Illustration of Nurse Ratched

One Flew Over the Cuckoo's Nest

by Ken Kesey

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What occurs if a patient doesn't take their medicine in One Flew Over the Cuckoo's Nest?

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There are several instances in One Flew Over the Cuckoo's Nest in which a patient either refuses or lies about taking his medication. One such instance is when Chief Bromden does not take his night medication and has horrible nightmares about the hospital turning into a slaughterhouse until Mr. Turkle wakes him up. Another instance in which we see a patient lie about taking his medication is when Sefelt insists that he no longer requires medicine for his seizures, and so he pretends to swallow his pills and then gives them to Fredrickson, who also suffers from seizures and wants to double the normal dose. In this case, Sefelt ends up suffering from a seizure and Nurse Ratchet makes an example out of him. Earlier in the novel, Ratchet also makes an example of Mr. Taber when he refuses to take his pills because they have given him a new one he does not recognize. She belittles him, calling him a child, and makes him go the day without his medicine, which causes him to mope around. 

Generally speaking, when a patient refuses to take his medication, it has a negative impact on him, both physically and mentally. Not only do they have to deal with the unmediated effects of their conditions, but they also have to deal with being humiliated by Nurse Ratchet. When she makes an example out of these patients, she is doing so because forcing patients to take their medication is the easiest way to keep them docile and easily manipulated. When they refuse their medicine, they become unruly and unpredictable. 

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Sefelt is one of the patients who does not take his medicine in One Flew Over the Cuckoo's Nest. As a result, in Chapter 19, he suffers an epileptic fit while waiting in the lunch line. His tray flies into the air, and food rains down on him. An orderly has to put a stick in Sefelt's mouth as he is having a fit, and the wooden stick splinters from Sefelt's bite. 

Nurse Ratched says that Sefelt has not been taking his Dilantin, which is an anti-convulsant, and has instead been holding it in his mouth and then giving it to Bruce Fredrickson, another patient with epilepsy who sleeps next to Sefelt. Fredrickson wants to take a double dose, while Sefelt does not want to take any Dilantin. Sefelt cares about his looks, and he thinks the medicine makes his hair fall out and his gums rot. 

In addition, patients such as Mr. Taber, who refuses to take his medicine orally, is forced down onto a mattress and is given his medicine in a shot with a long needle. 

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The answer to this question is chillingly presented to the reader in the figure of Mr. Taber and what Bromden remembers happened to him when he refused to take his medication. In fact, all Taber did was refuse to take the medication without being told what it was, but this was interpreted as a refusal by Nurse Ratched. As he, according to her, refused to take his medication "orally," he was forcibly mahandled and give him an injection in his rear:

They push him face down on the mattress. One sits on his head, and the other rips his pants open in back and peels the cloth until Taber's peach-colored rear is framed by the ragged lettuce-green... The nurse comes down the hall, smearing Vaseline on a long needle, plls the door shut so they're out of sight for a second, then comes right back out, wiping the needle on a shred of Taber's pants.

Such horrendous abuse clearly signals the way that the inmate's rights are taken away from them and how they are abused if they do not conform to Nurse Ratched's strict rule. Kesey uses the treatment of patients in this novel to question the way that such behaviour is justified through the use of labeling by society. If you label somebody as being mentally unwell, or "mad," suddenly they seem to lose all basic human rights. The novel suggests this is profoundly wrong.

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