Bromden hides behind a facade in order to survive his everyday life in the ward; this makes him seem more mentally ill than in reality. In chapter one, he is describing his life in a whole and the role that he plays in the hospital. "...and try to foul her equipment up as much as possible by not letting her see my eyes."(4) Bromden continuously compares the ward and the nurse to a machine; everything about the hospital, its tight schedule, the staff, and the monotony are all apart of a bigger machine that relies on precision in the ward. Chief tries to hide from this metaphorical machine by acting deaf and dumb. He prides himself on his 'caginess', or sneakiness, and his ability to sneak around the ward unnoticed. "Hum of black machinery, humming hate and death and other hospital secrets. They don't bother not talking out loud bout their hate secrets when I'm nearby because they think I'm deaf and dumb. Everybody thinks so. I'm cagey enough to fool them that much."(3) He believes that if he keeps this act up he will be safe from the machine, and he will be in on all the secrets, because no one ever hides their secrets from a deaf man; no one thinks they are listening.
Chief Bromden is a six foot seven war vet, and retired football star. He acts dumb and deaf because he truly believes he is weak and small. In the novel, Bromden describes one of his encounters with a young girl in a cotton mill, "...the girls all over the mill went to giggling in their fists. I laughed a little myself, seeing how clever I'd been."(39) This was on a high school football trip to California, he innocently flirted with the girls in the mill, and seemed to be the typical teenage boy; girls and football. This shows that something went wrong later in his life; he does not seem to have been born crazy. His time in the war left him with a strong case of PTSD (post traumatic stress disorder). He suffers from this especially painfully when he is being shaved. "I hold back the yelling. I hold back till they get to my temples. I'm not sure it's one of those substitute machines and not a shaver till it gets to my temples; then I can't hold back. It's not a willpower thing when they get to my temples." (7) He has a really tough time when they are shaving him because it triggers something that deals with his PTSD. The hospital does not recognize that this is the case; they brush it off as him being difficult. "...why don't we get a good head start on the week by shaving poor Mr. Bromden first this morning, before the after-breakfast rush on the shaving room, and see if we can't avoid some of the-ah-disturbance he tends to cause..."(6) Recognizing that shaving him is something that sets him off could potentially help cure his disorder, but the Big Nurse is too concerned with her schedule and making sure everything runs smoothly.
The way this mental institution is run is on a constant dosage of pills and plenty of observing time for the nurse. Mrs. Ratched runs the ward on such a tight schedule of drugs, group therapies, and waiting time, that she is way more concerned with keeping the schedule than she is with fully treating the patients. Her motives are based on keeping the ward on track by stopping disruptions and less about doing what is right for each individual patient's needs. "On rare occasions some fool might ask what he's being required to swallow."(34) The patients are not allowed to ask what they are taking, they are just expected to take it. Later in the book, Bromden doesn't take his pills before going to sleep and he says, "When you take one of these red pills you don't just go to sleep; you're paralyzed with sleep..."(85) Bromden has to take the red pills because he used to wake up in the middle of the night screaming. The nurse does not mind that he is paralyzed with sleep, as long as he sleeps through the night and does not disturb the rest of the ward.
The hospital in a whole is to blame for Bromden's mental state. He was a normal, functioning human being in his past life, and failure to treat and access his mental issues from the war has put him farther in his metaphorical fog.