Nurse Ratched has such control over the ward that she has made the patients believe that their conditions are much worse than they actually are. The patient's ultimate goal is to leave the hospital mentally stable and healthy, being told that their condition is worse than before only triggers panic. McMurphy is desperate to escape the ward, but he knows the only way out is through Nurse Ratched. He knows she can keep him on the ward for as long as she wants, and he fears it will be a very long time. “Doctor, do I look like a sane man?” (Page 30). McMurphy was made to believe that he was extremely mentally unstable. This forces him to ask his doctor for confirmation. McMurphy doesn't let it show, but he deeply fears that his mental state will worsen during his stay in the ward. Asking the doctor if he thinks he appears sane is McMurphy's way of admitting that he is desperate for a release from the hospital and Nurse Ratched's controlling ways. "You seem to forget, Miss Flinn, that this is an institution for the insane." (Page 19). The way Nurse Ratched addresses the mental institution is reminiscent of her dehumanization of the patients in the ward. sick as if they should be ashamed and punished for something they have no control over. The nurse inflicts pain on those who are mentally ill as a method of treatment. McMurphy, who is originally the most mentally stable patient, is given pain-relieving treatments prescribed by Nurse Ratched. The treatment that Nurse Ratched administers to McMurphy is a punishment for not being in the right state of mind. Since McMurphy's mental state has not yet worsened tremendously, treating the pain only causes him to fight internally.