A Mental Patients View of One Flew over the Cuckoo’s Nest

Mental patient, Cuckoos Nest, Jack Nicholson
 “I must be crazy to be in a loony bin like this.”

One flew East
One flew West
And one flew over the cuckoo's nest

In the 1975 film, One Flew Over the Cuckoo’s Nest, Jack Nicholson plays Randle Patrick "Mac" McMurphy, a small time crook serving time for the statutory rape of a fifteen year old girl, who is transferred to a mental asylum for evaluation.

The film was shot almost entirely on location at a working institution in Oregon and the actors spent time with actual patients before filming and patients also served as extras on the set so there is a definite air of authenticity to the film.

Despite the fact that it was released over 35 years ago, I only recently watched the film on DVD.

Having recently spent time in a British mental hospital myself, I was interested to see how a Hollywood movie would portray such an institution, albeit set in the 1960’s, and was surprised to find that similarities between the film and real life in a mental hospital still exist which can only be testament to the films accuracy when it was made.

Staff in bow ties and some of the more extreme treatments are gone now but many of the day to day routines depicted I the film are exactly the same today and Macs discovery that the patients are real people and his surprise at how many are voluntary rather than committed are experiences that I could relate to.

Cuckoos Nest, Kirk Douglas, Michael DouglasAbout the Film
My expectations were that the film would be a depressing account of life in a mental institution and its 18 rating suggested scenes of a horrific or disturbing nature but, though certainly not light family entertainment, One Flew Over the Cuckoo’s Nest portrays Macs (Jack Nicholson) discovery that the patients are real people very well.

From the first scenes of his admission where patients are depicted as anonymous fruit cakes staring at him from doorways through to his striking up friendships and starting to care for his fellow patients is very reminiscent of my own journey on my first admission.

The film, based on a 1962 novel of the same name by Ken Kesey, was directed by Miloš Forman and also starred Danny DeVito as Martini and Christopher Lloyd as Max Taber.

Kirk Douglas bought the film rights to the book and appeared as Mac in a Broadway production of the story in 1963 but could not find a studio willing to fund the making of a film.

He passed the film rights of the book to his son, Michael Douglas, who eventually succeeded in getting the film produced but with a limited budget and starring Jack Nicholson rather than Michaels father who was then deemed too old to play the part.

The film won five academy awards: Best Picture - Michael Douglas and Saul Zaentz, Best Director - Miloš Forman, Best Actor - Jack Nicholson and Best Actress - Louise Fletcher and is now considered one of the best American Films made.

Medication Time

“If Mr. McMurphy doesn't want to take his medication orally, I'm sure we can arrange that he can have it some other way. But I don't think that he would like it.”

Cuckoos Nest, Medication, Mental PatientMedication Time as portrayed in One Flew Over the Cuckoo’s Nest is still very much a feature of the modern mental hospital and the process is very much the same, right down to the paper cups that the medication is handed out in.

Three times a day, patients in a mental hospital queue at a dispensary door or window to receive their medication just as shown on the film. Some take it quietly, others insist on a description of

Music and TV

“Why don't ya shut your goddamn mouth and play some music.”

Cuckoos Nest, Mental Patients, MusicIn the film, the classical piece; Charmaine", written by Pollack and Rapee in 1926, is constantly broadcast over loudspeakers to keep the patients calm and television is strictly rationed by the domineering Nurse Ratched (Louise Fletcher).

In today’s institution, the TV is on constantly and the battle for the channels between the younger generation, who want MTV or similar and the older patients looking for something a bit more interesting is constant. If you are watching film then sit tight because even a brief visit to the toilet and you will find the music channel has returned!

During my last stay in hospital, the background noise to the day was normally the incessant thumping of hard-core rap music played on other patients own CD players rather than soothing classical music.

One rule that can’t, or shouldn’t, be broken is that no mobile telephones are allowed on the ward. Apparently this is not to stop you making calls but rather to stop you taking photographs of other patients.

Smoke Break

“Hit me, Chief, I got the moves!”

Cuckoos Nest, Jack Nicholson, Mental Patient, Smoke BreakExercise yards still exist too. Unlike the film, smoking is not allowed anywhere on the ward so regular smoke breaks in the yard are another way to break up the day. Rather than basketball, footballs were sometimes provided and occasionally set up a game though this was always short lived as it was never long before the ball was kicked over the fence.

The main purpose of the breaks is not for exercise but for smoking. The frequency of breaks varies from hospital to hospital. In one, an open garden area was left open for much of the day, in another smoke breaks were limited to just a few a day.

Patients in a modern mental hospital may be allowed unescorted leave and leave the grounds of the hospital. This applies both to voluntary patients (Informal) and some committed (Sectioned) patients as well.

The Staff

“Well I don't wanna break up the meeting or nothin', but she's somethin' of a c**t, ain't she Doc?”
Cuckoos Nest, Nurse Ratched, Mental Hospital, Phsyciatric Hospital 
Nurse Ratched Lives and Breathes!

I’m afraid to say that, whilst not quite so extreme in real life, the portrayal of the nurses and staff in One Flew Over the Cuckoo’s nest is accurate.

There are those who rigidly stick the rules and routines and behave more like prison guards than nurses, there are those who are just doing their job and can’t wait to get home and there even those who really don’t care so long as there is no trouble.

There was a ‘Nurse Ratched’ at the last hospital I stayed in. This individual was hated by all the patients and was the cause of much disruption to the ward. You could almost count down the minutes after her arrival for duty before a patient would begin to kick off.

Thankfully though, there are those who also genuinely care.

Kicking Off

“Is that crazy enough for ya'?”

Cuckoos Nest, Jack Nicholson, Mental Hospital, Psychiatric HospitalWhilst straight jackets and other leather strap restraints are no longer in use there is a fairly regular need for patients to be restrained. Often a patient ‘kicking off’ is caused by something really minor and the scene in the film where the rationing of cigarettes causes an outbreak of aggression is something that I have seen.

Today, if a patient becomes aggressive, an alarm will sound summoning help from other wards and the patient will be restrained and removed from the ward to allow them time to calm down and in some cases, medication will be administered.

My Opinion

“What do you think you are, for Chrissake, crazy or somethin'? Well you're not! You're not! You're no crazier than the average asshole out walkin' around on the streets and that's it.”

One Flew over the Cuckoo’s Nest is a thoroughly entertaining and thought provoking film and is still as valid today as it was thirty five years ago.

The walls, fences and locked doors, the mundane daily routine and the institutionalisation of patients is still the same but extreme treatments such as electric shock and lobotomies are, of course, a thing of the past.

When I was first admitted to a psychiatric hospital I had all the pre-conceptions that I suspect that most people do about mental illness until, like Mac in the film, I discovered that patients are just people like everyone else.

One of the biggest dangers of staying for any length of time in mental hospital is that you become institutionalised. The routine that, Nurse Ratched in the film is so fond of, is the same day in and day out and even a patient becoming aggressive or violent rarely breaks it.

Interestingly, the DVD that I bought included deleted scenes many of which I felt would have enhanced the film greatly as they show the indignities that some patients have to suffer. Perhaps they were just a bit too strong for mainstream movie audiences of the time.

Overall though, One Flew over the Cuckoo’s Nest is a film that richly deserves it’s accolades and its impact hasn’t been diminished by age. If you like your films to be intelligent and thought provoking; watch it and learn.