One Flew Over the Cuckoo's Nest

The inspiration for Kesey's first novel, One Flew Over the Cuckoo's Nest, came from his work at the Menlo Park Veterans Hospital on the night shift. There, Kesey often spent time talking to the patients, sometimes under the influence of the hallucinogenic drugs with which he had volunteered to experiment. Kesey believed that these patients were not insane, but that society had pushed them out because they did not fit the conventional ideas of how people were supposed to act and behave. One Flew Over the Cuckoo's Nest was an immediate success. It was later adapted into a successful stage play by Dale Wasserman; Miloš Forman directed a screen adaptation in 1975. The film starred Jack Nicholson and won the "Big Five" Academy Awards: Academy Award for Best Picture, Academy Award for Best Actor (Nicholson), Academy Award for Best Actress (Louise Fletcher), Academy Award for Best Director (Forman), Academy Award for Writing Adapted Screenplay (Lawrence Hauben, Bo Goldman). Kesey, who was originally involved in creating the film, left two weeks into production. He claimed to have never seen the movie because of a dispute over the $20,000 he was initially paid for the film rights. Kesey loathed the fact that the film was not narrated, as the book was, by the character Chief Bromden.

One Flew Over the Cuckoo's Nest was a direct product of Kesey's time working as an orderly at the Menlo Park Asylum. Not only did he speak to the patients and witness the workings of the institution, he received electroconvulsive therapy and took psychoactive drugs as well as the same drugs as the patients to gain a deeper insight into their lives.

Narrated by the schizophrenic American Indian "Chief" Bromden (who starts out pretending to be deaf and mute), much of the plot focuses on the antics of cheerfully rebellious Randle Patrick McMurphy, a man sent from a workfarm prison to a mental hospital. The all-male asylum, based upon the old Pendleton, Oregon asylum (now the Eastern Oregon Correctional Institution), is run by the domineering Nurse Ratched and her assistants, who are described as young black men filled with hatred. McMurphy constantly antagonizes the Nurse, attempting to organize the patients against her rule.

One night, after bribing the night orderly, McMurphy smuggles bottles of liquor and two prostitutes onto the ward for a wild nighttime party. Billy Bibbit loses his virginity, sleeping with one of the prostitutes at McMurphy's urging. However, McMurphy's plans quickly go awry when he falls asleep and does not awake until the morning staff returns and discovers what has happened. Nurse Ratched walks in on Billy Bibbit and the prostitute, still asleep, and threatens to tell Billy's mother what he has done. Hearing this, Billy enters a frenzied state, and when taken to the Doctor's office, slits his throat and commits suicide. It is implied that Nurse Ratched intended for Billy to kill himself in order that she might regain control of the ward. As such, McMurphy dutifully attacks her, ripping open her shirt and severely injuring her throat and face. McMurphy is promptly taken to the Disturbed ward and undergoes a lobotomy.

When McMurphy returns, he is wheeled onto the ward on a bed, now in a sort of vegetative state. Chief realizes that if McMurphy remains in that state, Nurse Ratched will have ultimately won; conversely, if Chief kills McMurphy, McMurphy cannot become a symbol of Nurse Ratched's power. In the final moments of the novel, Chief smothers McMurphy and uses the strength McMurphy restored in him to break the ward's window and escape into the night. Despite McMurphy's ultimate sacrifice, the consequent redemption of the patients, particularly Chief, provides an uplifting conclusion to the novel.