Nurse Ratched, I always thought, was a fictional character in a psych ward somewhere in Oregon.
But sometimes I wonder if she’s alive, fresh from the pages of One Flew Over the Cuckoo’s Nest, working a second career in Upstate New York.
It’s not that I’ve been subjected to electroconvulsive therapy or a lobotomy per se.
But much like Randle Patrick McMurphy, I’m a changed man.
You see, back in 2007 at Yale New Haven Hospital in New Haven, Connecticut, I was taught a few things.
First, I was supposed to care about patients.
Second, clean blood was a good thing, something to strive for.
And finally, extra salt and water in the body were bad.
But now, in 2026, thanks to Nurse Ratched, I stand corrected.
It turns out that I don’t actually need to care about the patient. As long as I bill for them in a software program called EPIC, I am a good boy.
Clean blood, I’ve learned, is just frankly bullsh*t. The scientists who keep harping on things like urea reduction ratio and phosphorous control should be ignored, especially when they bring up the term survival benefit.
And the salt and water craze, as in trying to remove the surplus, is over. I’ve been educated that breathing doesn’t need to be great—just good enough, even if that requires a ventilator. Edema is fake news, and left heart mass was invented by intellectual sinners.
(Nurse Ratched did mention, however, that if another type of nurse wants to deal with these things, that would be fine.)
In the world of modern medicine, I’m Billy Bibbit, which used to be referred to as Doctor.
Of course, I know better.
Sure, I could pull a Chief Bromden, toss a control panel through a window, and escape to the outside world.
But that was just fiction—and the dialysis unit has no windows.
Because in this nest, Nurse Ratched still reigns supreme.
