‘Ratched’: Unpacking the Violence and Homophobia in Psychiatric Hospitals

*This article contains spoilers for the Netflix series ‘Ratched’.*

‘Ratched‘ is the most disturbing web series I have watched in 2020. Streaming on Netflix, it is named after Nurse Mildred Ratched (Sarah Paulson) who mysteriously appears at Lucia State Hospital in northern California and gets hired by Dr Richard Hanover (Jon Jon Briones). He claims to ‘cure’ lesbianism through lobotomy and hydrotherapy. The series was written by Evan Romansky, Ian Brennan and Jennifer Salt, and developed by Ryan Murphy. It is based on a fictional character from Ken Kesey’s novel ‘One Flew Over the Cuckoo’s Nest‘ (1962).

Set in 1947, the series plays out as a psychological thriller as well as a lesbian love story. Nurse Ratched falls in love with Gwendolyn Briggs (Cynthia Nixon), who is a press secretary and campaign manager employed by Governor George Wilburn (Vincent D’Onofrio). Their courtship is far from smooth. Nurse Ratched struggles with internalised homophobia in a psychiatric hospital that deems homosexuality a mental disorder, whereas Mrs Briggs is in a ‘lavender marriage‘ with a gay man named Trevor Briggs (Michael Benjamin Washington).

Mildred Ratched and Gwendolyn Briggs, a still from ‘Ratched’ Source: @ratchednetflix on Instagram

Dr Hanover is keen on getting funds for research, and Governor Wilburn wants media publicity in exchange for his monetary support to the hospital. What looks like a win-win situation to them is a nightmare for the patients because the lobotomy becomes a semi-public spectacle. The operation theatre looks more like an auditorium because it is filled with observers. Nurse Ratched merely informs the patients instead of seeking their consent. “Just some government officials and a reporter…nothing for you to concern yourselves with,” she says.

When Lily Cartwright (Annie Starke), a patient undergoing treatment for lesbianism, mentions that she “was hoping that the details of my condition would remain confidential,” Nurse Ratched shows no empathy. She knows that Mrs Cartwright is deeply uncomfortable, and could do with some understanding and support, but Nurse Ratched is ruthless and condescending. She disregards the request for privacy, humiliating Mrs Cartwright in front of other patients. “What? That you’re a lesbian? That much is plain. It’s made obvious by your facial structure,” she says.

It is also painful to hear Dr Hanover speak of the lobotomy as a performance and to watch him execute the surgical procedure. After announcing “I present to you the lobotomy,” he goes on to explain that “the brain’s frontal lobe is the seed of its neuroses.” According to him, “juvenile distraction, mania, memory loss, lesbianism” are maladies that “can be subdued, if not reversed by surgically disrupting a series of neural connections in the brain’s white matter.” As he works on them using a hand drill, patients are mildly sedated but no anaesthesia is administered.

Dr Hanover instructs the observers to sit back and relax as they witness the procedure, almost as if he were inviting them to enjoy a concert or watch a play. He seems to care little about the dignity of his patients, and entirely about demonstrating his genius. He is assisted by Nurse Betsy Bucket (Judy Davis). As Dr Hanover proceeds with the task at hand, sounds of gasping can be heard from the audience. One of them faints. Nurse Ratched shows almost no sign of emotion; she tries to maintain composure. Mrs Briggs, on the other hand, can be seen cringing.

Mrs Cartwright is one of the four patients being lobotomised at the hospital. Ingrid Blix (Harriet Sansom Harris) is being treated for melancholia, Len Bronley (Joseph Marcell) for memory loss, and Peter (Teo Briones) for daydreaming — all using the same procedure. The portrayal of institutional violence in this series can be extremely triggering, so viewers must exercise discretion especially if they have been shamed for their sexual orientation and their families have sent them to psychiatrists who promise to ‘cure’ them of supposedly deviant behaviour.

In their essay ‘Clinical Legacies and Counter-Narratives‘ (2020) for the journal ReFrame, Amalina Kohli Dave and Raj Mariwala write, “On the basis of social norms, psychiatry solidified the creation of a normal/abnormal, which is what many experience as stigma today. Psychiatry also enabled the idea of segregation as safety for communities and societies…the idea of earmarking space for the containment of distress saw both public and private institutions providing treatment or incarceration of those deemed ‘insane’ or unmanageable by their families.”

Mrs Briggs hopes that Nurse Ratched would be open to her advances despite the fact that she works for Dr Hanover. She invites her new love interest to a long drive and an oyster bar without explicitly calling it a date. Nurse Ratched accepts the offer. At the oyster bar, Mrs Briggs asks, “So you believe in it, the lobotomy?”, Nurse Ratched replies, “A disordered mind cannot ease its own suffering. A person can be burdened by certain impulses and drives that are destroying their lives.” This is not what Mrs Briggs wanted to hear. She probes further.

Mrs Briggs asks, “But then, aren’t we playing God? Aren’t we saying there’s one feeling that’s right and another feeling that’s wrong?”, Nurse Ratched does not mull over this thought. She has convinced herself that Dr Hanover is on the right track. She says, “Well, there are rights and there are wrongs, Mrs Briggs. I believe that. I believe it because I’ve seen it. I believe there are some things that are worse to feel than simply feeling nothing.” Despite this disagreement, Nurse Ratched is having a good time. She agrees when Mrs Briggs invites her for a drink.

The drive seems too long, so Nurse Ratched gets impatient. She wonders where she is being taken, and if Mrs Briggs is certain of the route. “Oh, it’s just a little hole in the wall. Relax. It’s an adventure, remember?”, she says. When they reach the dive bar, Nurse Ratched realises that it is a place for lesbian women. She responds with anger and pointedly asks Mrs Briggs to explain why she brought her there. “Because I thought you were one of us”, comes the reply. This brings on further distress, and Nurse Ratched wants to know what gave her that impression.

She asks Mrs Briggs, “Aren’t you married?”. This is a rhetorical question. Nurse Ratched is feeling disoriented. She does not know what to make of the fact that Ms Briggs desires women but is married to a man. “Look, I’m sorry. I’m sorry if I made an assumption. It seemed quite clear to me what was going on between us but I understand if that’s something you are not ready to face yet”, says Mrs Briggs. This is deeply offensive for Nurse Ratched. She does not like being told that she is closeted and unwilling to accept the truth about herself. She walks out.

Later, in the series, Nurse Ratched mistakenly walks right into a moment of sexual intimacy between Mrs Cartwright and Miss Blix. She reports this incident to Dr Hanover. He, in turn, summons Nurse Bucket, and says, “The sodomy is alarming for two reasons. The lobotomy has clearly failed to cure the primary complaint of one patient and seeing as how I am not aware of Miss Blix displaying lesbian proclivities before, the procedure may have actually triggered deviant sexual behaviour in the other.” He wants to try hydrotherapy as an alternative treatment.

Nurse Bucket is attracted to her boss and hopes that he would reciprocate. In order to please him, she takes it upon herself to administer the protocols Dr Hanover has written up. When Nurse Ratched is sent over to bring Mrs Cartwright to the shower room, the latter is reading Walt Whitman’s ‘Leaves of Grass‘. Confiscating it, Nurse Ratched says, “Sexually explicit material is hardly appropriate for someone with your specific malady, Mrs Cartwright. This book is not allowed. Homosexual is what Walt Whitman was. Let’s get our minds out of the gutter.”

The indictment of her reading choices is a metaphor for the judgemental gaze that psychiatric institutions subject their patients to. Though she is at a hospital, which is known for scientific procedures, the manner in which she is treated is akin to moral policing and banishment by religious organisations that consider homosexuality a sin. Mrs Cartwright is boiled in hot water for 20 minutes, and thrown into an ice bath for five minutes immediately after that. Nurse Ratched cannot bear to see her in pain but Nurse Bucket dismisses the appeal to discontinue.

In her paper ‘Curative Violence Against LGBT+ People in India: Key Issues and Perspectives‘ (2020) for the R. Rajaram GRIT Research Fellowship, Suchaita Tenneti writes about “efforts to eliminate queerness or to suppress its expression through a range of interventions including medication, electroconvulsive ‘therapy’, hormone administration, physical assault, enforced dress codes, confinement within the home, corrective rape, and several others.” Unfortunately, these interventions are carried out in hospitals that should be safe, affirming, healing spaces.

Beneath Nurse Ratched’s tough exterior lies a history of childhood trauma as well as a mission to secure the well-being of her foster brother Edmund Tolleson (Finn Wittrock), who has been found guilty of murder and pronounced mentally unstable. He is held in underground captivity within the same hospital and kept isolated from other patients. Nurse Ratched shows no kindness to anyone other than him until she is moved by Mrs Cartwright’s suffering, and conspires with the orderly Huck Finnigan (Charlie Carver) to defy Nurse Bucket.

The compassion that arises within Nurse Ratched is linked to a growing acceptance of her own sexuality though she is not ready to articulate that yet. She refuses to let Miss Blix face the horrendous treatment that Mrs Cartwright was put through. Miss Blix says, “All my life, I have been fighting this thing inside of me. I couldn’t tell anyone, not even my doctors. Until finally, it drove me mad. I have pushed the true Ingrid down but all the time I could feel her digging her class into my skin, begging to be let out.” Nurse Ratched has tears in her eyes.

Finnigan is a war veteran. He must have seen a lot of violence during his career but he too finds hydrotherapy “barbaric.” He does not back down even when Nurse Bucket threatens to get him fired for insubordination. Nurse Ratched and Finnigan manage to sneak out Mrs Cartwright and Miss Blix from the hospital into a car. Nurse Ratched hands him some petty cash and asks him to put Mrs Cartwright and Miss Blix “on whichever train is going farthest.” Miss Blix wonders why she is doing this. Nurse Ratched says, “You said I didn’t understand but I do.”

After helping the lesbian couple escape from the hospital, Nurse Ratched aspires to a life of freedom for herself. She invites the press secretary, who has now left her husband, to go out with her to a restaurant. They have a lot to resolve because Nurse Ratched has built a tangled web of lies and secrets to protect herself and her brother but she wants to be honest. She says, “My feelings for you are the truest thing in me. I love you.” Their story is far from over. Fortunately, the creators of the series have already announced a second season.

While this series is extremely intense, it can sensitise mental health professionals towards the harm their predecessors have caused by pathologising LGBTQIA+ individuals and communities. It is heartening to know that some professionals identify themselves as queer-friendly or queer affirmative, and commit to practising in ways that minimise harm, but that may not be enough. Cultivating relationships of trust can take time. Allyship is not a crown to be worn or a publicity gimmick to encash; it requires an ongoing willingness to learn and unlearn.

Chintan Girish Modi is a writer, educator and researcher who tweets @chintan_connect.

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