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Fifty years ago today, a novel appeared that made its author a literary celebrity. It also inspired a movie that won the best Picture Oscar, and helped change the way we think about mental health institutions. Ken Kesey's debut novel "One Flew Over the Cuckoo's Nest" has become an American classic.

From New York, Tom Vitali has this appreciation.

TOM VITALE, BYLINE: In 1992, Ken Kesey told me the novel he admired most was Herman Melville's "Moby Dick."

KEN KESEY: "Moby Dick" deals with what I call the American terror. It's the thing that's out there ahead of us in the new frontier. A particular thing that is really frightening to us, that we avoid, until finally you've got an Ahab who goes out there and takes it on - for good or evil, he takes it on.

VITALE: "One Flew Over the Cuckoo's Nest" is about the terror of a group of mental patients at the mercy of an evil hospital administration. Their Ahab is Randle Patrick McMurphy; their Queequeg is the narrator, Chief Bromden, a 6-foot-8 Native American and a longtime patient at the Oregon asylum. The novel opens with the Chief contemplating his fear of the orderlies.

DR. ROBERT FAGGEN: (Reading) They're out there. Black boys in white suits up before me to commit sex acts in the hall and get it mopped up before I can catch them.

VITALE: The reading is by Kesey scholar Robert Faggen.

FAGGEN: (Reading) I creep along the wall quiet as dust in my canvas shoes, but they got special sensitive equipment detects my fear. And they all look up, all three at once, eyes glittering out of the black faces like the hard glitter of radio tubes out of the back of an old radio.

VITALE: Ken Kesey wrote this opening passage of "One Flew Over the Cuckoo's Nest" while he was high on peyote, working as a nurse's aide in the psychiatric ward of the Menlo Park Veteran's Hospital. It was 1960, he was a 25-year-old creative writing student at Stanford University, who had also volunteered for CIA-financed experiments with hallucinogens at the same hospital.

FAYE KESEY MCMURTRY: They gave these right on the ward, in a little room where you could look out and see everybody on the ward.

VITALE: Faye Kesey McMurtry was pregnant with the couple's first child while her husband was working on the overnight shift.

MCMURTRY: And as he would look out the window, he began to wonder, you know, what's the difference between the orderlies and the nurse and the patients? And he began to see that they were all damaged in some way or another.

KESEY: In "Cuckoo's Nest," most of those characters were people on the ward where I was working. The only character that really wasn't there was McMurphy and, of course, the Indian. But this was the character that they all wanted. And you could feel their desire for this John Wayne American character.

VITALE: Kesey's John Wayne is a brawling, swearing, poker-hustling Korean War hero who fakes insanity at a prison work farm, in order to be transferred to what he thinks is an easier time at the psychiatric hospital. When Randle Patrick McMurphy gets there, he begins an epic battle for freedom from the iron fist of Nurse Ratched, who runs the ward. In the film adaptation, Louise Fletcher plays the Nurse, Jack Nicholson plays McMurphy.

(SOUNDBITE OF MOVIE, "ONE FLEW OVER THE CUCKOO'S NEST")

JACK NICHOLSON: (as Randle Patrick McMurphy) What I'd like to suggest is that we change the work detail tonight so that we can watch the ballgame.

LOUISE FLETCHER: (as Nurse Ratched) Well, Mr. McMurphy, what you're asking is that we change a very carefully worked out schedule.

NICHOLSON: (as Randle Patrick McMurphy) A little change never hurt, huh? A little variety?

VITALE: Conformity was a pressing issue in the America of "One Flew Over the Cuckoo's Nest." Robert Faggen is writing a biography of Ken Kesey.

FAGGEN: And the failure to conform was looked at as a deviation, and therefore dangerous.

VITALE: In the story, McMurphy is punished for challenging authority. First, he's crucified with electro-shock therapy, and then martyred with a lobotomy. When he was researching the novel, Kesey volunteered to undergo shock therapy in a secret session at the hospital.

(SOUNDBITE OF MOVIE, "ONE FLEW OVER THE CUCKOO'S NEST")

NICHOLSON: (as Randle Patrick McMurphy) They was giving me 10,000 watts a day, you know. And I'm hot to trot. The next woman takes me on is going to light up like a pinball machine and pay off in silver dollars.

(SOUNDBITE OF LAUGHTER)

VITALE: The 1975 film of "One Flew Over the Cuckoo's Nest" swept the major Academy Awards, including Best Picture, Actor, Actress, Director and Screenplay. But Kesey wasn't happy with Hollywood's version. His own screenplay had been rejected.

KESEY: I really wrote it to be as weird as I thought being in the nuthouse was. But it wasn't what they wanted. I was naive at the time. I wanted to do "The Cabinet of Dr. Caligari" and they wanted to do "Hogan's Heroes."

VITALE: The main difference between the film and the novel is that the film is missing the Chief's disturbing point-of-view of the forces in society pressuring individuals to conform, a conspiracy he calls the combine. Robert Faggen says that perspective is what makes the story a fable for every time.

FAGGEN: It's this larger structure of the conflict between freedom and authority, and done in a way that recognizes the power of that story not only in our culture, but in almost any culture, that has kept the story itself so fresh.

VITALE: Ken Kesey followed "One Flew Over the Cuckoo's Nest" with another masterpiece two years later, "Sometimes a Great Notion." He continued to write for the rest of his life, but he said he was always writing the same story.

KESEY: That's the only story I got.

(SOUNDBITE OF LAUGHTER)

KESEY: That's why I have to keep changing locales and times and characters, because you have to keep disguising the story. And it's essentially that the small can overcome the large with treachery and creativity and humor.

VITALE: Ken Kesey died in 2001 after surgery to remove a tumor from his liver. He was 66 years old. He said he never saw the film version of "One Flew Over the Cuckoo's Nest."

For NPR News, I'm Tom Vitale in New York.

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