The patient ward itself is filled with a system of locks and keys that help the supervisor, Nurse Ratched, manage all of her affairs. She is usually positioned behind a locked glass door, from which she dispenses daily doses of medication that dull each patient’s senses. Ratched easily dominates the inmates, but when Randle McMurphy, a free-spirited outdoorsman, enters the ward, a classic confrontation unfolds as he challenges the neatly ordered world constructed by the nurse.
Day room. Common area in the patient ward in which many activities occur. Amid a scattering of tables and chairs, the men are expected to spend the day listening to a radio or participating in board games. As music blares from speakers throughout the day, the fog machine, an apparatus of fictitious wires, compressors, and vacuums, dulls the men into accepting their mundane daily routine.
McMurphy explodes into this environment and attempts to dismantle both the fog machine and the hospital’s tight-fisted management of everyone’s affairs. He immediately organizes a blackjack game in which he inevitably wins everyone’s cigarettes. During these card games, many of the more intricate and complex issues affiliated with the novel are explored. Through various conversations, it is revealed that few of these men are suffering from any real form of mental illness, and the real problem appears to be the state’s desire to eliminate all forms of individual expression.
Group therapy meetings also occur quite regularly in the day room. Run with a firm hand by Nurse Ratched, the men are forced to sit in a circle of chairs and reveal their deepest and darkest secrets. They are also encouraged to spy on one another and then expose each other’s weaknesses. During these meetings McMurphy discovers that the overall aim of the institution is to frighten patients into believing that they can recover only if they shed all remnants of their individuality.
Shock Shop. Place in which Ratched and her staff eradicate negative behavior of rebellious inmates. Behind an unmarked metal door, men are dragged into a room full of tubes, electronic machinery, wires, and a bare mattress. There they are strapped onto a table–on which they assume crucifixion poses–as electricity is shot through their brains. Most of the men in the ward have had this experience at least once and none of them wants to repeat it. Those who fail to respond to electroshock therapy, like McMurphy, are escorted to the surgical wing of the hospital, where they receive lobotomies.
Fishing boat. In an act of rebellion, McMurphy persuades other patients to disregard Ratched’s gloomy warnings about wrecks, drownings, and hurricanes by participating in a deep-sea fishing expedition for salmon off the Pacific coast. During the outing, the men successfully fix up reels and lines, attach poles to their harnesses properly, and systematically troll for fish. The tranquil ocean swells, the hum of the boat’s engine, and the scenic view of high flying birds provide the patients with an unprecedented sense of calm and temporary confidence. With the benefit of an ample supply of beer, they erupt into laughter as they catch fish. McMurphy also arranges for two women to join the expedition, and they flirt with the men throughout the trip. Despite rough seas, the men navigate safely back to port. Their success clearly reveals that the mental hospital is hindering, not aiding, their recoveries and ultimate return to life outside the institution.
Columbia River. River that forms the border between Oregon and Washington before emptying into the Pacific Ocean. Although none of the novel’s action takes place on the river, there are frequent references to it throughout. In earlier times, Native Americans erected wood scaffolding on the river from which to spear salmon and built tree stands to hunt birds. Several times in the novel one of the patients, Chief Bromden, dreams of his youth on the river before hydroelectric dams and government agencies destroyed his tribe’s land–like the mental hospital, an example of how government often undermines, rather than serves, the interests of people.