Sarah Paulson plays Nurse Mildred Ratched in Ratched, series creator Evan Romansky's prequel (of sorts) to One Flew Over the Cuckoo's Nest.

One of the most iconic movie villains of all time gets the American Horror Story treatment in Ratched, Netflix's star-studded prequel, of sorts, to Director Milos Forman's Oscar-winning 1975 film, One Flew Over the Cuckoo's Nest. The series is richly styled and visually striking, and the cast is terrific, but there's very little substance or insight, and the plotting is a meandering mess riddled with holes and inconsistent characterizations. It's basically a body horror soap opera in which everything is dialed up to 11 for maximum shock value.

(Spoilers for One Flew Over the Cuckoo's Nest book and film below. Some spoilers for Ratched but no major reveals.)

As I wrote previously, Forman's film is based on the 1962 novel of the same name by Ken Kesey. It's set in a psychiatric hospital in Salem, Oregon, where Randle Patrick McMurphy (Jack Nicholson) is sent after faking insanity to escape a prison farm sentence for assault and the statutory rape of a 15-year-old girl. The cold, rigidly controlled (and controlling) Nurse Mildred Ratched (aka Big Nurse, played by Louise Fletcher) rules the place with an iron hand. She maintains order by withholding basic necessities, medications, or patient privileges—with the occasional bit of hydrotherapy and electroshock therapy for especially unruly patients—but McMurphy's rebellious nature challenges her authority.

Their conflict soon escalates into all-out war after she drives another patient, the emotionally fragile Billy (a young Brad Dourif), to commit suicide. McMurphy nearly strangles her to death in revenge and is lobotomized for his trouble. One of the inmates, Chief (Will Sampson), discovers McMurphy in his now-vegetative state and smothers him with a pillow to end his suffering. As for Nurse Ratched, her injuries render her unable to speak—her most potent weapon in controlling her charges. In addition to winning Oscars for Best Picture, Best Director, and Best Adapted Screenplay, the film also snagged a Best Actress Oscar for Fletcher. The American Film Institute named Nurse Ratched the fifth-greatest villain in film history.

Kesey was a staunch counter-culture figure who was inspired to write One Flew Over the Cuckoo's Nest while working the night shift at a mental institution. Kesey convinced himself that the inmates weren't really insane, just relegated to the institution because their behavior didn't conform with social expectations. That conviction resonates throughout both the novel and Forman's film in the person of McMurphy, an unapologetic agent of chaos, although Nicholson's McMurphy begins to have doubts as consequences begin to pile up.

I'm generally a fan of classic films, but I've never liked Forman's Cuckoo's Nest. Its themes haven't aged particularly well, I found McMurphy to be an obnoxious character, and the deep-seated misogyny has always rankled. (It's a men's ward, ruled by a frigid, controlling woman to symbolize the "Establishment," with women invariably being blamed for the men's issues.) Yes, Nurse Ratched was manipulative and cruel, and patients did suffer under her "care," but her character was little more than a cartoonish straw woman for Kesey's anti-establishment views. She wouldn't crack my top 50 list of best villains in film.

Nonetheless, I was intrigued when news of the Netflix prequel series broke, given its stated goal of fleshing out Nurse Ratched's backstory to (hopefully) give us a sense of the woman behind the 1970s "monster." It's too bad Ratched largely fails in that regard. Other than the name Mildred Ratched and a few very minor details, the series doesn't have anything in common at all with the character as depicted in either Kesey's novel or Forman's film adaptation.

Welcome to Lucia

  • Mildred Ratched (Sarah Paulson) arrives at Lucia State Hospital in northern California, seeking employment as a nurse. Netflix
  • Assessing the lay of the land. Netflix
  • Dr. Richard Hanover (Jon Jon Briones) is initially reluctant to hire her. Netflix
  • Mildred's machinations are successful. Netflix
  • The real reason she came to Lucia: convicted murderer Edmund Tolleson (Finn Wittrock), her long-lost foster-brother. Netflix
  • Judy Davis plays Mildred's arch-rival, Nurse Betsy Bucket. Netflix
  • Huck Finnigan (Charlie Carver) is an orderly who cares deeply about the patients. Netflix
  • Mildred and Nurse Dolly (Alice Englert) man the front desk. Netflix
  • Amanda Plummer plays Louise, the eccentric manager of a seedy nearby motel. Netflix
  • Charles Wainwright (Corey Stoll) is a man on a secret mission—and an eye for the ladies. Netflix
  • What is Charles' connection to the wealthy socialite Lenore Osgood (Sharon Stone)? Netflix
  • Lenore's son, Henry (Brandon Flynn), is a former patient of Dr. Hanover. Netflix
  • Dr. Hanover seeks to curry favor with Governor George Willburn (Vincent D'Onofrio). Netflix
  • Cynthia Nixon gives an Emmy-worthy performance as Gwendolyn Briggs, the governor's campaign manager. Netflix
  • Sophie Okonedo plays Charlotte Wells, a woman whose past trauma has caused her to develop multiple personalities. Netflix

Kesey never revealed much about Nurse Ratched's background, other than a brief hint that she was deeply scarred by her time spent as an army nurse during World War II. So there was plenty of room for series creator Evan Romansky to creatively fill in the gaps. A recent film school graduate, Romanksy wrote the pilot script on spec, and it soon found its way to Emmy-winning producer Ryan Murphy (Glee, the American Horror Story anthology series), who managed to secure the rights to the character, as well as the screen rights to the film. American Horror Story alum Sarah Paulson signed on for the title role.

Per the official premise:

Ratched is a suspenseful drama series that tells the origin story of asylum nurse Mildred Ratched. In 1947, Mildred arrives in northern California to seek employment at a leading psychiatric hospital where new and unsettling experiments have begun on the human mind. On a clandestine mission, Mildred presents herself as the perfect image of what a dedicated nurse should be, but the wheels are always turning and as she begins to infiltrate the mental health care system and those within it, Mildreds stylish exterior belies a growing darkness that has long been smoldering within, revealing that true monsters are made, not born.

The pilot opens with the brutal murder of five priests (and the simultaneous rape of one of them) by a young man named Edmund Tolleson (Finn Wittrock, The Big Short. American Horror Story), who clearly has a few issues with the Catholic Church. Only Father Andrews (Hunter Parrish, Weeds) survives, a key witness for the prosecution. Facing the death penalty, Edmund is sent to Lucia State Hospital, a mental institution in Northern California run by Dr. Richard Hanover (Jon Jon Briones, American Horror Story: Apocalypse). That's when Mildred Ratched (Paulson) shows up and manipulates her way into joining the nursing staff.

We soon learn that Edmund is Mildred's long-lost foster-brother, and she is determined to thwart the execution plans by any means necessary. Let's just say that her introduction to the lobotomy during one of Dr. Hanover's demonstrations comes in quite handy. She clashes immediately with the head nurse, Betsy Bucket (Judy Davis, Barton Fink), and finds an ally in Huck (Charlie Carver, The Leftovers), a kind-hearted orderly with a disfigured face. Her place at Lucia is solidified when she wins the favor of Governor George Willburn (Vincent D'Onofrio, Daredevil), who decides to make the hospital a centerpiece of his re-election campaign on the advice of his campaign manager, Gwendolyn Briggs (Cynthia Nixon, Sex and the City).

Body horrors

  • Mildred and Nurse Bucket face off over a peach. Netflix
  • Sedating a patient in advance of the governor's visit. Netflix
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