OTHER ELEMENTS

SETTING

The hospital, Dr. Spivey says, "is a little world Inside that is a
made-to-scale prototype of the big world Outside." The literary
term for such a setting is a microcosm (from the Greek for
small universe). Most of the action in Cuckoo's Nest takes
place in a world that is indeed limited and specific-one ward of
one mental hospital in Oregon. But Kesey intends that limited
world to serve as a representative of a much larger one.

Mental hospitals have a long and not particularly inspiring
history in Europe and America. The first, such as Bedlam in
London, became symbols of chaos and cruelty. While waves of
reform in the 19th and 20th century improved life for patients
somewhat (as the public relations man insists) we see that, at
least in Nurse Ratched's ward, abuse both physical and
psychological is still rampant.

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