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.
Chief relates that Nurse Ratched runs the ward like a machine, and "gets real put out" if the machine isn't running smoothly. He believes that she also spends some of her time making adjustments to the machinery of the world outside the hospital as well. Through time, she has hired a staff that she uses as tools to regulate the Combine's machinery. Staff members that don't "fit" are discarded and replaced. The staff that remains, Chief tells the reader, is comprised of individuals who are on Nurse Ratched's "frequency."
Chief describes the hospital as an automotive mechanic's garage, where the employees require an alcoholic bracer before applying their trade. He imagines a staff member confessing, "It's getting I can't install the simplest frigging component but what I need a bracer. Well, what the hell, it's better'n garage work
." Later, Chief recounts that the hospital is nothing more than a garage for fixing the mistakes made by such societal elements as school and church. He believes that the hospital installs Delayed Reaction Elements in the patients who are cured, who, in turn, leave the hospital to install the same in their family members.
When the residents make their rounds of the ward, Chief says the machinery behind the walls of the hospital quiets until they leave again. During their visit, however, Chief relates that Nurse Ratched is suspicious of the young men with crew cuts. By 10:40 a.m. the machinery hums like a cotton mill.
lobotomy a surgical operation in which a lobe of the brain, especially the frontal lobe of the cerebrum, is cut into or across as a treatment for psychosis.
electroencephalograph an instrument for making electroencephalograms, graphic tracings of minute voltage changes resulting from bioelectric activity in the brain.
pinochle any of a family of card games, usually for three or four persons and typically played with a 48-card deck made up of two of every card above the eight, including the ace.