Set in the early 1960s, One Flew Over the Cuckoo's Nest takes place in a psychiatric hospital in Oregon. The novel reflects the societal changes and challenges to authority that were beginning to emerge during this tumultuous decade, particularly in regards to mental health treatment and institutionalization.

The story unfolds primarily within the confines of the hospital ward, a controlled environment where patients' lives are strictly regimented. This setting serves as a microcosm of society, with Nurse Ratched embodying the oppressive forces of conformity and control. The ward becomes a battleground between individual freedom, represented by McMurphy, and institutional authority.

While most of the action occurs inside the hospital, Kesey also provides glimpses of the outside world through flashbacks and a pivotal fishing trip. These moments highlight the contrast between the sterile, controlled hospital environment and the wild, unpredictable nature of the outside world, particularly the Pacific Northwest's rugged coastline and forests. This juxtaposition underscores the novel's themes of freedom, conformity, and the human spirit's resilience.

Characters

• Randle Patrick McMurphy: The rebellious new patient who challenges Nurse Ratched's authority. A charismatic gambler and con man who faked insanity to avoid prison labor.
• Chief Bromden: The novel's narrator, a large half-Native American patient who pretends to be deaf and mute. He has been in the hospital for years and believes society is controlled by an oppressive system he calls “The Combine".
• Nurse Ratched: The authoritarian head nurse who rules the ward through manipulation and emasculation of the patients. Her strict control is threatened by McMurphy's arrival.
• Billy Bibbit: A young, shy patient with a stutter and crippling anxiety, especially around women. He is easily manipulated by Nurse Ratched's threats to tell his overbearing mother about his behavior.
• Dale Harding: An intelligent, well-educated patient and the leader of the ward before McMurphy's arrival. He is ashamed of his repressed homosexuality.
• Charlie Cheswick: A loud, volatile patient who is quick to support McMurphy's rebellion but lacks the courage to see things through himself.
• Martini: A patient who suffers from severe hallucinations.
• Scanlon: A patient obsessed with explosives and destruction. One of the few involuntarily committed patients besides McMurphy and Chief Bromden.
• Dr. Spivey: The timid ward doctor who is easily manipulated by Nurse Ratched but begins to stand up to her after McMurphy's influence.
• Candy: A prostitute friend of McMurphy's who visits the ward and develops a relationship with Billy Bibbit.

Quick facts

• Ken Kesey wrote the novel while working as a night orderly at a mental health facility in California.
• Kesey participated in government-sponsored LSD experiments as part of Project MKUltra while writing the book.
• The novel's title comes from a line in a nursery rhyme that Chief Bromden's grandmother sang to him as a child.
• Kirk Douglas bought the film rights and starred in a 1963 Broadway adaptation before the movie was made.
• The 1975 film adaptation won all five major Academy Awards (Best Picture, Director, Actor, Actress, and Screenplay).
• Chief Bromden narrates the novel, despite pretending to be deaf and mute throughout most of the story.
• The book has been frequently banned and challenged in schools due to its content and themes.
• Kesey himself never saw the film adaptation, as he was upset about changes made from his novel.
• The character of Nurse Ratched was ranked as the fifth-greatest villain in film history by the American Film Institute.
• A prequel series titled Ratched, focusing on Nurse Ratched's backstory, was released on Netflix in 2020.

About the author

Ken Kesey was an influential American novelist and countercultural figure born in 1935. He rose to fame with his debut novel One Flew Over the Cuckoo's Nest (1962), which drew from his experiences working in a psychiatric hospital. The book was adapted into an award-winning film in 1975. Kesey's second novel, Sometimes a Great Notion (1964), further established him as a leading literary voice of his generation.

In the 1960s, Kesey became a key figure in the psychedelic movement. He formed a group called the Merry Pranksters, who traveled across the country in a colorfully painted school bus and hosted “Acid Test” parties featuring LSD use. These exploits were famously chronicled in Tom Wolfe's book The Electric Kool-Aid Acid Test. Kesey's drug experimentation and anti-establishment activities made him an icon of 1960s counterculture.

After legal troubles related to marijuana possession in the mid-1960s, Kesey retreated to his family farm in Oregon. There, he continued writing and publishing, though none of his later works achieved the same success as his first two novels. He occasionally reunited with the Merry Pranksters for events and performances in later decades. Kesey also taught creative writing at the University of Oregon.

Kesey died in 2001 at age 66 following surgery for liver cancer. He left behind a complex legacy as both an acclaimed author and a controversial cultural figure. His writing explored themes of individuality versus conformity and helped shape the literary landscape of postwar America. Meanwhile, his countercultural activism and promotion of psychedelic drugs influenced the hippie movement and 1960s youth culture.