Summary: Nurse Ratched runs her ward in an Oregon mental institution with an iron fist until McMurphy, a gregarious fighter, intentionally gets himself sent to the ward to avoid jail work duty. McMurphy makes it his mission to uproot Ratched's authority and awaken the submissive patients in the facility, including "Chief" Bromden, a giant half-Indian who has for years pretended to be deaf and dumb (and who narrates the story).
Musings: Going in, my only familiarity with the story was a vague picture of a grinning Jack Nicholas in a mental institution-- although I'd never actually seen the movie version. The book contains many of the tropes typical of stories about older institutions: pervasive abuse, electro-shock therapy, lack of respect of patients, and patients who are far less sick than they are treated.
Although the motifs and plot are basic, the story is engaging. From the start, McMurphy is the classic rebel, challenging Nurse Ratched and her reliance on structure and control. Nurse Ratched is the epitomic villain who cares more about order than improving the lives of her patients. Her authority comes from belittling the patients and making them reliant on her rules to survive, but McMurphy changes all that. His brazen defiance of the rules begins to encourage the other patients to also stand up for their rights.
The story, however, does not reach the a classic happy ending of total authoritative upheaval. McMurphy is successful at giving the other patients the courage to stand up for themselves, but McMurphy can only take them so far; at some point, each patient must be willing to independently become a rebel and break out of the bonds the label of "crazy" has tied around him. Some are successful; others are not. Nurse Ratched is wounded, but she is not gone and is likely unchanged.
In breaking up the "machine" of the institution, McMurphy must give all of himself. He is unable to step back and show restraint, even though the personal cost is severe.
In some ways the novel reminded me of the studies done by Milgram. People will obey, even when they disagree with the order, because it is easier to follow other people and blame them for their problems than face the difficulty and consequences of being responsible for their own actions. One Flew Over the Cuckoo's Nest argues that it is worth challenging the institution but that such challenges are not easy and are not always successful.