My Grandfather, the Psychiatrist, and One Flew Over the Cuckoo's Nest

For my Capstone, I’m working with my grandfather, or Zayda as I call him, to transcribe his memoir, which he began writing when I was born. There are over 100 handwritten pages, none of which have been read by anyone but us. This project has not only strengthen my relationship with him, but taught me things I never would have known about my family.

When we started reading One Flew Over the Cuckoo’s Nest, the connections between my grandfather’s stories and the book were immediate. He began his residency in the early 70s, about a decade after the novel came out. He recalls the intensity of the locked unit with adult patients and the “biological revolution in psychiatry,” as he put it. Sometimes the things he tells me are surprising, like that he entered psychiatry when these breakthroughs about depression being caused by your brain. Just in his lifetime, he has seen a complete transformation in how mental illness is diagnosed and how those who suffer from it are treated.

Very early in the book, we see that the Big Nurse (and aides and doctor) have considerably more power than the patients. The Big Nurse controls everything on the floor, including the medications and who goes to the Disturbed ward. Her obsession with routine has created a hostile environment. I often find myself comparing my grandfather to the Big Nurse (even though he didn’t have that kind of jurisdiction during the time I mentioned) when she seems particularly cruel. “The length of the time he spends in this hospital is entirely up to us,” (137). There appears to be little resentment or hesitation from the ward’s professionals, which seems absurd today. They had complete control over these people, and from what we can see, they weren’t cared for in the way they should have been. Knowing my grandfather was one of the individuals in the ward who had authority, I often get fearful, perhaps irrationally, that he may have participated in the unfair treatment of patients.

My grandfather and I have spent hours talking about the transformation my grandfather witnessed in psychiatry. Things that seem so obvious now were groundbreaking at the time. “The idea that serious mental illnesses were disorders of the brain, with genetic and neurochemical determinants, was emerging,” he says about his residency. Empathy and understanding, which had been lacking, as we can see in the book, were appearing regarding those who have severe mental illness. The knowledge of mental illness has changed considerably in the past 50 years, so what we know as usual treatment is entirely different than what Kesey and my grandfather did. “They’ve learned a lot since then,” (111) Bromden says, comparing his current placement to the “old hospital.” Somehow, he is making the ward we know well sound like a privilege. The two moments I’m discussing are almost ten years apart, so there has been progress, but it still seems insufficient. We know that at the time of the book, they are still performing lobotomies and using harmful (and not scientifically proven) ways to “fix” the patients. While reading, it often makes me think that no matter how progressive we feel at a certain point, in the future, we will look back and be shocked at how far behind we were.

For the second year of his residency, he was placed into an adolescent unit, which he says was philosophically different. [It] was organized as a therapeutic community, each day began with a morning meeting in which the previous 24 hours events in the life of the community and its members— the 24 patients and the staff could be discussed, confronted, explored, validated, and processed.” I remember hearing him say this and me typing it and thinking, “Huh, that doesn’t sound so bad,” then I read the group therapy from Bromden’s eyes, and my perspective changed. Group therapy is when they are drugged the most, as a way to subdue their personalities and allow Nurse Ratched to be in complete control. I know the book has some magical realism, yet I cannot stop asking, “What was it like for the patients where Zayda worked?”. I can only hear what it was like from his perspective, but the novel has forced me to consider what it felt like to be the patients he was working with, many of whom weren’t there by choice, and there were often patients who attempted to run away (just like McMurphy). I think this shift in perspective is invaluable since it allows me to empathize more with the people in the book and his memoir.