Nurse Ratched arrives and discovers that Bibbit and Starr have had sex. Bibbit blames Starr, the other patients for teasing him and, finally, McMurphy for his actions. Ratched threatens to tell Bibbit's mother and sends him to wait in Doctor Spivey's office where he commits suicide by cutting his neck.
Ratched blames McMurphy for the suicides of Bibbit and Cheswick, and he responds by physically attacking her after smashing through a glass door. He tears her uniform, exposing her ample bosom, and chokes her before being stopped by a group of aides, doctors, and nurses. He is sent to Disturbed, where he receives a lobotomy.
Several of the patients check themselves out before McMurphy is returned to the ward. When he does return, his friends deny that the lobotomized individual is McMurphy. Knowing that it is indeed McMurphy, Chief suffocates him and picks up the control panel to push out the screened window. Chief escapes, following the same path he saw the dog chase the geese. He takes a ride with a Mexican hauling sheep and decides to head back to visit the dam where his tribe once lived.
