He observes how Nurse Ratched presides over the sessions with a sly smile painted across her mouth. He sees how she appears to push and pull the patients to her own purpose. In response, he disrupts group therapy sessions by playing with a deck of cards; he stares at Nurse Ratched, and a silent challenge passes between the two. McMurphy not only challenges Nurse Ratched for her authority, but he also enjoys trying to break down those who control others.
From his first day on the ward, McMurphy questions the music and the medication that the hospital forces upon the inmates. When McMurphy enters the nurse's station and tries to turn down the music, Nurse Ratched reprimands him, all the while talking down to him in a slow, patronizing tone. Having been repeatedly incarcerated, McMurphy is used to being told what to do, but he is not used to being treated as if he is crazy. Although he is trying to pass some time hiding in a mental hospital, he is unwilling to give up control over himself as all the other patients have. Next, he asks about the purpose of his medication. He is informed that it is good for him and that he has to take it, as if he is a small child. When he refuses, Nurse Ratched suggests that if he will not take it orally, then she will just have to administer it another way. Here the nurse tries to snip his balls off in a way that she seems to have already mastered with the other patients. She uses her ultimate authority by threatening to humiliate him, insinuating that the medication will be administered anally. The threat works: McMurphy takes his medication, but spits it out when out of sight of the nurse's station. Another patient, Harding, seems outraged and lectures McMurphy on his lack of sensible behavior. McMurphy mimics the other patients' fear: "Oooh, oooh, God almighty, she's got you guys coming and going. What do you think she is? Some kind of champ or something? " He chooses to show the other patients how impervious he is to the control exerted over all of them by making a bet.
