"One Flew Over the Cuckoo's Nest" by Ken Kesey

 

This great but morally dubious novel was later made famous by an Oscar-winning movie starring Jack Nicholson.

Selected by Time magazine as one of the 100 best novels since Time began (1923).

It is set in a psychiatric ward containing both chronic patients, some in a more or less vegetative state, and acute patients which is run with fearsome efficiency by the autocratic Nurse Ratched. Randle McMurphy is a new patient who has feigned mental illness in order to avoid the harsh prison conditions of a work farm. He is a natural rebel and refuses to fit in with the rules of Ratched, even after he realises that he had been Committed and will never get out unless she endorses his sanity. So he and Big Nurse lock horns. She is for order and control and he is for laughter and gambling. She keeps the patients bullied and downtrodden; he tries to free them. The battle for dominance between these two drives the plot and enables the author to explore questions relating to human freedom.

The novel is narrated in the first person present tense by a mixed-race Native American, 'Chief Bromden', who is thought by the rest of the ward, including the staff, to be deaf and dumb. This narrative trick enables Chief, who repetitively cleans the ward, to be present at staff meetings to which patients would not be admitted, and patient discussions in the absence of staff. 

One of the strong points of the novel is the dialogue. Randle speaks in a free-wheeling slang, Billy Bibbit has a nervous stutter, Harding is refined, educated and articulate (enabling him to explain many of the concepts of psychiatric care to newcomer Randle). 

The plot is structured mostly around set pieces such as the fishing trip.

One of the themes is the idea of the emasculation of men in society. The novel was written in 1962, in the USA, which in hindsight seems a very patriarchal time and place. Indeed, McMurphy's attitude towards women is that of the sexually promiscuous rake. Billy Bibbit is a 31 year old virgin whose timidity with women is a result of a domineering mother who has colluded with Nurse Ratched - a symbol of overbearing womanhood - to have Billy incarcerated, presumably so he doesn't leave her for a woman of his own. The climax of the book comes when McMurphy rips Nurse Ratched's uniform to expose her breasts and then attempts to strangle her. 

There is an element of critique of McCarthyism. Although the book was first published in 1962, after the 'red scare' of the late 1940s to mid 1950s, McCarthy's use of supposition and innuendo, unrevealed 'evidence' and character assassination was still fresh in the public mind. So, for example, Scanlon tells McMurphy regarding the way that Nurse Ratched uses the therapy sessions: "If you don't answer her questions, Mack, you admit it just by keeping quiet. It's the way those bastards in the government get you." (part 1). The battle between McMurphy and Nurse Ratched in a supposedly democratic ward can be seen as an extended metaphor for the individual trying to assert their rights to freedom against an authoritarian government.

Selected quotes:

• “He's hard in ... the way a baseball is hard under the scuffed leather.” (part 1)
• “This world ... belongs to the strong, my friend! The ritual of our existence is based on the strong getting stronger by devouring the week.” (Part 1)
• “You are strapped to a table, shaped, ironically, like a cross, with a crown of electric sparks in place of thorns.” (A patient's description of ECT)
• “How come they treat this new guy different? He's a man made outa skin and bone that's due to get weak and pale and die, just like the rest of us. He lives under the same laws, got to eat, bumps up against the same troubles.” (Part 1)
• “Being lost isn't so bad.” (Part 1)
• “Nobody's very big in the first place, and it looks to me like everybody spends their whole life tearing everybody else down.” (Part 2)
• “The glass came apart like water splashing.” (Part 2)
• “It wasn't me that started acting deaf; it was people that first started acting like I was too dumb to hear or see or say anything at all.” (Part 3)
• “You could read the dates of the coins in her Levi pockets, they were so tight.” (Part 3)
• “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?” (Part 3)
• “You have to laugh at the things that hurt you just to keep yourself in balance, just keep the world from running you plumb crazy.” (Part 3)

It is a beautifully constructed book with clearly distinguished characterisations. The theme of David against Goliath, the rebellion of the little man, the individual, against the establishment, is universal and eternal. BUT it contains a tremendous amount of misogyny, perhaps typical for its period. Nurse Ratched is described as a "ball-cutter"; she is characterised as an emasculator of men. Almost the only other female roles are prostitutes. McMurphy's response to rules is violence. It could be an ur-text for the manosphere and, as such, leaves an unpleasant taste in the mouth.

Synopsis: (spoiler alert)

A new patient, McMurphy, arrives at the lunatic asylum. But he's not mad. He's faked madness to get out of a prison sentence. He immediately begins a psychological battle with the woman who runs the ward, Nurse Ratched. He tried to persuade the other patients to stand up for themselves, the ward is supposed to be run on democratic lines. His rebellion includes gaining permission from a pliant doctor  to use a room that is otherwise locked for a card school, and forcing and winning a vote to allow the patients to watch the World Series on TV. When he wins a battle, the Nurse practises passive rebellion (she switches the TV off during the World Series matches); when McMurphy loses a battle he resorts to violence, such as thrusting his hand through the pane of glass that separates the nurses' control station from the ward. 

The individual against the system is a key theme of the novel. Much of McMurphy's focus is on gambling: when he bets that he can pick up a large piece of machinery and throw it through a window, he fails, but walks away saying "But at least I tried." The Chief extrapolates this outwards from the ward into the external world, hallucinating that what he calls The Combine are turning humans into robots and remembering how his tribe were defeated by government bureaucrats who wanted to impose a hydro-electric power scheme on tribal land. 

About half way through the book, McMurphy organises a fishing trip, another symbol of macho independence: the only woman to participate is a prostitute of McMurphy's acquaintance. Subsequent to this taste of freedom,, McMurphy and the Chief get involved in a fracas which results in them being sent to the Shock Shop for  electro-convulsive therapy. 

McMurphy organises an unsanctioned party on the ward, bribing the night porter, partly with the aim of helping Bibbit lose his virginity and partly to enable him to escape from the ward in the early hours. But he falls asleep with his own prostitute and the morning shift discovers him and Bibbit in flagrante, together with the mess of the party. Bibbit, finally loses his stutter, answers back to Nurse Ratched ... until she threatens to tell his mother. He slits his throat. McMurphy blames Nurse Ratched and attacks her, stripping her of her uniform and trying to strangle her. He is moved to the Disturbed ward. When he returned, he has been lobotomised and is in a vegetative state. In the night, The Chief smothers McMurphy with a pillow, throws the hydrotheraphy machinery through the window and escapes.

First reviewed in April 2012; revised in July 2026; 310 pages

First published in the US by Viking in 1962

My Picador paperback was issued in 1973

This review was written by

the author of Bally and Bro, Motherdarling 

and The Kids of God