What transforms a run-of-the-mill character into an icon? Answers to this question abound, but as for us, we think nothing lodges a character in the all-timer pantheon quite like becoming a pop culture reference. In the case of Nurse Ratched, the villain immortalized by One Flew Over the Cuckoo’s Nest, the transformation from mere character to icon has long been complete. Ratched’s bruising, sadistic standard of medical care has given way to a familiar punchline, with people often invoking her name when treated brusquely—or worse—by members of the medical profession.
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But behind the pithy reference is a richly imagined character—one with a long and storied life in the annals of pop culture history. Before you tune into Netflix’s Ratched, a prequel that imagines Ratched’s formative years as a nurse in a Northern California mental institution, take a minute to brush up on her origin story—and maybe even revisit the source material.
In One Flew Over the Cuckoo’s Nest, published in 1962, Ken Kesey introduced Nurse Mildred Ratched, the domineering administrative head of the psychiatric ward at Salem State Hospital. Kesey, who drew inspiration for the novel from his time working as a night shift orderly at the Menlo Park Veterans’ Hospital, modeled Nurse Ratched after the real head nurse he worked under at Menlo Park. Decades later, Kesey ran into that nurse at an aquarium in Oregon; she joked, “Do you remember me, ‘Nurse Ratched’?"
''She was much smaller than I remembered, and a whole lot more human,'' Kesey said. ''I didn't know what to say, whether to apologize or what. It was a tremendous relief to me to find that she didn't hold it against me, because you don't want someone like that walking around out there.''
In Kesey’s novel, Nurse Ratched rules the psychiatric ward with an iron fist, aided and abetted by a team of orderlies, nurses, and junior doctors, who together operate largely without senior medical supervision. Beautiful but terrifying, she squares off against Kesey’s protagonist, Randle McMurphy, who landed in the ward after faking insanity to serve out a criminal sentence in medical care rather than at a prison work farm. Jokingly referred to as “Big Nurse” in a play on George Orwell’s Big Brother, Ratched knows and sees all, constantly working to oppress any insurrection among residents of the medical ward. Ratched takes pleasure in restricting patients’ access to basic necessities, medications, and privileges, while her superiors turn a blind eye to her psychotic games, knowing that her questionable methods maintain order.
Enter McMurphy, who shakes up Ratched’s law and order by joyfully flouting her rigid rules. His rebellion inspires other patients to follow suit, with the ward soon rising up against Ratched. McMurphy is brutally beaten down with electroshock therapy sessions, but his spirit remains unbroken. After a disastrous group fishing trip, culminating in a young patient slitting his throat after a harsh dressing down from Ratched, McMurphy attacks Ratched, strangling her and exposing her naked torso to the ward. An injured Ratched ships McMurphy off for a lobotomy, but the damage is done, as she is unable to control a ward where the patients are no longer afraid of her.
In 1963, One Flew Over the Cuckoo’s Nest was adapted into a stage play; in 1975, it hit the big screen, with Jack Nicholson’s McMurphy memorably squaring off against Louise Fletcher as Nurse Ratched. Fletcher and Nicholson each took home Best Actress and Best Actor at that year’s Academy Awards, while the film also collected Best Adapted Screenplay, Best Director, and Best Picture. The American Film Institute named Nurse Ratched the fifth greatest villain of all time, and the second greatest villainess (behind the Wicked Witch of the West).
In Ryan Murphy’s Netflix series, Murphy’s longtime muse Sarah Paulson portrays the infamous “Angel of Mercy,” who in this telling became a nurse during World War II (though, we soon learn, her credentials leave something to be desired). This Ratched is a master manipulator, cannily strong-arming her way into a nursing job at a Northern California mental institution, where one of the patients is someone close to her heart. At times tormenting, murderous, and sadistic, while other times sympathetic and kind, it’s easy to see the emerging cracks in Paulson’s Ratched, and to imagine how, over time, they could harden into the regimented cruelty of Fletcher’s Ratched. There’s no sign of McMurphy in this season, but with Paulson teasing a Season Two on the horizon, here’s hoping she crosses paths with her ultimate foe the next time around.
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