses he had worked with.
    • He talked a fellow orderly into secretly giving him electroshock treatment as part of the research, and did a lot of acid. His hallucinations provided the basis of Bromden's schizophrenic narration.
    • When Chief Bromden speaks just after McMurphy offers him a piece of gum, this is a reference to a real incident when a catatonic schizophrenic who had been silent for 19 years finally spoke after he was reinforced with chewing gum.
    • When Harding describes the origins of electroconvulsive therapy, the bit about two psychiatrists visiting a slaughterhouse is not made up: those were Cerletti and Bini, who visited an abattoir in 1938 and got the idea that an epileptic fit could be induced by electricity. The idea that inducing seizures could have therapeutic effects, however, was proposed a few years earlier. Harding's Brief Accent Imitation of them, however, as Germans, is false. As is evident by their names, they were Italian.
  • The Sociopath: What McMurphy pretends to be to get committed. Unfortunately for him, Nurse Ratched actually is one.
  • Soft-Spoken Sadist: Nurse Ratched, who is very good at putting on a friendly facade to get what she wants.
  • Speech Impediment: Billy, who has a stutter. He even mentions that he had to drop out of ROTC because his stutter made it difficult for him to say he was here when it was time for attendance to be called.
  • Suddenly Speaking: Chief finally speaks for the first time in years in order to tell McMurphy "Thank you" for offering him a piece of gum. The two of them proceed to have a conversation with each other afterwards.
  • Supporting Protagonist: Bromden is the narrator, but McMurphy is the protagonist.
  • Terrified of Germs: George Sorensen is constantly washing his hands until the skin is raw, but is such a germophobe he won't use soap. After the fishing trip and the participants are forced to take a special shower to be deloused, George has a meltdown.
  • Through the Eyes of Madness: The novel is narrated by "Chief" Bromden, a paranoid schizophrenic who hears machinery clanking in the walls, sees his fellow patients controlled like marionettes by Nurse Ratched, and repeatedly claims the entire ward is enveloped in a thick white fog that makes it impossible to see or move. At the beginning he claims that everything he describes "Is true even if it didn't happen." His narration doubles both as a terrifyingly astute metaphor, and a description of his own view of a reality that was long ago fucked over.
  • Title Drop: The child's poem containing the title appears when Bromden narrates the repressed memories from his childhood that come to his mind during electroshock therapy.
  • The Tooth Hurts: Sefelt suffers an epileptic seizure and has to have a stick put in his mouth to keep him from biting his tongue. When an orderly pulls the stick out, a couple of his teeth go with it.
  • Troll: McMurphy's main strategy in his war with the tyrannical Nurse Ratched is being one.
  • Troubled Abuser: Williams, one of the Scary Black Man attendants who are downright abusive toward the patients of the mental hospital they work in, is said to have seen his mother being raped by a white man as a child.
  • Unreliable Narrator: Bromden is schizophrenic, and often hallucinates Literal Metaphors and ties things into an overarching Mind-Control Conspiracy. He cops to altering what happened by stating that his narration is true, even if it didn't happen this way.
  • Unusual Euphemism: "Poozle", a euphemism for sex that McMurphy uses at least once. "Whambam" is another sexual euphemism that he uses as well.
  • Visual Pun: McMurphy's boxers, depicting white whales, which was given to him by a literary student because he "was a symbol."
  • Vorpal Pillow: Chief Bromden sets McMurphy free from the asylum by suffocating him with a pillow.
  • Wham Line:
    • More illustrative of a character than something that fundamentally changes our perception of them, but it still comes as a shock: we know Bromden is faking being deaf/mute right from the start. What we don't know until roughly the halfway point is that Mac has him figured out quite early on: Chief reacts when Mac warns him about the black aide coming, to which Mac responded with a snicker and "I thought somebody told me you was deef."
    • Another line that's often overlooked is this simple statement from Harding which casts a new light on the Acutes' situation and makes McMurphy realise that he's the only hope for these men:
    Harding: I'm voluntary. I'm not committed.
  • White Is Pure: A Light Is Not Good example. Nurse Ratched and her orderlies are described as wearing clean white uniforms, with Ratched, in particular, being obsessed with keeping order in the Bedlam House that the novel takes place in.
  • You Just Told Me: McMurphy runs through the hallways of the asylum warning the patients that an orderly is on their way to check on them. Everyone stops what they're doing and pretends to sleep, including Chief Bromden. After it turns out to be a false alarm, McMurphy casually says to Bromden, "Hey Chief, I could've sworn they told me you was deaf!"

"… you think this is too horrible to have really happened, this is too awful to be the truth! But, please. It’s still hard for me to have a clear mind thinking on it. But it’s the truth even if it didn’t happen."