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How does the culture in One Flew Over the Cuckoo's Nest by Ken Kesey affect reality?

In Ken Kesey's One Flew Over the Cuckoo's Nest, reality is a nebulous concept. This is due to the nature of the narrator that Kesey selected for his novel, a man known as Chief who suffers from paranoid delusions, auditory and visual hallucinations, and an obsession with McMurphy. 


That said, when considering reality as it is presented by Chief, using a reader's critical lens to analyse his statements and not necessarily accept them as true, it is inarguable that the culture of fear and mistrust in the ward deeply impacts Chief's reality there.


The symbol of machinery, which underlies the majority of Chief's delusions, is tied to the forces at work in the hospital. These forces, including Nurse Ratched, her aides, and the other nurses and doctors, seek to fix and transform the men of the ward to rejoin society. In the context of the novel, conformity had overwhelmed society as status quo, and as such, Chief aligns the ward with a kind of factory that resolves issues and produces efficient, alike robots to join society's unchanging environment. 

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