Ratched Ending Explained

This Ratched article contains spoilers.

Netflix’s Ratched, a Ryan Murphy series inspired by the iconic character Nurse Ratched from the film adaptation of One Flew Over the Cuckoo’s Nest, is full of twists and turns. In the final two episodes of the first season (season 2 has already been announced), just about every dynamic on screen changes, leaving the audience with a few cliffhangers, a lot of questions, and a dream sequence for good measure. Let’s dive into what really happened and what it all means for the future of Ratched.

Saving the Hospital

Thanks to an assist from Louise, who works the front desk at the motel, Betsy Bucket gets her hands on the recording of Mildred and the one priest who survived Edmund’s murder spree. She learns Mildred’s secret that Edmund is her brother, and creepily identifies a lobotomy by sound alone. Nurse Bucket suspected Mildred was lying about her qualifications and called the military but was surprised to learn Mildred really did serve as a nurse during the war.

Here’s where it gets interesting, as Mildred swerves toward candor and tells Bucket that while she did serve, she in fact has zero qualifications as a nurse. Mildred also confirms what was previously foreshadowed, that she mercy killed an alarming number of soldiers. It’s still unclear whether they actually needed to be mercy killed, but Mildred was found out and sent home rather than court-martialed, which would have caused embarrassment for all involved.

Mildred and Bucket team up to save the hospital from the governor, who they know (presumably thanks to Gwendolyn) plans to kill their funding, and from Dr. Hanover, who’s becoming more of a liability. (In a flashback, his wife is shown taking him to court for divorce, citing neglect, and taking full custody of their daughter.) The formidable pair got to their heretofore unmentioned wealthy donor with a list of grievances that doesn’t make much of an impression until Mildred pulls out the story of the Osborne amputation mess in the Philippines. Smelling a scandal and a PR nightmare, the donor sides with the women and Mildred suggests that Nurse Bucket serve as interim head of the facility.

Recalling an earlier conversation where Huck sweetly and respectfully asked Mildred out and shared a desire for a greater purpose in life, Mildred insists that Bucket make Huck the head nurse. She points out he lacks the qualifications (he’s not actually a nurse), but as Mildred counters, so does she. It’s worth noting that when Mildred turned down Huck’s offer, she came out to him, a first for her.

Hanover doesn’t take the news well, but belatedly admits to Bucket that he treated her poorly and she didn’t deserve it. He decides that curing the patient Charlotte Wells in Canada, where a friend of his has a practice, will be the key to clearing his good name, so he tries to escape with her, which Mildred allows.

Dr. Hanover’s Demise

Unfortunately, their escape doesn’t last long. As a mixed race couple, the two face increased scrutiny on the road. Hanover hides Charlotte in a closet when police come knocking at his door, and the time trapped in a small, dark space sets off her psychosis. While the police only wanted something minor and quickly leave, Charlotte shifts into her Apollo persona, seeing Hanover as Hitler. She kills him, leaving Charlotte to wake up covered in blood.

Mildred comes to Charlotte’s rescue, putting the shaken woman on a bus and taking care of Hanover. Mildred gives her some money and tells her in a few weeks she might have more to send her. Mildred doesn’t seem concerned with the obvious mental health concerns at play, which one might assume have only been exacerbated by waking up covered in the blood of a person she murdered.

Mildred brings his head, not quite on a platter, to Lenore Osgood, who paid her. She pays Mildred and brings the grotesque trophy to her son, who says this changes nothing. He tells his mother she’ll pay for what she’s done to him, and then a young man, a member of the staff, stabs her through the chest with a pitchfork and then he cries over his mother’s twitching dead body. This makes little sense, but Hanover was right – her son wasn’t cured. Apparently he still likes having someone else live out his fetish with stabbing people, which has clearly only escalated. The joke’s on him, though, because his mother gave half her money to a museum and half to her monkey. He is to be sent to a psychiatric facility. If you’re expecting him and Mildred to end up at the same one, you’ll have to wait for next season to see if we’re stuck with this twerp again.

Trevor Briggs, the lovely gentleman who has served as Gwendolyn’s beard, apologizes for the negative reaction he previously had when Gwendolyn said she wanted to end their relationship. He has since met a guy and he credits her with the courage he now has to be with another man so publicly. She plans to move east, where the governor can’t hurt her reputation, since politics is such a small world and there’s still so much stigma associate with being gay. He tells Gwendolyn he’ll always love her and they part on good terms, perhaps the only pure part of this entire show. 

Edmund Faces the Death Penalty

The final episode picks up a month later, with Louise serving a candy striper who is dressed suspiciously like a nurse, making creepy dolls, and generally terrorizing patients. To Bucket’s credit, she tells her to cut it out. Are there any doctors at this hospital? As Bucket said, “Honestly? Who needs ‘em?”

Gwendolyn and Mildred have spent the previous month playing house and generally having a lovely time, in spite of the fact that Gwendolyn is dying of cancer. Mildred wants to pursue experimental treatments, but Gwendolyn is happy to die in a hacienda with Mildred by her side (Mildred’s a millionaire now, remember?) Neither seems to be working.

Strangely enough, and contrary to her singular driving force for the entire show thus far, Mildred had accepted that Edmund would be put to death. However, the governor suddenly switched California from lethal injection back to the far more barbaric electric chair. He even flipped the switch himself and wouldn’t let anyone intervene when the dying man caught on fire, in a rather ridiculous turn of events that’s meant to help him secure the election.

Gwendolyne and Mildred make a last-ditch effort to plead with the governor for a more humane method of execution, which does not go well. It provides an opportunity for him to figure out that they’re gay and to say a bunch of idiotic things about that fact.

When that plan fails, Gwendolyn and Mildred go to Bucket. With the three women finally all in the know and on the same page, they go with Mildred’s plan to mercy-kill her brother with a lethal dose of sedatives so he won’t have to suffer in the electric chair. Mildred will do it with Huck’s help while Edmund’s out in that ridiculous barn Hanover wanted, since it’s finally finished and Bucket has been allowing Edmund to go for an hour a day; she seems to genuinely think he’s insane and deserves more humane treatment than what the state has in mind for him.

Mildred goes to see Edmund for the last time before the barn. He’s immediately suspicious of the nice meal and asks if it’s laced with poison, which isn’t far off. Mildred gets in some last words, asking her brother why he had to ruin her earlier plan. He tells her he did it for love, meaning Dolly.

One of the nurses lets Bucket know that Charlotte Wells is waiting for her in the lobby. Making matters far more grave, Charlotte thinks she’s Dr. Hanover. Is this how it happens? Does she acquire her new personalities by murdering them? Has she done it before? Does Charlotte truly not know? Does this mean she killed a small child, baby taffy? None of these questions are answered or even really hinted at.

Charlotte demands to see Edmund, his star patient, and when Bucket gets Huck to help sedate her rather than complying, Charlotte shoots Huck in the head, killing him. Charlotte then takes Bucket hostage and beats or kills her way toward Edmund, who locks Bucket in his cell. Confused by Mildred’s earlier actions and someone trying to bust him out and unaware of their newfound friendship, Edmund demands that Bucket tell him Mildred’s real plan, at gunpoint, and she does. He fails to see the merciful angle. Edmund and “Dr Hanover” leave together, with Charlotte telling Edmund about the money she came into thanks to Nurse Ratched, surely another frustration for him. They pass Mildred on the road as they leave.

Mildred Tries to Move On

Flash forward to Mexico in 1950 for what turns out to be a dream sequence, which looks an awful lot like Mildred and Gwendolyn’s daydream from the previous episode. Bucket comes to visit them and they lounge by the pool where she congratulates Gwendolyn on her excellent health (thanks to mistletoe, of all things) and Betsy expresses disbelief and regret about some of the treatments she used to administer, especially the hot and cold baths. When Bucket talks about how wonderful it is in Mexico and that the three of them are having such a good time with no men, Mildred can’t shake that her brother is still out there and won’t be satisfied until he comes after her. She goes back to her room for a book and is surprised by Charlotte and Edmund, who toy with her before Edmund stabs her and then she wakes up screaming in bed next to Gwendolyn, in the same hacienda from the dream.

In the real version of events, much is the same as mistletoe healed Gwendolyn and Bucket visits them but she comes early, makes no mention of regretting treatments, and there’s no women’s empowerment speech on the pool deck. Instead, Gwendolyn reads the paper while they eat, making note of a massacre of seven nurses. Just then, someone on staff brings a phone over with a call for Mildred, which she answers by correctly predicting it’s Edmund, who was sending a message with those murders.

Edmund doesn’t much react to Mildred taking all the wind out of his sails for this creepy call, but she continues to turn it around on him, not only predicting much of what he might say but telling him that he should be afraid of her, that she’s coming after him. On the other end of the line, Edmund hangs up, leaves a gas station, and gets in a car with not only Charlotte, but also Louise from the motel/creepy dolls, and they head out on the open road.