One Flew Over the Cuckoo’s Nest

1. One Flew Over the Cuckoo’s Nest Ken Kesey

2. Ken Kesey Born in Oregon in 1935, Kesey grew up in Colorado; he married his high school sweetheart in 1956 and graduated from the University of Oregon in 1957. Throughout the 1960’s, Kesey sank deeper into the drug culture and developed into a leader of the counterculture hippie set. (Eventually, he was arrested for drugs and fled to Mexico to avoid prison; he later returned and served 6 months in jail.) Kesey formed the Merry Pranksters, a group of people who lived together and at one time traveled around the country on a painted bus they called “Further.”

3. The Merry Pranksters

4. & More… The misdeeds of the Merry Pranksters were chronicled by Tom Wolfe in The Electric Kool-Aid Acid Test (1967), as well as in poems by Allen Ginsberg. Other contemporaries include Timothy Leary, Jack Kerouac, Hunter S. Thompson, Neal Cassady, and The Grateful Dead. Kesey remained in the public eye with articles in numerous magazines, such as Rolling Stone, Newsweek, Esquire, and High Times. At age 60, he appeared in Even Cowgirls Get the Blues. In 1997, he reunited with the Merry Pranksters at a Phish concert, one of his last public performances.

5. More… Kesey is often remembered as the link between the Beat generation of the 1950’s and the Hippie generation of the 1960’s. Kesey died in November of 2001, after an operation for liver cancer.

6. Inspiration The narrative of this novel is strange. Why? Kesey worked as a night warden at a mental hospital. He was so determined to understand what it felt like to be a patient, he underwent electroshock therapy himself. While studying at Stanford, Kesey volunteered for a medical study. Conveniently for him, the study consisted of ingested a ton of LSD and other hallucinogens. While working in the mental institution, Kesey started formulating the plot for Cuckoo’s Nest. He decided many of the patients were nonconformists rather than insane. Many characters were based on actual patients and staff at the hospital. He wrote parts of the book while on acid, especially to create Chief Bromden.

7. Adaptations The novel was adapted for both stage and the screen. The 1975 film won the “big five” Oscars: best film, best adapted screenplay, best actress, best actor, and best director. Kesey sued the producers because he was upset they changed the point of view of his novel in the film.

8. Narration Chief Bromden Be patient with the Chief. He’s done a lot of drugs (just like Kesey) and has been treated with ECT many times. Remember that Chief is our narrator and not the protagonist (that’s McMurphy).

9. What is this?

10. Combine Harvester • A combine harvester is an agricultural machine that harvests all types of cereals, oil seeds, and legumes through four main steps: • The crop is cut and directed into a rotating chamber with a series of beaters going the opposite direction. The grain is dislodged, falls to the bottom, and is then separated from debris by sieves and wind. The grain is transferred to a hopper for transfer and the debris falls from the back of the machine through a chute.

11. Motifs Fog Hands Nature (as purity) Machinery (the combine, for example) Christ/Christ-figure Sanity vs. Insanity Laughter

12. Inside Mental Wards

16. Procedures All guests must check in with the front desk (i.e. a nurse). Most patients were/are admitted by family members, though some patients commit themselves. Many patients are given off-campus privileges, meaning they could leave at any time for short day trips. But many do not leave.

17. Mental Hospitals in the 1930-1960s • Conditions were often bad. • Over-crowded • Dirty • Lacked privacy • Shared many features with that of a prison – if not worse

19. Inside Patients were provided with “adequate care” (and segregated) which often led to inadequate care, poor facilities, and loss of dignity. Patients were usually given uniforms and daily “chores.” In fact, it wasn’t until 1973 that New York state banned public hospitals from requiring patients to work in exchange for their room and board. Families were often ashamed of the patients and denied their problem and/or existence. Ultimately, some of the hospitals became holding areas for a person’s entire life.

20. Medical Care Deaths and injuries sometimes resulted from both appropriate and inappropriate treatments. Patients were often treated with medically approved procedures like: being put in tanks of ice-cold water, spun in chairs for hours, and forced “medications” (powerful psychoactive drugs). Patients were also “treated” with non-medically approved procedures which were simply designed to control them. For example, patients could be shackled to walls, placed in seclusion, or placed in restraints.

21. Types of Treatments for the Mentall Ill Group Therapy Drug Therapy Electroshock therapy lobotomy

22. Drug Therapy • Thorazine • The first psychotropic drug. • A milestone in treatment therapy. • Made it possible to calm unruly behavior, anxiety, agitation, and confusion without using physical restraints. • “Chemical restraint.”

23. Drug Therapy • Chlorpromazine • Schizophrenic psychosis or manic-depressive disorder

24. Electroshock/Electroconvulsive Therapy Popular in the 1930-1940s. Originated to control negative behaviors in animals. A doctor noticed that schizophrenic epileptics who had a seizure often were more “normal” after the seizure, which led to chemical convulsives and ultimately electroconvulsive treatment. Used to alter the chemistry in the human brain, producing the desired behaviors (i.e. docile, calm). Cruelly, it was used as a control device in most wards.

25. ECT Today • Electroshock therapy was and is controversial, but it is still used today. • It is used primarily to treat certain forms of severe depression. • Control the elderly. • Correct wild/unwanted behaviors in children.

26. Lobotomy Surgical procedure for cutting nerve pathways in the frontal lobes of the brain. The operation has been performed on mentally ill patients whose behavioral patterns were not improved by other forms of treatment; it was supposed to be a last resort, but often was not. The procedure was pioneered by Nobel laureate Egas Moniz in the 1930s. Between 1939 and 1955, over 100,000 lobotomies were performed in the United States alone. If performed correctly, disconnecting the frontal lobes caused no loss intellect, no impairment of memory, and no problems with speech or gait.

27. How to Perform a Lobotomy • Leucotomy • The goal was to cut the nerves that run from the front of the brain to the rear. A technique was devised that involved drilling two holes on either side of the forehead, inserting a surgical knife, and severing the prefrontal cortex from the rest of the brain. Ice Pick Lobotomy Invented in 1936 by Walter Freeman Insert any ordinary ice pick above each eye with only local anesthetic, drive it through the thin bone with a light tap or a mallet, swish the pick back and forth, then remove.

28. Lobotomy Abuse Freeman developed what others called assembly line lobotomies, going from one patient to the next with his gold-plated ice pick, even having his assistants time him to see if he could break the lobotomy speed record. It is said that even some seasoned surgeons fainted at the sight. Doctors would recommend the procedure for everything from psychosis to depression to neurosis to criminality.

29. Lobotomy “Every patient probably loses something by this operation, some spontaneity, some sparkle, some flavor of the personality.” The aim was that “the patient might be transformed from a disturbed to a quiet clement [insane person]” There was no intention to “help” the patient. The goal was only to eradicate the behavior which others found undesirable. “Mercy killing of the psyche.” The frontal lobe is the seat of the higher functions, such as love, concern for others, empathy, self-insight, creativity, initiative, autonomy, rationality, abstract reasoning, judgment, future planning, foresight, will-power, determination and concentration.

30. “Deinstitutionalization revolution” : the mid-1960s A radical “deinstitutionalization revolution” began. It was supposed to end the cruel and inadequate care in institutions. Individuals would live in their communities and have a “normalized” life. Group homes, residential care facilities, and rooming housing were developed. The movement helped to break up the control that was happening in the hospitals.

31. Major Themes Yes or No?

32. Discipline Insanity Discipline is absolutely necessary in most situations. All people are “crazy” – at least a little.

33. Power Institutions One person can change an established, stable environment. The best place for those with mental illness is in an institution and/or hospital.

34. Men Hatred Our society forces men to act like “real men.” Hatred is part of human nature.

35. Rules Self-esteem The more rules the better off we are. Self-esteem is not very important to daily living.