Review: One Flew Over The Cuckoo’s Nest (Ken Kesey)

After the success of my first book review
I’ve decided now’s time for number two.
This time it’s something on a quasi-medical theme
one which comments on the nature of conformity and power as seen
throught the lense of psychiatric care and remnants of the asylum system
an area which most doctors try to avoid based on conventional wisdom.

First a little about the author – Ken Kesey-
he graduated UO in 1957 then says he
became an orderly at a veterans hospital in Menlo Park
which along with MKULTRA gave him the creative spark
to complete the manuscript for a novel which would go on to drive
the creation of a succesful play in ’63 and a movie in ’75.

The story’s set on a psych ward run like a Stalinist state
where the head nurse uses her authority to insistently manipulate
her powerless patients and cowed staff to create a
culture which serves to magnify and inflate her
claims of beneficience to suppress patient rights
while maintaining ward-wide obedience at cult-like heights.

Into this mix comes the protagonist, McMurphy.
Upon entering the nurse’s tightly controlled turf he
starts encouraging inmates to take their lives into their own hands,
become empowered, address the future and make plans.
This modus operandi puts him in direct defiance
of the nurse’s strategy of tearing patients down to ensure their compliance.

The passive-aggressive conflict which subsequently results
sees the two threatening and charming each others allies and trading insults.
The battle of wills escalates as the book goes on,
with every freedom won by the patients receiving increasingly strong
retaliation and counter-measures until finally both reap the whirlwind they sowed
the nurse is choked ‘til she loses her larynx and costs McMurphy his frontal lobe.

There’s two main readings (though really they’re one and the same).
The monolithic institution vs the individual portrayed again and again
Indians and the government, mentally ill vs the asylum, man against society, but all across this range
the process never really alters, it’s only the names that change.
Because even if the individual wins a while it never lasts too long
they always slip, always lose, for the collective is just too strong.

The second reading’s just a more superficial version of the first:
the gross imbalance of power with which psychiatry is inherently cursed.
The implication is that the head nurse with her oppressive punitive measures
is just the natural consequence of attitudes that the system treasures.
The outlook of psychiatry in the ‘50s and society as a whole
meant they would always need someone like her to step into such a role.

Obviously this story paints a pretty grim portrait.
In the last 50 years have we improved this poor state?
Having worked in a psych hospital here for a year
I can only answer yes, but still I fear
modern medicine’s left psychiatry far behind
with a different paradigm being applied to the theory of mind.

There are various other themes to be seen
but I take the fact I’ve reached 500 words to mean
it’s time to wrap this up and get back to reading medical stuff
so it looks like this review’ll just have to pass as good enough.

They banned these the year before I started work (though drugs made them obsolete long before then).

One component of an old-school ECT machine at our hospital's museum.

Review: The Metamorphosis (Franz Kafka)

Just for variety, I’m going to try something new
and integrate into this blog a book review.
For my inaugural, cutting-edge literary post
I chose a novella that I expect most
of my readers have probably heard
even if they’ve never read it word for word.

‘The Metamorphosis’ was originally published in 1915,
all across the Western world it’s subsequently been
acclaimed as a seminal work – influential beyond a doubt.
But what is this novella actually about?

It’s deceptively simple, the plot’s central conceit
that a man is transformed into a beast with many feet,
an armoured carapace and feelers on his head
when he wakes up one morning in his warm, familiar bed.
The change in his circumstances, appearance and behaviour
take him from being in the position of his family’s financial saviour
to a giant insect barely tolerated by those who surround him
and through this change we learn more about the circumstances in which we originally found him.
He slowly loses hope and his family come to consider him a pest
until, approaching the books dénouement, he decides it would be best
if his family didn’t have him in the house acting as a constant burden
and having surrendered to his fate he dies quietly like the vermin
he has metamorphosed into and his family, now free,
rather than mourn him see this as a golden opportunity
to live their lives and each to exploit the new prospect
they were forced to develop when Gregor became an insect.

Obviously this story has a whole host of themes.
One of them is that Gregor had no wants or dreams.
As a man he lived purely for others and filled their every demand,
never thought for or about himself or ever took a stand
and having lost his identity figuratively to his family and employer,
is it so surprising when he loses it to an ungeziefer?

Another interesting facet of the plot that we should consider other
than identity, is that Gregor supports his sister, father and mother
when later in the plot things become clearer and we finally discover
that they could comfortably support themselves with only a minimum of bother.
Gregor’s huge sacrifice (made literal in his final fate)
had in actuality allowed his family to stagnate.
Although they dehumanise their son after his transformation
they transform themselves too with an all round elevation
in confidence, ability, and prospects (as noted at the end).
It is only by the removal of a prop that the family is allowed to mend.

Rationality vs. irrationality also plays a part in the character’s interactions
Gregor’s purposeless wandering, garbage eating, insectile actions
are portrayed through the prose as been understandable and sensible.
By contrast, his family is often implied to be reprehensible
for simply expressing a natural mixture of fear and disgust
at seeing a human-sized cockroach that the average person must
necessarily react to in this manner. Hence we see an inversion
where the rational response is portrayed as a perversion,
while the more animalistic, instinctive beetle’s irrationality
is shown, at least superficially, as being devised logically and intelligently.

Another view which I have heard critics promulgate
is that Kafka’s goal in this book was simply to satiate
a need to tell the story of his own situation
with Gregor’s en-roach-ment merely a fictional representation
of his own, frequent tuberculous convalescence which he maligned
as leaving him mentally and physically repulsive while he was confined
to his room and reliant on family support and his sister’s care.
Parallels with the course of the novella are clearly there.

But even if the book is nothing more than a thinly veiled reflection
of the author’s own life, I think his intention,
while certainly worth knowing, doesn’t really matter when all’s said and done.
The message taken from it by millions of readers is the important one.