One Flew Over the Cuckoo’s Nest is a historical fiction novel by Ken Kesey, published in 1962. Kesey drew on his experiences working in a veterans’ hospital to develop a critique of then-current psychiatric practices. The novel’s central conflict between a domineering nurse and an unruly patient can also be read as an allegory for the emerging culture wars of the 1960s. The novel was adapted into a Broadway play one year after its publication and, subsequently, into a 1975 film starring Jack Nicholson, which won five Academy Awards, including Best Picture. In 2005, Time named the novel one of the 100 greatest English-language novels published since the magazine’s inception in 1923.

Citations in this guide correspond with the 2003 edition published by Penguin Books.

Plot Summary

The story takes place in the psychiatric ward in an Oregon hospital and is narrated by one of the ward's patients, Chief Bromden. Bromden is a Native American man who presents himself as deaf and mute, though he is neither. He experiences paranoia and frequent hallucinations, including a thick fog that clouds his perception whenever hospital staff exert influence over him.

As the story opens, a new patient arrives in the ward. The new patient, Randle McMurphy, was transferred from a work farm, where his aggressive behavior marked him as a potential psychopath. McMurphy quickly learns that the ward is under the control of Nurse Ratched, the ward’s head nurse, who rigidly enforces a set of seemingly arbitrary rules.

An avid gambler, McMurphy bets the other patients that he can expose Ratched’s vulnerability within a week. This sets off a power struggle between Ratched and McMurphy that continues throughout the novel. At first, McMurphy merely mocks and questions the hospital’s rules and methods. Soon, he uses his charisma to convince the ward’s doctor to make changes against Ratched’s wishes. McMurphy then leads an effort to change the schedule so that the patients can watch the baseball World Series; Ratched refuses, even when most of the patients vote in favor the plan. In protest, McMurphy and the others sit in front of the blank television during the game as Ratched reprimands them.

Ratched calls a staff meeting to discuss McMurphy. At the end of the meeting, she reveals her decision to keep McMurphy on the ward, rather than transfer him, so that she can discredit him in the eyes of the other patients. One day, McMurphy realizes that, unlike a prison sentence, the date of his release from the hospital depends on Ratched’s judgment. He begins to follow the rules, much to the disappointment of his peers in the ward, one of whom drowns himself. When McMurphy learns that most of the other patients in the ward are there by choice, he reverts to his disobedient behaviors, even breaking the glass window at the nurse’s station after Ratched revokes a privilege.

McMurphy’s next initiative is to host a fishing trip. As he invites other patients to join, Ratched tries to scare them out of it, but McMurphy succeeds in filling a roster. Because they are a driver short on the day of the trip, he also convinces the ward’s doctor to attend. On the way to the ocean, the patients are ashamed to be seen in public, but their attitudes change as they fish, and they return to the hospital with newfound confidence.

Ratched enacts a new plan to discredit McMurphy, revealing how much money he made from the fishing trip and from gambling. Bromden and the others feel betrayed. However, when McMurphy gets into a fight with one of the ward’s aides in defense of another patient, they realize that McMurphy wasn’t motivated by greed. Bromden joins the fight, after which he and McMurphy are temporarily transferred to an upstairs ward that houses more volatile patients. Ratched sends them both to receive electroshock therapy, but it has no effect on McMurphy’s attitude. Bromden finds that he recovers more quickly than ever before.

Bromden and McMurphy are hailed as heroes when they return to Ratched’s ward. A few of the patients plan McMurphy’s escape, but he delays his departure to throw a nighttime party, which includes a tryst between Billy Bibbit, a childlike man with a stutter, and Candy, McMurphy’s friend who accompanied them on the fishing trip. The day after the party, which leaves a trail of wreckage throughout the ward, McMurphy oversleeps. The staff round up the patients as they find evidence of the night’s activities. When Ratched finds Billy alone in a room with Candy, she threatens to tell Billy’s mother what happened. Moments later, Billy dies by suicide, and Ratched confronts McMurphy, blaming him. McMurphy attempts to strangle Ratched, but the staff pull him away.

In the aftermath, most of the patients who were close to McMurphy leave the hospital. Ratched returns a week later, bruised and bandaged but unable to speak. Two weeks later, McMurphy returns in a vegetative state after undergoing a lobotomy. Bromden suffocates him as an act of mercy before breaking out of the hospital in a way that McMurphy suggested weeks earlier. He plans to visit the Columbia River gorge where he grew up.