Content warning: abuse, ableism, suicide. Spoilers for the film.
The film adaptation of the psychological comedy-drama “One Flew Over The Cuckoo’s Nest” features heavy amounts of ableism — even for a product of its time — for laughs. The other patients of the psych ward are mostly outshined by an intense rivalry between the cold and seemingly apathetic antagonist Nurse Ratched and protagonist Randle McMurphy. McMurphy, a selfish, toxically impulsive “patient” who feigned mental illness to dodge prison labor, demonizes Ratched while being glorified as a hero who liberated the psych ward from tyrannical rule. Others argue that Nurse Ratched is doing her job and ensuring the safety of her vulnerable patients is wrong when there’s a perceived threatening personality that could endanger the ward’s structure. Regardless of who you’re more sympathetic to, these are only parts of the real villain: a longstanding autonomy-thieving ableism engrained in our world which we are still grappling with.
It’s important to differentiate that the book version of “One Flew Over” is a different beast with its own development of characters and themes. This article will treat the film’s story as a standalone piece of media for the sake of clarity and focus.
Prior to McMurphy’s arrival to the psych ward, Ratched was understood as the sole authoritative force keeping the patients in an oppressive grip. She attempted to detach her emotions from her work. This led to a hospital environment without much room for patient self-expression and, generally speaking, affirmations of humanity. After McMurphy’s individualistic influence on the other patients, this mistreatment ultimately led to Ratched’s fall from grace.
From a modern lens, Ratched would certainly be damned as an abuser of medical power, but her abuse stems from following the rules laid before herself and other professionals. Ratched seems to adhere to her teachings in medical school and does her job as a nurse in a 1960s psych ward. The problem is that her education has been infected with the dogma of ableism and instead of realizing the violence, she perpetuates it.
Subscribing to ableist beliefs was casual for many hospital staff in the 1960s. As parts of the medical system continued to encourage eugenicist-adjacent ideology, this definitely permeated psychologically in the treatment of the disabled in psych wards. They were largely viewed as having less value and thus undeserving of many quality of life implementations. These people were dehumanized. Their autonomy was stolen from them. This led to enabling overt torture methods such as electric shock therapy and lobotomies as well as the covert social death inflicted by the very people who are supposed to help them.
Understanding Ratched’s prioritization of what she was taught over ensuring the social health of her patients, it’s no wonder McMurphy became so popular with the residents of the psych ward. He gave the patients what Ratched couldn’t give them: freedom. They wanted any chance they could get to feel like they’re in control of their bodies again with the same liberties as they previously enjoyed in the outside world. With someone as bold, lively and rebellious as McMurphy, it was practically inevitable that he would lead such a revolution if he could express himself.
McMurphy, however, is still the other side of the ableist coin based on his personality and his own perpetuation of bigotry. Beyond the many insensitive remarks he makes, he treats the other patients questionably. By giving his “friends” freedom, it could be seen that McMurphy used it to coerce them to take risks they normally wouldn’t do so that they could stay on his good side over time. This is evident in how they react to McMurphy telling them what to do and how insistent he is for them to do these things. McMurphy mainly acts in his own interest; for example, he very actively tries to take advantage of the patients to vote to tune into a baseball game.
One of the most memorable scenes in the entire movie involves when a patient kills himself after Ratched was going to call his mother after she found out he had sex. After he bled out, Ratched tried to make the other patients calm down instead of letting them feel their emotions. This proved disastrous when McMurphy strangled her. This scene speaks to Ratched’s want to suppress emotion and McMurphy’s need to express it. The patients’ feelings about their friend’s suicide were actively being invalidated: a systemic practice of medical officials of the time.
Although “One Flew Over The Cuckoo’s Nest” aged poorly and is rife with bigotry mainly for comedic value, it can still teach a modern audience about perceptions of disability in the 60s and 70s. Ratched is the face of a much larger body of institutionalized ableism in hospital settings, which sucks the dignity out of patients. By contrast, McMurphy shows the more social side of the discrimination. Together, they paint a fuller picture of how expansive ableism can be and leave us with questions on how we can combat it.