This brief portion features Chief's recounting of an old doctor who visits the hospital. The doctor observes Chief and, by implication, the other patients as bugs. Chief imagines himself escaping the hospital through a picture hung in the ward, depicting a fly fisherman in a rustic scene. He remembers the hospital where he stayed before being transferred to Nurse Ratched's care, and recalls that it was much worse than what he is currently experiencing. He witnesses the visiting doctor shivering, and wonders if he feels the cold from the snow-capped peaks of the mountains in the picture.
Chief is not ready to declare himself recovered. He rationalizes that the condition of his current care is better than what he has experienced in the past, so therefore it must be the best of all conceivable worlds. This despite the fact that he is familiar with the scene in the photograph that he imagines escaping into.