Summary and Analysis Part 1: They're Out There



One of the "black boys" boasts to another that he can order Chief — who is "big enough to eat apples off my head" — to do his bidding, establishing Chief, the narrator of the story, as a large, passive, half-Indian. Chief can hear the men talking, which they do freely in his presence because they believe Chief is deaf. Not only does Chief hear the employees, he describes their conversation as the "hum of black machinery, humming hate and death and other hospital secrets."

Big Nurse Ratched enters the ward, and Chief describes her as carrying a wicker basket that contains the wheels and cogs she'll need to maintain the machinery of the Combine. He relates that her basket contains none of the feminine accoutrements one normally would imagine in a woman's purse.

Big Nurse catches the black boys' conversation, and Chief describes her resulting anger as a powerful force that inflates her size to as "big as a tractor," enabling him to "smell the machinery." She reverts to her original physical shape, however, when other patients enter the hall. She tells the employees to quit talking and go back to work, addressing them in an authoritative yet patronizing tone.

Chief describes Big Nurse's large breasts as a source of bitterness for her, because he believes she would have been a perfect machine without a woman's physical attributes to remind her that she is human. The rest of his description of Big Nurse refers to her less-than-human characteristics: a "smooth, calculated, and precision-made" face "like an expensive baby doll" and her "flesh-colored enamel" skin.

Big Nurse instructs the employees to shave Chief before breakfast, causing him to panic and hide in a closet. Chief informs the reader that he fears the Combine is more effective on its victims weakened by hunger. He remembers himself back to his youth on the Columbia River in Oregon, bird hunting with his father. Chief believes that the employees smell his fear the way that a bird dog smells a hunter's prey.

Discovered by the employees, Chief passively submits to his shave, because he believes that fighting would make his situation worse. He hallucinates that the Combine starts the fog machines while he screams louder and louder until Big Nurse comes to stifle his screaming by forcing her wicker basket into his mouth, using a mop handle.

Chief tells the reader that the story he is telling is about the horrors of the hospital, about Nurse Ratched, about an individual named McMurphy, and that it is difficult for him to relate to it. He swears his story is true "even if it didn't happen."


The first section of this novel begins with the line, "They're out there," which establishes the paranoia of the novel's first-person narrator, Chief Bromden. Bromden, it becomes apparent later, is also schizophrenic. Bromden describes African-American employees wearing white suits, dirtying the hall by performing "sex acts" and mopping "up before I can catch them."

Chief's conviction that the ward is controlled by the Combine is evidence of his paranoia. He alludes to the Combine when he describes the employees' eyes "glittering out of the black faces like the hard glitter of radio tubes out of the back of an old radio," inferring that the employees are merely cogs in a much larger and much more foreboding machine.

Chief introduces Big Nurse, a woman he describes as carrying a large wicker basket in which she does not carry lipsticks, makeup, or other feminine beauty products. Chief believes that she uses the bag to carry replacement parts for the Combine. Chief depicts her as an individual who can increase her size at will, exhibiting her power over the other employees and the patients of the ward. He comments on Big Nurse's large breasts, which she attempts to conceal. He remarks that a "mistake was made somehow in manufacturing, putting those big, womanly breasts on what would of otherwise been a perfect work, and you can see how bitter she is about it."

Chief is so paranoid of the Combine that he fears that the electric shaver the orderlies use on him actually implants machinery in him. He hides in the closet, but the orderlies find him. He finds solace in his memories of bird hunting with his Indian father, and eventually succumbs to the fog that he believes is generated by the Combine.


Combine a large mind- and environment-controlling mechanism concealed within the walls of the hospital.

The Dalles a geographic region located in Oregon, the setting of the novel.

fog the fog as used by Chief Bromden indicates his paranoid perception that the Combine emits a thick cloud when it needs to subdue and control the patients.