Let's be honest, most people will think of the Jack Nicholson movie upon hearing this title, not Kesey's unique novel. I haven't seen the movie but do intend to soon; I'm curious how this story is told on screen.
You'll sometimes hear the phrase "unreliable narrator." This book is told from the first person perspective of a very tall half-Indian man who lives in the psychiatric ward of a hospital in Oregon; the others call him Chief Bromden, or simply Chief, and he's cultivated the belief that he is both deaf and dumb. He is neither, and understands far more than he ever lets on, but he is also, quite definitely, crazy. The Chief calls the outside world the Combine - people enthralled by the Combine are part machinery and live very sanitized, regimented lives. Within the ward, the Combine's greatest weapon is the Big Nurse, Miss Ratched. Her name gets thrown around a lot in pop culture, and from that context only I thought she was some kind of yelling, spitting, terrifying beast of a woman. While she is terrifying, she is none of those other things. Quiet, patient, always with a smile frozen in place, with a perfectly starched uniform: Miss Ratched is the pinnacle of passive aggression, and rules the ward (including the aides and the doctor) with an iron, milk-white fist.
Into this, Randle McMurphy is thrust. Fresh off the fields doing hard labor, McMurphy loves two things most in this world: gambling and screwing. Through the entire novel, it's unclear and unknown whether McMurphy pretended to be crazy in order to get off work duty, or whether he is actually insane. He shakes up the ward in a myriad of ways, and a battle of wills takes place between him and Miss Ratched.
It's a heartbreaking book, really, witnessing these men who so very much want to get better be systematically undermined by the Big Nurse and contemporary psychology's rather tenuous understanding of the human psyche. Group therapy is anything but therapeutic, as Miss Ratched uses the hour to break down and shame her chosen target, even having his fellows report on him and try to analyze him themselves. McMurphy, disruptive though he is, breathes life back into these broken men. Now, of course, we understand that listless days, group analysis (without the addition of group support), and electroshock therapy are quite the opposite of what most mentally ill patients need. The Chief might be crazy, but he is still a man, Kesey is telling us, still a human being with human needs. Being crazy doesn't mean he shouldn't feel happy or fulfilled. This book is indeed a classic, much deserving of that label.