One Flew Over the Cuckoo's Nest

“But it’s the truth even if it didn’t happen.”

Bromden’s comment may suggest he is aware that his account, filtered through his hallucination-prone perspective, deviates from a literal recounting of events. It can also be seen as a metafictional commentary on the novel itself, or even the role of fiction generally. Though the specific characters and events are not real, they are analogous to things that could or do happen, making the novel truthful, if not literally true.

“I remember the fingers were thick and strong closing over mine, and my hand commenced to feel peculiar and went to swelling up out there on my stick of an arm, like he was transmitting his own blood into it. It rang with blood and power. It blowed up near as big as his, I remember.”

McMurphy manages to rouse Bromden and the other patients from their complacency. Bromden senses this charisma from the moment he first shakes McMurphy’s hand. The physicality of the handshake and Bromden’s sense of a blood transfer signifies the primal, instinctive level through which McMurphy acts and communicates, as opposed to the dry clinical environment of the ward.

“What she dreams of there in the center of those wires is a world of precision efficiency and tidiness like a pocket watch with a glass back, a place where the schedule is unbreakable and all the patients who aren’t Outside, obedient under her beam, are wheelchair Chronics with catheter tubes run direct from every pantleg to the sewer under the floor.”

Whereas Ratched suggests that McMurphy causes chaos for its own sake, Bromden observes that Ratched similarly prefers order for its own sake. Thus, their conflict takes on political overtones, not merely moral or social ones. Ratched’s ideal world can manifest only through manipulation and control, whether subtle or overt.

“He adjusts them like he was adjusted. This is the way they spread it.”

Bromden imagines a reformed patient returning to society and exerting a normalizing influence on others. This viral spread pattern helps to explain how and why the Combine has such a strong hold in society. As McMurphy demonstrates, however, liberation can also be contagious.

“I can’t help it. I’m tired. I’m give out trying. I had so many insults I was born dead. You got chances. […] You got it easy.”

Pete, who sustained brain damage as a child, maintains that his mental health challenges are on a fundamentally different level than those of the acute patients he addresses. His repeated assertions of fatigue constitute a reminder that, for him, life is inherently difficult. Others, like Bromden and Billy, experience challenges and develop unhealthy thinking patterns primarily because of their experiences and the environments in which they live rather than because of any physiological phenomena.

“What she is is a ball-cutter. I’ve seen a thousand of ‘em, old and young, men and women. Seen ’em all over the country and in the homes—people who try to make you weak so they can get you to toe the line, to follow their rules, to live like they want you to. And the best way to do this, to get you to knuckle under, is to weaken you by gettin’ you where it hurts the most.”

McMurphy compares society’s processes for obtaining submission to castration. Though the symbol and the language he uses to describe it are sex specific, he clarifies that both men and women play the role of “ball-cutter” and, presumably, both are subject to the same treatment. The suggestion that applying or threatening pain obtains compliance mirrors Ratched’s efforts to control the ward through fear and shame.

“But if they don’t exist, how can a man see them?”

After one of Bromden’s hallucinations, he anticipates the skeptical responses others would give if he shared what he saw. He then counters their imagined responses with his reasoning that the things he sees must exist. Bromden offers mounting evidence of the damages caused by the social structures he collectively calls “the Combine,” and readers must decide how much sense they find in his visions.

“I get a smell of something that makes me realize for the first time since I been in the hospital that this big dorm full of beds, sleeps forty grown men, has always been sticky with a thousand other smells […] but never before now, before he came in, the man smell of dust and dirt from the open fields, and sweat, and work.”

Though the patients are supposedly preparing to re-enter society, they spend their days playing games and completing menial tasks in a sterile environment. McMurphy brings with him evidence of a difference kind of work: strenuous, physical, outdoor labor. In large part a product of his experience, McMurphy’s raw physicality makes him a difficult target for Ratched to tame.

“He’s safe as long as he can laugh, he thinks, and it works pretty fair.”

McMurphy’s laugh is more than an expression of amusement; it is a defense against Ratched’s humorless worldview. Whereas fear and despair keep the other patients from laughing, McMurphy’s ability to find humor in unpleasant situations provides him with an extra layer of resilience.

“‘But I tried, though,’ he says. ‘Goddammit, I sure as hell did that much, now, didn’t I?’”

Although the conflict between McMurphy and Ratched takes place on uneven ground, with institutional advantages in Ratched’s favor, McMurphy continues to struggle. When he loses his bet about moving the control panel, as he knew he would, he turns the moment into a teaching opportunity of sorts. His anger at the others for not trying demonstrates his real purpose: to help them.

“Nobody complains about all the fog. I know why, now: as bad as it is, you can slip back in it and feel safe.”

McMurphy expresses his confusion at the other patients’ choice to remain in the hospital instead of leaving. Here, Bromden provides a significant reason why they do so: security. Although being figuratively lost in the fog is not ideal, it can appear preferable to the alternative, resistance, which involves risks and effort.

“I’d think, That ain’t me, that ain’t my face. It wasn’t even me when I was trying to be that face. I wasn’t even really me then; I was just being the way I looked, the way people wanted. It don’t seem like I have ever been me. How can McMurphy be what he is?”

Bromden considers how thoroughly his identity has been shaped by outside forces even before he checked into the hospital. If McMurphy guides Bromden to an awakening of sorts, his journey of self-discovery just begins as the novel closes. His goal is not to become like McMurphy but to be authentic to himself in the same way that McMurphy is authentic to himself.

“Even if you take into consideration the harmful effects of the medicine, don’t you think it’s better than that?”

Ratched poses this question after Sefelt has a seizure. It exemplifies the passive-aggressive scare tactics with which she manipulates the patients on the ward. In the end, when Sefelt comes to terms with taking his medication, he does so within the context of living an affirmative, confident life rather than acting out of fear.

“‘What a life,’ Sefelt moans. ‘Give some of us pills to stop a fit, give the rest shock to start one.’”

Sefelt’s comment hints at the irony, even hypocrisy, of a medical system that diagnoses seizures as symptoms of illness in some cases while inducing them as treatment in others. This inconsistency is one example of the seeming insanity of the medical system. Kesey juxtaposes these examples with the rational thinking and actions of the patients classified as insane.

“They talk for a while about whether [Ratched is] the root of all the trouble here or not, […] but McMurphy isn’t so sure any more. He says he thought so at one time but now he don’t know. He says he don’t think getting her out of the way would really make much difference; he says that there’s something bigger making all this mess and goes on to try to say what he thinks it is. He finally gives up when he can’t explain it.”

While Ratched is the most immediate target of resentment for the ward’s patients, Bromden and McMurphy come to understand that she is just one part of a larger entity. McMurphy’s inability to explain it reveals one area in which Bromden is better suited to speak, given his background and experience. Although McMurphy recognizes that Ratched is only part of the problem, he still decides to attack her in the end, offering proof of his earlier insistence that there is value in trying to resist.

“I tell you this hoping you will understand that it is entirely for your own good that we enforce discipline and order.”

Ratched claims to act with the patients’ best interests at heart. However, she fails to provide compelling evidence that her methods result in any marked improvement—whether in mental health or quality of life—in her patients. She counts as success those who, like Mr. Taber, assimilate themselves into society, but such ambiguous success comes at the cost of individuality.

“The salt smell, the poundin’ sea, the crack o’ the bow against the waves—braving the elements, where men are men and boats are boats.”

McMurphy presents the fishing trip as a chance to escape the hospital ward’s mind games and psychological warfare for a time. Ironically, the fishing trip turns out to have plenty of therapeutic value, at least in terms of self-actualization, providing newfound confidence to those who attend. The implication is that time spent in nature helps undo the Combine’s oppressive effects.

“It wasn’t me that started acting deaf; it was people that first started acting like I was too dumb to hear or see or say anything at all.”

Bromden explains that the discrimination he experienced as a child and in the army pushed him toward acting as though he were deaf and mute. In the hospital, the staff continue to treat him as though he cannot hear or speak, which leads him to continue the behavior. Only when McMurphy suspects that Bromden can hear and speak—and treats him accordingly—does Bromden begin to open up again.

“All up the coast I could see the signs of what the Combine had accomplished since I was last through this country, things like, for example—a train stopping at a station and laying a string of full-grown men in mirrored suites and machined hats […] Or things like five thousand houses punched out identical by a machine and strung across the hills outside of town.”

During his first trip in a long time to the world outside the hospital ward, Bromden observes changes in the world with a fresh perspective. What he sees convinces him that the trends he observes within the hospital are taking place on a much broader scale. His comments come as a critique of urbanization and the kind of repetitive, institutional office work that men like McMurphy would never do.

“Because he knows you have to laugh at the things that hurt you just to keep yourself in balance, just to keep the world from running you plumb crazy. He knows there’s a painful side, […] but he won’t let the pain blot out the humor no more’n he’ll let the humor blot out the pain.”

Bromden considers the function of humor and what it means to have a balanced outlook when McMurphy laughs during the fishing trip. The notion of laughter as medicine is cliché, but Bromden’s perspective accords with his personal experience. Only when Bromden allows himself to laugh—even at himself—does he begin to adopt a more balanced outlook that acknowledges fears and concerns without letting them dominate.

“Maybe the Combine wasn’t all-powerful. What was to stop us from doing it again, now that we saw we could? Or keep us from doing other things we wanted?”

At the beginning of the novel, Bromden has a defeatist outlook on life. After witnessing McMurphy’s impact, he begins to imagine new possibilities for himself and the future. His realization pushes him to set out from the hospital ward in search of a better life after years of stagnation.

“It wasn’t the practices, I don’t think, it was the feeling that the great, deadly, pointing finger of society was pointing at me—and the great voice of millions chanting, ‘Shame. Shame. Shame.’ It’s society’s way of dealing with someone different.”

Harding identifies shame as the most significant factor affecting his mental health and driving him to seek help. Ironically, his stay in the hospital only compounds his shame, as Ratched leads meetings in which the patients critique one another’s perceived faults. McMurphy, on the other hand, has little or no shame, and he does not use it to manipulate others.

“The thing he was fighting, you couldn’t whip it for good. All you could do was keep on whipping it, till you couldn’t come out any more and somebody else had to take your place.”

Aware of the Combine’s scope and reach, Bromden recognizes that McMurphy, dynamic as he is, cannot overthrow the entire system. Instead, the struggle between conformity and individuality persists and spans generations. When McMurphy dies, he leaves behind a group of peers whom he has helped equip to carry on his effort. Bromden’s plan to visit the Columbia River gorge where he grew up represents the possibility to restore some of what he has lost.