The third section of this novel begins with Chief recognizing that McMurphy's behavior also has infected Doctor Spivey. Spivey stands up to Ratched when she questions the wisdom of allowing the patients to play basketball on the ward.
The relationship between Ratched and McMurphy has become marked by a strained politeness until Ratched denies McMurphy an Accompanied Pass with a woman named Candy Starr. In response, McMurphy puts his hand through the glass of the nurses' station again, pretending it was an accident.
McMurphy coaches a game pitting the patients against the African-American aides that soon turns unruly. McMurphy bloodies the nose of the aide named Washington, which will impact future events in the novel.
The patients' behavior is changed because of McMurphy's influence. Harding flirts with the student nurses, Billy Bibbit stops writing about other patients in Ratched's log book, and Scanlon throws the basketball through the recently replaced glass in the nurses' station.
McMurphy applies for a pass for a fishing excursion that will include eight or nine patients, writing that he'll be accompanied by "two sweet old aunts." The pass is granted, but Ratched attempts to frighten the patients who will accompany him with a newspaper clipping about how rough the sea will be. She posts this clipping on a bulletin board, adding similar clippings of boating accidents as the excursion draws nearer.
Ratched's tactic frightens the Acutes, but Chief desires to go. He is concerned, however, that if he signs on, it will indicate to everyone that he has heard everything. He tells the reader, "I had to keep on acting deaf if I wanted to hear at all." He remembers that the first time his presence wasn't felt was when he was ten years old. At that time, three white people visited the Chief's family and behaved as if Chief wasn't present. They disparaged the living conditions of Chief's family and discussed how they should approach Chief's father to sell their land so that the government can build a hydroelectric dam in its place. It is the woman in the group, a woman who reminds Chief of Nurse Ratched, who determined they should avoid Chief's father and go directly to his mother. The woman reasoned that, because he took his white wife's name, Chief's mother will actually bear more influence on her husband's decision to sell the land. She told her comrades, "As my sociology professor used to emphasize, 'There is generally one person in every situation you must never underestimate the power of.'"
That night in the hospital ward, Chief awakens to hear McMurphy talking to an aide who is scraping gum from the bottom of Chief's bed. This inspires McMurphy to sing "Does Your Chewing Gum Lose Its Flavor on the Bedpost Overnight?" after the aide exits. This song causes Chief to laugh, indicating to McMurphy that he can hear. McMurphy offers a stick of Juicy Fruit to Chief and the Indian utters the words, "Thank you."
His ability to speak causes Chief to tell his life story to McMurphy. He says that his father's name was Tee Ah Millatoona, which means "The-Pine-that-Stands-Tallest-on-the-Mountain." He says that his white mother began at 5'9" tall but eventually grew bigger than Chief or his father together. Chief says that his mother and the Combine worked on his father to conform because he was physically large and did as he pleased — comparing him to McMurphy.
Chief tells McMurphy that eventually the Combine caused his father to sell the tribal lands and waterfalls. His father wound up a destitute alcoholic. He warns McMurphy that the Combine will work on McMurphy as well, because it believes he's too big.
The two men agree that McMurphy will pay for Chief to go on the fishing trip if Chief will lift the control panel that physically stymied McMurphy in Part 1. McMurphy begins to build Chief's self image, telling him that he has grown "half a foot already."
McMurphy's positive impact on the patients continues to increase, prompting them to think more of themselves, as well as to question Nurse Ratched's arbitrary and abusive authority. For example, Chief's first utterances indicate a willingness to overcome his oppressive paranoia and engage himself communicatively with McMurphy. In addition, Chief, to his amazement, is able to recall details of his childhood for the first time in years. These memories recount when he first felt ignored, indicating to the reader that Chief has pinpointed the source or cause of his illness and, by extension, knows that he can be cured.
The control panel that McMurphy wants Chief to lift is significant. The panel represents one thing that McMurphy is incapable of achieving, as outlined in Part 1 when he loses a bet trying to lift it. That fact that Chief can lift it reveals that he is regaining his physical confidence, but because he'll lift it as part of McMurphy's attempt to win a bet against the other patients by tricking them foreshadows McMurphy's downfall.
Chief's observation of McMurphy's tattoo also is revelatory in that it depicts the "dead man's hand" of aces and eights, the poker hand that Wild Bill Hickok was holding when he was shot to death.