The Ending Of Ratched Season 1 Explained

Contains major spoilers for Ratched

When does dedication turn from an honorable trait to a pathological behavior? That's one of the questions at play on Netflix's Ratched, the new original series created by Evan Romansky and developed by American Horror Story mastermind Ryan Murphy. The show takes one of cinema's great characters, Nurse Mildred Ratched, and explores the years before she became the steely-eyed woman viewers first met in 1975's One Flew Over the Cuckoo's Nest. In typical Murphy fashion, Ratched is a harrowing and violent story of a woman who finds herself forced to make desperate choices.

At the beginning of the first season, we follow Mildred Ratched (Sarah Paulson) as she cons her way into a job at the Lucia State Hospital. Coincidentally, it's the very hospital where a violent serial murderer named Edmund Tolleson (Finn Wittrock) is being cared for by Dr. Richard Hanover (Jon Jon Briones) and head nurse Betsy Bucket (Judy Davis) before it's determined whether he's fit to stand trial. By the time the end credits on the Ratched season 1 finale roll, Mildred has weathered shifting political alliances, taboo romances, and more than a few gruesome murders.

Here are all the gory details on the finale of Ratched season 1, and what they mean for the series moving forward. 

Not everybody made it to the end of Ratched season 1 with a pulse. Although Dr. Hanover appears to be an upstanding (if not a bit rude) psychologist who's eager to think out of the box to treat his patients, we learn toward the end of the season that that's only part of the story. Early on, viewers meet a wealthy eccentric named Lenore Osgood (Sharon Stone), who wants Dr. Hanover dead.

It's eventually revealed that Dr. Hanover's real name is Dr. Manuel Bañaga, and that he once attempted to treat Lenore's spoiled and cruel son Henry (Brandon Flynn) with an LSD-induced therapy session. Things don't go to plan, and to make a long (and grotesque) story short, Henry Osgood ends up a quadriplegic. Dr. Hanover adopts his new identity, and Lenore hires a few would-be assassins — including Nurse Ratched herself — to try to bring him to justice.

Ultimately, though, Dr. Hanover meets his end at the hands of a patient. Charlotte Wells (Sophie Okonedo) is a woman with multiple personality disorder and an extremely traumatic past whom Dr. Hanover believes he can help. Even when Dr. Hanover is forced to flee the hospital (put a pin in that), he brings Charlotte with him. His decision ends in catastrophe when Charlotte has a mental health crisis and murders him.

Both Dr. Hanover's and Lenore's storylines touch on the dangers of obsession. Dr. Hanover is obsessed with the idea that he's uniquely qualified to treat his patients, and is eventually killed by one. Lenore is obsessed with killing Dr. Hanover as a gift to her son. When she does finally get her wish, Henry responds by revealing his hatred of her for how he's treated her, before having her murdered.

Before Dr. Hanover's violent death, Mildred and Betsy expose him as a fraud who was lying about his identity. The women spend much of the season as bitter rivals, but when Betsy confronts Mildred about her own deceptions, the women have an unexpected moment of bonding. Mildred reveals that she conned her way into her job as an army nurse, and that she was discharged for euthanizing soldiers who were in excruciating pain without hope of recovery, for which Betsy admires her.

Mildred also tells her the truth about her relationship with Edmund, which viewers learn in detail on the episode "Got No Strings." Mildred and Edmund were in the same foster program when they were children, and were placed in a series of horrifically abusive homes, one of which involved sexual abuse. This led Edmund to kill their foster parents. It explains not only why Mildred has been so hell-bent on helping Edmund, but also why Edmund is prone to violence against those he believes deserve it in the first place.

However, Mildred faces a difficult challenge in keeping her foster brother safe while he's incarcerated. California Governor George Willbur (Vincent D'Onofrio) is determined to execute Edmund. Not only that, but he also wants to do away with the relatively sedate lethal injection in favor of the more violent electric chair. In order to prevent him from suffering an excruciating death at the hands of the governor, Mildred comes up with a plan to free her brother from that torment by killing him herself to ensure he has a painless death. She enlists her new ally Betsy's help, and it seems to be going smoothly until, well, it doesn't. 

Charlotte Wells storms into Lucia State Hospital before Mildred is able to carry out her plan. Going on the run after killing Dr. Hanover hasn't helped Charlotte's recovery; she now believes that she herself is Dr. Hanover, and uses her authority — and a gun — to force Betsy to take her to see Edmund. She's manifesting Dr. Hanover's desire to help his patients no matter what, and wants to free him before he's executed.

After Betsy frees Edmund from his cell, he threatens her life and forces her to confess what he's suspected ever since he noticed Mildred acting strange around him: His sister plans to kill him. As we find out later, Edmund doesn't see the good intent in Mildred's plans, and instead interprets her attempt at a mercy killing as a grave betrayal.

Like Dr. Hanover and Lenore, Edmund and Charlotte are two characters with similar plights. They are both the victims of horrific abuse that has twisted them into violent people. Multiple times throughout the series, we see Edmund express discomfort with killing people who haven't wronged him. Likewise, when not taking on one of her violent personas, Charlotte is actually a kind and timid woman. It's fitting that they end up escaping the hospital together in the end, as both are the only ones truly capable of understanding the other.

Other than her brother, Mildred's most important relationship on Ratched is with Gwendolyn Briggs (Cynthia Nixon), Governor Willbur's press secretary. Mildred is slow to accept her feelings for Gwendolyn, but Gwendolyn is savvy and recognizes that Mildred's chilly attitude and prickly behavior is a defense mechanism she's cultivated due to her terrible childhood. When Gwendolyn is able to break through that wall, the two quickly become confidantes and lovers. As the possibility of saving and reuniting with her brother slips further from her grasp, Mildred turns to Gwendolyn to be her anchor in life.

The two do endure some bumps in the road, including Mildred's initial dishonesty around her relationship with Edmund and Gwendolyn being shot and then diagnosed with lung cancer. However, despite the fact that their relationship seems destined to fail, when Ratched flashes forward after Edmund and Charlotte escape the hospital and go on the lam, we see that they've withstood the test of time (at least for a few years).

After watching her brother escape Lucia State Hospital, the next we see Mildred is three years later in Mexico. Gwendolyn is responding to cancer treatments, Betsy has come for a visit, and the two seem to be living a happy life away from the problems that plagued them in California.

But although things appear idyllic on the outside, Mildred lives in fear of Edmund reappearing in her life. We see her have an elaborate nightmare wherein Edmund and Charlotte track her down and kill her, and she meticulously reads the American papers each morning for any sign of him. One morning she gets just that: a news story about a group of nurses who were brutally murdered. Mildred suspects this is her brother's way of sending her a sign.

Almost as soon as she reads the news story, Mildred gets a call from Edmund. He confirms that the nurse murders were indeed a message, and after questioning how he knew where to find her, Mildred realizes someone close to her must have snitched. Realizing that Edmund is going to come after her, Mildred turns his threat around on him, saying, "You are the one who should be afraid. Because I'm coming for you, Edmund."

The Ratched season 1 finale certainly leaves the door open for another season — but, at the time of this writing, Netflix has yet to officially confirm a second season of Ratched. Don't let that get you down, though. According to a tweet by Murphy himself, the show was Netflix's most popular in the world the weekend it debuted. At this point, a renewal seems likely to happen.

So, what could a potential Ratched season 2 hold for viewers? Based on where things were left, it looks like Mildred and Edmund, who began season 1 as each other's only family in the world, are about to go to war. On her side, Mildred has Gwendolyn and Betsy, who's now the head of Lucia State Hospital. However, as she alluded to, it seems that somebody close to her is leaking information to her brother.

Meanwhile, Edmund is still traveling with Charlotte, and the two even picked up Louise (Amanda Plummer), the eccentric owner of the motel Mildred used to live in, along the way. How this battle plays out remains to be seen, and knowing Murphy's particular brand of maximalism, the story could take viewers in any number of outlandish directions.

One thing that does seem certain: considering how things went down in season 1, Ratched season 2 is likely to be a blood bath.