We were first introduced to the terrifying and tyrannical Nurse Mildred Ratched in Ken Kesey’s book One Flew Over the Cuckoo’s Nest — but her character was brought to life by Louise Fletcher in Miloš Forman’s film adaptation, which earned her the Academy Award for Best Actress in 1976. Nurse Ratched manipulated her patients in order to maintain the order she liked, despite it causing them more psychological distress. In addition to her distinctive bone-chilling stare, she spoke in a polite tone when explaining her rules, as though everything she said was too reasonable to be disputed. Netflix’s Ratched, created by Evan Romansky and executive produced by Ryan Murphy, sets out to explore the iconic and unforgettable character’s origin to determine why someone would behave as she did.
Ratched opens at a rectory in 1947, where a group of priests partake in a candlelit dinner during a late-night thunderstorm. Lurking outside is Edmund Tolleson (Finn Wittrock), who knocks on the door asking to use the phone because his car has broken down. But Edmund’s motives quickly turn sinister, resulting in the tense and gruesome mass murder that lands him in Lucia State Psychiatric Hospital and sets the tone for the rest of the series.
Elsewhere, Mildred (Sarah Paulson) is on her way to the hospital on a covert mission. She convinces hospital head Dr. Richard Hanover (Jon Jon Briones), who is deciding whether or not Edmund’s fit to stand trial, to hire her in a nursing position that doesn’t exist. Mildred is immaculately presented, the perfect image of what a nurse should be, but she is also cold, confident, and manipulative — qualities that allow her to reach the goals of her meticulous plan. She often acts unpredictably, even maliciously, when things go awry. Although capable of wicked things, she also expresses seemingly uncharacteristic, but genuine kindness to certain patients and colleagues.
Paulson has said that, if she’s done her job right, no one will completely know who Mildred really is: “I don’t think even Mildred knows yet. She’s a work in progress. She had a very traumatic childhood.” This trauma defines her character and is well explored throughout the series. It comes out in many of Mildred’s actions, including specific sexual roleplay scenarios. Writer Ian Brennan explained that Paulson had a strong desire to show Mildred’s private and vulnerable moments so we would understand that her polished appearance is just a façade. It adds depths of humanity to Mildred as “she suddenly becomes an entirely different woman,” completely unlike the Mildred we saw in the film.
In addition to Mildred, the hospital is made up of an eclectic ensemble of characters, such as trainee nurse Dolly (Alice Englert), orderly Huck (Charlie Carver), and patient Charlotte (Sophie Okonedo), who gives a wonderfully dark and nuanced performance as a patient with multiple personality disorder. Nurse Betsy Bucket (Judy Davis), the head nurse that runs the mental hospital, stands out in particular. She is cold, strict, and carries a fantastical image of herself that’s challenged when she meets Mildred. Davis’s rich performance embodies the cold fear found in the film version of Mildred, but she’s a hopeless romantic yearning for love and joy.
It’s impossible to avoid new and unsettling treatments in a series set inside a mental hospital in the late 40s — particularly lobotomies, which were first introduced in the mid-30s and were most prevalent throughout the 50s. As the procedure originally involved drilling into a person’s head, a more efficient method dubbed the “ice-pick” lobotomy was created and first performed in 1946. This is the procedure that is demonstrated by Hanover, which disturbs some of his nursing staff so much that one of them even throws up — but not Mildred. She is fascinated by this “revolutionary” treatment and takes a mental note of how exactly it is performed, should she ever need to use it.
During this time, lesbianism was also considered a mental illness, meaning various women in the mental hospital are met with torturous treatment to soothe their “uncontrollable nervous impulses.” On the outside, women like Gwendolyn Briggs (Cynthia Nixon), secretary to Governor Willburn (Vincent D’Onofrio), are forced to conceal their true identity or face being judged or sent to the funny farm. Gwendolyn works to convince Mildred to embrace her identity, as the pair become romantically involved. Paulson and Nixon, who are both dating women in real life, evoke warm and inviting chemistry, making us invested in their story. Executive producer Alexis Martin Woodall said the series is about many things — women, mental health, war — but it’s “also about marginalized groups and how we can better help communities early on.”
When Governor Willburn says, “You’re the guy who runs the loony bin in Lucia,” Hanover retorts back with “I prefer the term psychiatric rehabilitation facility.” Most of the staff, including Hanover, seem to want to genuinely help — even if their methods aren’t conventional or helpful, which is one of the main themes in One Flew Over the Cuckoo’s Nest that the series carries over well. Even Mildred and Huck find it hard to watch certain treatments be carried out, though Nurse Bucket follows instructions with no qualms. As mental health was vastly misunderstood at this time, barbaric methods became commonplace and people did what they thought was right until more research brought forward compassionate understanding and treatment to boot. This setting, however, isn’t new to Murphy or Paulson, who both worked together on American Horror Story: Asylum, which offers a more nightmarish look into mental hospitals.
Visually, Ratched is reminiscent of the Technicolor films from the 50s, where the sets were bright and luxurious, yet often clinical in tone. With Murphy as an executive producer, it’s not surprising to see the highly stylized sets that commonly appear in his work, alongside striking costume design by frequent collaborators Lou Eyrich and Rebecca Guzzi. The whole cast is a treat, too — full of strong characters with an abundance of haunting emotional depth; their words and actions always driving the narrative forward or revealing more about the characters respectively. Murphy’s projects always blend together dark and fun themes for optimal entertainment, which the creative team has achieved seamlessly in more ways than one — bring on the bloody mess!
All in all, Ratched achieves what it set out to do by providing a backstory for one of the most cited female villains in cinematic history — but it actually does more than that. It turns Nurse Ratched into a fully fleshed-out character capable of more things, both good and bad, than her film counterpart. Morally conflicted, Mildred is desperate to right the injustices in her life by any means necessary and her personal journey is thrilling to watch. It is, however, worth separating Fletcher’s rendition from Paulson’s, as Paulson takes the blueprint and makes the character completely her own. Ratched is absolutely full of humanity as the series proves that monsters are not born, they are made.
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