Introductory Lecture and Objectives

One Flew Over the Cuckoo's Nest eNotes Lesson Plan content

Ken Kesey, a creative writing student at Stanford University in 1960, was recruited as a human test subject in psychedelic drug research at the Menlo Park Veteran’s Hospital, where he also worked as a night aide. These experiences inspired his novel One Flew Over the Cuckoo’s Nest, which was published in 1962 to great acclaim.

The novel is narrated by Chief Bromden, a mental patient. His paranoid visions of the hospital and the world make him an unreliable narrator, yet the narrative’s events ultimately suggest that Bromden sees the world more accurately than anyone else. As the novel opens, he is mute and pretends to be deaf, and the virtual invisibility this grants him allows him to see and hear everything. When he does ultimately speak, the question of his reliability is put to rest; the novel’s protagonist, Randle McMurphy, says of the Chief’s outlook, “I didn’t say it didn’t make sense, Chief, I just said it was talkin’ crazy.”

The story the Chief narrates is that of a battle between redheaded, outspoken, fun-loving, gambling McMurphy, a new patient who has faked mental illness in order to serve out a prison term in the comfortable hospital, and Nurse Ratched, a cold, strict woman likened by the Chief to a frightening, all-powerful machine. McMurphy finds clever ways of subverting Nurse Ratched’s authority and diminishing her power, rallying the other patients to do likewise. Nurse Ratched finds subtle ways of turning the patients against McMurphy in order to bring him down from the pedestal on which the rest of the patients have placed him.

Through this battleground of patient versus nurse, Kesey weaves a much broader tale of individualism versus conformity, man versus woman, and humanism versus self-interest. Thanks to McMurphy, the patients remember what it means to enjoy life, to speak up for themselves, and to speak up for others. They become men rather than the frightened rabbits to which they are compared at the book’s beginning.

At the time One Flew Over the Cuckoo’s Nest was written, feminism was in full swing in the United States, and some critics have perceived Kesey’s book as a backlash to the movement. Virtually all the antagonists in the book are females who resort to manipulation, mind games, and metaphorical castration of the male characters. The only positive rendering of females comes in the form of the prostitutes McMurphy invites to the hospital.

One Flew Over the Cuckoo’s Nest became a successful play in 1963 and in 1975 was made into a movie starring Jack Nicholson as McMurphy and Louise Fletcher as Nurse Ratched. The film won five Academy Awards. In 2005 the book was listed by Time Magazine as one of the top one hundred best English-language novels since the magazine’s inception.

Kesey became a figurehead of the 1960s counterculture movement, bridging the divide between the Beat generation and the hippie generation. He hosted parties devoted to testing psychedelic drugs, and along with Beat icon Neal Cassady, inspired the cross-country school bus adventure chronicled by Tom Wolfe in The Electric Kool-Aid Acid Test. Kesey’s other novels are Sometimes a Great Notion (1964) and Sailor Song (1992). He died in 2001.

By the end of the unit the student will be able to:

1. Explain how Chief Bromden evolves from a passive presence to an active person.

2. Identify the use of laughter and humor as a literary device in the novel.

3. Examine the tension Kesey creates between individualism and conformity.

4. Explain how and why McMurphy becomes the group’s “cowboy.”

5. Cite how sexual politics influences the novel.

6. Describe how mental illness is perceived by the patients and the outside world.

7. Identify the use of irony in the novel.

8. Explain how the spirit of rebellion in the hospital grows and ultimately flourishes.

9. Examine how violence or the threat of violence—against Nurse Ratched, the aides, and the patients—is used in each section.

Instructional Focus: Teaching With an eNotes Lesson Plan

This eNotes lesson plan is designed so that it may be used in numerous ways to accommodate ESL students and to differentiate instruction in the classroom.

Student Lesson Guide

  • The Lesson Guide is organized for studying the book in sections. Lesson Guide pages may be assigned individually and completed at a student’s own pace.
  • Lesson Guide pages may be used as pre-reading activities to preview for students the vocabulary words they will encounter in reading each section of the book and to acquaint them generally with its content.
  • Before Lesson Guide pages are assigned, questions may be selected from them to use as short quizzes to assess reading comprehension.
  • Lesson Guide vocabulary lists include words from the book that vary in difficulty.

1. The vocabulary lists for each section are sufficiently comprehensive so that shorter lists of vocabulary words can be constructed from them.

2. Working from the Lesson Guide vocabulary lists, the teacher also may construct vocabulary studies for individual students, choosing specific words from each section that are most appropriate for them.

Essay and Discussion Questions

The essay and discussion questions vary in degree of difficulty.

1. Some questions require higher levels of critical thinking; others engage students with less challenging inquiry.

2. Individual discussion questions may be assigned to students working in pairs or in small study groups; their contributions may then be added to a whole-class discussion.

Multiple-Choice/Essay Test

Test questions also vary in degree of difficulty.

1. Some multiple-choice questions address the factual content of the book; others require students to employ critical thinking skills, such as analyzing; comparing and contrasting; and drawing inferences.

2. The teacher may select specific multiple-choice questions and one or more essay questions to assess an individual student’s understanding of the book.

3. The essay portion of the test appears on a separate page so that it may be omitted altogether in testing.

Teaching the Literary Elements

Before students read the novel, explain that themes are universal ideas developed in literature. Point out that these themes will be developed in the work; discuss them with students as they read and/or after they finish reading:

  • Control
  • Rebellion
  • Mental illness
  • Racism
  • Sexuality
  • Individualism vs. conformity
  • Self-interest vs. selflessness
  • Technology(as reflection of humankind’s progress or its wickedness)

Talk with your students about how a motif is a recurring pattern or repeated action, element, or idea in literature. As they read, have them pay attention to the following motifs:

  • Humor
  • Violence
  • Nature vs. technology imagery
  • Fog
  • Paranoia
  • Irony
  • Depression
  • The Combine
  • Invisibility
  • Military service
  • Blindness/deafness vs. perception

A symbol is a concrete object or place that has significance in a literary work because it communicates an idea. Have students discuss how the author develops the following symbols and what ideas the symbols could suggest. Have them look for other symbols on their own.

  • Rabbits
  • Wolves
  • McMurphy’s boxer shorts
  • The glass nurse’s station
  • The log book
  • Machinery
  • The Disturbed ward
  • Cowboys

Essay and Discussion Questions

1. Does McMurphy save the Chief? Why or why not? If yes, how?

2. Nurse Ratched suggests that McMurphy’s loyalty is only to himself. Is the nurse right about him? Why or why not?

3. Is the Chief primarily self-interested or primarily altruistic? Use examples from the novel to support your position.

4. How is humor used throughout the book? What is its role in the beginning? Has that role changed at the story’s end?

5. How is irony used throughout the book? What is its role in the relationship between “healer” Nurse Ratched and “troublemaker” McMurphy?

6. The film version of One Flew Over the Cuckoo’s Nest is not told from the Chief’s point of view. How might this affect the novel’s themes?

7. Why might Kesey have chosen to title his novel with a line from a nursery game?

8. The Chief, Colonel Matterson, George, McMurphy, and even the nurse all have military experiences in their past. How does Kesey use this military motif throughout the book? What does he suggest about its influence on these individuals’ lives?

9. What is the Combine? How is it a symbol of control?

10. The Chief seems to fear technology and sees the nurse as a watchful robot. If Kesey were to write this book today, how would the theme of technology be different? Are people more or less vulnerable to technology now than we were in the early 1960s?

11. The Chief observes of McMurphy, “He knows that there’s no better way in the world to aggravate somebody who’s trying to make it hard for you than by acting like you’re not bothered.” Is this true? Share examples of when this tactic has been effective in your life and when it has not.

12. One Flew Over the Cuckoo’s Nest has...

(The entire section is 555 words.)

Part 1


ample: generous; more than adequate

apathy: indifference, a lack of feeling or interest

bays: barks with prolonged tones

brassy: shamelessly bold

bull goose: the alpha or lead male in a group of geese

cagier: more wary, more clever, more hesitant about committing oneself

caisson: a two-wheeled device used for hauling ammunition

camphor: an aromatic substance often applied to the skin to alleviate mild pain or irritation

castors: a set of mounted wheels used to support and move furniture and equipment

catheters: flexible tubes inserted through a narrow opening into the body, especially the bladder, to remove fluid

contrivance: a skillfully created mechanical device

covey: a small party or flock of birds (used figuratively in the text)

culls: noun rejected items, often rejected for being worthless or inferior

dago: slang a usually derogatory term for a person of Italian or Spanish descent

dandyism: a manner that unduly stresses style, neatness, and fashion in dress and appearance in men

ethereally: in a manner that is characterized by extreme delicacy and lightness

fester: to putrefy, to rot; to cause increasing irritation or bitterness

filch: to steal in a casual way, especially something of small value

flint: a hard gray rock often used by ancient humans to form tools or weapons

fracas: a noisy fight, a brawl

hex: a magical spell or curse

hullabaloo: a commotion, a fuss

hypodermic: refers to a needle used for injections beneath the skin

id: in psychoanalytic theory, the part of the mind that manifests primary and instinctive impulses

impregnable: incapable of being taken by assault

infernal: irritating and tiresome; refers to that which is hellish (in context)

insinuations: hints or suggestions of something unpleasant or bad

insubordination: defiance or disobedience to authority

juggernaut: a massive force or object that crushes whatever is in its path

jurisdiction: control, the power or right to exercise authority

latrine: a toilet, especially a communal one used in a camp or barracks

lockworks: the parts of a lock

lolling: hanging loosely, drooping

magneto: a part of an engine that generates current by using magnets

maudlin: self-pityingly sentimental

ornery: bad-tempered, combative

oxblood: reddish-brown

passel: a large number or amount

pinochle: a card game for two or more players

piston: a sliding piece that moves back and forth inside a cylindrical chamber, often as part of a machine such as a car engine

poozle: slang vagina

primitive: belonging to an early stage of development, crude, rudimentary

protocol: the conventions prescribing rules and etiquette

razz: to tease playfully

rimrock: the top layer of rock on a plateau that remains as a vertical surface after the land near it is worn away

sadistic: getting pleasure from inflicting pain, suffering, or humiliation on others

sinewy: strong in a tough, stringy way, such as the fibrous tissue that connects muscle to bone

skillo wheel: a carnival game consisting of a wheel that players, in theory, spin or manipulate through skill in order to win prizes

sniggered: laughed in a secretive or partly suppressed manner

stoicism: indifference to pleasure or pain, impassiveness

sunned: exposed to the rays of the sun

superego: in psychoanalytic theory, the part of the mind that is self-critical and reflects social standards learned from parents and teachers

taut: tightly drawn, tense

The Dalles: a small city in northern Oregon located along the Columbia River

therapeutic: providing or assisting in a cure

Umpqua: a tribe of Native Americans in southwest Oregon, taking their name from a local river

uncouth: awkward and uncultivated in appearance, rugged

veritable: being in fact the thing named and not false or imaginary—often used to stress the aptness of a metaphor

Study Questions

1. Describe the book’s narrator. How does he present himself? How do others perceive him?

The book’s narrator is Chief Bromden, but everyone at the hospital calls him Chief Broom because he spends much of his time sweeping. He is a large Columbia Indian who appears to others to be deaf and mute, when really he hears and observes everything around him. He is also perceived by others to be frightened and meek.

2. What mood does Kesey set in the first few pages of the book, narrating from the Chief’s point of view?

The tone of the first few pages of the book is dark and ominous, soaked with the Chief’s paranoia. The word “hate” is used frequently, and the descriptions are dark and filled with paranoia, as when the Chief describes his surrounding as having the “hum of black machinery, humming hate and death and other hospital secrets.”

3. Describe the Big Nurse, as seen through the Chief’s eyes.

The Chief sees the Big Nurse as a big, scary machine. He describes her as “swelling up” to a superhuman size, and he describes her smile as a “snarl.” To the Chief’s eyes, she transforms from looking normal to looking like a frightening mechanical beast capable of great destruction.

4. What is the setting of the book?

The book is set in a ward of a mental hospital.

5. Why doesn’t the Chief want to shave before he has breakfast?

The Chief believes that if he shaves before breakfast, he is weaker and less able to ward off people from the Combine. He believes those people are not really shaving him but rather slipping a harmful machine on him.

6. The Chief, about to embark on McMurphy’s story, reflects, “But it’s the truth even if it didn’t happen.” What might he mean?

The Chief may mean there is no official record or proof of the events. He may also be acknowledging that he knows he is not a reliable narrator, yet what he witnessed has truth.

7. What does the Chief think of the Public Relations man? How does the man describe the hospital, and is he right in his assessment?

The Chief thinks the Public Relations man is a “fool” and characterizes him as a cartoonish phony. The man describes the hospital as “cheery” and contrasts it to its brutal, inhumane past, implying it is humane and somehow gentle. The Chief’s portrait of the hospital shows a much darker reality.

8. Describe McMurphy. What does the Chief notice right away about him?

McMurphy is different from other people in the hospital. He “sounds big” and appears confident. He is large, sturdy, redheaded, and speaks and moves with an ease the others do not have: “He shows up in the door and stops and hitches his thumbs in his pockets, boots wide apart, and stands there with the guys looking at him.”

9. Though it’s not explicitly stated, what images are on the playing cards McMurphy brings into the ward?

McMurphy’s cards contain lewd images of women.

10. What’s the difference between Acutes and Chronics?

The Acutes are the younger patients who have not been in the hospital long and who have a chance of leaving. They’re called Acutes “because the doctors figure them still sick enough to be fixed,” according to the Chief. Chronics are those who are never leaving the hospital. They are more mentally ill than the Acutes—some of them much more so—and do not interact with others in the way the Acutes do.

11. What does the Chief hear from McMurphy that he hasn’t heard in a long time?

McMurphy laughs, which takes the Chief a moment to realize because he hasn’t heard laughter in so long.

12. How does the Big Nurse foster an environment of distrust among the patients?

If one patient tells another something about his past in an unguarded moment, the listener will write it in a log book that goes to the Big Nurse. The informant will be permitted to sleep in the next day. By rewarding informant behavior, the Big Nurse creates an atmosphere in which no one can trust anyone else.

13. What happened to Ellis and Ruckly? Why?

Ellis and Ruckly were victims of faulty “installations.” They were Acutes who were taken to the Shock Shop where something went wrong with their treatments, and their brains did not function properly afterward.

14. Why does the Chief suggest that Ruckly is not a failure and that it is the patients who have successful “installations” who are failures?

Ruckly stares at a picture all day and does not do much else, but the Chief feels even this is better than to be returned to society as “another robot for the Combine.” He feels Ruckly is still Ruckly, although a diminished version of himself, whereas the patients who have successful installations and are discharged no longer belong to themselves.

15. How does the Big Nurse use the Chronics to perpetuate fear?

She knows that the Acutes fear turning into Chronics, whose pathetic condition they must look at all day long in the day room. When she wants an Acute to fall in line, she will say, “You boys be good boys and cooperate with the staff policy which is engineered for your cure, or you’ll end up over on that side.” She means, of course, they will end up on the same side of the room as...

(The entire section is 4138 words.)

Part 2


aplomb: complete composure, poise

bile: a bitter yellow or greenish fluid secreted by the liver

brahma: a type of humped ox, bred in India

brooding: dwelling gloomily in thought

chabobs: slang a woman’s breasts

constitute: to make up, to form, to compose

curtail: to impose a restriction; to reduce in quantity

Faulknerian: referring to the American novelist William Faulkner (1897–1962) whose themes often revolved around the history of the American South and its decline

gangly: loosely and awkwardly built, lanky

hobnails: short nails inserted into the soles of boots to help provide traction

impound: to...

(The entire section is 1851 words.)

Part 3


acrawl: crawling or swarming with

appraise: to evaluate the worth or merit of something

bald: lacking a natural covering

bosun: boatswain, a petty officer on a ship in charge of the hull

brads: slender nails with barrel-shaped heads

cormorants: greedy, grasping persons (in context)

decipher: to decode, to make out the meaning of

‘dobe: slang adobe, a building material of sun-dried earth and straw

flails: tools used for separating seed from a plant by hand

Hiawatha: the Native American hero of Henry Longfellow’s poem The Song of Hiawatha, based on a real person

hovel: a small, simple, and...

(The entire section is 1559 words.)

Part 4


balking: hesitating or unwilling to proceed

chicanery: clever trickery

condoned: regarded (especially something bad) as acceptable or forgivable

courtesan: a prostitute, especially for wealthy clients

croupier: an employee of a gambling casino who collects and pays bets

effrontery: shameless display of boldness

fleeced: stripped of money or property by illegal or fraudulent means

graphite: a soft shiny black carbon substance used as a dry lubricant

inert: chemically inactive

Jezebel: a biblical character often associated with fallen or abandoned women

ripsnorter: something characterized by extraordinary vigor or intensity


(The entire section is 2336 words.)

Multiple-Choice Test and Answer Key

1. To what does the Chief compare Nurse Ratched?

A. an alligator

B. a broom

C. a frightening monster machine

D. Randle McMurphy

E. his father

2. The fog machine is probably

A. a combination of the Chief ’s medication and depression.

B. an actual machine the Combine uses to mollify patients.

C. a World War II weapon.

D. the Chief ’s interpretation of the fog coming in from the coast.

E. a mechanism to make the patients forget...

(The entire section is 1427 words.)

Essay Exam Questions With Answers

1. Chart Chief Bromden’s evolution from a fearful mute to a proactive, able-bodied man, using at least three specific turning points in his recovery as examples.

In the opening sections of One Flew Over the Cuckoo’s Nest, Chief Bromden is silent. He has no voice, he has a presence that is rarely acknowledged or appreciated, and he spends his time sweeping and mopping up after others. His opening observations are filled with fear and paranoia: “When they hate like this,” he observes of the black aides, “better if they don’t see me.” By the novel’s end, Chief Bromden not only speaks, he acts on his conviction. He is courageous, and once he liberates McMurphy from his vegetable life and...

(The entire section is 2859 words.)