Chief Bromden, the son of a Native American father and a white mother, begins the novel by relating the real and imagined humiliations he suffers at the hands of the African-American hospital assistants. While their treatment of him is tolerated, despite the fact that he is physically much larger than they are, Chief expresses a greater fear of Big Nurse, Nurse Ratched. The Nurse is identified as a woman of great power and control, who is bitter because her ruthless, machine-like efficiency is thwarted by her naturally endowed large breasts. Despite her power, the paranoid-schizophrenic Chief believes her to be in service of the Combine, a large mechanized matrix that hums behind the walls and floors of the hospital, controlling everything from the environment to human behavior.
Randle Patrick McMurphy is introduced as a new patient on the ward. McMurphy immediately distinguishes himself from the other patients in the disregard he displays for all authority. He gambles, swears, makes off-color sexual remarks, and immediately sets himself in opposition to Nurse Ratched. McMurphy verbalizes his views that Ratched is a "ball-cutter." She controls the men by encouraging them to spy on each other and participate in group sessions where they verbally brutalize each other. At first they defend Ratched, but eventually agree with McMurphy's assessment. He attempts to assert his newfound leadership role among the patients by requesting permission to watch the World Series on the ward's television set. When this permission is denied, he turns the television on anyway. Because she controls power, Ratched shuts off the electricity to the television. McMurphy, however, gets the upper hand by insisting on watching a blank screen, an action imitated by the other patients.
