Study Guide

One Flew Over the Cuckoo’s Nest Madness

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Part I, Chapter One

They don't bother not talking out loud about their hate secrets when I'm nearby because they think I'm deaf and dumb. Everybody thinks so. I'm cagey enough to fool them that much. If my being half Indian ever helped me in any way in this dirty life, it helped me being cagey, helped me all these years. (1.1.7)

Because everybody assumes Chief is already crazy, he’s able to keep on fooling them.

Part I, Chapter Three

One side of the room younger patients, known as Acutes because the doctors figure them still sick enough to be fixed, practice arm wrestling and card tricks where you add and subtract and count down so many and it's a certain card. Billy Bibbit tries to learn to roll a tailor-made cigarette, and Martini walks around, discovering things under the tables and chairs. The Acutes move around a lot. They tell jokes to each other and snicker in their fists (nobody ever dares let loose and laugh, the whole staff'd be in with notebooks and a lot of questions) and they write letters with yellow, runty, chewed pencils.


Across the room from the Acutes are the culls of the Combine's product, the Chronics. Not in the hospital, these, to get fixed, but just to keep them from walking around the streets giving the product a bad name. Chronics are in for good, the staff concedes. Chronics are divided into Walkers like me, can still get around if you keep them fed, and Wheelers and Vegetables. What the Chronics are—or most of us—are machines with flaws inside that can't be repaired, flaws born in, or flaws beat in over so many years of the guy running head-on into solid things that by the time the hospital found him he was bleeding rust in some vacant lot. (1.3.2-5)

Patients identify themselves, and each other, according to whether their condition is considered curable or incurable, so they see their mental illness is their defining characteristic.

Part I, Chapter Five
Randle McMurphy

The doctor fishes his glasses out again and puts them on and looks to where McMurphy is pointing.

"Right here, Doc. The nurse left this part out while she was summarizing my record. Where it says, 'Mr. McMurphy has evidenced repeated'—I just want to make sure I'm understood completely, Doc—'repeated outbreaks of passion that suggest the possible diagnosis of psychopath.' He told me that 'psychopath' means I fight and fuh—pardon me, ladies—means I am he put it overzealous in my sexual relations. Doctor, is that real serious?"

He asks it with such a little-boy look of worry and concern all over his broad, tough face that the doctor can't help bending his head to hide another little snicker in his collar, and his glasses fall from his nose dead center back in his pocket. All of the Acutes are smiling too, now, and even some of the Chronics.

"I mean that overzealousness, Doc, have you ever been troubled by it?"

The doctor wipes his eyes. "No, Mr. McMurphy, I'll admit I haven't. I am interested, however, that the doctor at the work farm added this statement: 'Don't overlook the possibility that this man might be feigning psychosis to escape the drudgery of the work farm.'" He looks up at McMurphy. "And what about that, Mr. McMurphy?"

"Doctor"—he stands up to his full height, wrinkles his forehead, and holds out both arms, open and honest to all the wide world—"do I look like a sane man?"

The doctor is working so hard to keep from giggling again he can't answer. McMurphy pivots away from the doctor and asks the same thing of the Big Nurse: "Do I?" (1.5.52-58)

Crazy or not crazy, McMurphy is one smart cookie. He’s getting the doctor and all the patients on his side.

Part I, Chapter Fifteen

And we're all sitting there lined up in front of that blanked-out TV set, watching the gray screen just like we could see the baseball game clear as day, and she's ranting and screaming behind us. If somebody'd of come in and took a look, men watching a blank TV, a fifty-year-old woman hollering and squealing at the back of their heads about discipline and order and recriminations, they'd of thought the whole bunch was crazy as loons. (1.15.134-135)

When the men assert their will against Nurse Ratched and her petty attempts to control them, they look as if they’re crazy—even though they’ve never been saner in their lives.

Part II, Chapter One
Doctor Spivey

"You fellows," the doctor says, "I realize you haven't had adequate time to arrive at a proper diagnosis of the patient, but you have had a chance at observing him in action. What do you think?"

The question pops their heads up. Cleverly, he's put them on the carpet too. They all look from him to the Big Nurse. Some way she has regained all her old power in a few short minutes. Just sitting there, smiling up at the ceiling and not saying anything, she has taken control again and made everyone aware that she's the force in here to be dealt with. If these boys don't play it just right they're liable to finish their training up in Portland at the alky hospital. They begin to fidget around like the doctor.

"He's quite a disturbing influence, all right." The first boy plays it safe.

They all sip their coffee and think about that. Then the next one says, "And he could constitute an actual danger."

"That's true, that's true," the doctor says.

The boy thinks he may have found the key and goes on. "Quite a danger, in fact," he says and moves forward in his chair. "Keep in mind that this man performed violent acts for the sole purpose of getting away from the work farm and into the comparative luxury of this hospital."

"Planned violent acts," the first boy says.

And the third boy mutters, "Of course, the very nature of this plan could indicate that he is simply a shrewd con man, and not mentally ill at all."

He glances around to see how this strikes her and sees she still hasn't moved or given any sign. But the rest of the staff sits there glaring at him like he's said some awful vulgar thing. He sees how he's stepped way out of bounds and tries to bring it off as a joke by giggling and adding, "You know, like 'He Who Marches Out Of Step Hears Another Drum'"—but it's too late. The first resident turns on him after setting down his cup of coffee and reaching in his pocket for a pipe big as your fist.

"Frankly, Alvin," he says to the third boy, "I'm disappointed in you. Even if one hadn't read his history all one should need to do is pay attention to his behavior on the ward to realize how absurd the suggestion is. This man is not only very very sick, but I believe he is definitely a Potential Assaultive. I think that is what Miss Ratched was suspecting when she called this meeting. Don't you recognize the arch type of psychopath? I've never heard of a clearer case. This man is a Napoleon, a Genghis Khan, Attila the Hun."

Another one joins in. He remembers the nurse's comments about Disturbed. "Robert's right, Alvin. Didn't you see the way the man acted out there today? When one of his schemes was thwarted he was up out of his chair, on the verge of violence. You tell us, Doctor Spivey, what do his records say about violence?"

"There is a marked disregard for discipline and authority," the doctor says.

"Right. His history shows, Alvin, that time and again he has acted out his hostilities against authority figures—in school, in the service, in jail! And I think that his performance after the voting furor today is as conclusive an indication as we can have of what to expect in the future." He stops and frowns into his pipe, puts it back in his mouth, and strikes a match and sucks the flame into the bowl with a loud popping sound.

When it's lit he sneaks a look up through the yellow cloud of smoke at the Big Nurse; he must take her silence as agreement because he goes on, more enthusiastic and certain than before. (2.1.26-37)

The staff discusses what to do about McMurphy, but only one person is willing to question whether he’s crazy or just really smart. It is his propensity toward rebellion that makes him, in the eyes of the staff, mentally ill. Yet even within that meeting, you can see that everybody has something to lose if they admit they don’t think he’s crazy. The power Nurse Ratched wields over the staff results in McMurphy’s ongoing diagnosis as mentally ill.

Out in the hall all by myself, I notice how clear it is—no fog any place. It's a little cold where the nurse just went past, and the white tubes in the ceiling circulate frozen light like rods of glowing ice, like frosted refrigerator coils rigged up to glow white. The rods stretch down to the staff-room door where the nurse just turned in at the end of the hall—a heavy steel door like the door of the Shock Shop in Building One, except there are numbers printed on this one, and this one has a little glass peephole up head-high to let the staff peek out at who's knocking. As I get closer I see there's light seeping out this peephole, green light, bitter as bile. The staff meeting is about to start in there, is why there's this green seepage; it'll be all over the walls and windows by the time the meeting is halfway through, for me to sponge off and squeeze in my bucket, use the water later to clear the drains in the latrine.

Cleaning the staff room is always bad. The things I've had to clean up in these meetings nobody'd believe; horrible things, poisons manufactured right out of skin pores and acids in the air strong enough to melt a man. I've seen it.

I been in some meetings where the table legs strained and contorted and the chairs knotted and the walls gritted against one another till you could of wrung sweat out the room. I been in meetings where they kept talking about a patient so long that the patient materialized in the flesh, nude on the coffee table in front of them, vulnerable to any fiendish notion they took; they'd have him smeared around in an awful mess before they were finished.

That's why they have me at the staff meetings, because they can be such a messy affair and somebody has to clean up, and since the staff room is open only during the meetings it's got to be somebody they think won't be able to spread the word what's going on. That's me. I been at it so long, sponging and dusting and mopping this staff room and the old wooden one at the other place, that the staff usually don't even notice me; I move around in my chores, and they see right through me like I wasn't there—the only thing they'd miss if I didn't show up would be the sponge and the water bucket floating around. (2.1.11-14)

Part of Chief’s madness is seeing things that don’t really exist—yet they do exist. He sees intangible things like emotion, or evil, or manipulation, or attempts to assert power as tangible, like green slime oozing out of the pores of staff members while they discuss the men on the ward.

Part II, Chapter Three
Charles Cheswick

In the group meetings there were gripes coming up that had been buried so long the thing being griped about had already changed. Now that McMurphy was around to back them up, the guys started letting fly at everything that had ever happened on the ward they didn't like.

"Why does the dorms have to be locked on the weekends?" Cheswick or somebody would ask.

"Can't a fellow even have the weekends to himself?"

"Yeah, Miss Ratched," McMurphy would say. "Why?"

"If the dorms were left open, we have learned from past experience, you men would return to bed after breakfast."

"Is that a mortal sin? I mean, normal people get to sleep late on the weekends."

"You men are in this hospital," she would say like she was repeating it for the hundredth time, "because of your proven inability to adjust to society. The doctor and I believe that every minute spent in the company of others, with some exceptions, is therapeutic, while every minute spent brooding alone only increases your separation."

"Is that the reason that there has to be at least eight guys together before they can be taken off the ward to OT or PT or one of them Ts?"

"That is correct."

"You mean it's sick to want to be off by yourself?"

"I didn't say that—"

"You mean if I go into latrine to relieve myself I should take along at least seven buddies to keep me from brooding on the can?"

Before she could come up with an answer to that, Cheswick bounced to his feet and hollered at her, "Yeah, is that what you mean?" and the other Acutes sitting around the meeting would say, "Yeah, yeah, is that what you mean?"

She would wait till they all died down and the meeting was quiet again, then say quietly, "If you men can calm yourself enough to act like a group of adults at a discussion instead of children on the playground, we will ask the doctor if he thinks it would be beneficial to consider a change in the ward policy at this time. Doctor?"

Everybody knew the kind of answer the doctor would make, and before he even had the chance Cheswick would be off on another complaint. (2.3.1-14)

The men begin questioning the rules and regulations that govern their lives. Nurse Ratched clings to ward policy, and reminds them of their mental illnesses, to prevent a full-scale rebellion. She posits law and order as the cure to their inability to adjust to society; if they get the freedoms they want, they will never be able to live on the Outside.

Part III, Chapter Two
Dale Harding

"No, my friend. We are lunatics from the hospital up the highway, psycho-ceramics, the cracked pots of mankind. Would you like me to decipher a Rorschach for you? No? You must burry on? Ah, he's gone. Pity." He turned to McMurphy. "Never before did I realize that mental illness could have the aspect of power, power. Think of it: perhaps the more insane a man is, the more powerful he could become. Hitler an example. Fair makes the old brain reel, doesn't it? Food for thought there." (3.2.102)

Harding realizes that mental illness has the power to invoke fear and, thus, to manipulate people.

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