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 the actress Louise Fletcher during filming here 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.

Dr. 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. Mr. Forman ultimately offered him the part, Dr. 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....