One Flew Over the Cuckoo's Nest (novel)

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One Flew Over the Cuckoo's Nest
First edition
Author Ken Kesey
Cover artist Paul Bacon[1]
Country United States
Language English
Publisher Viking Press & Signet Books
Publication date
Pages 320
OCLC 37505041

One Flew Over the Cuckoo's Nest (1962) is a novel written by Ken Kesey. Set in an Oregon psychiatric hospital, the narrative serves as a study of the institutional processes and the human mind as well as a critique of behaviorism and a celebration of humanistic principles. It was adapted into the broadway (and later off-broadway) play One Flew Over the Cuckoo's Nest by Dale Wasserman in 1963. Bo Goldman adapted the novel into a 1975 film directed by Miloš Forman, which won five Academy Awards.

Time magazine included the novel in its "100 Best English-language Novels from 1923 to 2005" list.[2] In 2003 the book was listed on the BBC's The Big Read poll of the UK's 200 "best-loved novels."[3]


The book is narrated by "Chief" Bromden, a gigantic yet docile half-Native American patient at a psychiatric hospital, who everyone presumes is deaf and mute, a belief he passively allows so he can be "cagey". Bromden’s tale focuses mainly on the antics of the larger than life, happily rebellious Randle Patrick McMurphy, who faked insanity to serve his sentence for battery and gambling in the hospital rather than at a prison work farm. The head administrative nurse, Nurse Ratched, known throughout the story as the "Big Nurse", rules the ward with absolute authority, zero compassion, and little medical oversight. She is assisted by her three hate-filled day-shift orderlies whom she selects based on how bitter and angry they each are, and her weak-willed assistant doctors, knowing they will always go along with what she says.

Acting on a bet to get the Big Nurse to lose control of her infamous steel resolve, McMurphy constantly antagonizes her and upsets the routines of the ward, leading to endless power struggles between himself and the nurse. He encourages gambling and runs a card table, captains the ward's impromptu basketball team, comments on the Big Nurse's figure, her over-sized womanly features being a source of shame she resents for having no control over, inspires the other patients to conduct a vote about watching the World Series on television, a vote the Big Nurse refuses to acknowledge, and organizes a deep-sea fishing trip resulting in the participating patients leaving the ward and being outside for the first time in years, particularly the Chief. He is determined to get the patients to open up and laugh, something he notices during his first day on the ward no one seems able to do, which he finds greatly upsetting and disturbing.

Prior to the fishing trip, a particularly poignant scene in the book occurs when McMurphy's reaction, after claiming to be able to and subsequently failing to lift a heavy control panel in the defunct hydrotherapy room (referred to as the "tub room"), "But I tried, though. Goddammit, I sure as hell did that much, now, didn't I?", gives the patients, known as Acutes, incentive to finally try standing up for themselves rather than allowing the Big Nurse to take control of every aspect of their lives, and make attempts at being men rather than "rabbits" the world and the Big Nurse, the "Combine" as the Chief calls it, has beat them down into being.

The Chief eventually opens up to McMurphy, revealing late one night that he can speak and hear, by saying, "Thank you." This sudden utterance of gratitude occurs when McMurphy gifts him with a stick of Juicy Fruit chewing gum after McMurphy catches a night aide spitefully taking away the Chief's secret stash of gum he'd been chewing over and over again and hiding under his bed frame. The Chief, for the first time in years, talks long into the night while McMurphy listens, and it is then that it's eventually decided the Chief will participate in the upcoming fishing trip.

A disturbance after the fishing trip during which the aides physically abuse and psychologically torture a patient, George, also known as Rub-a-dub due to his obsession with cleanliness and not wanting to touch anything for fear of getting dirty, results in McMurphy and the Chief being sent away to the Disturbed ward by the Big Nurse for electroshock therapy sessions; they defended George by beating up the cruel aides, but the EST treatments do little to curb McMurphy's rambunctious behavior, further inspiring the Acutes that perhaps they can also be strong of body, spirit, and will.

One night, after bribing the night orderly, McMurphy sneaks in two prostitute girlfriends, Candy and Sandra (Candy also went on the fishing trip after first checking into the hospital as a Visitor, whereas Sandra was unable to go having just gotten married, resulting in the Big Nurse's assistant doctor, Dr. Spivey, to also go on the trip so as to fit everyone going in both Candy's and his car). The Acutes break into the pharmacy for cherry-flavored codeine cough syrup to use as a mixer for the alcohol the women bring, and McMurphy, making good on his promise to help Billy Bibbit "cash in his cherry", a timid, boyish patient with a terrible stutter and little experience with women, arranges it so Billy can be alone with Candy in the ward's windowless Seclusion Room, whom he met during the fishing trip and fell for. Not being able to believe it even as it's happening, the Acutes get drunk, play racing games with wheelchairs and flashlights in the dark, have fun, and laugh.

Although there was a plan made for McMurphy to escape the ward and the Big Nurse's relentless EST treatments, with Candy and Sandra driving him to a safe place before the morning shift arrived, he and the other patients fall asleep amidst the mess of the group’s antics, and the morning staff discovers the ward in complete disarray. The Big Nurse learns during a role call that Billy is missing and eventually finds him and Candy in the Seclusion Room, happily in each other's arms; she immediately commences to shaming him. For the first time in his life, Billy asserts himself, responding to the Big Nurse without stuttering.

Determined to break Billy, the Big Nurse then pseudo-regretfully proceeds to tell Billy she must tell his smothering mother what has happened. Billy reacts exactly how she hopes he will, immediately regressing back to his weak-willed, fearful, stuttering ways, and he has an emotional breakdown; left alone in Dr. Spivey's office, he tragically commits suicide by cutting his throat.

The Big Nurse coldly calculates this is her opportunity to lay into McMurphy in front of everyone, blaming him for the loss of Billy's life, as well as the life of another patient who commited suicide earlier in the story, Cheswick, who drowned himself in the ward's pool, unable to cope with his inability to escape the relentless, merciless pressures of the Big Nurse, despite all attempts by McMurphy and the lifeguard to wrench free Cheswick's death grip from the grate at the bottom of the pool.

Enraged at what she has done to Billy, and really to everyone, McMurphy attacks the Big Nurse, attempting to strangle her to death after tearing through the front of her uniform, revealing her breasts that she so determinedly tried to hide all this time, to the patients and aides who are standing by watching in shock. McMurphy is eventually pulled off the Big Nurse by ward staff and is moved to the Disturbed ward.

The Big Nurse misses a week of work due to her injuries, during which time many of the Acutes either transfer to other wards or check out of the hospital forever, no longer rabbits, but men. When she returns she cannot speak and is thus deprived of her most potent tool to manipulate and keep the patients in line. With Bromden, Martini, and Scanlon the only patients who attended the boat trip left on the ward, McMurphy is brought back, rolled in the day room on a gurney for the sole purpose of being put on display for the remaining men to see what happens when one tries to stand up to the Combine, and for the Big Nurse to silently gloat over: he has received a lobotomy, and is now in a permanent vegetative state, rendering him silent and motionless forever. This abhorrent act is foreshadowed earlier in the story when, upon seeing how the Big Nurse grinds the patients down, McMurphy labels her as a "ball-cutter." Harding, a patient on the ward, adds to McMurphy's description by stating the Big Nurse is fond of the beastly procedure, saying, "I guess if she can't cut below the belt she'll do it above the eyes."

The Chief, in an act of mercy, smothers McMurphy with a pillow in the night before lifting the tub room control panel that McMurphy could not lift earlier, throwing it through a window and escaping the hospital. Thanks to McMurphy and his ultimate sacrifice, the Chief, as well as the other patients who left the hospital, is finally free of fear and sets out to reacquaint himself with the world, a rabbit no more...but a man. His closing line is, "I been away a long time."


One Flew Over the Cuckoo's Nest was written in 1959 and published in 1962 in the midst of the Civil Rights Movement[4] and deep changes to the way psychology and psychiatry were being approached in America. The 1960s began the controversial movement towards deinstitutionalization,[5][6] an act that would have affected the characters in Kesey's novel. The novel is a direct product of Kesey's time working the graveyard shift as an orderly at a mental health facility in Menlo Park, California.[7] Not only did he speak to the patients and witness the workings of the institution, but he voluntarily took psychoactive drugs, including mescaline and LSD, as part of Project MKUltra.[8]

In addition to his work with Project MKUltra, Kesey experimented with LSD recreationally. He advocated for drug use as a path to individual freedom,[9] an attitude that was reflected in the views of psychological researchers of the time.[10][11] In the 1960s LSD was thought to offer the best access to the human mind. Each individual's experiences were said to vary; emotions and experiences ranged from transformations into other life forms, religious experiences, and extreme empathy.[10] It was Kesey's experience with LSD and other psychedelics that made him sympathetic toward the patients.[12]

The novel constantly refers to different authorities that control individuals through subtle and coercive methods. The novel's narrator, the Chief, combines these authorities in his mind, calling them "The Combine" in reference to the mechanistic way they manipulate and process individuals. The authority of The Combine is most often personified in the character of Nurse Ratched who controls the inhabitants of the novel's mental ward through a combination of rewards and subtle shame.[12] Although she does not normally resort to conventionally harsh discipline, her actions are portrayed as more insidious than those of a conventional prison administrator. This is because the subtlety of her actions prevents her prisoners from understanding they are being controlled at all. The Chief also sees the Combine in the damming of the wild Columbia River at Celilo Falls, where his Native American ancestors hunted, and in the broader conformity of post-war American consumer society. The novel's critique of the mental ward as an instrument of oppression comparable to the prison mirrored many of the claims that French intellectual Michel Foucault was making at the same time. Similarly, Foucault argued that invisible forms of discipline oppressed individuals on a broad societal scale, encouraging them to censor aspects of themselves and their actions. The novel also criticizes the emasculation of men in society, particularly in the character of Billy Bibbit, the stuttering Acute patient who is domineered by both Nurse Ratched and his mother.


The title of the book is a line from a nursery rhyme:

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

Chief Bromden's grandmother sang a version of this song to him when he was a child, a fact revealed in the story when the Chief received yet another ECT treatment after he assisted McMurphy with defending George, a patient being abused by the ward's aides.

Main characters[edit]

  • Randle McMurphy: A free-spirited, rebellious con man, sent to the hospital from a prison work farm. He is guilty of battery and gambling. He had also been charged with, but never convicted of due to the girl in question not wishing to testify so as not to implicate herself and her willingness to participate, statutory rape. McMurphy is transferred from a prison work farm to the hospital, thinking it will be an easy way to serve out his sentence in comfort. In the end, McMurphy attacks Nurse Ratched, sacrificing his freedom and his health in exchange for freeing the previously shackled spirits of the cowed patients on the ward.
  • Chief Bromden: The novel's half-Native American narrator has been in the mental hospital since the end of World War II. Bromden is presumed by staff and patients alike to be deaf and mute, and through this guise he becomes privy to many of the ward's dirtiest secrets.[12] As a young man, the Chief was a high school football star, a college student, and a war hero. After seeing his father, a Native American chieftain, humiliated at the hands of the U.S. government and his (white) wife, Chief Bromden descends into clinical depression and begins hallucinating. Soon he is diagnosed with schizophrenia. He believes society is controlled by a large, mechanized system which he calls "The Combine."
    • Richard Gray, author of A History of American Literature, said Bromden "supplies" the novel's "vision".[13] Gray explains Bromden's "eye" "sees the inner truth" and Bromden "is an outsider, an innocent eye in a way like Huck Finn, but what he sees is far stranger, far more surreal."[13] Gray explained Bromden's vision "may not be literally true but it is symbolically so because, to quote Emily Dickinson again, 'Much madness is divinest sense.'"[13] The first chapter ends with the Chief pleading to the reader, " 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."


  • Nurse Ratched (also known as "Big Nurse"): The tyrannical head nurse of the mental institution, who exercises near-total control over those in her care, including her subordinates. She will not hesitate to restrict her patients' access to medication, amenities, and basic human necessities if it suits her manipulative whims. Her favorite informant is the timid Billy Bibbit, whom she coerces into divulging the unit's secrets by threatening to complain about him to his mother. McMurphy's fun-loving, rebellious presence in Ratched's institution is a constant annoyance, as neither threats nor punishment nor shock therapy will stop him or the patients under his sway. Eventually, after McMurphy nearly chokes her to death in a fit of rage, Nurse Ratched has him lobotomized. However, the damage has already been done, and Nurse Ratched's rule is broken after McMurphy's attack leaves her nearly unable to speak, which renders her unable to intimidate her patients, subordinates and superiors.
  • The "Black Boys" Washington, Williams and Warren: Three black men who work as aides in the ward. Williams is a dwarf, his growth stunted after witnessing his mother being raped by white men. The Chief says Nurse Ratched hired them for their sadistic nature.
  • Dr. John Spivey: The ward doctor. Nurse Ratched drove off other doctors, but she kept Spivey because he always did as he was told. Harding suggests that the nurse could threaten to expose him as a drug addict if he stood up to her. McMurphy's rebellion inspires him to stand up to Nurse Ratched.
  • Nurse Pilbow: The young night nurse. Her face, neck, and chest are stained with a profound birthmark. She is a devout Catholic and fears sinning. She blames the patients for infecting her with their evil and takes it out on them.
  • Mr. Turkle: An elderly African American aide who works the late shift in the ward. He agrees to let McMurphy host a party and sneak in prostitutes one night.
  • The Japanese Nurse: The nurse in charge of the upstairs disturbed ward, for violent and unmanageable patients. She is kind and openly opposes Nurse Ratched's methods.


The acutes are patients who officials believe can still be cured. With few exceptions, they are there voluntarily, a fact that angers McMurphy when he first learns of it, then later causes him to feel further pity for the patients, thus further inspiring him to prove to them they can still be strong despite their seeming willingness to be weak.

  • Billy Bibbit: A nervous, shy, and boyish patient with an extreme speech impediment, Billy cuts and burns himself, and has attempted suicide numerous times. Billy has a fear of women, especially those with authority such as his mother. To alleviate this, McMurphy sneaks a prostitute into the ward so Billy can lose his virginity. The next morning, Nurse Ratched threatens to tell his mother; fearing the loss of his mother's love, Billy has an emotional breakdown and commits suicide by cutting his own throat.
  • Dale Harding: The unofficial leader of the patients before McMurphy arrives, he is an intelligent, good-looking man who's ashamed of his repressed homosexuality. Harding's beautiful yet malcontent wife is a source of shame for him.
  • George Sorensen: A man with germaphobia, he spends his days washing his hands in the ward's drinking fountain. McMurphy manages to persuade him to lead a fishing expedition for the patients after discovering he had captained a PT boat during World War II. Afterward, the three black boys maliciously forcibly delouse him, cruelly knowing the mental anguish this will cause him.
  • Charlie Cheswick: A loud-mouthed patient who always demands changes in the ward, but never has the courage to see anything through. He finds a friend in McMurphy, who's able to voice his opinions for him. At one point McMurphy decides to fall in line when he learns his stay in the ward is indefinite and his release is solely determined by the Big Nurse. As a result, Cheswick drowns himself in the ward's swimming pool when he decides he himself will never escape the relentless Big Nurse.
  • Martini: A patient who suffers from severe hallucinations.
  • Scanlon: A patient obsessed with explosives and destruction. He is the only other non-vegetative patient confined to the ward by force aside from McMurphy and Bromden; the rest can leave at any time.
  • Jim Sefelt and Bruce Fredrickson: Two epileptic patients. Sefelt refuses to take his anti-seizure medication, as it makes his teeth fall out and as such makes him self-conscious over his appearance. Fredrickson takes Sefelt's medication as well as his own because he is terrified of the seizures, and loses teeth due to the resulting overdosage.
  • Max Taber: An unruly patient who was released before McMurphy arrived, a broken man. The Chief later describes how, after he questioned what was in his medication, Nurse Ratched had him "fixed."


The chronics are patients who will never be cured. Many of the chronics are elderly and/or in vegetative states.

  • Ruckly: A hell-raising patient who challenges the rules until the Big Nurse authorizes his lobotomy. After the lobotomy, he sits and stares at a picture of his wife, and occasionally screams profanities.
  • Ellis: Ellis was put in a vegetative state by electroshock therapy. He stands against the wall in a disturbing messianic position with arms outstretched.
  • Pete Bancini: Bancini suffered brain damage at birth but managed to hold down simple jobs, such as a switch operator on a lightly-used railroad branch line, until the switches were automated and he lost his job, after which he was institutionalized. The Chief remembers how once, and only once, he lashed out violently against the aides, telling the other patients that he was a living miscarriage, born dead.
  • Rawler: A patient on the Disturbed ward, above the main ward, who says nothing but "loo, loo, loo!" all day and tries to run up the walls. One night, Rawler castrates himself while sitting on the toilet and bleeds to death before anyone realizes what he has done.
  • Old Blastic: An old patient who is in a vegetative state. The first night McMurphy is in the ward, Bromden dreams Blastic is hung by his heel and sliced open, spilling his rusty visceral matter. The next morning, Bromden learns Blastic died during the night.
  • The Lifeguard: An ex-professional football player, he still has the cleat marks on his forehead from the injury that scrambled his brains. He explains to McMurphy, unlike prison, patients are kept in the hospital as long as the staff desires. It is this conversation that causes McMurphy to fall in line for a time.
  • Colonel Matterson: The oldest patient in the ward, he suffers from severe senile dementia and cannot move without a wheelchair. He is a veteran of the First World War, and spends his days "explaining" objects through metaphor.

Other characters[edit]

  • Candy: The prostitute McMurphy brings on the fishing trip. Billy Bibbit has a crush on her and McMurphy arranges a night for Candy to sleep with him.
  • Sandra: Another prostitute and friend of Candy and McMurphy. She and Sefelt sleep together on the night she and Candy are snuck into the ward late one night. Sefelt has a seizure while they are having sex.
  • Vera Harding: Dale Harding's wife. Described as very attractive. She is a primary cause of concern for Dale, who often worries about her fidelity.


One Flew Over the Cuckoo's Nest is one of America's most challenged and banned novels.


The novel was adapted into a 1963 play, starring Kirk Douglas (who purchased the rights to produce it for the stage and motion pictures) as McMurphy and Gene Wilder as Billy Bibbit. A film adaptation, starring Jack Nicholson, and co-produced by Michael Douglas was released in 1975. The film won five Academy Awards. The characters of Nurse Ratched and Chief Bromden appear as recurring characters in ABC's Once Upon a Time, where they are portrayed by Ingrid Torrance and Peter Marcin. Netflix and Ryan Murphy are producing a prequel series titled Ratched which follows Sarah Paulson playing a younger version of Nurse Ratched, with a two-season, eighteen-episode order.[15]



See also[edit]


  1. ^ "The Covers of Paul Bacon". Retrieved June 15, 2015. 
  2. ^ "Time 100 Best English-language Novels from 1923 to 2005". Time. October 16, 2005. 
  3. ^ "BBC – The Big Read". BBC. April 2003, Retrieved August 23, 2017
  4. ^ "America's Civil Rights Timeline". International Civil Rights Center & Museum. 2015. Retrieved June 15, 2015. 
  5. ^ Stroman, Duane (2003). The Disability Rights Movement: From Deinstitutionalization to Self-determination. University Press of America. 
  6. ^ Scherl, D.J.; Macht, L.B. (September 1979). "Deinstitutionalization in the absence of consensus". Hospital Community Psychiatry. 30 (9): 599–604. doi:10.1176/ps.30.9.599. PMID 223959. 
  7. ^ Mitchell & Snyder, p. 174
  8. ^ Huffman, Bennett (May 17, 2002). "Ken Kesey (1935–2001)". The Literary Encyclopedia. Retrieved March 10, 2009. 
  9. ^ "Ken Kesey Biography". Oregon History Project. 2015. Retrieved June 15, 2015. 
  10. ^ a b Masters, R.E.L. & Jean Houston, (1966) The Varieties of Psychedelic Experience, America Press Inc., 115(4). 110.
  11. ^ The LSD Pother (1966), America Press Inc., 115(14). 377
  12. ^ a b c "Life in a Loony Bin". Time. February 16, 1962. Retrieved March 10, 2009. 
  13. ^ a b c Gray, Richard (September 23, 2011). A History of American Literature. John Wiley & Sons. p. 574. ISBN 978-1-4443-4568-1. Retrieved June 15, 2015. 
  14. ^ "Banned & Challenged Classics". American Library Association. 2015. Retrieved June 15, 2015. 
  15. ^ Goldberg, Lesley (September 6, 2017). "'One Flew Over the Cuckoo's Nest' Prequel From Ryan Murphy Scores Two-Season Order at Netflix". Retrieved September 6, 2017. 

Further reading[edit]

  • L. Horst, Bitches, Twitches, and Eunuchs: Sex Role Failure and Caricature in Pratt, J, One Flew Over the Cuckoo’s Nest: Text and Criticism, Penguin Books (1996).
  • M.G. Porter, One Flew Over the Cuckoo's Nest: Rising to Heroism, Boston: Twayne Publishers (1989).
  • E. Safer, The Contemporary American Comic Epic: The Novels of Barth, Pynchon, Gaddis, and Kesey, Detroit: Wayne State University Press (1988).
  • Nellie Bly: Ten Days in a Mad-House (1887)