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In Chapter Eight, McMurphy exposes some of the ward's inane policies. He realizes ways in which the ward impedes a person's ability to make rational decisions. Even deciding when to brush one’s teeth is no longer a choice for the ward residents. The boy’s response invokes, hilariously, the chaos that would ensue if people brushed their teeth willy-nilly. Such arguments are the irrational arguments of control for control’s sake; all too often, an authority figure has no good reason for a rule and can only try to scare off the inquirer by invoking an impossible, extreme case.
Ratched is not interested in working with McMurphy to change anything. In rejecting his requests, she demonstrates her dominance over him and refuses to empower him. Her interest is not in the patients but in perpetuating her own sense of control, as shown by her apparent dislike of any idea that is not her own. Once McMurphy finds that his proposals will be immediately dismissed, he manipulates the system by using Dr. Spivey. Nurse Ratched is of course infuriated by what it means that Dr. Spivey can talk separately with McMurphy and work with him to make decisions for the ward. This more subtle uprising, the passive-aggressiveness that McMurphy succeeds with, opens a crack in her steel facade. He is winning at the system that Nurse Ratched has been an expert at manipulating against him and the insane people on the ward.