ONE FLEW OVER THE CUCKOO’S NEST

Ken Kesey

About the Author

Kesey actually worked as a night warden on a ward in a mental hospital.

He was so determined to get the feel of being a patient that he underwent ECT.

While at Stanford, Kesey volunteered for medical studies on the effects of psychoactive drugs (often hallucinogens).

He used these experiences to inform how Chief would see the world.

Narration

Be patient with your narrator, Chief Bromden.

He has had too much electroshock therapy and too many drugs.

Keep in mind that our narrator is not the same as our protagonist.

Essential Question: What is the significance of Chief’s narration? How would the novel be different without it?

Symbols Symbols are really anything that stands for

something else. Obvious examples are flags, which symbolize a nation; the cross is a symbol for Christianity; Uncle Sam a symbol for the United States. In literature, a symbol is expected to have significance.

Symbols in Cuckoo’s Nest:The fogRatched’s windowMcMurphyThe CombineOutside

Check out some images that McMurphywould have seen in his ward.

Mental Hospitals 1930s-1960s

Conditions at These HospitalsCould Be Atrocious

Over crowded Dirty Not nurturing No privacy Similar to—or in some cases worse than

—prison

Inside the Institutions Patients were provided with “adequate care” (and

segregated) which often times led to inadequate care, poor facilities, and loss of dignity.

They were usually given uniforms and daily “chores.” In fact it wasn’t until 1973 that New York state banned public hospitals from requiring patients to work in exchange for their room and board.

Families were often ashamed of the patients and would deny their existence.

Ultimately, some of these hospitals became holding areas for a person’s entire life.

Medical Care in Mental Hospitals Deaths and injuries sometimes resulted from both

appropriate and inappropriate treatments. Patients were treated with medically approved

procedures like: being put in tanks of ice-cold water, spun in chairs for hours, and forced "medications" (powerful psychoactive drugs) .

Patients were also “treated” with non-medically approved procedures which were simply designed to control them.For example, patients could be shackled to walls, placed in

seclusion (most often without clothing) or placed in restraints (being strapped to a bed with leather restraints, often in a spread-eagle position).

Treatments for the Mentally Ill: Drug Therapy

Thorazine: the first psychotropic drug, was a milestone

in treatment therapy, making it possible to calm unruly behavior, anxiety, agitation, and confusion without using physical restraints.

"chemical restraint" Chlorpromazine:

schizophrenic psychosis or manic depressive disorder

Treatments for the Mentally Ill: Electroshock Therapy Became very popular 1930’s- 40’s. Originated to control negative behaviors in

animals A doctor had noticed that schizophrenic

epileptics who had a seizure often were more “normal” after the seizure— which led to chemical convulsives and ultimately electroconvulsive treatment

Used to alter the chemistry in the brain to produce desired behaviors.

Cruelly, it was used as a control

Electroshock Therapy Today Used to treat some forms of severe

depression Used to “control” the elderly Used on children in an attempt to correct

their wild and/or unwanted behaviors

Treatments for the Mentally Ill: Lobotomy Surgical procedure for cutting nerve pathways in the

frontal lobes of the brain. The operation has been performed on mentally ill

patients whose behavioral patterns were not improved by other forms of treatment; it was supposed to be a last resort.

The procedure was pioneered by Nobel laureate Egas Moniz in the 1930s

Between 1939-1955 over 100,000 lobotomies were performed in the United States.

If performed correctly, disconnecting the frontal lobes there caused no loss of intellect, no impairment

How a Lobotomy Was Performed Leucotomy

The goal was to cut the nerves that run from front of the brain to the rear.

A technique was devised that involved drilling two holes on either side of the forehead, insert a surgical knife, and sever the prefrontal cortex from the rest of the brain.

Ice Pick LobotomyInvented in 1936 - Walter FreemanInsert an ordinary ice pick above each eye of a patient

with only local anesthetic, drive it through the thin bone with a light tap of a mallet, swish the pick back and forth, then remove.

A formerly difficult patient is now passive.

Abuse of Lobotomy "Every patient probably loses something by this

operation, some spontaneity, some sparkle, some flavor of the personality”

The aim was that "the patient might be transformed from a disturbed to a quiet clement [insane person]." There was no intention to "help" the patient. The goal was only to eradicate the behavior which others found undesirable.

The frontal lobe is the seat of the higher functions such as love, concern for others, empathy, self-insight, creativity, initiative, autonomy, rationality, abstract reasoning, judgment, future planning, foresight, will-power, determination and concentration

Discipline is absolutely necessary in most situations.

All people are “crazy” to some extent.

Our society forces men to act likestereotypical men.

Hatred is inherent to human nature.

One person can change an established, stable

environment

The best place for those with mental illness in an institution

and/or hospital.

Rules are necessary to maintain order

War is a terrible thing for all involved—and should be avoided whenever possible.

Some people simply can/will never change.