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One Flew Over the Cuckoo's Nest

1. Discuss how Cuckoo's Nest, written in stream of consciousness for immediacy, is absurdist like The Plague, reflecting counterculture attitudes and the lifestyle of the 1940s and 1950s Beat Generation, seen also in Ker-ouac's On the Road and Wolfe's Acid.

2. Relate Cuckoo's Nest characters to Melville's in Moby Dick and Billy Budd.

3. Political figures: What did Senator Eagleton say about his mental illness that caused him to leave politics, and how did Kitty Dukakis find relief?

4. Drugs, often a godsend in treating mental disorders, also have disastrous side effects. Learn about the Haldol lawsuits and the plaintiffs' claims of being turned into vegetables.

5. Teenagers often forced against their will into mental institutions do not have the rights of an adult. Discuss this hot topic, relating the more progressive measures some states take.

6. Trace the effects of 1) the ability to diagnose mental illness and 2) the establishment of civil rights laws on filling and then emptying mental institutions. Why has there been a return to the mentally ill roaming the streets? Read Dr. John Friedberg's Shock Treatment Is Not Good for Your Brain and Dr. Max Fink's Electroshock: Restoring the Mind to discuss psychiatric battery and involuntary admissions. What is a psychiatric protection order?

7. Psychiatrists monitoring depression also manage communicable diseases. Ratched fumigates the men, for instance. Through shared needles Hepatitis C infects 20 percent with severe mental illness such as depression and schizophrenia, with the standard treatment being alpha interferon, an injection, with ribavirin, a pill, a combination difficult to tolerate. Discuss interrelated aspects.

8. Nobel Prize-winning economist John Nash, a Princeton professor, suffered with the debilitating mental illness schizophrenia. Read and discuss Sylvia Nasar's A Beautiful Mind and compare and contrast it to the movie A Beautiful Mind that has been called a sentimental fairy tale about mental illness. Is Dr. Nash, who is described as having a willpower that controls his symptoms, a typical schizophrenic? Research project: What are the three categories of schizophrenics and what newer medications are effective with fewer side effects?

9. Read Chekhov's "Ward Number Six" and demonstrate how "the norm of reciprocity" (open and free communication—cooperation between doctor and patient; and truth-telling) does not apply in psychiatry, especially in a totalitarian state such as Cuckoo's Nest. Comment on why it is particularly disturbing that some inmates choose voluntarily to be committed.

10. Opponents of the widespread use of Ritalin for ADHD say it kills the creative spark. Thomas Edison, Albert Einstein, Salvador Dali, and Winston Churchill may have had this disorder defined by impulsiveness, daydreaming, and disorder. Discuss.

Note: Cuckoo's Nest is rich in SAT-type words: chronic, pinochle, replica, grievance, prototype, acoustic, matriarchy, maudlin, folio, vulnerable, punitive, hallucinate, and lobotomy.

Possessing the Secret of Joy

Note to teachers: This novel contains mature sexual themes, explicit language, and graphic descriptions, all of which serve to enhance the subject matter, culturally perpetuated female genital mutilation. While Possessing is often taught in 11th and 12th grade, some teachers who do not have school board approval choose to get parental permissions for students under 18. Alternatively, students who are very uncomfortable with reading the text may be assigned the less graphic The Color Purple, also ultimately adding to the conversation.

1. Compare the ubiquitous 1950s tonsillectomy to male circumcision. Is either medically necessary? Cite research.

2. Compare the culturally entrenched habit of smoking to female genital mutilation. The World Health Organization estimates 47 percent of men smoke compared to 12 percent of women, and because tobacco companies market to women and girls in developing countries the Centers for Disease Control and Prevention recommend programs be developed specific to gender warning of the serious health consequences of tobacco use.

3. Compare and contrast the Prime Directive and cultural relativism. According to Star Trek, a television show and a movie, the Prime Directive states it is forbidden for Starfleet to interfere with the normal development of any culture or society, which is more important than the protection of spaceships or members of Starfleet. Losses are tolerated as long as they are necessary to observe this directive. Cultural relativism is a philosophical concept claiming moral rules are customs specific to particular cultures; consequently no moral rules are universal. International human rights advocates reject the primacy of cultural relativism, by its very nature, in dealing with the abolition of slavery, the fundamentalist treatment of women, abuse of children in workshops, and so forth.

4. Walker's new interests include protecting indigenous cultures in their natural environment. How do you do this when you interfere with their traditions?

5. Research birth control methods, including RU-286, and review how they have changed the course of history, comparing their availability in the United States and in Third World countries.

6. For related issues Possessing touches upon, please read and discuss the following:

• Ernest Hemingway, "Hills Like White Elephants" (short story).

• Charlotte Perkins Gilman, The Crux (The Charlotte Perkins Gilman Reader). A woman, who has been denied medical knowledge about transmission, prevention, and so forth almost marries a man with venereal disease. Issues: taboos; doctor-patient confidentiality; and misogyny.

• Perri Klass, "Invasions" in A Not Entirely Benign Procedure.

• Unknown author, "Indian Poem," Lancet 13 (March 1993): 669-72. A mother must decide how to divide her limited resources between her three children: a strong son with no immediate need, a weak son soon to die, and a girl "who is a girl anyway."

7. Read Mirella Ricciardi's lush descriptions in African Saga for a colonist's viewpoint of cultural history, which underscores a tribe's ability to subsist on what it has, and that colonists often exploit natives with no attempt to introduce social and political measures. Note the effects of political change and the seductive safari imagery. Excerpts:

• "The tribes I visited differed greatly from each other, but they all shared one similarity, which I discovered later was very important to the survival of the human race. They had adapted to their environment and did not crave for things beyond their immediate needs. They seemed primitive by our standards, but their simple code of life was built on the basic laws of survival: eating, sleeping and reproducing. They solved their problems in their own ways, and law and order were kept by the elders of the class. Women never questioned their positions as perpet-uators of the tribe and the children grew up naturally, according to the teachings of the elders for generations back" (164).

• "[W]hites in Africa were like an army of occupation, to be tolerated but never accepted" (298).

• "The modern world where all men are to be equal is closing in around us and there is nowhere left to run" (300).

8. For works covering misdiagnosis (misperception of patient experience), psychosomatic disorders, hysteria, and neurasthenia, read Charlotte Perkins Gilman's "The Yellow Wallpaper" and Kate Chopin's The Awakening. Isolate the issues in the works, touching upon the protagonists' relationships to their husbands and the relationships' effects on their well-being. How does this relate to the Andrea Yates case in Houston?

9. Define feminism. Contemplate Pope John Paul II's definition of feminism: "In transforming culture so that it supports life, women occupy a place . . . which is unique and decisive. It depends on them to promote a 'new feminism' which rejects the temptation of imitating models of'male domination'."

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