University of Oregon

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University of Oregon
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Stanford University
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Menlo Park Veterans Hospital
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Sometimes a Great Notion
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La Honda, California
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Merry Pranksters
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Ginsberg, Kerouac
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Beat Generation/Beatniks
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The Grateful Dead
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Tom Wolfe
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Epigraph

• ...one flew east, one flew west,One flew over
  the cuckoo's nest.
• - Children's folk rhyme.

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Motifs keep an eye out for

• Fog
• Hands
• Animals
• Nature/Purity
• Laughter
• Christ/Savior
• Sanity/Insanity
• Machine/Combine

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What is this?
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Combine Harvester

• A combine harvester is an agricultural machine
  that harvests all types of cereals, oil seeds,
  and legumes through four main steps
• The crop is cut and directed into a rotating
  chamber with a series of beaters going the
  opposite direction. The grain is dislodged, falls
  to the bottom, separated from debris by sieves
  and wind. The grain is transferred to a hopper
  and the debris falls out the rear

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Check out some images that McMurphy would have
seen in his ward
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Check out some images that McMurphy would have
seen in his ward
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Check out some images that McMurphy would have
seen in his ward
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Similarities to One Flew Over the Cuckoos Nest

• Guests had to check in
• Most were admitted by family members
• Many patients had the power to leave on their own
  but were controlled by staff and manipulated to
  believe that they needed to stay.

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Mental Hospitals in 1930-1960s

• Over-crowded
• Dirty
• Not nurturing
• No privacy
• Similar toor in some
• cases worse than--prison

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Inside the Institutions

• Patients were provided with adequate care (and
  segregated) which often times led to inadequate
  care, poor facilities, and loss of dignity.
• They were usually given uniforms and daily
  chores. In fact it wasnt until 1973 that New
  York state banned public hospitals from requiring
  patients to work in exchange for their room and
  board.
• Families were often ashamed of the patients and
  would deny their existence.
• Ultimately, some of these hospitals became
  holding areas for a persons entire life.

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Check out some images
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Check out some images
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Medical Care in Mental Hospitals

• Deaths and injuries sometimes resulted from both
  appropriate and inappropriate treatments.
• Patients were treated with medically approved
  procedures like being put in tanks of ice-cold
  water, spun in chairs for hours, and forced
  "medications" (powerful psychoactive drugs) .
• Patients were also treated with non-medically
  approved procedures which were simply designed to
  control them. For example, patients could be
  shackled to walls, placed in seclusion (most
  often without clothing) or placed in restraints
  (being strapped to a bed with leather restraints,
  often in a spread-eagle position).

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Types of Treatments for the Mentally Ill

• Group therapy
• Drug Therapy
• Electroshock Therapy
• Lobotomy

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Drug Therapy

• Thorazine
• the first psychotropic drug, was a milestone in
  treatment therapy, making it possible to calm
  unruly behavior, anxiety, agitation, and
  confusion without using physical restraints.
• "chemical restraint"
• Chlorpromazine
• schizophrenic psychosis or manic-depressive
  disorder

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Electroshock/Electroconvulsive Therapy

• Became very popular 1930s-40s.
• Originated to control negative behaviors in
  animals (electroshock)
• A doctor had noticed that schizophrenic
  epileptics who had a seizure often were more
  normal after the seizurewhich led to chemical
  convulsions and ultimately electroconvulsive
  treatment
• Used to alter the chemistry in the human brain to
  produce desired behaviors.
• Cruelly, it was used as a control device within
  most wards.

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Electroshock Therapy Is Very Controversial But Is
Still Used Today

• Used to treat some forms of severe depression
• Used to control the elderly
• Used on children in an attempt to correct their
  wild and/or unwanted behaviors

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Lobotomy

• Surgical procedure for cutting nerve pathways in
  the frontal lobes of the brain. The operation has
  been performed on mentally ill patients whose
  behavioral patterns were not improved by other
  forms of treatment it was supposed to be a last
  resort. The procedure was pioneered by Egas
  Moniz in the 1930s.
• Between 1939-1955 over 100,000 lobotomies were
  performed in the United States.
• If performed correctly, disconnecting the frontal
  lobes caused no loss of intellect, no impairment
  of memory, and no problems with speech.

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How a Lobotomy Was Performed

• Leucotomy
• The goal was to cut the nerves that run from
  front of the brain to the rear. A techniques was
  devised that involved drilling two holes on
  either side of the forehead, insert a surgical
  knife, and sever the prefrontal cortex from the
  rest of the brain.

• Ice Pick Lobotomy
• Invented in 1936 - Walter Freeman
• Insert an ordinary ice pick above each eye of a
  patient with only local anesthetic, drive it
  through the thin bone with a light tap of a
  mallet, swish the pick back and forth, then
  remove.
• A formerly difficult patient is now passive.

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Lobotomy

• "Every patient probably loses something by this
  operation, some spontaneity, some sparkle, some
  flavor of the personality
• The aim was that "the patient might be
  transformed from a disturbed to a quiet clement
  insane person." There was no intention to
  "help" the patient. The goal was only to
  eradicate the behavior which others found
  undesirable.
• Mercy killing of the psyche
• The frontal lobe is the seat of the higher
  functions such as love, concern for others,
  empathy, self-insight, creativity, initiative,
  autonomy, rationality, abstract reasoning,
  judgment, future planning, foresight, will-power,
  determination and concentration

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Abuse of Lobotomy

• Freeman developed what others called assembly
  line lobotomies, going from one patient to the
  next with his gold-plated ice pick, even having
  his assistants time him to see if he could break
  the lobotomy speed record.  It is said that even
  some seasoned surgeons fainted at the sight.
• Doctors would recommend the procedure for
  everything from psychosis to depression to
  neurosis to criminality.

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"deinstitutionalization revolution mid-1960's

• A radical "deinstitutionalization revolution"
  began
• It was supposed to end the cruel and inadequate
  care of institutions
• Individuals would live in their communities and
  have a "normalized" life
• Group homes, residential care facilities, and
  rooming houses were developed
• The movement helped to break up the control that
  was happening in the hospitals.

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So lets think about some major issues that occur
in the novel

• Decide where you fall on the spectrum

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Discipline

• Discipline is absolutely necessary in most
  situations.

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Youre Crazy

• All people are crazy to some extent

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One Person

• One person can change an established, stable
  environment

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Institutions

• The best place for those with mental illness in
  an institution and/or hospital.

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Men

• Our society forces men to act like stereotypical
  men.

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Hatred

• Hatred is inherent to human nature.

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Rules

• The more rules the better.

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Self-Esteem

• Self-esteem is not very important in life.