Ratched Review (Spoiler-Free)

This Ratched review contains no spoilers.

In dramatic lighting and with lush period costumes, Ryan Murphy’s Ratched tells a sordid backstory of Mildred Ratched, the militant, unfeeling nurse made famous in the film One Flew Over the Cuckoo’s Nest. Ryan Murphy’s take on Nurse Ratched was always going to be bombastic and campy, and with a shorter episode count and tighter runtimes, unraveling her aim and getting inside her head could have been a thrilling game. But instead of deliciously wild, it reads like a failed high-budget parody of a Ryan Murphy show. Almost every editorial choice, from the radio play-esque musical cues to the use of splitscreen is ham-fistedly overblown, as if yelling at the audience “Here! Look here! This is important!”

Sarah Paulson owns this star vehicle, and Ratched, which was written almost entirely by Evan Romansky, owes much of what works to her performance. Starting in 1947, well over a decade before Cuckoo’s Nest takes place, the show introduces us to a warmer, younger Ratched, one who insists on being called Mildred, but is nevertheless full of secrets. Paulson particularly excels at showing Mildred’s many conflicting goals with the slightest change of expression. 

Mildred comes to work for Dr. Hanover (Jon Jon Briones), an esteemed but shifty man dodging the amorous aims of his head nurse, Nurse Betsy Bucket (Judy Davis, who starts strident but becomes more fun to watch as things go.) Their facility houses chameleon-esque accused murderer Edmund Tolleson (Finn Wittrock), among other, far less dangerous patients. Cynthia Nixon makes a welcome turn as gay press secretary Gwendolyn Briggs, responsible for any real political finesse from the incompetent misogynist governor (Vincent D’Onofrio). Sharon Stone assumes the Jessica Lange role, playing Lenore Osgood, a rich lady with a monkey who has a score to settle with Dr. Hanover. 

The rare look at undercover queer life in the 1940s is measured, quiet, and warm, especially when it centers around Gwendolyn and her trips to a lesbian bar hideaway or a restaurant where no one will look askance at one woman feeding another oysters. There’s also a chilling but all-too-real take on the early days of conversion therapy, before it was even called that, with the physically dangerous ice bath (though substantiating the boiling bath proved difficult.) 

Choices so big they strain credulity – like a dance between staff and patients, or staff committing homicide several times in the first few episodes – undercut the brutal reality of the American mental health care system of the time. Casual viewers would be forgiven for thinking a medical procedure involving taking an instrument that looks like an ice pick to the brain is as fictitious as a doctor sewing another man’s limbs onto a patient in a hotel room. Sadly, they would be wrong. But so many of the story choices of Ratched serve only to bring viewers to that incorrect conclusion. 

A patient (an arresting Sophie Okonedo) does the TV-version of multiple personality disorder where she changes from one increasingly bombastic manic persona to the next at the drop of a hat. It’s well-acted, in the sense that I’m sure this is exactly what Murphy as show creator (and occasional director, but not writer) was looking for and impossible to stop watching. We see something of range, from a timid adult woman to a baby voice to running around the room screaming. All the same, it feels like low hanging fruit. A depiction as well-trod as it is inaccurate, it’s hard to consider its merits outside of their real world and narrative implications. Given the lazy inaccuracy of it, one has to wonder, are Murphy and Romansky kidding themselves that they’re actually critiquing the system here? 

The one theme Ratched carries over well from Cuckoo’s Nest is the way Mildred uses subtle shame to control people, to the extent that most don’t even realize they’re being controlled. It’s how she kept her iron grip on the facility in the film, humiliating everyone from patients to orderlies, and here it’s how she insinuates herself into all manner of situations where she does not rightly belong. One wonders what a Ratched that leaned on the origins of this psychology and dropped the murder, mayhem, and emerald green lighting would look like. 

Ratched pursues, at every juncture, the most salacious version of the story, while also managing a plodding season where viewers will feel every minute of each episode as it passes. Rather than an indictment of the mental health care system, Murphy plays both sides up the middle, taking every opportunity to show patients dripping saliva, playing up the idea of people with mental health issues as deranged and a burden. The ableism, as the kids say, jumps out, but here it’s no exaggeration – a musical cue is played when someone is revealed to be an amputee. An orderly with a facial disfigurement (Teen Wolf’s Charlie Carver as Huck) is used to scare Mildred – and the audience – in an early episode. 

It’s too bad, because the most effective horror doesn’t come from the green lighting and Finn Wittrock brandishing a knife to dramatic musical cues. It’s watching a man lobotomize four people with an eager audience, all excited to see the latest innovation in science. It’s the sinking knowledge that yes, the ice pick lobotomy is real, even if Dr. Hanover isn’t, and it was practiced on approximately 50,000 in the US – and more worldwide. 

Rather than a character-driven exploration of how the cold, ridged nurse we love to hate came to be, like Aunt Lydia’s backstory episode on Handmaid’s Tale, Murphy and Romansky deliver an over the top fever dream so cartoonish it robs itself of its best moments. Horror by way of a Stepford Wife with a medical degree is all the more unsettling for its realism than unsanctioned brain surgery in hotel rooms and inducing people to suicide. For all the impressive performances and gorgeous costuming, Ratched manages to be unsatisfying, rather than either substantive or a guilty pleasure.