One Flew Over the Cuckoo's Nest

What does McMurphy's "haggard, puzzled look" indicate about the evolution of his character?

One flew over the cuckoos nest

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McMurphy notices Sefelt’s seizure. He understands that there is no way out for these guys. The EST gives them seizures and the medicine for them has its own nasty side effects. As McMurphy looks upon the pathetic Sefelt, "His (own) face has commenced to take on that same haggard, puzzled look of pressure that the face on the floor has.”