Striving to reach utopia, our society attempts to conform and tries to make all people equal. If one is not as equal as the other, he is mad, or has a problem. As Ralph Waldo Emerson states, "Sanity is very rare; every man almost, and every woman, has a dash of madness." As much as society tries to get people to conform, the institution of society must be adapted to accept the fact that there is not a person who is labeled sane. There is no formula for a sane man. In Ken Kesey's novel, One Flew over the Cuckoo's Nest, a small ward of a small hospital in Oregon is the ironic setting symbolizing the foibles of the large American society.
Having a degree of madness, the leader in society has certain quirks not unlike the common man. The "Big Nurse" Ratched asserts her dominance as the leader in the ward in Kesey's novel.
The nurse's name sounds similar to a ratchet, a tool used to fasten bolts, turning only in one direction. She has a madness about her, a compulsive need for everything to run smoothly, for the bolts to all come into place without resistance. She is a machine, and wants everything to work like one. "The slightest thing messy or out kilter or in the way ties her into a little white knot of tight-smiled fury." The narrator, Chief Bromden, says "A mistake was made somehow in manufacturing, putting those big, womanly breasts on what would have otherwise been a perfect work, and you can see how she is bitter about it." The nurse has a defect, as does everyone from the great manufacturer; she is a perfectionist and is insecure about her womanliness.
Checking into the ward, the patients exhibit madness on face value.