Friday, September 08, 2017

Nurse Ratched For President

Update:  Apparently I have gotten this pretty thoroughly wrong.  I would like people's impressions based on the movie, however.

I have never seen "One Flew Over The Cuckoo's Nest."  I disliked the book.  I understand the movie is different, and anyone who has worked in my field for forty years is supposedly obligated to be familiar with it. It is a cultural tentpeg for my generation and my profession, so I have let the side down in two distinct ways.  Yeah, well, deal with it.

A senior psychiatrist I admired once observed that Nurse Ratched is universally regarded as an evil, officious person, but he regarded her as a hero.  With limited resources and no backup she created a safe environment for vulnerable people and would not be bullied by those who thought themselves better than her. She was willing to be hated in order that real victims could be safe from the pretend ones.

Well, I don't know if that's fair, or the conventional wisdom is fair.  I confess I have considerable sympathy with the idea, having spent a lifetime watching perps take advantage of desperately vulnerable people and insulting or assaulting very decent staff members who attempt to set fences around them.  But there is apparently a TV series coming out this fall about an imagined backstory of how she came to be. I imagine it will take the conventional wisdom as its starting point.  It may seek to humanise her and give people pause, or it may run with current political fashion by portraying her as raised by white-supremacist Republicans, so what do you expect?

I ask that if any of you catch the series, be alert there's another side to this.


Sam L. said...

I saw the movie way back when, did not think much of it, and did pick up the Nurse Ratched bad vibe. It's been too long for me to remember it well enough to say more.

Sam L. said...

I would have seen it sometime in '76. That would have been a fairly busy time in my life.

james said...

I read the book--I think for a college class. In the book she condones, or at least does not interfere with, the pair of orderlies who rape every man brought in--except for the Indian, whom they feared to molest. Also in the book, most of the inmates were not violent or condemned to stay there, but could be fairly easily released if they weren't more afraid of the outside (IIRC on that last detail). The movie is very vague in my memory, but I don't recall that violence was a major possibility--she was simply an adversary. "Making a safe place" would seem a bit of a stretch.

Assistant Village Idiot said...

Yeah, the good doctor wouldn't have read the book then. I had forgotten that part, amazingly.

jaed said...

We may've read a different book. I remember her driving one vulnerable patient to suicide, seemingly quite deliberately and with no mercy.

Assistant Village Idiot said...

Fascinating. I remember nothing of her evil in the book, and her reputation for evil is based entirely on the movie, which I have never seen. So I am about as off-kilter from matter as one could get. What are people remembering from the movie?

Sam L. said...

I never read the book. Having seen the movie, I had no interest in the book.

Laura said...

I never saw the movie, and read the book many years ago, as a late-teen, so my memory might be off on the details (or, I was too immature to catch some innuendo)-- I don't remember the orderlies raping the patients, but they were presented as basically nothing more than stupid and cruel.

No reason to see the movie, as the book was so full of holes and paper characters that there was no need to go back. All of the women were sexually repressed and took it out ruthlessly on every man they could; they all not-so-secretly wanted to be raped. (The women were also all smarter than the men, which was presented as an evil thing.) Oh, there were a couple of cardboard-cutout whores, too. All of the blacks were stupid and cruel, except for the one who was totally venal, a pimp and de-facto drug dealer (he let the patients break into the pharmacy and take the codeine and other drugs for a big orgy). All of the psychiatric treatments were solely for torture and never had any good effects on the patient. Nobody ever checked anything, ever.

Yet, somehow, a group of random, committed-for-life mentally-ill patients (including some who are thought to be catatonic) end up choosing to go on an unsupervised, deep sea fishing trip-- and are let go????? Whaaaaat? And then came back to the hospital, which they viewed as a hellhole?????? Who's crazy enough to do that? Why would anybody do that? So they could have another argument over setting the TV channel?

I remember thinking that none of it held together, and man, did that author have some Issues. (Which, of course, he did-- the really sad/scary part was, he actually did work as a night-shift orderly in one of the old-time asylums. I wonder how much of that break-into-the-pharmacy-at-night-and-throw-a-party-with-the-loonies was actually autobiographical. )

Assistant Village Idiot said...

Reading the wikipedia about the book, none of it seems familiar. I wonder if long ago I read an article about it, not the actual book.

RichardJohnson said...

Over four decades have passed since I saw the movie, so I am hazy on the details. I believe I also read the book- also 4 decades ago. Before being exposed to the book/movie, I worked for a year as an aide in a psych hospital. There was not a 1-1 comparison of the psych hospital portrayed in the book/movie and the psych hospital where I worked. The psych hospital where I worked was privately owned, so it was less likely to have involuntary commitments or violent patients. Only those with hefty insurance policies need apply. Stays tended to be short-term. I do not recall any patient ever being a physical danger to another patient- or to staff. Though I did have to calm down a patient who had done some damage to a coffee table. Or did he simply slam his fist on the table? I don't remember. In any event, he quickly calmed down after I said noting more than something like "Calm down.”

My take on Nurse Ratched was that she was a metaphor for the benevolent welfare state. We know what is best for you- and you WILL do what is best for you. That somewhat parallels my take on the psych hospital where I worked.

Psych patients have had unhappy lives before they end up in a psych hospital. Psych patients' views of what led them to end up in a psych hospital, and what they need to do to improve their situations, are at the outset generally not the views of staff. Staff sees its job as getting patients to agree with staff about what patients need to do to improve things. Psych patient, you WILL come to agree with staff on what needs to be done.

Unfortunately, staff doesn't always know how to get from step A to step B. I recall a patient who had a bad reaction to his medications. So, even if a patient falls in line with what staff tells him to do, there is no guarantee that things will proceed as planned. This is in large part due to the problematic, even intractable situations that psych hospitals deal with. (Several years after I resigned, I heard of patients who came in for second or third stays. I worked in the beginning years of the hospital, so had little experience with repeats.)

My year as an aide definitely affected my view of government. How many times over the last century have people with good intentions informed us that after spending government money on a certain program, a given problem will be improved or solved? Many, many times. My year as an aide informed me that devoting resources to certain problems does not necessarily mean that problem will be improved or solved. Psych hospitals deal with problems that often seem intractable, or are actually intractable. That doesn't mean that society shouldn't devote resources to such areas. However, it did leave me with a skeptical attitude towards those who inform us that they have such a GREAT program that if funded, will lead to GREAT results. I also came to the conclusion that needs are unlimited while funds are limited.

On the other hand, the "intractable" line has been pushed. When I worked as an aide, while the psychiatrists may have used Freudian methods in therapy sessions, treatment on the ward was oriented towards behavior therapy. Little steps in the right direction. I came to the conclusion that cognitive behavioral therapy has some usefulness- certainly more than a Freudian approach. Medications have generally improved.

But it is still a difficult, problematic business. I tip my hat to those like AVI who can spend a career in psych hospitals. Like many aides, a year was enough for me. The powers that be recognize that limit. Several years after I resigned, a peer interviewed for an aide job there. The nursing director- much more personable than Nurse Ratched- informed him that most aides quit after about a year, when they fear they are going crazy.

Doc at the Radar Station said...

I saw the movie when it first came out as a teenager, but never read the book. I think the story needs to be viewed in terms of the cultural milieu of the time and who wrote the story - Ken Kesey.

There was a view that psychedelics might be a cure for all sorts of mental problems and social ills. It was a revolt against the mid-20th century status quo. The trend was towards civil rights, individualism, do your own thing and against the state, society, communities and collectives of any kind with all their rules and conventions.

The primary characters in the movie weren't seriously mentally ill. They were neurotics that were being sheltered from the world by an institution. Nicholson's character believed that he could help them by getting them to embrace the world - not escape from it. Nurse Ratched was an over-protective mother that wouldn't allow her patients to 'grow up'.