Bromden says that Nurse Ratched can set the wall clock at whatever speed she chooses just by turning a dial in the door. She generally slows time down to keep the patients at her mercy. Meanwhile, the speakers on the ceiling are playing music loudly, so McMurphy complains to Harding, who explains that they hear music nearly all the time, but never the news because the news might not be therapeutic. McMurphy goes into the Nurses' Station to complain, and one of the nurses, Miss Pilbow, tells him to stay back, apparently because she is a Catholic and may have heard that McMurphy is a sex maniac. He merely picks up a watering can that the nurse dropped. Soon after, McMurphy realizes that Bromden is not deaf, for Bromden jumps whenever McMurphy claims that one of the boys is coming for him.
For the first time in a long while, Chief Bromden goes to sleep without taking the little red capsule, which normally makes him fall into a heavy slumber. That night, Chief Bromden dreams for the first time in a while. In the dream, he sees the workers lifting Blastic, one of the Vegetables, onto a hook and slicing him open with a scalpel. No blood comes out, only glass, rust, and ashes, the contents of a broken machine. Bromden thinks of waking up everyone, but he thinks that the workers would do the same to him. Mr. Turkle pulls Bromden out of the fog, telling him that he was having a bad dream.
The next morning, McMurphy is awake early, singing. Most of the people on the ward floor have not heard singing in years. Bromden wonders why the black boys allow such loud noise, but he soon realizes that McMurphy is different. He may be as vulnerable as the rest in the ward, but the Combine has not gotten to him. McMurphy asks for toothpaste to brush his teeth, but a boy tells him that it is ward policy to have the toothpaste locked up and only used at a certain time. McMurphy mocks the boy’s question, "What would it be like if everybody was to brush their teeth whenever they felt like it?" Nurse Ratched arrives, and the boy tells her that Blastic died the night before and that McMurphy has been confrontational. Then she hears McMurphy singing. He steps out of the shower in a towel and stands in front of her. She tells him he cannot run around in a towel, and he prepares to drop it, telling her that someone stole his clothes. She chastises Mr. Washington, one of the boys, and orders him to get McMurphy a new set of clothes.
McMurphy clowns around during breakfast, embarrassing Billy Bibbit by claiming that Billy is known as "Billy Club" Bibbit of the famous fourteen inches. McMurphy bets the other patients that he can fling a dab of butter into the center of the face of the clock. He misses, but the butter slides down to the clock, hitting the face.
McMurphy complains to Nurse Ratched about the loud music in the hall, but she retorts that he is being selfish, for older men could not hear the radio at all if it were at a lower volume, and the music is all that they have. McMurphy suggests that patients be allowed to take their card games someplace else, such as the room where the tables are stored, but she replies that they do not have adequate personnel for two separate day rooms.
McMurphy has an interview with the doctor. During the daily meeting, the doctor tells the patients that he and McMurphy went to the same high school, and they reminisced about their school's carnivals. He suggests a similar carnival for the ward. The patients reluctantly take to this idea. Nurse Ratched tells the doctor that an idea like this should be discussed in a staff meeting first. Dr. Spivey also mentions that McMurphy was concerned that the older fellows could not hear the radio. Since the younger men have complained about the noise, McMurphy suggests opening a second day room as a game room—the plan that Nurse Ratched recently shot down. Dr. Spivey believes that there is sufficient staff to cover two rooms. When they return to the normal business of the meeting, Nurse Ratched's hands seem to shake. Chief Bromden thinks that this is a sign of her terrible weakness, though he realizes she has the Combine at her disposal to silence the opposition.
In Chapter Six, Chief Bromden's suggestion that Nurse Ratched can control the clocks at the ward reveals his paranoia. At the same time, his suggestion provides a sense of the thoroughness with which Nurse Ratched has enacted her domination. Controlling time in this way seems entirely consistent with her controlling character.
Harding continues to serve the plot by providing exposition, explaining to McMurphy the routines and tenets of the ward, including the loud music.
This chapter also highlights the contrast between McMurphy and Nurse Ratched in terms of sexuality. In his confrontation with Nurse Pilbow, McMurphy represents a dangerous sexuality, the opposite of the passionless and repressed Nurse Ratched.
Chief Bromden’s dream in Chapter Seven presents his fear that all the men in the ward are turning into mechanized vegetables, losing their capacity to feel, to live, and ultimately to rediscover their own souls. Rather than helping them, their stay at the hospital is slowly obliterating everything inside of them and replacing it with machine-like deadness. At the same time, the Chief still seems unreliable as a narrator in that he is apt to completely lose track of reality at the slightest trigger. He normally does not dream because of the pills that plunge him into heavy slumbers. Now, however, with the opportunity to dream, his subconscious is unleashed, and while this nightmare is not so different from those of sane people, his reaction suggests that he is in another fog. Perhaps he senses that he has reached a critical point where he either must fight back to lucidity or surrender to the fate of Blastic. McMurphy will be pivotal in helping Chief Bromden choose to start recovering.
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.
Chief Bromden perceives that McMurphy is different from the other characters. Bromden’s way of expressing this is to say that McMurphy has not been transformed by the Combine. McMurphy's antisocial history may play a large part in this assessment; he has not yet had the experience of drudge work and responsibility to subdue him. This puts him in substantial contrast to Harding, whose sense of responsibility plays a large role in his psychoses.
The confrontation between Nurse Ratched and McMurphy has clear sexual undertones. Indeed, one of the major themes of the novel involves the contrast between liberated and repressed sexuality. By appearing in front of Nurse Ratched wearing only a towel—and threatening to lose even that—McMurphy confronts her with the prospect of forbidden nakedness. In their final major confrontation, it will be Ratched whose nakedness is exposed against all propriety and at the hands of McMurphy. The fact that McMurphy is actually wearing boxer shorts reveals that he is playing a game with Ratched and figures correctly that she is vulnerable to his charms or at least to his threats of startling activity. Significantly, this is the first moment at which Nurse Ratched shows any strain or tension. McMurphy thus begins to find a place for a wedge and make Big Nurse crack, in line with the bet that he made with other patients.
Although One Flew Over the Cuckoo's Nest can be construed as a parable pitting the counterculture (McMurphy) against the establishment (Ratched), McMurphy is too complex to be set up merely as a metaphor. If McMurphy is a challenge to the establishment, he also attempts to work within it. Dr. Spivey has power in the ward that McMurphy hopes to redirect against Ratched and in favor of McMurphy’s desires and the needs of the men. His request in Chapter Nine to have the music volume lowered is also an acknowledgment of Ratched’s power, and the request is both rational and diplomatic. Similarly, his counterproposal to open the tub room as a game room for the patients also seems appropriate.
Nurse Ratched seems less complex. True to her controlling character, she 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.
Nevertheless, Chief Bromden emphasizes that no matter what McMurphy gains, his struggles are inevitably in vain. Ultimately, Nurse Ratched has the power of the Combine, a social sanction for any punishment the institution has at its disposal against those who rebel. Ratched has many cards left to play.