Ken Kesey's portrayal of the characters within the psych ward further asks the reader to question the line between what is sane and insane. In other words, a ward that is meant to help cure those who are insane is instead treating as insane a man who its chief nurse believes to be sane-a fact which is, arguably, itself insane behavior. Regardless of Nurse Ratched’s personal suspicions that McMurphy is not, in fact, insane, Ratched must treat him as insane because only then can she exercise control over him. This question becomes central with the arrival of Randle McMurphy to the ward, a likeable, crass gambler who may have faked psychosis to get relocated to the ward from a work camp. One of the novel’s most salient insinuations is that the psych ward, Nurse Ratched, and all the other tools of “sanity” in the book are, in fact, insane. One Flew Over the Cuckoo’s Nest explores the idea of what it means to be sane or insane, and, perhaps most importantly, who gets to define what qualifies as sane versus insane.
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