1. University of Oregon

2. Stanford University

3. Menlo Park Veterans Hospital

4. Sometimes a Great Notion

5. La Honda, California

6. “Merry Pranksters”

7. Ginsberg, Kerouac

8. Beat Generation/Beatniks

9. The Grateful Dead

10. Tom Wolfe

11. Epigraph
...one flew east, one flew west, One flew over the cuckoo's nest.
- Children's folk rhyme.

12. Motifs: keep an eye out for…
Fog
Hands
Animals
Nature/Purity
Laughter
Christ/Savior
Sanity/Insanity
Machine/Combine

13. What is this?

14. Combine Harvester
A combine harvester is an agricultural machine that harvests all types of cereals, oil seeds, and legumes through four main steps:
The crop is cut and directed into a rotating chamber with a series of beaters going the opposite direction. The grain is dislodged, falls to the bottom, separated from debris by sieves and wind. The grain is transferred to a hopper and the debris falls out the rear

15. Check out some images that McMurphy would have seen in his ward

16. Check out some images that McMurphy would have seen in his ward

17. Check out some images that McMurphy would have seen in his ward

18. Similarities to One Flew Over the Cuckoo’s Nest
Guests had to check in
Most were admitted by family members
Many patients had the power to leave on their own but were “controlled” by staff and manipulated to believe that they needed to stay.

19. Mental Hospitals in 1930-1960s Over-crowded Dirty Not nurturing
No privacy
Similar to—or in some
cases worse than--prison

20. Inside the Institutions
Patients were provided with “adequate care” (and segregated) which often times led to inadequate care, poor facilities, and loss of dignity.
They were usually given uniforms and daily “chores.” In fact it wasn’t until 1973 that New York state banned public hospitals from requiring patients to work in exchange for their room and board.
Families were often ashamed of the patients and would deny their existence.
Ultimately, some of these hospitals became holding areas for a person’s entire life.

21. Check out some images

22. Check out some images

23. Medical Care in Mental Hospitals
Deaths and injuries sometimes resulted from both appropriate and inappropriate treatments.
Patients were treated with medically approved procedures like: being put in tanks of ice-cold water, spun in chairs for hours, and forced "medications" (powerful psychoactive drugs) .
Patients were also “treated” with non-medically approved procedures which were simply designed to control them. For example, patients could be shackled to walls, placed in seclusion (most often without clothing) or placed in restraints (being strapped to a bed with leather restraints, often in a spread-eagle position).

24. Types of Treatments for the Mentally Ill
Group therapy
Drug Therapy
Electroshock Therapy
Lobotomy

25. Drug Therapy Thorazine Chlorpromazine
the first psychotropic drug, was a milestone in treatment therapy, making it possible to calm unruly behavior, anxiety, agitation, and confusion without using physical restraints.
"chemical restraint"
Chlorpromazine
schizophrenic psychosis or manic-depressive disorder

26. Electroshock/Electroconvulsive Therapy
Became very popular 1930’s-40’s.
Originated to control negative behaviors in animals (electroshock)
A doctor had noticed that schizophrenic epileptics who had a seizure often were more “normal” after the seizure—which led to chemical convulsions and ultimately electroconvulsive treatment
Used to alter the chemistry in the human brain to produce desired behaviors.
Cruelly, it was used as a control device within most wards.

27. Electroshock Therapy Is Very Controversial But Is Still Used Today
Used to treat some forms of severe depression
Used to “control” the elderly
Used on children in an attempt to correct their wild and/or unwanted behaviors

28. Lobotomy
Surgical procedure for cutting nerve pathways in the frontal lobes of the brain. The operation has been performed on mentally ill patients whose behavioral patterns were not improved by other forms of treatment; it was supposed to be a last resort. The procedure was pioneered by Egas Moniz in the 1930s.
Between over 100,000 lobotomies were performed in the United States.
If performed correctly, disconnecting the frontal lobes caused no loss of intellect, no impairment of memory, and no problems with speech.

29. How a Lobotomy Was Performed
Leucotomy
The goal was to cut the nerves that run from front of the brain to the rear. A techniques was devised that involved drilling two holes on either side of the forehead, insert a surgical knife, and sever the prefrontal cortex from the rest of the brain.
Ice Pick Lobotomy
Invented in Walter Freeman
Insert an ordinary ice pick above each eye of a patient with only local anesthetic, drive it through the thin bone with a light tap of a mallet, swish the pick back and forth, then remove.
A formerly difficult patient is now passive.

30. Lobotomy
"Every patient probably loses something by this operation, some spontaneity, some sparkle, some flavor of the personality”
The aim was that "the patient might be transformed from a disturbed to a quiet clement [insane person]." There was no intention to "help" the patient. The goal was only to eradicate the behavior which others found undesirable.
“Mercy killing of the psyche”
The frontal lobe is the seat of the higher functions such as love, concern for others, empathy, self-insight, creativity, initiative, autonomy, rationality, abstract reasoning, judgment, future planning, foresight, will-power, determination and concentration

31. Abuse of Lobotomy
Freeman developed what others called assembly line lobotomies, going from one patient to the next with his gold-plated ice pick, even having his assistants time him to see if he could break the lobotomy speed record.  It is said that even some seasoned surgeons fainted at the sight.
Doctors would recommend the procedure for everything from psychosis to depression to neurosis to criminality.

32. "deinstitutionalization revolution” mid-1960's
A radical "deinstitutionalization revolution" began
It was supposed to end the cruel and inadequate care of institutions
Individuals would live in their communities and have a "normalized" life
Group homes, residential care facilities, and rooming houses were developed
The movement helped to break up the control that was happening in the hospitals.

33. So let’s think about some major issues that occur in the novel
Decide where you fall on the spectrum

34. Discipline
Discipline is absolutely necessary in most situations.

35. You’re Crazy
All people are “crazy” to some extent

36. One Person
One person can change an established, stable environment

37. Institutions
The best place for those with mental illness in an institution and/or hospital.

38. Men
Our society forces men to act like stereotypical men.

39. Hatred
Hatred is inherent to human nature.

40. Rules
The more rules the better.

41. Self-Esteem
Self-esteem is not very important in life.