For instance, the demeanor of Nurse Ratched at the time of the World Series game offers perplex thoughts to the patients for the fact that she reacted in a complete ballistic manner in which even Bromden says that she behaved as delirious as the patients. McMurphy and the others only formed a remonstration against Nurse Ratched who was not allowing the shut-ins to watch the game. This was the destructive and atrocious nature of the institution because it made the patients believe that they were truly insane and mentally instable when in fact they were sane.

Furthermore, the madness of the hospital shrouds the free thought and questioning of the patients inside. When the patients leave for their fishing trip, they strike upon the idea that madness is a sense of power and authority, as in the situation of where the station attendants are frightened by the mental instability of the patients. Kesey then parallels this trait towards Nurse Ratched and compares her to Hitler, because she possesses the traits of a madman and she has discovered on how to use the skills and ideas of a madman to her own benefit. These acts are reflected upon the lack of confidence of Billy Bibbit. McMurphy asks Bibbit why hasn’t we left the institution when he had come here voluntarily and that he knows that he is not insane. He replies by saying that he doesn’t have the guts to make it with the people from the outside. This idea was planted into the mind of Bibbit by Nurse Ratched because her techniques to help the mentally ill demolish the confidence of the people, rather than encouraging it. As a result, sane men are becoming insane because the nurses who are supposed to help these people in their turmoil are, instead, adding on to the trauma that they are already experiencing. Madness is now a tool that can break down an individual, or even an entire population as in the case of the novel, and it can then fill the empty space inside the person with false ideas.

The importance of sexual freedom is also a theme within then novel and the character of McMurphy is the greatest method in how Kesey expresses this theme into the story. McMurphy is unafraid to express his sexual needs, experiences, and temptations, for example, his sexual attraction towards the Big Nurse. She is described to have large breasts, which is a trait of her womanhood, but she does not aim to boast them because she is afraid of the patients’ sexuality. McMurphy is constantly making sexual comments about the Big Nurse and sometimes to her in person which shows that he is not scared to express what he truly feels and thinks. The climax of his sexual urge is when he tears her clothes and reveals her breasts, which makes her seem less of an authority figure and shows that she is still only a woman no matter how much power she has over the patients. The masculine sexual power of the patients is stronger than the authority of the nurses over the patients.

Further instances of sexual independence include McMurphy telling his doctor about the rape charge against him. He has no embarrassment in telling the incident and he even says that the victim had lied about her age so McMurphy claimed that she is as guilty as he is. This aspect of McMurphy is what drives him and the other patients to revolt against the madness and insanity of the institution. McMurphy reminds the other patients of their masculine sexual power over the nurses because of their femininity. Also, McMurphy tells the patients of another instance of his sexual experiences which was the first time he had sex with a woman, which was when he was less than the age of ten. He prizes this moment and, in fact, regards this moment almost like the time that he became alive. All of these experiences intensify his sexual character and he simply cannot control his hormones when he sees a woman, which is a problem because the institution limits his freedom to explore his sexuality.

Women are also a theme within the story because it highlights their controlling and overseeing characteristics. The patients, who are men, are under control of the supervisors and nurses, who are women which is ironic towards history. Men would always be in control of every aspect in life except for cooking, cleaning, and taking care of children; however, it seems that the women in this story sought revenge among the men who regard them as a piece of property in the past. For example, the death of a patient named Rawler is significant because it shows the drastic measures that the patients went to to free themselves of the oppression of the women. He could not take the repression of the women in the institution so much, that he symbolically committed suicide by cutting off his testicles. This represented that the women in the ward had successfully taken away his manhood, literally and symbolically.

Another example of the impact of women upon the patients was in the case of Billy Bibbit’s mother and her controlling attitude. She treated Bibbit like an innocent child and she prohibited him to do anything enjoyable, particularly being sexually active. Her power over him, even when he was an adult, elicited his seclusion from the outside world and his own manhood. However, when he has sex with Candy that is when Bibbit experiences an epiphany and earns his masculinity, as well as getting his confidence to break away from his mother’s grasps. Nevertheless, that manhood is taken away from yet another woman, Nurse Ratched. She threatens to tell Bibbit’s mother about him going against her commands and this drives his completely insane; enough to lead him to end his own life. Bromden’s experiences with the opposite sex have also leaded him to be suspicious about them because of the way that his own mother was overwhelming in his own household. His mother was so controlling and manipulating that her husband had taken her last name. The woman taking the man’s last name in marriage is a symbol of the woman giving her own identity as a form of love towards her husband. However, her influencing characteristic lead a strong, bold, and honorable chief to a weak, spineless, and a pathetic drunk. Her nature of putting the others down lead to her being emotionally stronger and striking fear into both her husbands’ and Bromden’s hearts.

The motif of laughter echoes throughout the novel and is very significant for it explains the conditions of the characters and of the institution. When McMurphy enters the hospital, he notices that none of the patients ever laugh; all they ever do is smile, or even snicker a bit behind their hands. Kesey shows that the patients are afraid to laugh and express their happiness because of the institution’s efforts to break the patients’ spirits. The institution, in some way, parallels the characteristics of a totalitarian society for the fact that it limits the rights of the people so much, that they are unable to even laugh or express their joy.

Laughter is an instrument that McMurphy uses part from the shackles of the institution because it shows individuality which leads away from the control of the hospital. McMurphy’s laughter, in a way, is his form of revolt against the rules and regulations of the institution and that he wants to do whatever he pleases to do. The other patients, however, are frightened by the Big Nurse to laugh which keeps them from recovering from their psychological illnesses. Laughter is, in fact, the medicine that the patients need to become well again because the ward, a place so depressing and miserable, is affecting their personalities and causing them to lose hope of being cured. McMurphy tries constantly throughout the novel to humor the patients because that will make them realize that they need to include happiness in their lives. For example, during the time that the patients were playing cards, McMurphy strives to humor the others at how they were gambling during the game in order to make the patients understand that there is another side to life and that is to enjoy the bounties give to you.

Invisibility is a very considerable motif because it highlights the character of Bromden, the narrator. Bromden describes how he feels invisible in the hospital, even though he is responsible for this because he pretends to not know what is occurring around him. This leads to people not noticing him less and less as time progresses. He claims that he is supposedly both deaf and dumb, which makes his presence in the institution less significant. This also hides his mind against the influence of the nurses with the ward.

However, this invisibility also has a disadvantage which the reader knew from Kesey describing Bromden’s childhood. The white men never noticed Native Americans, no matter how much Bromden raised his voice towards them. He may be able to hear everything that goes on, but he cannot act upon it because nobody will listen to him or take his words into seriousness; his large and powerful stature are in contrast to the ways in how he influences the others in the ward. Ultimately, he will have done nothing to change the world for the better no matter how hard he would have tried, and he would have died unnoticed.

McMurphy, on the other hand, can never be invisible because of his assertive and powerful attitude. He acquires attention everywhere he goes and he leads other people to become visible by recovering their personalities. For instance, when be shatters the glass window of the Nurses’ Station, he claims that he could not see it because it was too clean. This symbolically meant that McMurphy was trying to let the other patients know that the oppression of the women in the ward is not always seen, yet they are constantly acted upon them. The manipulation is similar to an invisible force, such as gravity; it may not be seen, but it is constantly at work.