Sarah Paulson rewrites an iconic character anew with Ratched. The latest series in the Ryan Murphy televisual universe gives the sociopathic nurse an origin story. Louise Fletcher won an Oscar for her chilling turn as Mildred Ratched in One Flew Over the Cuckoo’s Nest and Paulson deserves an Emmy for interpreting the character with playfully beguiling menace. Created by Evan Romansky and Murphy with writing credits for Hollywood’s Ian Brennan and American Horror Story’s Jennifer Salt, the series should delight genre fans and cinephiles. Purists needn’t worry since Ratched merely uses the character from Ken Kesey’s novel and Milos Forman’s film as a springboard. Little relates this work to prior ones aside from the character’s name. This Nurse Ratched is something altogether fresh. She’s twice as sick and twisted as Fletcher’s hardened version, yet twice as humane. Ratched makes audiences privy to the creation of a monster.
When Mildred Ratched first appears, she asserts herself the polar opposite of Fletcher’s drab and sexless nurse. Paulson’s Ratched sports a signature style of frumpy chic. She can turn a head, but disapproves of the looks. Her weird handle on her sexuality unfolds throughout the eight-episode arc, which delivers some of the kinkiest shit ever to stream on Netflix. Ratched is a family affair with Mildred pursuing a violent offender, Edmund Tolleson (Finn Wittrock), who himself institutionalised after he butchers several priests. Envisioning herself the angel of mercy, Mildred finagles a job at the local nuthouse and asserts herself as Edmund’s keeper.
Playing Doctor
Somewhat staying true to the spirit of Cuckoo’s Nest, the doctors and staff at Lucia State Hospital are mostly bonkers. The chief psychiatrist, Dr. Hanover (Jon Jon Briones) is a dope fiend with a shady past. His chief nurse, Betsy Bucket (a deliciously bitchy Judy Davis) gets off on her authority and clearly wants Dr. Hanover to call her in the morning.
The seaside town in this part of Northern California is equally shady. Mildred’s lodging looks like a franchise location for the Bates Motel run by Norman’s crazy sister (Amanda Plummer). Throw in Corey Stoll as a virile private dick with a thing for Mildred, and a delightfully wicked Sharon Stone as a socialite with both a chip and monkey on her shoulder, and there are at least two baddies vying to make Dr. Hanover squirm when Mildred needs him to save her beloved Edmund. The only beacon of sanity is Gwendolyn Briggs (Cynthia Nixon), the press secretary to the boorish state governor (Vincent D’Onofrio) who sees Lucia as a prime item for his re-election. Or, possibly, her ticket to the loony bin.
The plot of Ratched is as sensationally ludicrous as it sounds, but it works. The eight episodes of Ratched’s first season (of a possible four) contain twist upon twist. Each wheel in the machine services its purpose, though, craftily turning one another as fates align. The bodies pile up quickly and the blood spatters the carpets for a gruesomely bloody affair. One can’t unpack the story too much without giving things away. Major characters appear late in the season, like Sophie Okonedo’s Charlotte Wells, a patient with multiple personality disorder who might be Hanover’s salvation. Okonedo’s performance turns Ratched on its head as she ignites true fury into her mercurial role.
Queering the Sexless Nurse
The story can’t fully explode, moreover, until the audience gets inside Mildred Ratched. The series understands the machinery of an origins tale as Mildred’s backstory unfolds in tandem with the forward motion of the plot. Her work at the hospital sees her struggle with her sadistic streak and her compassionate heart. Antagonising Nurse Bucket becomes a favourite pastime with usurping her being the final prize.

Mildred is a stickler for professionalism, however, just as she is in Cuckoo’s Nest. (Albeit on her own terms.) She recognizes the inhumane treatment at the heart of psychological care circa 1947. As she witnesses the cruelty of certain treatments, she sees something of herself in the patients. Most notably, when Dr. Hanover seeks to cure homosexuality by boiling patients alive and throwing them into ice-filled waters, Mildred stands her ground. Ratched proves itself more productively political than some of Murphy’s previous works, which generally draw the line at idealistic revisionist history. Ratched underscores the fight for LGBTQ rights with an unlikely hero at a time when they’re threatened by a different monster. Mildred knows that being gay isn’t an aversion or malady, because she reads the symptoms. The feelings she has for Gwendolyn might be new, but Mildred knows they aren’t deviant.
Murphy again queers Hollywood history by casting Paulson and Nixon at the heart of the affair. The actors bring their own star personas and activist voices to the characters. The show has an extra layer of urgency as it confront violent acts through a graphically violent plot, exploring how Hollywood sensationalizes one kind of violence when society normalises another. One might prefer the stone-faced and subdued menace of Fletcher’s character, but the mercurial nature to Paulson’s Ratched gives the show its spark. As much as Ratched is about the evolution of a monster, it’s about the hardening of a young woman as she develops her capacity for meanness. There are grand splashes of Mildred’s villainy, though, which Paulson relishes each time Ratched roams the halls of Lucia with the camera trained on her icy stare.
Cinematic Stew
This Mildred Ratched is Cuckoo by way of Douglas Sirk, Brian De Palma, and Alfred Hitchcock. Split screens, direct stares, buxom blondes, and sensationally gorgeous curtains situate Ratched in the handiwork of film icons. Ratched’s point of reference is film history rather than one book or movie. Throw those names into an homage stew and the chef could only be Ryan Murphy. The series is a melodramatic feast for the senses with grand production design, eye-popping costumes, and off-kilter musical overtures.
The series situates Mildred’s place in film history while paying tribute to other psychopaths and cinematic icons. The relationship between Mildred and Edmund, for example, is straight-up Clarice Starling and Hannibal Lecter. Ratched evokes this allusion through the familiar staging of Edmund’s cell and the intimate quid pro quo they entertain. (The signature Dr. Lecter mask naturally makes an appearance, too.) There are overtones of Bonnie and Clyde in one episode and a direct shot citation the next. The set design, moreover, makes Lucia look like Manderlay—a dizzying, dazzling five-star estate rife with ghosts and demons.
Ratcheting Up Mildred Ratched
As an avowed fan of Fletcher’s performance in One Flew Over the Cuckoo’s Nest, this review must finally confront the elephant in the room. Paulson’s performance is even better. There’s just more to work with in eight hour-long episodes than in one two-hour film. Paulson’s Mildred is a shape-shifting witch. She wrestles with internalised venom, repressed desire, and past trauma. However, there are also flickers of light as Mildred rationalises her awful deeds with good intentions. Mildred isn’t sure who she is yet as Ratched unfolds fifteen years before the story of Cuckoo’s Nest. Ratched is to Cuckoo’s Nest what Todd Haynes’s remake of Mildred Pierce is to Michael Curtiz’s original film. It’s an altogether different interpretation, which lets an old favourite keep its ground in its own right, while letting a new spin open up different textures of a familiar tale.