Ken Kesey’s take on a psych ward goes much deeper than brain dead patients who piss on themselves. There are patients there who do not even belong. What keeps these patients there is the Big Nurse. The Big Nurse continuosly digs at patients insecurities until the patient thinks there is something wrong with them. I believe McMurphy and the Cheif are the most sane patients of all. McMurphy catches the flaw of the ward the instant he gets there, while the Cheif has known the flaw the whole time. The flaw is that the Big Nurse and Combine keep sane people in the ward. McMurphy tries to fix this flaw but going toe to toe with the Big Nurse. After all the little battles though, the Nurse seems to be victorious. McMurphy has won the battle for the patients by helping the sane realize they do not belong there, but he has lost the battle against the Big Nurse and the Combine. He eventually does not escape, and after he is taken to recieve is lobotomy, the Big Nurse goes back to ruling the ward as she always did. This inner struggle within the ward does suggest a broader struggle with human agency and the Combine. The Cheif already experienced the powers of the Combine when the white men came to take over his reservation. The Combine wore down his father, just like McMurphy. The Combine can also be compared to the government and legal system. There are rules you must abide by, and if you do not follow the rules, you are punished. You must follow these rules even if you do not agree with them. The president can be compared to the Big Nurse. If you do not agree with a presidents decision, you must live with it. You can’t buck the system.