The ward in Cuckoo’s Nest differs from earlier mental institutions we’ve seen in a number of ways. Most patients remain voluntarily; there’s a clear emphasis on community therapy and some reference to democratic possibilities; we see nothing like the filth of Blackwell’s Island or Byberry, and the long-term use of restraints is plainly discouraged. If not by any means cheery, the look of the place seems to be decidedly clean, clinical, orderly, and professional, with polished floors, starched uniforms, and immaculate glass windows. One of my favorite but very minor characters is “Public Relation” who guides tours through the facility, in a way somewhat reminiscent of Bedlam in the 1700s, while asserting how different this hospital is: “What a cheery atmosphere, don’t you agree? . . . Oh, when I think back on the old days, on the filth, the bad food, even, yes, brutality, oh, I realize ladies that we have come a long way in our campaign!”
But if Ratched’s ward makes discipline and control less outwardly brutal and visible to tourists, it shows how fully under the watchful eye of authority the hospital remains. Authority is just exercised differently, through group therapy sessions, the piped music, and silent observation from behind glass walls. It’s striking to me how visible and vulnerable these patients are, despite the tendency to use physical coercion only as a very last resort. In Cuckoo’s Nest more than any asylum we’ve seen, medicine, the protocols of actual and professionalized treatment, become the mechanisms of control. It’s a historical progression that allows for educational tours and good public relations while providing an intensely repressive atmosphere for the patients. Perhaps that’s why visitors see nothing amiss while the chief has visions of inmates crucified on the wall.
What do others see as changes in the Cuckoo’s Nest ward?