Chief overhears Big Nurse explain to Nurse Flinn, a young nurse, that McMurphy is a manipulator who had himself put in the hospital to escape work detail. Big Nurse explains that McMurphy reminds her of another patient, Mr. Taber. Maxwell Taber, Chief tells the reader later, was an Acute that Big Nurse had lobotomized and dismissed from the hospital.
Chief describes Big Nurse as a mechanical robot, manipulated by fine wires visible only to him that connect her to the Combine. She has been able to manipulate doctors into either conforming to her will or transferring elsewhere. He depicts the orderlies as handpicked by Big Nurse for their ability to hate and the easiness by which she can sterilize them into their pressed white uniforms.
Resident doctors make their rounds at 9 a.m. to have superficial discussions with the Acutes. The residents' presence annoys and worries Big Nurse because she can't control them. When they leave, Chief notices that the Combine's machinery runs smoothly again until the Public Relations man conducts a tour of the ward.
The humming of the Combine's machinery reminds Chief of when he played football in high school and the places the coach made the team visit. One of these places was a cotton mill in California where Chief met a young African-American girl who begged him to take her away.
Chief imagines Taber being dismissed from the hospital as a respected member of society, which would vindicate Big Nurse's methods. He foreshadows upcoming events when he says that, "Everybody's happy with a Dismissal," and begins talking about the methods to bring an Admission into the hospital's routine.
