Transcript One Flew Over the Cuckoo`s Nestx

Ken Kesey
About the Author
Kesey actually worked as a night
warden on a ward in a mental hospital.
 He was so determined to get the feel of
being a patient that he underwent ECT.
 While at Stanford, Kesey volunteered for
medical studies on the effects of
psychoactive drugs (often
hallucinogens).
 He used these experiences to inform
how Chief would see the world.
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Narration
Be patient with your narrator, Chief
Bromden.
 He has had too much electroshock
therapy and too many drugs.
 Keep in mind that our narrator is not the
same as our protagonist.
 Essential Question: What is the
significance of Chief’s narration? How
would the novel be different without it?
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Symbols
Symbols are really anything that stands for
something else. Obvious examples are
flags, which symbolize a nation; the cross
is a symbol for Christianity; Uncle Sam a
symbol for the United States. In literature, a
symbol is expected to have significance.
 Symbols in Cuckoo’s Nest:
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The fog
Ratched’s window
McMurphy
The Combine
Outside
Check out some images that McMurphy
would have seen in his ward.
Mental Hospitals 1930s-1960s
Conditions at These Hospitals
Could Be Atrocious
Over crowded
 Dirty
 Not nurturing
 No privacy
 Similar to—or in some cases worse
than—prison
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Inside the Institutions
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Patients were provided with “adequate care”
(and segregated) which often times led to
inadequate care, poor facilities, and loss of
dignity.
They were usually given uniforms and daily
“chores.” In fact it wasn’t until 1973 that New
York state banned public hospitals from
requiring patients to work in exchange for their
room and board.
Families were often ashamed of the patients
and would deny their existence.
Ultimately, some of these hospitals became
holding areas for a person’s entire life.
Medical Care in Mental Hospitals
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Deaths and injuries sometimes resulted from
both appropriate and inappropriate treatments.
Patients were treated with medically approved
procedures like: being put in tanks of ice-cold
water, spun in chairs for hours, and forced
"medications" (powerful psychoactive drugs) .
Patients were also “treated” with non-medically
approved procedures which were simply
designed to control them.
 For example, patients could be shackled to walls,
placed in seclusion (most often without clothing) or
placed in restraints (being strapped to a bed with
leather restraints, often in a spread-eagle position).
Treatments for the Mentally Ill:
Drug Therapy
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Thorazine:
 the first psychotropic drug, was a milestone
in treatment therapy, making it possible to
calm unruly behavior, anxiety, agitation, and
confusion without using physical restraints.
 "chemical restraint"
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Chlorpromazine:
 schizophrenic psychosis or manic
depressive disorder
Treatments for the Mentally Ill:
Electroshock Therapy
Became very popular 1930’s- 40’s.
Originated to control negative behaviors in
animals
 A doctor had noticed that schizophrenic
epileptics who had a seizure often were
more “normal” after the seizure— which led
to chemical convulsives and ultimately
electroconvulsive treatment
 Used to alter the chemistry in the brain to
produce desired behaviors.
 Cruelly, it was used as a control
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Electroshock Therapy Today
Used to treat some forms of severe
depression
 Used to “control” the elderly
 Used on children in an attempt to correct
their wild and/or unwanted behaviors
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Treatments for the Mentally Ill:
Lobotomy
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Surgical procedure for cutting nerve pathways in
the frontal lobes of the brain.
The operation has been performed on mentally ill
patients whose behavioral patterns were not
improved by other forms of treatment; it was
supposed to be a last resort.
The procedure was pioneered by Nobel laureate
Egas Moniz in the 1930s
Between 1939-1955 over 100,000 lobotomies
were performed in the United States.
If performed correctly, disconnecting the frontal
lobes there caused no loss of intellect, no
impairment
How a Lobotomy Was Performed
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Leucotomy
 The goal was to cut the nerves that run from front of
the brain to the rear.
 A technique was devised that involved drilling two
holes on either side of the forehead, insert a
surgical knife, and sever the prefrontal cortex from
the rest of the brain.
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Ice Pick Lobotomy
 Invented in 1936 - Walter Freeman
 Insert an ordinary ice pick above each eye of a
patient with only local anesthetic, drive it through
the thin bone with a light tap of a mallet, swish the
pick back and forth, then remove.
 A formerly difficult patient is now passive.
Abuse of Lobotomy
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"Every patient probably loses something by this
operation, some spontaneity, some sparkle, some
flavor of the personality”
The aim was that "the patient might be transformed
from a disturbed to a quiet clement [insane person]."
There was no intention to "help" the patient. The goal
was only to eradicate the behavior which others
found undesirable.
The frontal lobe is the seat of the higher functions
such as love, concern for others, empathy, selfinsight, creativity, initiative, autonomy, rationality,
abstract reasoning, judgment, future planning,
foresight, will-power, determination and
concentration
Discipline is absolutely necessary in
most situations.
All people are “crazy” to some extent.
Our society forces men to act like
stereotypical men.
Hatred is inherent to human nature.
One person can change an
established, stable environment
The best place for those with mental
illness in an institution and/or hospital.
Rules are necessary to maintain order
War is a terrible thing for all involved—
and should be avoided whenever
possible.
Some people simply can/will
never change.