Chapters 1-4 (pages 3-41)

First of all, the Acutes are “...still sick enough to be fixed…” (page 15) and the doctors intend to eventually fix the Acutes enough to return them to the outside world. They are all a lot more mobile and in some aspects a bit more sane, although all of them do seem to have a degree of mental issues. On the other hand, the Chronics are patients that the doctors have no intention of fixing at this point because they’re too far gone, so these people are just kept in the ward so they aren’t a menace to society. Chief calls himself a Walker, which is a Chronic that can still get around well enough but basically needs some tending to here and there. Essentially, Chief is saying he’s in the ward for good but isn’t as messed up as some of the others there. It does seem like this categorization is pretty accurate. Chief clearly has some mental issues just based on the disconnected way he narrates at times and knowing what he’s been through in the ward, but I also think that he could probably be “fixed up” enough to return to the Outside, so I don’t think he should be completely categorized as a Chronic. 

Chief has a background of living in the Native American culture, so when he’s viewing situations he sometimes looks at them from the perspective of his upbringing. It seems like this perspective of his emerges most often when Chief is stressed or scared. For example, when hiding in the closet he envisions himself as the bird being hunted and the black boy coming for him as the hunting dog. He thinks, “He don’t know where I’m hid, but he’s smelling and he’s hunting around. I try to keep still…(Papa tells me to keep still, tells me that the dog senses a bird somewheres right close...” (page 6-7). Chief seems to see animal qualities in the people around him in the ward that turns them inhuman. For example, when the Big Nurse was angry at the black boys, Chief sees her turn into a vicious animal. “She’s swelling up, swells till her back’s splitting out the white uniform and she’s let her arms section out long enough to wrap around the three of them five, six times. She looks around with a swivel of her huge head...her painted smile twists, stretches to an open snarl, and she blows up bigger and bigger…” (page 5). Another example is Chief viewing other patients quite literally as rabbits when Harding and McMurphy were talking about them. He says, “Billy Bibbit and Cheswick change into hunched-over white rabbits, right before my eyes…” (page 65). Later on he says, “I see Billy Bibbet has changed back from a rabbit” (page 68). Chief does a lot of watching and quietly observing, and views the people around him with animal-like qualities, probably because of his Native American background. The others in the ward think that Chief can’t hear or speak, but really he’s just pretending. The Big Nurse considers him, “...just old Broom Bromden the half-breed Indian back there hiding behind his mop and can’t talk to call for help” (page 5), and “...they think I’m deaf and dumb. Everybody thinks so. I’m cagey enough to fool them that much” (page 1). Chief is actually quite smart, but the other patients are fooled by the act. Billy tells McMurphy, “There’s not m-much else he can do, I guess. He’s deaf...He’s de-de-deef and dumb” (page 24). So, the others in the ward don’t have an accurate perception of what Chief is really like on the inside because he doesn’t talk and they can’t hear his thoughts and observations. 

I would say the Chief is an acute patient because he does not need constant attention from a caregiver. There are other patients in the ward that do need nonstop care, and those are the chronic patients. For example: the Chief is able to move around, “other than me, the Chronics don’t move around much… the Chronic side smells worse than a dirty diaper” (18). The Chronics are not able to care for themselves and need to depend on someone else. The Chief thinks that Chronic patients are the ones who are born with their flaws or developed them over time. I do not agree with that, just because someone has flaws does not mean that they are chronically ill. To me it depends on the state of your illness and how capable you are to take care of yourself. He also considers himself to be ‘well’ in the state he is in. I do not think he is well compared to everyone, but I would say he is in comparison to the Chronic patients in the ward.

Others view him as a really tall Indian who is deaf, “but even if he is big, he’s scared of his own sh-sh-shadow. Just a bi-big deaf Indian” (24). In reality he is actually very observant and understands a lot of what is going on, “I remember all this part real clear… I remember real clear the way that hand looked” (23, 25). So, everyone else in the ward might think less of him than he is really capable of but the reader knows what is going on in his head. The Chief definitely knows that what is going on in the ward is wrong but he is censured because he sees it all the time. That view would be a little different when compared to someone who is just seeing it for the first time. McMurphey did not like what he saw when he first came to the ward, “my name is R. P. McMuphy and I don’t like to see a full-grown man sloshin’ around in his own water. Whyn’t you go get dried up” (22). He knows how gross and unsanitary that is and nobody should have to live like that. I'm sure most people in the ward also think that but they know that they have no control and would not be much help trying to solve the problem.

Acutes, as stated on page 15, are “sick enough to be fixed.” They are the people that are still able to function and will someday be allowed out of the facility. Chronics on the other hand are “in for good” (page 16) They are separated into three different categories; The Walkers, the Wheelers and the Vegetables. As the Chief puts it he is “still able to get around if you keep them fed.”(page 16) This categorizes him as a Walker. This could be false however because we do not know him well enough yet to be able to tell if he, if at all, is able to function. 

The Chief, as compared to others, is very dramatic in his perceptions of others. He sees people differently than the rest of the people on the ward and it seems as though he likes to over exaggerate. “Her painted smile twists, stretches to an open snarl, and she blows up bigger and bigger, big as a tractor, so big I can smell the machinery inside the way you smell a motor pulling too big a load.” (page 5) This big tractor that the Chief is talking about is just the “Big nurse” as he likes to put it. She is about to scold someone but Chief sees it as though she is going to run someone over or explode. This description of the nurse is an exaggeration of what is really happening. Although she is scary to others as well, she does not scare them as much as the Chief. The same is to be said about how Chief feels about the Black Boys. He is scared of them and does not want to disobey because something bad will happen. This does not seem to bother others as much as it bothers the Chief however. “ And get back away from me with that thermometer, Sam, and give me a minute to look my new home over; I never been in an Institute of Phycology before.” (page 11) McMurphy, who is speaking, is not afraid of the Black Boys, or “The Big Nurse” at all. He does not see them as being scary or “Big” at all. McMurphy also does not see Chief the same way that others on the ward do. “He’s de-de-deef and dumb” “well, what the hell, he can shake hands, can’t he? Deef or whatever.” (page 25-26) Hardening, a fellow chronic, tells McMurphy that, pretty much, the Chief is not worth your time. However McMurphy does not see him that way, he believes that the Chief is worth his time and does not want to leave him out.

The big difference between Acutes and Chronics are Acutes are the ones to be believed can “still be fixed” ; whereas the Chronics “in for good.”(16)The chief categorizes himself as a Chronic. “Some of us who were Acutes when we came in, and got changed over” (16) “What the Chronics are-or most of us- are machines with flaws…”(16) Chief has been here the longest which is why Chronics is an accurate categorization. 

Chief seems to notice how cruel the Big Nurse is. Not just mean, but an evil or malicious tendency. The way he describes her “little white knot of tight-smiled fury” isn’t a description a normal bully would receive. (28) He views her as someone that enjoys power trips while everyone else sees her as a well trained employee. “The Big Nurse recognizes this fear and knows how to put it to use; she’ll point out to an Acute, whenever he goes into a sulk, that you boys be good boys and cooperate with the staff policy which is engineered for your cure, or you’ll end up on that side” (18) I feel as if Chief has accepted the policy of chronics and Acutes. As if there’s no way he could leave or escape. However R.P. McMurphy feels differently. He has no problem testing the waters. “Do you have an appointment, Mr McM-m-murphy?..” Billy says. “The you tell Bull Goose Loony Harding that R.P. McMurphy is waiting to see him and that this hospital ain’t big enough for the two of us” (21) Murphy isn’t phased by the ward. He’s prepared to make it a fun experience whether that be a good or bad thing. 

The main character and narrator of “One Flew Over the Cuckoo’s Nest” is a residence of the mental hospital where the story takes place. Nicknamed Chief because of his Native American heritage, the narrator is able to give a unique perspective on what happens in this mental hospital. Chief gives us some background information in the first few chapters on what the hospital is like including the differences between the two types of patients: Chronics and Acutes. The Acutes consist of younger patients that the “...doctors figure… still sick enough to be fixed…”(Pg 15) while “ Chronics are in for good…” because most of them “... are machines with flaws inside that can’t be repaired, flaws, born in, or flaws beat in over so many years of the guy running head-on into solid things that by the time the hospital found him he was bleeding rust in some vacant lot” (Pg 16). The Chronics also have three sub-categories that consist of Walkers, Wheelers, and Vegetables. Chief classifies himself as a Chronic and a Walker. However, “... other than [Chief], the Chronics don’t move around much…” (Pg 18) which implies that Chief is more similar to the Acutes than the rest of the Chronic patients. Despite some similarities that Chief may have with the Acutes, it is becoming clear that he has some mental issues that cause him to pretend that he is deaf and can’t talk in addition to influencing his behavior. The origins of how this came to be is not clear yet, but it seems that “Chronic” is an accurate categorization.

Although the readers know that Chief isn’t deaf and has the ability to speak, everyone else is under the impression that he is in fact deaf and cannot speak. This puts Chief in a unique position that aids him as a narrator because he is able to see and hear things that people wouldn’t normally do or say in front of him. As Cheif says at the beginning of the book, people “... don’t bother not talking out loud about their hate secrets when I’m nearby because they think I’m deaf and dumb. Everybody thinks so. I’m cagey enough to fool them that much” (Pg 3). Staff and patients alike let their guard down around him. For example, when Nurse Ratched was going to let her anger out on “black boys” in front of Chief but as soon as other patients start coming out of their rooms, “...she has to change back before she’s caught in the shape of her hideous real self” (Pg 5) or when Billy Bibbit goes on to say how he would kill himself if he was deaf right in front of Chief. It’s clear that they don’t see any harm in doing this in the presence of Chief Bromden because he wouldn’t be able to hear anything they say or talk about anything bad he sees. Although everyone may assume he’s dumb, he is actually really perceptive and likely knows more about what’s happening than any of the other patients because of the unique position he’s in. He knows that the staff (Nurse Ratched in particular) are nasty people even though they try to hide it, the differences between the Acutes and Chronics and how they interact with each other, what happens to patients during different procedures, and the daily schedule. He could even tell that the Public Relations guy looked like he glued hair on his head at some point and that his hands were wet just by the sound of his hands clapping. The only person who doesn’t assume that Chief is deaf and dumb is McMurphy. McMurphy treats him exactly the same as everyone else and exclaims “Well, what the hell, he can shake hands, can’t he? Deef or whatever” and then proceeds to speak directly to him saying “By God, Chief, you may be big, but you shake my hand or I’ll consider it an insult” (Pg 25). It’s because McMurphy is the only person to treat him with any respect and talk directly to him that Chief thinks he must see through his deaf-and-dumb act. 

Acutes are the patients that are fixable. They are sick, but the doctors are trying to fix them up so they can at some point return to society. On the other hand, chronics are not fixable. They are there, “...just to keep them from walking around the street giving the product a bad name” (pg. 15). The chronics have no hope in being fixed and are too messed up, so they are kept in the ward solely to keep them away from the rest of society. Chronics are also broken up into sub categories: Walkers, Wheelers, and Vegetables. Chief categorizes himself as a Walker, because even though he is beyond fixing, he can still get around without needing much attention or help from doctors. I think that this does seem to be fairly accurate because of how bad Chief is at communicating with others, so it would make sense that he would be hard to repair. However, he also seems to be right in the head enough to get around on his own. He probably could be an Acute, but his lack of communication acts as a barrier for the doctors to help him get better, so he ends up being a lost cause. 

Chief is perceived by the other patients and doctors as being this big dumb Native American who is deaf and doesn’t talk. He hides out in corners and seems to be observing everyone else instead of interacting with them. However, McMurphy is the only patient that may think otherwise of Chief. Chief says that, “...I remember thinking that he was laughing because he wasn’t fooled for one minute by my deaf-and-dumb act; it didn’t make any difference how cagey the act was, he was onto me and was laughing and winking to let me know it” (pg. 24). This shows that McMurphy may be the only patient there that sees Chief as being more than just a dumb Indian. However, Chief is actually not as dumb as he is percieved as being. He is very observant of everything going on, and he seems to know the routine of things very well. He says that, “Other mornings I figure it’s cagier to step right into place between A and C in the alphabet and move the route like everybody else, without lifting my feet…” (pg. 32). Chief is smart enough to be playing this dumb act on his own and he is well aware of what he is doing. During this part, he is saying that sometimes he tries to hide and mess with things, but other times he steps in and goes about like everyone else does.

The Acutes are viewed as fixable. The doctor believes with enough meddling the acutes could be released from the mental hospital. “One side of the room, younger patients known as the acutes because the doctors figure they are still sick enough to be fixed…(pg. 15)” The chronic however are viewed as hopeless vegetables that have no chance at life in the outside world again. “Across the room… The Chronics. Not in the hospital these to get fixed but just to keep them from walking around the street giving the product a bad name (pg. 16)” Chief categorizes himself as a Chronic because that is what he is portraying as, however this is not accurate because he is not actually deaf or mute. 

The chief's perception of those around him seems dramatized. His view of the nurse is a prime example. The chief views the nurse as unpredictable. “ The slightest thing messy or out of kilter or in the way ties her into a little white knot of tight smiled fury. (pg. 28)” The way that he is describing the nurse we can infer that she is short tempered. One thing I have noticed about the chief is that he is very aware of his surroundings. Others perceive him as a “Just a big dead indian. (pg. 24) While others think the chief is incapable of mustering up his own thoughts on matters, the chief is very observant. Even though on the outside he has created the feeling for everyone around him that he is not listening by acting mute, in reality he pays attention to every little detail. 

In the first four chapters of Cuckoo’s Nest, we learned the differences between chronics and acutes. In his description of the acutes they are “the younger patients… the doctors figure them still sick enough to be fixed” (3). Whereas the chronics were “not in the hospital, these, to get fixed, but just to keep them from walking around the streets giving the product a bad name. Chronics are in for good, the staff concedes” (3). It was also stated how chronics are also divided into whether or not they are wheelers/vegetables or if they were walkers. He described himself as a walker, “walkers, like me, can still get around if you keep them fed” (3). I would have to agree with him categorizing himself like that. He’s not necessarily there to get better, just there to basically do the jobs and the dirty work that no one else wants to do. 

As stated in the previous question, the two groups are categorized between the chronics and the actues. Of course, there’s this big separation between the two; actues don’t like the chronics and the chronics don’t like the acutues. The chief plays a role in which he does not speak which leads people to think that he is deaf. The actues say some not-so-great things to him and because he doesn’t react to them the way the others do, they assume that he can't hear. I think that people think the chief is weird and so it makes it easy for them to target him. He doesn’t react the way others do so to them, he’s just the easy target. Little do they know, the chief can actually hear everything they say to him. He just knows how to not give them the attention that they want. 

The major differences between the acutes and chronics from the Chief’s perspective are the severity of the patient's inability to function. The acute is high functioning and the Chief describes them as curable, “because the doctors figure them still sick enough to be fixed, practice arm wrestling and card tricks where you add and subtract and count down so many and it’s a certain card” (Kesey 15). The chronics are not so capable compared to the acutes.  “Chronics are divided into Walkers like me, can still get around if you keep them fed, and Wheelers and Vegetables. What the chronics are - or most of us- are machines with flaws inside that can't be prepared, flaws born in,” (Kesey 16) as Chief would describe his grouping. Although the chief categorizes himself into this cluster of residents in the ward, he is much more capable than he lets others believe. The newest member to the hospital is the only one that was aware of this, “he wasn’t fooled by my deaf-and-dumb act; it didn’t make any difference how cagey the act was, he was onto me and was laughing and winking to let me know it”(Kesey 24). Everyone else in the ward is solely convinced that Chief is indeed dumb and deaf which would put him in the group of chronics when in reality he belongs with the acutes or not in the facility at all. We do see at the beginning of the novel some creativity going on in his thoughts, but being placed in such a boring building, being forced to believe you are crazy can give the effect as if you are. This is why Chief has those “crazy” thoughts, but then he mentions that what he says is not always real, “But it’s the truth even if it didn’t happen”(8 Kesey). 

The Acutes are considered 'curable' whereas the Chronics are portrayed as patients who will probably never get any better than their current state. He also categorizes them into 'Wheelers", patients in wheelchairs, and "Vegetables", patients who are essentially braindead. He also believes that he is more stable and functional than the other patients, but leads them to believe that he is not. "Across the room from the Acutes are the culls of the Combine’s product, the Chronics. Not in  the hospital, these, to get fixed, but just to keep them from walking around the streets giving the  product a bad name. Chronics are in for good, the staff concedes. Chronics are divided into Walkers  like me, can still get around if you keep them fed, and Wheelers and Vegetables." (3 Kesey)

The perspective that Chief tells the story from is odd because the thoughts in his head greatly differ from conversations occurring around him. He almost seems to exaggerate descriptions of people and their actions, and also events that unfold. He also has a way of making assumptions about what people are thinking based on their body language and facial expressions. For example, "This new redheaded Admission, McMurphy, knows right away he’s not a Chronic. After he  checks the day room over a minute, he sees he’s meant for the Acute side and goes right for it, grinning and shaking hands with everybody he comes to." (14 Kesey) The others in the ward believe that Chief is 'deaf and dumb', but from the way the Chief tells things, we know that he is not. For example, in the text Chief thinks to himself, "But then’s when I remember thinking that he was laughing because he wasn’t fooled for one minute by my deaf-and dumb act; it didn’t make any difference how cagey the act was, he was onto me and was laughing and winking to let me know it." (17 Kesey) 

The Chronics are the people who need constant nonstop care, and they are sorted out between three different groups which are Walkers, Wheelers, and Vegetables. They are not in the ward to be fixed they are considered too sick to be able to be fixed. "Not in the hospital, these, to get fixed, but just to keep them from walking around the streets giving the

Chief categorizes himself as a Chronic Walker which means that he is stuck in the ward and cannot be fixed but he is able to walk around and do things in the ward. I would say that he is pretty accurate because is still able to walk around but you can tell by the way he asks and how he narrates, you can tell that he has a mental illness of some sort. 

Chief has a different perception than most of the people in the ward based on his childhood, he seems to relate things to his upbringing quite often like when he is scared in the closet it brings him back to a time in his childhood and something that occurred in the past. "He don’t know where I’m hid, but he’s smelling and he’s hunting around. I try to keep still. ...(Papa tells me to keep still, tells me that the dog senses a bird somewheres right close..." (Kesey 7) He has perceived differently than he actually is because, he does not know how to communicate with others well, so he doesn't really talk but everyone else seems to think that he is deaf and mute but he is not so the people around him think since he can't hear them they can say whatever they want. " “He’s de-de-deef and dumb.” McMurphy puckered his lips and looked at my face a long time. Then he straightened back up and stuck his hand out. “Well, what the hell, he can shake hands can’t he? Deef or whatever." (Kesey 24-25) Some people still like to include Chief even though he may not be able to do much while others feel like it is useless too. Chief can hear so he is able to make judgments of people that he just keeps to himself he doesn't really talk but he also plays along with the act that he is dumb and deaf so he can he everything that people have to say. "But then’s when I remember thinking that he was laughing because he wasn’t fooled for one minute by my deaf-and-dumb act; it didn’t make any difference how cagey the act was, he was onto me and was laughing and winking to let me know it." (Kesey 24)

 In the first section of the novel, Chief Bromden, the narrator, is a half-Indian patient in the ward, who has been in the institution the longest. He describes the two main patient categories in the ward; the Acutes, who are the “curable” patients. And broken up into various categories, Walkers, Wheeles, and Vegetables, this other group is known as the Chronics, which includes Chief himself as a Walker. He calls the chronically ill patient group “machines with flaws inside that can’t be repaired” (16 Kesey). Chief does not need constant attention from a caregiver, as other patients in the ward do. Some significant differences between the Acutes and the Chronics would be mobility. Chief has the ability to move and he harshly explains that “other than [him], the Chronics don’t move around much…the Chronic side smells worse than a diaper” (18 Kesey). Even though Chief identifies himself as a Chronic patient, I think his condition is more flexible like an Acute. Since Chief isn’t deaf and he is a lot smarter than people give him credit for, as he is fooling the entire ward. Though, his lack of communication makes it difficult for help to be given by doctors, making it a gradual process. 

As the readers know that Chief is not deaf and has the ability to speak, the rest of the ward is under the impression that Chief is chronically deaf. Due to this facade, Chief ironically hears more than the ward intends, he describes that the people “...don’t bother not talking out loud about their hate secrets when I’m nearby because they think I’m deaf and dumb. Everybody thinks so. I’m cagey enough to fool that much”(3 Kesey). The ward sees him as a tall Indian man who is dumb and deaf, “but even if he is big, he’s scared of his own sh-sh-shadow. Just a bi-big deaf Indian” (24 Kesey). Due to the fact that Chief is Indian, his nickname, Chief, was given by the ward because of his heritage. Chief is aware that the patients and staff of the ward are not to build relationships with, rather the facade of his deafness makes it so he doesn’t have to interact with them. Also, provides him with a unique situation to overhear things people wouldn’t typically say or do right in front of him. Though McMurphy, a new patient, is the first person to treat him with respect, which builds Chief’s character further; as we see him build a genuine relationship with McMurphy.