In Part One, Bromden introduces Nurse Ratched not as a human, but as a machine "big as a tractor" who can disguise herself as a human. When the other patients come out of their dorms, there is an interesting interplay between dramatic irony and Bromden's status as an unreliable narrator:
[S]he has to change back before she’s caught in the shape of her hideous real self. By the time the patients get their eyes rubbed to where they can halfway see what the racket’s about, all they see is the head nurse, smiling and calm and cold as usual [...]
Chief Bromden is a self-declared unreliable narrator. In Part One, he presents himself, paradoxically, as a narrator who might get facts wrong but not the broader truth:
Unlock with LitCharts A+I been silent so long now it’s gonna roar out of me like floodwaters and you think the guy telling this is ranting and raving my God; you think this is too horrible to have really happened, this is too awful to be the truth! But, please. It’s still hard for me to have a clear mind thinking on it. But it’s the truth even if it didn’t happen.