One Flew Over the Cuckoo’s Nest by Ken Kesey [A Review]

The film is an all-time classic. But here is why you should read the book

Cover image of One Flew Over the Cuckoo's Nest by Ken Kesey

There are some stories and characters that become so iconic that I suspect many people do not even bother becoming acquainted with their original sources. The two that frequently come to mind are the gothic novels Dracula and Frankenstein. Frankenstein in particular may surprise readers who think they already know it. The creature is far from the slurring, lumbering, giant you may suppose from old black and white horror films. Rather he is intelligent and soulful and, unlike the rest of us (the religiously minded at least), he has the ability to question his maker directly, demand answers from him and charge him with his right to happiness. Something the relationship between Man and God cannot hope for.

Similarly, the film of One Flew Over the Cuckoo’s Nest has achieved such iconic status, I wonder how many still bother to experience the novel. Like Frankenstein, they will be surprised by how much more it has to offer.

The novel is narrated by Bromden, a half-Native-American patient in a psychiatric ward of an Oregon hospital. ‘Chief’ Bromden is assumed to be deaf and dumb, having not communicated for many years, but he is in fact fully comprehensive. He is the longest-serving patient of the ward and his gentle nature, not to mention his assumed inability to communicate, allows him access other patients do not have. He therefore acts an omniscient observer and educates the reader as to life within the ward.

The ward is run by the tyrannical Nurse Ratched, a rigid stickler for routine, protocol and order. Stubborn and righteous, she has her rationale carefully crafted to the point where she can be confident in winning any argument and snuffing out any subversion or insubordination. So successful is she, she remains completely unflustered and unmoved, with an unflinching countenance, whenever challenged or provoked.

Having now served for so long, her authority is unquestioned. Her greatest achievement is not the authority she wields over her subordinate nurses and orderlies, or even the patients, many of whom are there voluntarily, but that she also has the ward doctor under her control. Somewhat lethargic, uninterested and easily manipulated, the doctor often acquiesces to Nurse Ratched’s experienced opinion.

Though he has successfully hid his ability to hear and speak for years, Bromden is not a well man. He suffers from paranoia and delusions. In particular, he sees the world being controlled in a mechanistic way by those in authority. He finds the power of these coercive forces, which he calls ‘the Combine’, to be overwhelming and, despite his enormous stature, feels hopeless and too weak to offer resistance.

But Nurse Ratched’s carefully constructed order meets its greatest test with the arrival of one Randal P McMurphy

McMurphy has been transferred to the ward, from a work farm where he was serving his prison sentence, on the suspicion that he may be a psychopath. Though he has a history of violence and statutory rape, he is suspected of faking his condition to avoid manual labour and to complete his sentence within the relative comfort of the ward.

An engaging and affable easy-talker, not to mention a compulsive gambler, McMurphy soon makes himself at home with his fellow inmates and learns the ins and outs of the ward. Though he becomes concerned at what he observes and begins to challenge the authority of Nurse Ratched, the gambler in him compels him to cautiously, patiently, observe and size things up first. His mischievous and fun-loving nature, plus a few minor victories over Nurse Ratched, earn him the respect and admiration of the more conditioned inmates, who in turn question their rights and their treatment.

Though tempted to conform after he discovers that his future release is no longer determined by the length of his term but is in the hands of the nurse and the doctor, McMurphy cannot abide by the rule of Nurse Ratched.  Even greater than his victories is the fact that McMurphy won’t be deflated by his defeats, won’t be dissuaded from taking risks and won’t stop standing up from what he thinks is right, that inspires his fellow patients.

The cold war between McMurphy and Nurse Ratched continues to escalate – with McMurphy taking his fellow inmates on a deep-sea fishing trip and hosting a late-night, alcohol-fuelled, prostitute-attended party – until it culminates in the final tragedy.

One Flew Over the Cuckoo’s Nest, Ken Kesey’s first novel, was first published in 1962 and is very much a product of its time

Consider the context of the time. This was right in the middle of the Civil Rights Movement. The March on Washington with Martin Luther King Jr’s iconic speech came the following year. The rights of institutionalised patients, often treated cruelly in the past, was also a much debated issue and is a key theme in the novel. This is best exemplified in the novel by the PR man who brings donors to tour the ward and reassure them that the patients are being treated humanely.

Kesey began writing the novel in 1959. Although this is a few years after the fall from grace of McCarthy, the issues of conformity, of free expression and association were still prevalent at the time and are explored in the novel. In particular, the patients in Cuckoo’s Nest are encouraged to spy on one another and report anything of interest to the staff.

Psychology and neurology, due to their inherent complexity and difficulty to study, are perhaps the slowest of the major medical sciences to emerge but their influence was starting to be felt at the time. Neurologist Oliver Sacks’ memoir, Awakenings, though published in 1973, mainly concerned his work in the 60’s. Psychotherapy too, was just becoming a more common and socially-acceptable treatment for ordinary people.

The question of who, in this crazy world, is truly insane; of life within an institution and what the experience of treatment is really like; was increasingly treated as a canvas for novelists and artists. Consider Catch-22 (1961) and The Bell Jar (1963). In addition, Kesey, who worked as an orderly in an institution, was one of many writers, artists and musicians (and some researchers) who advocated the use of psychoactive drugs as a path to individual freedom.

So what does the novel offer that the film does not?

Let me start with a few trivial points before moving on to more essential ones. I did not like how McMurphy discovers Bromden’s secret in the film. It happens because Bromden slowly lets his guard down and shows his hand. In the novel, McMurphy figures out Bromden’s secret long before Bromden is ready to admit it. It is a great moment in the novel, one that shows that McMurphy is not some petty crook of low-intelligence, but is clever and insightful, particularly when it comes to observing and figuring-out other people and the cards they are holding.

The question of humane treatment of the institutionalised is embodied solely in the treatment of McMurphy as he undergoes electroconvulsive therapy and a lobotomy. But McMurphy is a special case in the ward, the treatment of the other patients is not heavily portrayed, nor does the PR man, mentioned above, make an appearance.

The main omission from the film is the central theme of the novel – where life for the patients within the ward is a metaphor for life outside in a largely conformist society. The ability of those in power to control and manipulate a majority who feel powerless, become conditioned and ultimately lose even the awareness that they are being controlled, is severely diluted in the film. Instead, the film reduces the story to a battle between two wills; the rebellious McMurphy and the powerful Ratched, the irresistible force against the immovable object. Although, even in this regard, some of their battles are omitted from the film.

That the film is not told from Bromden’s point of view is an understandable but defining omission. It is from Bromden’s experienced, omniscient view that we see the ward for what it really is. His personal history – with the fate of his tribe, his relationship with his father, his experiences as a young man and in the army – plus his particular delusions and paranoias are a difficult perspective to make a film from and as such the major theme of the novel is eroded. It is the key reason author Ken Kesey refused to see the film, knowing its message would be missed. More than anything, it is Bromden’s larger role in the novel that new readers will enjoy.

Less understandable is the reduced role of Dr Spivey in the film. It would not have been a difficult or time-consuming inclusion, but would have gone a long way to expressing the major theme. It is clear in the novel that Nurse Ratched’s control of the ward extends to Spivey as well. McMurphy though, shows the reader that he can play that game as well. He befriends Spivey and even uses his influence to help achieve his goal of taking the inmates on a fishing trip, which Spivey also attends. Two things that were missing in the film.

As good as Louise Fletcher’s performance in the film was, the Nurse Ratched of the film has a slightly different characterisation. Ratched in the film is not quite the mother-goddess, of bountiful bosom, to be equally worshiped and feared, who emasculates the male inmates (although she does to Billy in the end). The novel also has a fairy-tale aspect to it with Nurse Ratched as an evil white witch, with her starched, perfectly white uniform and admittedly beautiful face. Her subordinate orderlies, though they take sadistic pleasure in their violence, also live in fear of the nurse. I could not help but think of the nurse and the orderlies as being like an evil witch with her minions – the orderlies are violent, cruel, hideous and unthinking but also unquestioningly obedient. I miss this fairy-tale sense in the film.

The Nurse Ratched of the film is an annoyance, an authority figure we want to see subverted, but she is not necessarily evil. In fact, it is even possible to feel sympathy for her. After all, is she not just trying to maintain order and efficiency in an institution where it is most difficult and could be least expected?

Sympathy for Nurse Ratched is not possible in the novel and for a good reason that is not fully appreciated in the film. In the novel, it becomes clear to the reader that the nurse values order and protocol above the health of the patients. The patients have no chance of improvement as long as the nurse is in charge, they are doomed be stuck in the parallel universe of the ward forever. Their submission takes priority over their treatment. In fact, their treatment runs counter-intuitively to their best interests in almost a Catch-22 kind of way. It takes the insubordination of McMurphy to expose this. McMurphy, therefore, is less the rebel threatening to create chaos than he is an agent of change for the better. He certainly orchestrates the liberation of Bromden.

In the final confrontation between McMurphy and Ratched in the film, it is her insistence that order be resumed that sets McMurphy over the edge. In the novel, it is more the fact that she implies that McMurphy is to blame for what has occurred. In their final fight in the novel, McMurphy exposes the breasts of Ratched, literally denuding her of the mother-goddess façade. He ensures his own destruction but destroys her power as well.

As good as the film is, without the analogy to the pressure to conform in the outside world, the symbolic characterisation of Ratched and the failure to treat the patients in the interest of maintaining the bureaucracy; the film is reduced to a battle between the rebel McMurphy and the authority-figure Ratched.

New readers to One Flew Over the Cuckoo’s Nest will be surprised by how much the novel has to offer. It is a far deeper and more clever work than you might prejudge, to be enjoyed by those who delight in the anti-authoritarian, anti-bureaucratic, and just-who-is-really-insane themes of novels such as Nineteen Eighty Four, Animal Farm and Catch-22, or those that warn of primal chaos when order is lost like Lord of the Flies.


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