The Chief opens up to McMurphy, revealing late one night that he can speak and hear. After claiming to be able, and subsequently failing, to lift a heavy control panel in the defunct hydrotherapy room (referred to as the "tub room"), his response-"But at least I tried"-gives the men incentive to try to stand up for themselves, instead of allowing Nurse Ratched to take control of every aspect of their lives.
He runs a card table, captains the ward's basketball team, comments on Nurse Ratched's figure, incites the other patients to conduct a vote about watching the World Series on television, and organizes a deep-sea fishing trip wherein the patients were going to be "supervised" by prostitutes. McMurphy constantly antagonizes Nurse Ratched and upsets the routines of the ward, leading to endless power struggles between the inmate and the nurse.
She is assisted by her three day-shift orderlies and her assistant doctors and nurses. The head administrative nurse, Nurse Ratched, rules the ward with absolute authority and little medical oversight. Bromden's tale focuses mainly on the antics of the rebellious Randle Patrick McMurphy, who faked insanity to serve his sentence for battery and gambling in the hospital rather than at a prison work farm. The book is narrated by "Chief" Bromden, a gigantic yet docile half-Native American patient at a psychiatric hospital, who presents himself as deaf and mute.