In this portion of the novel, Kesey seems to indicate that the methods of therapy used by Nurse Ratched are intended more to control the patients rather than cure them (for example, the destructive spying that she encourages between the Acutes exemplified by the log book). In addition, the orderlies emotionally torture the Chronics, as typified by the dwarf black orderly who “gets a rise out of him [Ruckly] from time to time by leaning close and asking, ‘Say, Ruckly, what you figure your little wife is doing in town tonight?’”
Nurse Ratched keeps the Acutes and the Chronics on the same ward, apparently to frighten the Acutes with the possibility that they may end up as Chronics if they don’t yield to her authority. Chief writes, “The Big Nurse recognizes this fear and knows how to put it to use; she’s point out to an Acute, whenever he goes into a sulk, that you boys be good boys and cooperate with staff policy which is engineered for your cure, or you’ll end up over on that side.”
Chief introduces two of the Chronics, Ellis and Ruckly, both of whom he refers to as “culls of the Combine,” and products of the “filthy brain-murdering room that the black boys call the ‘Shock Shop.’” Speaking specifically about Ruckly, Chief believes that, although Nurse Ratched considers Ruckly one of her failures, perhaps he’s “better off as a failure,” rather than as a successful example of the Combine’s machinations.
