The part Native American narrator of the novel, Chief Bromden, has been a patient living in one of Oregon’s psychiatric facilities for nearly a decade. From the opening paragraph on it is evident that he is a paranoid man, one suffering from delusions and seeing things. The Chief’s outlook on the world around him is controlled by a deep rooted fear of something he refers to as ‘the Combine’, a mass collective that exercises control over society and forces mankind to conform. Chief Bromden often pretends that he is both deaf and dumb and, despite his six foot seven inch stature, endeavors to go through life unnoticed.
The male only facility consists of two distinct patient classification systems;
- Acutes, the patients who can potentially who can be cured of their symptoms. And,
- Chronics, the ones who cannot be cured of their symptoms.
Nurse Ratched, a hard-edged ex-Army nurse, runs the hospital with prison-like rule and order. Daily, at the scheduled group meetings, she encourages Acute patients to turn on each other, using the vulnerabilities of their peers to their benefit. The patients who refuse to follow her rule are from time to time subjected to electroshock treatment performed with electroshock therapy machine.
Some of these poor creatures have even been lobotomized. This is the tactics that Ratched continues to deploy, despite it being considered outdated and inhumane by thought leaders in the medical community.
When a man by the name of Randle McMurphy arrives to the hospital, after being transferred from Pendleton Work Farm, the Chief recognizes that he has something special, unusual about his personality, something unlike the others. McMurphy slyly enters the ward and introduces himself to the others as a gambler with a fierce popularity with the ladies.
Shortly after attending his first group meeting, McMurphy coyly states to the other patients that Nurse Ratched is a ‘ball-cutter.’ They tell him that there is absolutely no crossing her, and insist that she is in complete control at all times. A betting man, McMurphy claims that he can make the Nurse lose her temper within the week.
Initially, the interactions between McMurphy and Nurse Ratched prove to be highly entertaining for the other patients. However, McMurphy’s defiance soon encourages them all to begin to rebel. McMurphy’s bet lies with a lost vote to watch the World Series on television, as it airs during chore time.
To express his protest, McMurphy sits in front of the blank television instead of completing his delegated chore tasks. Slowly, other patients begin to join him. This angers Nurse Ratched and she yells at the men. The Chief states with certainty that anyone looking on from the outside would surely think they’ve all gone mad – including Ratched.
In Part II, McMurphy boastfully taunts Nurse Ratched and her staff. As the others look on, they anticipate his being sent to the ward for the Disturbed. However, this never happens. Nurse Ratched keeps in with the others hoping that they will soon view him as cowardly. McMurphy soon realizes that patients who have been sent to the hospital involuntarily must remain there until the staff determine that they’ve been cured of their afflictions.
This means that McMurphy is at the complete mercy of Nurse Ratched and must appease her if he ever intends to leave. Unfortunately for him, however, the other patients have begun to view him as their leader and are dismayed when he stops standing up for them. Patient Cheswick, depressed that McMurphy is not joining him in his fight against Ratched, drowns himself in the pool.
His death proves to McMurphy that he has unknowingly shouldered the burdens of rehabilitating his fellow patients. He also begins to bear witness to the heinous truth of electroshock therapy and is horror-struck by the ramped abuse of power by the facility’s staff. Feeling pressured by the obligation he now has to the others, and fearing for his own life, McMurphy begins to crack.
Nevertheless, in Part III, he arranges for himself and ten others to go on a fishing trip. He hopes to teach them how to defuse the unfriendliness of the world outside of the hospital and teaches them to be manly as they catch fish without help. Later in the novel, he arranges for Billy Bibbit to lose his virginity to prostitute Candy Starr.
Back in the hospital, in Part IV, McMurphy rebels again. This time he gets involved into a physical fight with the aides in a bid to defend George Sorenson. The Chief steps in to help him and the pair are both sent to electroshock therapy. McMurphy does his best to pretend as though the shock therapy has no effect on him, causing his reputation as a hero to flourish.
Nurse Ratched wants the others to see him as weak and feeble so she parades him around in his post shock state. The patients plead with him to escape, but he has made plans for Billy that evening and refuses to let him down. McMurphy bribes the night aide, Mr. Turkle, to sneak Candy and another girl into the ward and the men party. Harding pleads McMurphy to escape with the girls, running away to Mexico. However, drunk and stoned on marijuana, McMurphy passes out.
The next morning, the nurse’s aides discover the mess the men have left, and violence ensues. When Ratched discovers Candy and Billy, she threatens to inform Billy’s mother. Billy lives in fear of his mother, and he gets extremely shocked afraid and ashamed. This causes Billy to fall into a fit of hysterics, and he slashes his own throat, bleeding out and dying before he gets help. Angered by the loss of his friend, McMurphy attacks the Nurse, tearing open the front of her dress and trying to strangle her. She gets revenge on him by having him lobotomized. McMurphy is catatonic when he is returned to the ward.
Despite this, Nurse Ratched is no longer able to control the ward as the patients begin to either check themselves out or transfer to other wards. Not wanting his friend to suffer any longer, Chief Bromden puts a pillow over McMurphy’s face and suffocates him, allowing him to die with a trace of dignity instead of living out his life as a reminder of Nurse Ratched’s power. Feeling a sense of renewed strength, Chief then escapes through a broken window.