One Flew Over the Cuckoo’s Nest

Ken Kesey

Part IV

Summary Part IV

McMurphy and Sandy climb into bed after asking Turkle to wake them up right before the morning staff arrives. Unfortunately, Turkle falls asleep, and the aides discover them in the morning. Bromden surmises that the ensuing repercussions were inevitable, whether or not they followed through with McMurphy’s escape. He figures that even if McMurphy had escaped, he would have had to come back and not let the nurse get “the last play.”

The next morning all the patients are incredulous about the night’s activities. As Ratched turns up more and more incriminating remnants from the party, the patients cannot keep their laughter in, and the nurse looks like she is going to “blow up like a bladder.” McMurphy has a chance to escape when Turkle undoes the screen to let Sandy out, but he refuses, despite Harding’s warnings of what is to come. When Ratched finds Billy with Candy, he is calm and peaceful. He and Candy both move “like cats full of warm milk.” The nurse threatens to tell Billy’s mother. Billy regains his stutter and begins to cry, begging her to keep it a secret and blaming Candy, McMurphy, and Harding for the whole thing. She sends him to Spivey’s office to wait while she clears things up with the other patients. But Billy ends up committing suicide by cutting his throat.

Nurse Ratched asks McMurphy if he is satisfied with his accomplishments, and then she retreats to the Nurses’ Station. Bromden realizes that nobody will be able to stop McMurphy from rebelling, because it is the need of the patients that has been encouraging him all along, “making him wink and grin and laugh and go on with his act long after his humor had been parched dry between two electrodes.” Then, McMurphy smashes through the glass door, rips open the front of Ratched’s uniform, and tries to strangle her. As he is pried off of the nurse, he gives out a cry “of cornered-animal fear and hate and surrender and defiance.”

Several of the Acutes transfer to other wards, and some check themselves out of the hospital altogether. The doctor is asked to resign but refuses. Ratched returns after a week on medical leave with a heavy bandage around her throat, unable to speak. She cannot regain her former power over the ward. Eventually the only patients left on the ward are Bromden, Martini, and Scanlon. McMurphy is given a lobotomy for his attack on Nurse Ratched. When he is returned to the ward after the operation, he is a vegetable. That same night, Bromden suffocates McMurphy with a pillow. He throws the control panel through a window screen and escapes from the hospital, hitching a ride with a trucker.


Ratched makes one last feeble attempt to regain control when she uses the same principle she used earlier to ensure the patients’ submission to her authority: divide and conquer. She begins to sow the seeds of distrust among the patients by publicizing the financial gain McMurphy has enjoyed since his transfer from the work farm. Harding defends McMurphy, pointing out that McMurphy has more than repaid the patients’ financial losses by providing them with the means to resist Ratched’s influence.

But it is McMurphy’s timing of the rigged bet on the control panel that proves extremely disadvantageous. He fleeces them of their money too soon after Ratched has planted the seeds of doubt in their minds. Bromden is affected most acutely, because he feels that McMurphy has used him to take advantage of the others. Only after McMurphy regains the patients’ trust by taking on yet another personal risk for their benefit—defending George against the aides—do Bromden and the others realize McMurphy’s true objectives. Even Bromden helps this time, demonstrating the extent to which he has regained his self-confidence.