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SALEM, Ore. — Nurse Ratched slept here.

The punctiliously cruel psychiatric ward tyrant in the book and movie “One Flew Over the Cuckoo’s Nest” was brought to cinematic life by actress Louise Fletcher during filming at the Oregon State Hospital in the 1970s.

But the melding of real life and art went far beyond the film set. Take the character of John Spivey, a doctor who ministers to Jack Nicholson’s doomed insurrectionist character, Randle McMurphy. Dr. Spivey was played by Dr. Dean Brooks, the real hospital’s superintendent at the time.

Brooks read for the role, he said, and threw the script to the floor, calling it unrealistic — a tirade that apparently impressed the director, Milos Forman. Forman ultimately offered him the part, Brooks said, and told the doctor-turned-actor to rewrite his lines to make them medically correct. Other hospital staff members and patients had walk-on roles.

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Now jump to the present: The office and treatment rooms of the hospital, which opened in 1883, have been turned into a Museum of Mental Health — one of only a few around the world that are part of a still-functioning hospital.

In the museum, a steel examination table sits near a photograph of the Oregon State Insane Asylum baseball team, which once played against local challengers in and around Salem, Oregon’s capital. A straitjacket and a spilled bag of handcuffs fill another display.

A photograph of Fletcher’s character adorns a wall near a television that blares the movie itself on a continuous loop showing the movie’s patients watching that very television.

The result — physical evidence of the hospital’s past alongside the Hollywood portrait — creates questions that McMurphy and his cohorts might have asked. What is real and what merely seems real? Was the hospital, which had a large number of voluntary admissions in its early years, a place of sanctuary, an old definition of the word “asylum,” or of confinement? Darkness and dread, or escape?

Brooks, now 96, and living near the hospital in a retirement home, minces no words when he says that mental-health treatment in years past had its flaws. But anyone looking back, he said in an interview, should also look hard at the present.

Institutions like the Oregon State Hospital, which he supervised for nearly 30 years — from the mid-1950s to the early ’80s — might not have been perfect, he said, but they were at least out there and trying to help. Today, he said, prisons have taken over the job, with barely a pretense of treatment.

“Three-fourths of all mentally ill people are in jails or penitentiaries,” he said.

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