One Flew Over the Cucoo's Nest, Ken Kesey“I’ve heard that theory of the Therapeutic Community enough times to repeat it forwards and backwards – how a guy has to learn to get along in a group before he’ll be able to function in normal society; how the group can help the guy by showing him where he’s out of place; how society is what decides who’s sane and who isn’t, so you got to measure up. All that stuff. Every time we get a new patient on the ward the doctor goes into the theory with both feet: it’s pretty near the only time he takes things over and runs the meeting. He tells how the goal of the Therapeutic Community is a democratic ward, run completely by the patients and their votes, working towards making worthwhile citizens to turn back Outside onto the street. Any little gripe, any grievance, anything you want changed, he says, should be brought up before the group and discussed instead of letting it fester inside of you. Also you should feel at ease in your surroundings to the extent you can freely discuss emotional problems in front of patients and staff. Talk, he says, discuss, confess. And if you hear a friend say something during the course of your everyday conversation, then list it in the log book for the staff to see. It’s not, as the movies call it, ‘squealing’ , it’s helping your fellow. Bring these old sins into the open where they can be washed by the sight of all. And participate in Group Discussion. Help yourself and your friends probe into the secrets of the subconscious. There should be no need for secrets among friends.”

Set in a hospital mental ward in the 1960s, this novel follows the story of Randle P McMurphy, a swaggering bullish gambling wisecracking man with a fighting heart who has engineered his committal to the hospital in order to avoid serving out his sentence on a prison work farm.

What he finds on the ward is about 20 chronics, patients who are so far gone that they will never be cured or even interact rationally with the world around them, and about 20 acutes, patients who theoretically have a chance of successful treatment but who in reality are so rabbitlike in response to the “tender” mercy of the seemingly omnipresent and omniscient, big-brother style ward nurse (Big Nurse) that their true prospects of recovery seem to be slim to non-existent. The narrator is one of the chronics, “Chief” Bromden, a long term inmate who has pretended to be deaf and dumb for so long he has almost forgotten how to speak.

McMurphy does all in his power to chivy the patients out of their passive misery, starting a gambling school, organising a basketball team, standing up to the Big Nurse, joking and teasing all the way. His task seems hopeless. Yet he doesn’t seem able to stop, despite knowing that he is committed at the Big Nurse’s pleasure and that he is better off keeping his head down and his nose clean – he is on a collision course, risking his liberty, risking committal to the Disturbed ward, risking EST, even risking lobotomy. And for what?

Although I have no idea whether Kesey’s portrait of an asylum is anywhere close to reality, this is nevertheless a pretty chilling account and if not true literally it is certainly true in literary terms. I mean it is convincing and plausible – and it shows us in the clearest possible light how the inhuman treatment of people with mental illness can strip them of their dignity and self-esteem and can perpetuate or exacerbate their illness, or even cause a perfectly sane person to lose himself completely.

As well as chilling, and tragic, the book is chock full of black humour and beauty. But for its built-in racism and misogyny, I might even be recommending it… Ho-hum.

Here is am Amazon link.
I have a creased old orange copy that I didn’t finish reading a long long time ago.