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patients of the novel fear so much and refer to as brain burning (Kessey 178). This callous

display of the ECT has stimulated many people to rise and go against the therapy; this portrayal,

however, is blatantly distorted, or, at least in comparison to the current ECT. The practice of the

current ECT has gone through many steps of improvements and amendments since the novel.

The image of a person thrashing with seizures is now outdated; Rael Isaac, the co-author of

Madness in the Streets: How Psychiatry and the Law Abandoned the Mentally Ill, asserts that in

modern forms of ECT, an anesthetic and muscle relaxant is given before electricity is applied,

hence the body lies still when the shock goes through, and the seizure only happens in the brain

(Isaac 161). It is a much safer procedure without the bone fractures and sprains which the past

ECT procedures frequently caused. Furthermore, the Duke University psychiatry professor and

an authority on ECT, Richard Wiener MD, states that, the likelihood that ECT is more effective

against depression than are antidepressant is 99.99% (Isaac 161). Had ECT been a useless

therapy for the patients, the controversial treatment would have already ceased to continue and

simply the less controversial medication would have taken its place. Nevertheless, since ECT

had been so effective, many amendments have been made to continue to treat and cure the needy

patients and return them to the society, though many other problems besides ECT still remain yet

to be amended.

Another problem the novel clearly shows of psychiatric hospitals is lobotomy. In the

novel, the protagonist, McMurphy, is a recalcitrant character who riles on the staffs nerves.

After a fight against one of the biggest power figure, the Big Nurse, McMurphy is condemned to

undergo a lobotomy, a psychiatric procedure in which some parts of the brain that control one s

emotions are removed or damaged (Rebato). The McMurphy after the lobotomy, however, is not

the same carefree, vigorous McMurphy he was before the lobotomy. Chief Bromden, a close


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friend of McMurphy, describes McMurphy after lobotomy as just like those store dummies.

Theres nothin in the face (Kessey 260). McMurphy, who had been a quite normal person

feigning mental illness really turned into a vegetable without any expression or individuality.

Since the time, fortunately, no scientific evidence had been found to support the ongoing of the

controversial procedure of lobotomy; the current psychiatric community bans the practice of

lobotomy and the original lobotomy operation is now rarely performed, if ever, although many

countries still accept psychosurgery as a form of radical control of violent behavior (Japan,

Australia, Sweden and India are among them) (Rebato). Despite the existing problems of

psychiatric hospitals, getting rid of lobotomy has been a huge leap towards a commendable

psychiatric hospital.

Even with these positive changes, many problems still persist in mental institution today,

such as government funding and staff power abuse. In order to try and make any changes either

inside or outside, however, the culture and the perspective on psychiatry must first change.

Although mental illnesses are one of the most serious illnesses in America with statistics

revealing that more than 19 million Americans are suffering from depression and more than 2

million Americans have schizophrenia, many people view psychiatry with stereotypes

influenced by superfluous amounts of misleading films and novels such as the TV program

Psycho that induces the watcher into believing that all mentally ill people are violent and

deranged (Clinton 39). Mental illness is a disease of the brain and mind, just like any other

diseases (Clinton 38). Yet when the patients of the novel One Flew Over the Cuckoo s Nest take

a visit outside the hospital, they are looked down on by others just because of their mental

hospital uniforms. As the patients have a visit outside the hospital for recreation and stop for gas,

the employer at the gas station comments, those uniforms. You guys are from the asylum, and


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makes fun of the patients with his co-worker (Kessey 223). The ultimate goal of psychiatric

hospitals is to cure the curable patients and prepare them for their release to the society; these

stereotypes created from films and novels, however, hinder this goal and lower the patients self-

esteem. To change an already set perspective is very difficult; nevertheless, the government

should at least start censoring the movie, literature, and TV industry, just like those censored for

racism and sexism. Hopefully, with these less stereotyping influences of the media, the mislead

views of mental health will subside, and people regard mental health more seriously, realizing

that some of the patients are not any crazier than the average asshole on the street (Kessey

63).

After the general view on psychiatry has been corrected, the problems within the

psychiatric hospitals must be attended. The entire plot of the novel One Flew Over the Cuckoo s

Nest focuses on the abusive power of the staff, especially the Big Nurse, and the corruption of

the system of the psychiatric hospitals. In response, the patients begin to turn recalcitrant against

the oppressive staffs; the Big Nurse, however, firmly takes her stand, You are under the

jurisdiction of me the staff under the jurisdiction and control (Kessey 126). While most

people assume that this kind of extreme show of abusive power is no longer present in the

psychiatric hospitals today, a different form of the problem persists. The problem is within the

involuntary commitment law or otherwise known as the Kendras Law, which grants judges the

authority to commit patients involuntarily under the witness of a psychiatrist. Although we, as

Americans, believe in the judges for their sound adjudication, in this case, the judges mainly

follow the psychiatrists decisions for their lack of profession in the area; thus, the psychiatrists

ultimately have the power to enforce involuntary commitment on a person. Many fair and helpful

psychiatrists that make good observations and have good intentions exist, but other psychiatrists


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such as the Big Nurse that may either take an intentional or unintentional toll on the patients also

exist. Committing a person into a psychiatric institute is very serious as seen with Mr. Jonathan

Hardys, a former schizophrenic patient, who confesses, I spent of huge part of my life for the

treatment and I couldnt things that I had planned to do (Hardys). Mr. Hardys had freshly

graduated from the Cornell University and had a prominent future ahead of him until he was

committed to a hospital for schizophrenia, spending many years of his life for his treatment.

Thus, heavy decision such as the involuntary commitment should not be prone to human error,

and to decrease the potential risk, at least more than three psychiatrists should be required to

evaluate the patient and discuss in the court before the judge like a mini jury. This way, the judge

can make a better decision after he had seen the different perspectives of various psychiatrists

and almost eliminate the risk of granting unnecessary involuntarily commitment and taking away

a valuable member of the community. Thus, the current outpatient commitment law is too lenient

and should be reformed to make sure no one unnecessarily receives treatment.

Finally, the problem of the psychiatric hospitals that should be visited is government

funding. The fact that mental illness is serious and effects many people is already proven by a

myriad of evidence in the paragraphs before such as stereotypes and staff power abuse. The

psychiatric hospital, however, receives less than one tenth the federal funding even though

depression takes a greater cumulative toll on society than, say, heart disease (Clinton 39). The

people who go against raising federal funding claim that mental illness is not a disease, that

since the mind is not a physical organ, it cannot have a disease (Bobgan 43). Mental illness,

however, with a little research, is proven to be a disease of the brain in which it produces

abnormal levels of chemicals or hormones, and that illnesses such as autism, schizophrenia, and

maniac-depressive illnesses are incredibly genetic disorders (Clinton 39). So then, mental


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illness, which is found to be a real disease just like heart diseases, and is the leading cause of

disability worldwide, including the US has no reason to receive the meager amount of funding it

is currently receiving. The citizens of the US are extremely sympathetic to those poor people

who we think has no responsibility for their position. Likewise, informing this simple

scientifically proven fact that mental illness is a real disease to the people with wrong knowledge

through awareness programs and positive campaigns can significantly alter the peoples opinions

win the sympathy needed to solve the government funding problem, which can lead to better

research and treatments for mental illnesses. The petty sum that the mental illness receives

proves how it is discriminated from the other fields such as the cardiac disease, and is in need of

reform.

As seen, although the psychiatric hospitals have gone through many phases and made

amendments of the several superficial and palpable problems of psychiatric hospitals such as the

electroconvulsive therapy and lobotomy, many more intangible and fundamental problems such

as the perspectives and laws on psychiatry are left yet to be attended. With more than 20 million

Americans suffering from mental illness and surely many more undiagnosed, psychiatric reforms

are urgent (Clinton 39). Mental patients are same patients as any other patients with other

illnesses; it is just that their problems are in unfamiliar organs with unfamiliar symptoms. Just as

other patients such as cancer patients are respected and treated with attentive care, mental

patients should also receive the same respect and care in areas ranging from the how the people

view them to how much the government funds. With persistent efforts of the informed and

dedicated people, more improvements can be made just as it had since the 1960s One Flew Over

the Cuckoos Nests banning the brutal gouging of the frontal lobe and inducing of unpleasant,

thrashing seizures.


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Works Cited

Bobgan, Martin. Mental Illness is not a Disease. Rpt inMental Illness Opposing Viewpoints.

Ed. Tamara L. Roleff. San Diego, CA: Greenhave Press. 2000. 42-46. Print.

Clinton, Hillary Rodham. Mental Illness is a Disease. Rpt inMental Illness Opposing

Viewpoints. Ed. Tamara L. Roleff. San Diego, CA: Greenhaven Press. 2000. 37-41. Print.

Hardys, Jonathan. Personal Interview. 2 January 2012.

Isaac, Rael Jean. Electroconvulsive Therapy is an Effective Treatment for Schizophrenia and

Depression. Rpt in Mental Illness Opposing Viewpoints. Ed. Tamara L. Roleff. San

Diego, CA: Greenhaven Press. 2000. 160-168. Print.

Kessey, Ken. One Flew Over the Cuckoos Nest. New York City, New York: Viking Press, 1962.

Print.

Rebato, M.E Sabbatini. The History of Lobotomy.Brain and Mind Magazine (1997). Web. 12,

March 2012.

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