One Flew Over the Cuckoo’s Nest Part I, Chapter Four Summary

  • Nurse Flinn asks Nurse Ratched what she thinks of McMurphy. Big Nurse responds that in her opinion the new patient is a manipulator and plans to "take over."
  • But why would he want to do that? Nurse Flinn wants to know.
  • Big Nurse responds, "You seem to forget, Miss Flinn, that this is an institution for the insane."
  • Big Nurse likes everything run perfectly, and she likes to keep absolute control. But since she spends time on the Outside, she likes to control that, too.
  • Chief thinks of Nurse Ratched as a part of the "Combine," which to him is a sort of group of controlling people who not only try to manipulate the ward (the Inside), but the outside world as well.
  • The Big Nurse wants such perfect control that she hopes every patient becomes a wheelchair Chronic. She even she creates a perfectly subservient staffdoctors, nurses, etc.to fit what she wants. If a doctor won’t conform to her wishes, she makes him so miserable that he begs for a transfer out of her ward.
  • As far as orderlies go, Nurse Ratched has gotten rid of tons of orderlies who didn’t conform to what she wanted. If they don’t hate enoughif they don’t hate her enoughthen she lets them go. The ones she keeps are all black. Chief usually refers to them as "the black boys."
  • The first orderly she decided to keep had seen his mother raped while his father stood by, tied to the hot iron stove. The other two orderlies, also black, came two years later. They are very dark-skinned. According to Big Nurse, the darker their skin, the more likely they are to keep the ward spotlessly clean.
  • The orderlies are in such sync with Big Nurse that she doesn’t even have to communicate what she wants. They are "in contact on a high-voltage wave length of hate."
  • At 6:45, the shavers buzz and the Acutes line up to get shaved. Next, the walking Chronics go through; the Wheelers go in last.
  • At 7:00, the mess hall opens and they enter in reverse order.
  • At 7:30, they’re back to the day room.
  • Big Nurse pushes a button to get everything started. Everybody waits.
  • At 7:45, the orderlies move down the line of Chronics to tape catheters on those who need them.
  • At 8:00, the Big Nurse announces "Medications." The Acutes first, then the Chronics, then the Wheelers get their medicines. The Vegetables get theirs last.
  • If somebody asks what they’re being required to swallow, they’re dealt a punishment. This time, it’s Taber who asks. He’s forced to spend the morning mopping latrines.
  • Chief once managed to keep one under his tongue, then crushed it to see what was inside. He saw it contained microscopic wires and grids, like the ones he helped the Radar Corps work with in the Army. (Sounds like more hallucinations here.)
  • At 8:20, the cards and puzzles come out.
  • At 8:30, the ward door opens and two technicians come in, smelling like wine.
  • Two of the orderlies catch Taber in the latrine and take him to the mattress room. They push him face down onto the mattress. The nurse comes in with a long needle and they close the door. She comes back out, wiping the needle on part of Taber’s pants. The orderlies are in room with Taber for a long time and then they come out, carrying the patient across the hall. He’s wrapped in a damp sheet.
  • At 9:00, residents (young doctors) come in to talk to the Acutes about what they did when they were little boys.
  • At 9:50, the residents leave.
  • Taber is wheeled out on a gurney.
  • They take him over to the Shock Room.
  • At 10:00, the mail comes.
  • At 10:30, Public Relation, the hospital employee responsible for public relations, comes in with a ladies’ club following. He brings women on tours through the ward and then they have coffee with the nurses. Sometimes, he stays outside in the day room and laughs and laughs, but Chief doesn’t know what’s so funny.
  • At 10:40, 10:50, 11:00, etc., patients shuffle in and out for appointments.
  • Chief describes the ward as humming the way a cotton mill hums.
  • Chief enters memory lane and he tells us about his high school days as a member of the football team.
  • The entire team goes to visit a cotton mill. Chief stays inside the building, out of the way of the black girls who are running around and working the machines. Chief is wearing his championship jacket and the girls begin to stare at him.
  • One of the girls approaches Chief and chats about football for a while. She’s obviously flirting. Chief comments on how all of the cotton fluff floating around makes it seem like he’s seeing her through a fog on a duck-hunting trip.
  • The girl flirtatiously asks what he’d want with her, out alone in the woods in a duck blind. He answers that she could take care of his gun. All the girls are giggling by this point.
  • She takes ahold of his wrists and says, "Do, take me out of here, out of the mill, out of this life. Take me to a duck blind sometime, huh, Big Boy?" And Chief is totally confused, standing there looking at her, with his mouth open.
  • The memory ends.
  • The ward is like a factorya factory for the "Combine" that deals with mistakes made out in society. And Big Nurse is happy about it.
  • She mentions how Taber is so much better since he got back from the hospital.
  • But an Admission is different. An Admission will always need to be worked on to make him fit into the routine. A new Admit might foul everything up. Chief reminds us that Big Nurse gets really peeved if anything keeps her operation from running smoothly. This is what we call blatant foreshadowing.