One Flew Over the Cuckoo's Nest

Michele Farina - “You’re not crazy, you’re no crazier than the average asshole out walking around on the streets, and that’s it.” This is one of the most memorable—and in some ways most misleading—tirades that Randle P. McMurphy (Jack Nicholson) directs at his band of “lunatics” during a dehumanizing group session led by the cold Nurse Ratched. One Flew Over the Cuckoo's Nest is one of those works that can be described as a “cult classic,” with its rituals and followers. In Italy, it is available on some platforms, and here on my desk, I keep a copy of the DVD I bought goodness knows when, featuring Jack Nicholson’s laughing, upturned face.

A few days ago, on the American public radio station NPR, psychiatrist Ken Duckworth, head of the National Alliance on Mental Illness, said he saw the movie shortly after it was released: “I was 17 and my father was in and out of the hospital at the time with severe bipolar disorder. I recognized the institutional and industrial coldness of that place in the movie.” For Duckworth, One Flew Over the Cuckoo's Nest “sheds light on the overcrowded psychiatric institutions of the 1960s.” However, it still leaves an ambiguous aftertaste. “For example, when you talk to a patient suffering from severe depression who is on medication and ask if they have ever tried electroshock therapy [Editor’s note: ECT is now only performed under anesthesia], the answer is: ‘Oh no. Did you see what happened to Jack Nicholson? I won’t let them do that to me.’”

The movie has long-lasting side effects, consequences for a story that is “perfect from a cinematic point of view, which initially had a positive cultural impact in Italy as it was preparing to close its asylums,” Paolo Milone, a psychiatrist born in 1954, tells La Lettura. Milone is the author of several insightful books based on his work experience, including L’arte di legare le persone (The Art of Tying People) (2021) and Una piccola fine del mondo (A Small End of the World), published this year.

“From the first time I saw it, when I was 22 and finishing my specialization at university, I felt that there was something that didn’t add up, that didn’t make sense from a medical point of view,” Milone explains. “It’s a bit like when I write something beautiful from a narrative perspective, but then I realize that it doesn’t correspond to reality, because reality stumbles all the time. How can I put it? Reality is ugly, it’s lame, but my pen ran away with me. So I delete it and start again.”

Luckily, director Miloš Forman didn’t do the same when he worked on the novel published by Ken Kesey in 1962. Milone agrees. For La Lettura, he rewatched the movie 50 years later, and the impression is the same as it was then: “As a viewer, I really liked it. It’s a beautiful fairy tale, but it has little to do with psychiatry.” He remembers the day they discussed it in class at the psychiatric clinic in Genoa. Professor Romolo Rossi, a leading figure in the world of psychoanalysis, said to the students: “You’ve seen the movie, you’ve seen what it says about suicide? But people don’t kill themselves for reasons like that…” Rossi was referring to the story of young Billy, the character who, looking back now, would have most interested Milone the psychiatrist. The movie is now so old that many young people probably haven’t seen it and might want to, so it’s best not to give too much away. Let’s just say that Billy, like other inmates (and this is what angers Randle: “Who do you think you are, crazy?”), is voluntarily in the ward, under the clutches of the inflexible Nurse Ratched. “I’ve never seen such a tough character in my entire working life,” says Milone, who, in a way, sees her as a patient hidden on the other side of the fence, arguing that “if a person like that has chosen this profession, it’s not just for the sake of being mean, but because she herself was in need.”

In the book on which the movie is based, she is even tougher: Kesey said he was inspired by a head nurse he met at a veterans' center where he had volunteered, but admitted to exaggerating her sadistic traits. Her counterpart, Randle, is in the psychiatric center for evaluation: sentenced to six months for having sex with a 15-year-old girl (who, according to him, had pretended to be an adult), he faked being “crazy” to avoid prison. In today’s Hollywood, a character with such a past could not become the “free spirit” hero that The New York Times described after the premiere on November 28, 1975. The review rejected the movie as a failed metaphor for the turmoil of the 1960s but promoted it as a “human comedy” with a group of characters who, according to Vincent Canby, “are variations of us, the audience, if only we could cross the threshold of what is called sanity.”

Here is a crucial point: One Flew Over the Cuckoo's Nest does not tell the story of mental illness, says Milone, “because the psychiatric patient is dominated by an inner world that is difficult to explore.” And it is made up of that “lame, stumbling” reality that is unsuited to a Hollywood fairy tale. Miloš Forman made “a beautiful action movie that grabs you. A perfect story that came at the right cultural moment.” Indeed, the 1978 psychiatric reform in Italy, argues the author of Una piccola fine del mondo, was not the product of a revolution led by a legendary handful of people, nor was it a reflection of the heroic deeds of Randle P. McMurphy-type characters. Fundamentally, the closure of asylums—which in a country of 58 million inhabitants housed about 90,000 people—“was made possible by the miracle of psychotropic drugs,” which in the mid-1950s were given to patients “from a pot, with a ladle. The asylum became a quieter, more peaceful place, and so the movement demanding that patients be treated in the community grew in society and politics (the trade unions gave it an important boost, and the first demonstrations took place in Genoa).”

Of course, Milone points out, Italy now spends less on mental health than when there were asylums (down from 5% to 3% of healthcare spending). But the patients remain: more funds, education, and services are needed. So what is the point of revisiting a movie like One Flew Over the Cuckoo's Nest? To stay on topic, if we wanted to understand more about the “inner world” of psychiatric distress through a work of fiction, according to Milone, we should study another immortal Jack Nicholson: the psychotic, murderous one in The Shining (1980). In five years, for the half-century anniversary, let’s book Dr. Milone in Genoa for another viewing of “the little end of the world.”

But in the meantime, to satisfy our need for consolation (“You come out of the movie feeling heartened, don’t you?” says Milone), we reflect on the adventure of Randle and Martini, Billy, Chief, and all the other “lunatics” who together made the movie worth five Oscars. What a character, Chief: Kesey tells the story in the book from the point of view of the giant nicknamed Chief, the Native American man who, in self-defense, pretends to be deaf and dumb, detached from everything. In the movie, he is the pillar from whom Randle wrings a smile and who provides him with an ultimate escape (“What are you and me doing here, Chief?”; “I’m not leaving you here like this. I’m taking you with me”).

Everyone has their favorite scenes from this cult movie. The basketball game between patients and staff; the play-by-play of the baseball final, so imaginary and yet so real that it captivates the entire ward: Randle invents every move because Nurse Ratched won’t turn on the television (“Koufax throws, Richardson hits, it’s a long, hard line drive...”). And then there’s the wonderful boat escape, when a wild Nicholson, wearing a captain’s cap and with a girl by his side, takes everyone fishing. It is after this display of perfectly normal madness that the medical board decides that McMurphy “is very dangerous.”

One Flew Over the Cuckoo's Nest does not tell the story of psychiatry, past or present. It may well be a fairy tale. But fifty years have passed, asylums no longer exist, and we all talk about the “dignity of the person” that must be preserved (remember the documentary Human Forever?) at any age and in any condition. Yet the call for a breath of life in institutions, “a little jungle for me too,” as Italian singer-songwriter Paolo Conte sings, is not useless or obsolete. In nursing homes and care centers of various kinds, instead of barbed wire, there may be beautiful gardens and wellness areas, but every now and then we need a Randle P. McMurphy, a Martini, a Chief Bromden to shake up the established order. We need them to create bonds, distributing them with a ladle rather than a dropper, because what saves us from tragedy is human comedy. Sometimes these figures exist, but they are considered dangerous. Of course, they are not punished with a lobotomy. It is enough to remove them, put them in a bad light, treat them like caricatures. Sometimes, however, they take root. They form communities. They want the jungle and the footbath together. They move boulders, or at least they try to. As Nicholson says in the cuckoo’s fable after yet another failure, “But at least I tried.”

One Flew Over the Cuckoo's Nest was released in US cinemas on November 19, 1975. The movie, directed by Miloš Forman (1932-2018), won five Oscars: Best Picture, Director, Adapted Screenplay, Actress (Louise Fletcher as Nurse Mildred Ratched), and Actor (Jack Nicholson as Randle Patrick McMurphy). Nicholson’s formidable performance earned him his first Oscar. The movie also became a historic box office success, grossing over $160 million. The cast also includes Danny DeVito as Martini and Will Sampson, a member of the Muscogee Nation, in the role of Chief Bromden. The movie is an adaptation of the bestseller by Ken Kesey (1935–2001), published in 1962 in the US. The title is a line from a nursery rhyme: “Three geese in a flock, one flew east, one flew west, and one flew over the cuckoo’s nest”—with “cuckoo’s nest” being American slang for a mental asylum.

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