Synopsis Of The Novel

An Oregon state mental institution in the 1960s is the scene for a contest of wills between the staff and the inmates. The catatonic Native American Chief Bromden (Chief Broom) narrates One Flew Over the Cuckoo's Nest even though he appears deaf and mute. Diagnosed with delusional paranoia, while in a fog and feeling helpless, he fears the Combine controls everything. The driving force in the mental institution is the militaristic Nurse Ratched (the Big Nurse), who wields her authority severely over everyone, including the professional medical staff, the black boy aides, and the patients. The new patient, Randle P. McMurphy (Mack), whom the court ruled a psychopathic prisoner, has feigned insanity to be transferred from Pendleton Work Farm. In his cocky, in-your-face manner, he introduces himself as "a gambling fool" to other asylum inmates. Using his charm, he craftily sets them up as pigeons to pluck in card games. The patients are divided into the incurable Chronics like the big half-breed Chief, who is a flawed product of the Combine, and the curable Acutes who Nurse Ratched eggs on, attacking them where they are most vulnerable. A patient may come in as an Acute and then be turned into a robotic Chronic (Walker, Wheeler, or Vegetable) after being punished in the Shock Shop with electroshock treatments or with the permanent disfiguration of psychosurgery (lobotomy). Threats with these therapies enforce cooperation while keeping the two groups separated. Ratched has already assessed Mack as a troublemaker who will manipulate the system and disrupt the mental ward. She runs a tight ship, shunning outside disturbances to keep the precision asylum machinery (the Combine) humming. Her ideal medical staff, the Chief tells us, has been hand-picked and after years of training molded to suit her needs, staying "in contact on a high-voltage wavelength of hate." She taught them her way to get inmates into shape was to patiently "wait for a little advantage . . . then twist the rope and keep the pressure steady."

Through the fog of his schizophrenia the Big Chief keenly watches the new admission, McMurphy, in the group psychotherapy meeting. Ratched begins the discussion from a topic logged in the ward book having to do with Dale Harding's promiscuous, well-endowed young wife, his feelings of inferiority, and resultant sexual dysfunction. He is a probable case of situational madness resulting from his wife's emasculating nature. Mack had initially challenged Harding, the effeminate, college-educated president of the Patients' Council, for the role of the Bull Goose Loony or the alpha male, but they soon become friendly when Harding proves a valuable source of information. Mack garners the most interest in the meeting, however, when Ratched introduces him as a recipient of the Distinguished Service Cross in Korea for leading a Communist prison camp escape. Subsequently, he was dishonorably discharged for insubordination and later arrested for drunkenness, gambling, assault and battery, and statutory rape. Mack refutes only the latter. Dr. Spivey, the ward doctor, misaddresses him as "Mr. McMurry"—Ratched's attempt to demoralize Mack through improperly pronouncing his name—and looks into his file, reading the diagnosis: "repeated outbreaks of passion that suggest the possible diagnosis of psychopath." In retaliation, Mack tries to intimidate Ratched. Meanwhile, Dr. Spivey explains the group meeting protocol and why a democratic therapeutic community, as a prototype of the outside world, requires conformity that will allow them to return to the outside. The patients in group therapy are encouraged to discuss and confess, revealing the secrets of the subconscious. Rather than being Freud-inspired talk therapy, though, it turns out to be a Ratched-led pecking party, and this time Harding is unmercifully grilled and shamed. Hearing all this and watching an agitated patient receive a subduing hip shot, Mack, in the end, thinks it might be smart to carefully assess the situation before he "makes any kind of play." He enters into a lengthy dialogue with Harding and others about Ratched's role in emasculating them, culminating in a bet that he will "get her goat" within a week.

Mack's rebellious nature takes over as he begins rallying the patients and gaining hero status by challenging Ratched's authority and by procuring special favors for them. For example, in the shower room Mack complains to a black orderly about the ward policy that he can brush his teeth at only a certain time, and when Ratched comes in, he tells her his clothes were taken and threatens to drop his towel. Ratched angrily calls for new clothes. Further taunting Ratched, Mack complains about loud ward music overriding his conversation while gambling for cigarettes; however, Ratched says it consoles the hard-of-hearing older patients. Mack then presses to move his game to the old tub room, no longer in use because drugs have replaced hydro-therapy. She refuses, but Mack persuades Dr. Spivey to change the venue. Mack continues to break the rules by using real money (not cigarettes) to play Monopoly. He takes bets on the World Series. In a key vote to watch the World Series, Mack gets the Big Chief to raise his hand. Ratched balks at the schedule change, and the Acutes do a sit-in protest in front of the TV set. With each loss of authority Ratched patiently, coldly waits: "she has all the power of the Combine behind her."

In part 2 Ratched is suspicious of the Big Chief's new cognitive responsiveness, and even though he still exhibits paranoia, his schizophrenic fog may be lifting. In a staff meeting, the question arises whether Mack is a clever con man or a violent psychopath. Ratched convinces others that sending Mack to the Disturbed Ward would only enhance his hero status; therefore, she favors keeping him in the general population where, before long, he will show his own avarice and cowardice. The Chief, in his narration, theorizes Mack truly is an extraordinary man, capable of resisting the Combine. Noting aberrant staff actions, however, he questions who in the mental institution is completely sane. Mack's leadership continues to embolden the Acutes. He has given them a reason to wake up, and they now question ward policies, such as on rationing cigarettes. Then Mack, in a catch-22, backs off when he realizes, as an involuntarily committed patient, Ratched decides if he is cured or not (released or not). By failing to rally forces against Ratched, he disheartens the patients, possibly leading to Cheswick's suicide. Ward privileges are revoked, and therapy sessions return to silence.

Mack witnesses an epileptic seizure, learning about the side effects of the drug that may prevent it, as well as the staff wielding its power through using electroshock therapy ("brain burning"), which, ironically, is actually the induction of a seizure. Mack is shocked to learn that Harding, Billy, and others have voluntarily committed themselves, and they are free to leave at any time. It is only their fears of the outside world that keep them there. Ratched, feeling her control returned, smugly informs the men that they must have the privilege of using the tub room for card playing taken away as punishment for their insurrections and that having a sense of order and discipline will help them adjust to societal rules in the outside world. Convinced she had the final victory and control over Mack, Ratched is startled to see him plunge his hand through the glass window of the nurses' station, extracting one of his own cigarettes. She does not retaliate but bides her time.

In part 3 sports are introduced, causing the men to renew their muscle-flexing and to build self-esteem. Being denied day passes, Mack again puts his hand through Ratched's glass window. Tension builds as Mack's rebelliousness increases. At this time, he recruits the patients to go on a supervised deep-sea fishing trip, but Ratched frightens the men. Chief Bromden really wants to go but knows he will blow his cover by indicating so. Acting deaf has allowed him to hear. It started as a child when outside people who saw an American Indian as invisible quit listening to him. When Indian land was seized to make a hydroelectric dam, the government had his white mother, instead ofhis chief father, sign the deal. Chief Broom begins to emerge from his silence one night when Mack offers him some gum, and he replies, "Thank you." A conversation ensues, and Mack works on the Chief's ego to convince him to throw the tub room control panel out the window for escape.

Mack pushes to arrange a deep-sea fishing trip, signing up the Chief as the only Chronic going. With great effort, because Ratched had tried to "damp the man out of them," Mack gets the quota needed for the trip. But, when only one chaperone shows up, the prostitute Candy Starr, Dr. Spivey must step forward as the second chaperone. All the way to the dock, the men show bravado and courage, and instinctively a manliness once derailed returns. They surpass many obstacles on their road trip to the sea; in the end, without a properly signed waiver, they even hijack a boat. The fishing trip, complete with victorious fishing and hearty camaraderie, has returned a natural masculinity to formerly emasculated men. And laughter "started slow and pumped itself full, swelling the men bigger and bigger." Mack watches as the men appear to slowly take back their lives. Billy and Candy become smitten, and Mack invites her to the mental institution on Saturday.

Back at the mental institution in part 4, Ratched plots to discredit Mack by disclosing to the patients how much money he is making on them from gambling and arranging games and trips. Her ploy seems to be working, until Mack and Chief Bromden defend George Soren-son in a fistfight with the black orderlies. As punishment, they receive EST in the Disturbed Ward, which Mack compares to electrocution. Because he will not relent, but rather acts heroically, Ratched orders more EST for Mack. When he begins to attain legendary status, Ratched brings him back to her ward where she works on making him appear weak. Still rebellious, Mack arranges for Billy to lose his virginity to Candy during a drunken night on the ward. The other patients urge Mack to escape rather than face further repercussion from Ratched. But, drugged and drunk, he falls asleep. In the morning, Ratched takes it all in and threatens to tell Billy's mother about his encounter with Candy. When Billy cuts his throat, Mack attacks Ratched. In retaliation, she has him lobotomized. Bromden humanely releases Mack from his vegetative state by suffocating him, and he escapes back out into his life.

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