One Flew Under the Cuckoo’s Nest is a dark commentary on the dismal state of mental health care in modern society. The book follows Bernie as she battles through a schizophrenic fugue trying to make sense of her own mental state. She struggles through her treatment trying to make sense of her life, her passions, and her circumstances. Over medicated, under treated, she is caged like a beautiful bird beating her wings against the constraints of the facility in which she has been placed.
Bernie’s fight to free herself from her illness takes her on a journey through a system filled with caregivers, misguided family members, and health care professionals who are each sympathetic to her problems. What is missing is any empathy for her loss of rational thinking.
The ward is filled with those who are ill and require the help of those who are trained to help them. The working conditions and the feeling of hopelessness of those who are in a position to treat the mentally ill become themselves ill in the process. Do they treat the ill because they themselves are ill or is the madness like a virus and “catching” and they become mad themselves? The fruitless work, the ineffective therapies, and the failure of the public health care system to effectively care for the mentally ill are all dynamically presented in One Flew Under the Cuckoo’s Nest.
The cacophony of the sterile hospital environment leads the reader to ponder what is causing more damage to the patients? The never ending cycle of medication, psychotherapy, and shock itherapy leave the reader to feel the despair and desolation of the patients. Do the treatment and the environment of the ward cocoon the patients or lead them further down into the depths of their individual madness?
Amara’s frighteningly realistic depiction of the book’s characters leaves one wonderng if the world has truly gone mad. Her work thoughtfully addresses the very real stigma associated with mental illness in modern society. The mentally ill sit locked away behind a door, unseen and in deafening silence waiting for release from their illness. Their release is often into the only community left open to them in their fragile mental state…the society of the disenfranchised, the Society of the Perpetually Homeless and Hopeless.
This book raises multiple issues about the care of our mentally ill members of society as well as the troubling trend in the collapse of the mental health care infrastructure. Seeing the plight of the ill through their own eyes leaves the reader with the conviction that more must be done. It also leaves one with a feeling of despair that we really do not have a clear notion of what that ‘more’ is that must be done.