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The decade marked a drastic proliferation of books that looked at psychiatry and mental illness but garnered little diagnostic or therapeutic value. Despite the prestige of these publications that usually attuned to academic standard in intellectual circles, none of such literature had the widespread impact of this novel written by Kesey who worked the graveyard shift at a mental hospital in Menlo Park, California. He participated in government-sponsored drug experiments during his employment with this hospital and became sympathetic to the patients and began to seriously question the boundaries that had been created between the sane and the insane.

ONE FLEW OVER THE CUCKOO'S NEST is an unforgettable story of a mental ward in which the despotic Nurse Ratched reigns over the doctor and all the inhabitants. She exercises a somewhat cultic tactics to render her patients completely submissive. In what she embellishes a Therapeutic Community, an outwardly democratic entity run by patients, she imperceptibly manipulates them into grilling each other as if they are criminals.

ONE FLEW OVER THE CUCKOO'S NEST is narrated by a patient in the ward, a Columbia Indian whom everyone thinks deaf, mute, and unintelligible, but who throughout the years of his commitment has overheard all the trickery of staff meetings. He epitomizes the mishap of the erroneous boundary with which the sane separates them from the insane. McMurphy's arrival and his friendship with the Indian Chief spur him on to recover his own identity and rebuild his self-esteem. The novel examines the notion of madness in the sense of its own and in the sense of the term being patronized by mental institution. The narrator's seamless observation and eagle-eyed description of the ward illustrate salient flaws of such a mindless system that targets only at reducing patients' mental capability. Kesey considers whether madness really means the common practice that confines to a mindless system or the attempt to escape from such a system altogether. Like its audacious protagonist, the novel itself is a literary outlaw.

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