As The Fault in Our Stars begins, sixteen-year-old Hazel Grace Lancaster reflects that her parents and doctors have declared her depressed and signed her up for a weekly Support Group. She thinks this is stupid. She has cancer, and she is going to die. “Depression is a side effect of dying,” she says.
The Support Group for cancer kids is held in the basement of an Episcopal church. The building is shaped like a cross, and the group meets in its the exact center. The leader of the group, an adult cancer survivor named Patrick, constantly reminds the kids that they are sitting in the part of the cross where Jesus’s heart would have been during the crucifixion. Hazel wonders why anyone thinks such a comment would help people fight depression.
Hazel goes to Support Group only for her parents’ sake, and she hates every minute of it. She hates Patrick’s ridiculous encouragements, and she dislikes the way the other kids speak in clichés about “fighting and battling and winning” against their diseases. The only thing she likes is a boy named Isaac, who exchanges sighs with her whenever people say stupid things.
One day when Hazel arrives at Support Group, she meets a new boy, Augustus Waters. He explains that he is recovering from “a little touch of osteosarcoma,” a kind of bone cancer, but that he is attending the group only as a favor to Isaac. Isaac has lost an eye to cancer and is scheduled to have the other eye removed next week.
During the discussion, Augustus admits that he is afraid of “oblivion.” Hearing this, Hazel speaks up. She says that, someday, the entire human race will go extinct. She advises Augustus to forget about it and go on with his life.
After the meeting, Augustus and Hazel flirt for a while. He is sweet and funny, and he invites her to watch a movie with him. She thinks he is great—until he pulls out a cigarette and puts it between his lips. She is shocked at his stupidity, and she tells him so:
Even though you HAD FREAKING CANCER you give money to a company in exchange for the chance to acquire YET MORE CANCER. Oh, my God. Let me just assure you that not being able to breathe SUCKS.
Hazel stalks away, but Augustus follows. He says that cigarettes can only give people cancer if people smoke them. He does not:
It’s a metaphor, see: You put the killing thing right between your teeth, but you don’t give it the power to do its killing.
Hazel has never before met a boy who would say such a thing. She accepts his invitation to the movie.
Augustus had one of his legs amputated during his cancer treatment, and his prosthetic leg makes him a terrible driver. As he drives Hazel to his house, the two of them agree that he was probably given his license as a “Cancer Perk.” According to Hazel:
Cancer Perks are little things that cancer kids get that regular kids don’t: basketballs signed by sports heroes, free passes on late homework, unearned driver’s licenses, etc.
Hazel wants to know about Augustus’s history of cancer, but she does not want to ask depressing questions. Instead she asks whether he goes to school. Among cancer kids, this is a polite way of asking about “approximate survival expectations” because parents usually remove kids from school when it seems clear they are going to die.
Augustus goes to high school but is only a sophomore at seventeen. When he learns that Hazel has been out of school for three years, he is aghast. She tells him her story, which she sarcastically calls a “Cancer Miracle.” She got diagnosed at thirteen, nearly drowned in her own lung fluid at fourteen, and then suddenly responded to an experimental drug. She still has terminal cancer, and her “lungs…suck at being lungs.” Her doctors do not know how much longer she will live, but her cancer has not grown worse in two years.
After hearing this story, Augustus comments that Hazel should go back to school. She explains that she got her GED, which means she cannot return to high school. Instead she takes classes at community college. He jokes that this must be why she has such an “aura of sophistication.”
At Augustus’s house, Hazel meets his parents, a friendly but cheesy pair who adorn their home with embroidered quotations like, “True Love Is Born from Hard Times” and "Without Pain, How Could We Know Joy?" Augustus says that they call these quotations Encouragements.
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That night, Hazel stays up late reading The Price of Dawn, the book Augustus loaned her. It is a ridiculous story full of adventure and killing, but she rather enjoys it. The following morning, she is surprised to be awakened by her mother, who usually lets her sleep as long as she wants because "sleep fights cancer."
Hazel protests that she wants to stay in bed, but her mom, who loves to make a big deal out of the smallest occasions for celebration, reminds Hazel that it is her half birthday. Hazel does not particularly care, but she puts up with her mom’s attempts to make it an exciting thing. She texts her friend Kaitlin and suggests spending the afternoon at the mall to celebrate.
That afternoon, Hazel arrives at the mall early. She buys two sequels to The Price of Dawn and then sits at the food court to wait for her friend. When she spots her mom sitting in a corner reading some papers, she sighs. She wishes her mom could be out with friends or otherwise living her own life. Instead, she is sitting around waiting for her sick daughter, working on cancer-related paperwork.
When Kaitlyn arrives, she talks all about her latest romance. Hazel does not mention Augustus, reasoning that there is too little to say. The two girls go shoe shopping, but Hazel is not very interested. During their conversation, Kaitlyn uses the word "die" and then stops short, as if it is “a crime to mention death to the dying.” Hazel finds it annoying when people tiptoe around her illness this way. A while later, she pretends to be too tired to continue shopping.
After saying good-bye to her friend, Hazel enjoys a few rare minutes alone. She sits down on a bench to read the sequel to The Price of Dawn. It is full of blood and death, but she likes the rolling pace of the adventure, which always moves forward no matter what. It has been a long time since she read such a story, and she finds it comforting to know that it will always have another sequel.
At one point, Hazel’s reading is interrupted by a child who is curious about her oxygen tank. Hazel explains that the tube in her nose is a cannula, and it helps her breathe. The child's mother is embarrassed, but Hazel lets the girl try using the cannula to breathe. The girl clearly enjoys this, but Hazel has to take it back almost immediately. She really needs the extra oxygen to get along.
When the child is gone, Hazel reflects that it would be nice if more people could talk to her with so little self-consciousness. Then she returns to her book, noting in amusement that the hero sustains seventeen bullet wounds during the climactic scene. She is sort of disgusted when he survives.
That evening, Hazel re-reads part of her favorite book, An Imperial Affliction. It is about a teenage girl named Anna, who is dying of cancer but does not act all brave and heroic like most cancer victims in stories. She has a mother who is obsessed with tulips and who starts a relationship with a Dutch tulip salesman Anna believes to be a fraud. The mother and the Dutch man are talking about getting married, and Anna is about to start a strange new treatment, when the book ends in the middle of a sentence.
Hazel loves and hates this ending, which she takes to mean that Anna dies or gets too sick to continue writing. However, Hazel also desperately wants to know how the story turns out. Hazel has written many letters to the author, Peter Van Houten, asking him to tell her what happened after the book ends. He has never replied.
The following day, Hazel goes to a community college lecture on poetry that she finds uninspiring. Afterward, she is disappointed to see her mother already waiting in the parking lot. Her mom claims that she kept busy with a book during Hazel’s class, but Hazel remains worried that her mother has no life. When she says so, it seems to hurt her mother’s feelings. Hazel tries to make amends by suggesting that they go to a movie.
After the movie, Hazel has several text messages from Augustus on her phone. He has finished An Imperial Affliction, and he begs her to tell him what happens next. Like Hazel, he seems to love and hate the book all at once. A few hours later, she calls him, expecting to talk more about the book—but she hears sobbing in the background. Augustus tells her Isaac is there, upset, and he invites her to come over.
When Hazel arrives at Augustus’s house, she finds Isaac and Augustus playing Counterinsurgence, the video game that inspired the book The Price of Dawn. Isaac is wailing loudly, tears running down his face, and he keeps...
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For a week, Augustus does not call Hazel. She wants to talk to him, but since she was the last one to call him, she stubbornly insists to herself that it is his turn. She goes through all her normal activities, trying not to worry about the PET scan she has scheduled to check on the tumors in her lungs in a few weeks. She is feeling a lot of aches and pains lately, but she tells herself that worrying does not help. She worries anyway, thinking, "Worry is yet another side effect of dying."
When Augustus finally calls, he reveals huge news: he has managed to contact Peter Van Houten, the author of An Imperial Affliction. Augustus reads Hazel a letter he has received from Van Houten and then gives her an e-mail...
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Hazel’s mom talks to the doctor and to the Genie Foundation, and soon it is decided that Hazel can go on the trip as long as her mother goes along. By the end of the afternoon, the decision is made—but for some reason Hazel feels out of sorts.
Alone in her room that afternoon, Hazel asks herself why she tensed up when Augustus touched her. She calls Kaitlyn, who is excited that Hazel has such a hot romantic interest. Unfortunately, she has no advice to offer. She is more interested in the idea of sex with a one-legged boy. “Do you think you’d have to be on top?” she asks.
After getting off the phone, Hazel begins wondering about Augustus’s former girlfriend, Caroline. She visits Caroline’s...
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Hazel’s parents rush her to the hospital. During the ride, she tries to tell herself that the pain will go away eventually—but it is too much to bear. Privately she thinks it would be better to die than to continue feeling this way.
When Hazel next awakes, she is in the ICU, and she can hear a group of people nearby crying about someone’s death. She calls a nurse, who rushes to get her parents from the waiting room. A few minutes later, Hazel’s mom explains that fluid has been building up in Hazel's lungs. That has made it difficult for her body to get oxygen. It caused Hazel's recent aches and pains as well as her terrible headache.
The good news is that Hazel’s cancer has not gotten any worse....
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A few days after Hazel gets out of the hospital, she attends a Cancer Team meeting, a gathering of doctors, social workers, and family members who all discuss her treatment. The doctors say that Hazel’s medication is still working and that her lung tumors are not increasing in size “yet.” Everyone agrees on a plan to “stay the course,” which sounds to Hazel like they are going to “do nothing.”
Hazel asks for a lung transplant, but she is told that she is not a good candidate. She understands what this means: human organs are too valuable to be wasted on a girl who has little chance of survival. This idea makes Hazel’s dad cry, which makes Hazel want to kick herself for speaking up. She reflects that she...
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Just before the trip to Amsterdam, Hazel attends her Support Group in the Episcopal Church basement she refers to ironically as “the Literal Heart of Jesus.” Before the meeting starts, she chats with a girl named Lida, a cancer survivor who always says she feels “strong” when anyone asks. Hazel cannot help being jealous of Lida, who is comparatively healthy and who lost nothing to cancer except her appendix, an organ her body does not need. When Lida comments that she admires Hazel’s bravery, Hazel snaps that that she would trade it for Lida’s health any day.
During the meeting, the Support Group leader, Patrick, prays for the former attendees who have died. There are so many names that he cannot memorize...
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The day of the trip to Amsterdam finally arrives. As Hazel says good-bye to her dad, he tells her that he is “proud.” This comment perplexes her somewhat because she has not really done anything to inspire that feeling. He is tearful during the departure, and she wonders if he is thinking that he might never see her again. It occurs to her that he probably thinks something of that sort every time he leaves for work in the morning.
Hazel’s mom is so excited that she insists on leaving very early. When they show up at Augustus’s house, they overhear him sobbing and shouting at his mother that his life is his own. Hazel wants to continue listening, but her mom insists on returning to the car. From there, Hazel...
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When they arrive in Amsterdam, Hazel, Augustus, and Hazel’s mom take a taxi to the Hotel Filosoof. It is a charming old building with rooms named after philosophers. After they check in, Hazel is too tired to go anywhere. She urges her mom to go out to see a nearby park, and then she lies down to take a nap. When Hazel awakes many hours later, her mom is still in the room. She admits that she did not go anywhere. All she has seen of Amsterdam so far is the guidebook.
Peter Van Houten has left a message for Hazel and Augustus offering to buy them dinner at a fancy restaurant. Hazel dresses up in a pretty sundress, and Augustus puts on an expensive suit. They go to a restaurant called Oranjee, where they start the meal...
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The following morning, Hazel and Augustus make their way eagerly to Peter Van Houten’s house. Their knock is answered by a potbellied man in pajamas who immediately slams the door in their faces. The man—Peter Van Houten—holds a loud argument with his assistant, Lidewij, who has apparently set up the meeting without her boss’s knowledge. Van Houten commands her to tell Hazel and Augustus that he “was making a rhetorical offer to meet, not an actual one.”
Lidewij soon opens the door and ushers Hazel and Augustus inside, apologizing for her boss’s behavior. Van Houten sits down across from them and, although it is still morning, begins drinking straight Scotch. He is pigheaded and rude, insulting...
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At a café the following day, Augustus and Hazel tell Hazel’s mom all about the meeting with Van Houten. They play up the humorous side of the whole thing. Hazel reflects:
You have a choice in this world…about how to tell sad stories, and we made the funny choice.
After they finish the story, Hazel’s mom says she is going for a walk. She tells Augustus sternly that he needs to talk to Hazel. Augustus looks unhappy, and Hazel gets scared. Something about the way her mom suggested a talk, and about Augustus’s reaction, makes her think that he may not have recovered from cancer as completely as she has always believed.
As she and Augustus walk silently back...
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On the way home, Hazel and Augustus order champagne on the plane, using their cancer to gain special treatment. This is fun, but soon Augustus begins to be bothered by pain. He takes a pill that makes him want to sleep. As he drifts off, he comments that Van Houten’s anger at them seemed “personal.”
At home, Hazel describes Amsterdam to her dad, and he tells her he read An Imperial Affliction while she was away. He says that he may not be a good judge of literature, but he found the book “defeatist.” Hazel replies that this makes it “honest,” but her dad disagrees. He says that it is hard to decide what to believe about life and death and God, but in his opinion, hopelessness is not the only...
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One night, Hazel and her family eat dinner with Augustus and his family. Hazel’s parents exclaim about how good the food is, but Augustus says that it does not taste like the food at Oranjee in Amsterdam. He and Hazel launch into a poetic series of reminiscences about the food at Oranjee, which made them feel like “God himself cooked heaven into a series of five dishes….” This lavish description goes on for quite a while. At the end of it, all the parents agree that Augustus and Hazel are “weird.”
About a week later, Augustus’s condition worsens, and he is admitted to the hospital. When Hazel goes to visit, she compares her own hospital, a children’s hospital, to Augustus’s, which...
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As Augustus gets sicker, Hazel falls into the habit of spending most days at his house. She always shows up around noon, after he has eaten breakfast and vomited most of it up. He comes to the door in his wheelchair, looking frail and sick. She privately misses the bright, healthy boy she met a few months ago.
Hazel typically eats lunch with Augustus’s parents while Augustus just watches. He claims to be feeling “grand,” but he also admits that he is too tired to write the sequel of An Imperial Affliction he promised to write after their disappointing meeting with Van Houten. Hazel asks Augustus to tell it to her instead, and he makes a few predictions about what will happen to the characters...
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One day, a little more than a month after the trip to Amsterdam, Hazel arrives at Augustus’s house as usual. He is still asleep, so Hazel goes downstairs and knocks on his door. He does not answer, so she cautiously enters.
Inside the bedroom, Hazel finds Augustus still in bed, mumbling incoherently. He has peed all over himself. She tries not to look closer, and she calls for his parents. She waits upstairs while they take care of the mess.
When everything is ready, Hazel returns to the basement and finds Augustus fuzzily awake, ready for “the excruciating day.” They both sit on the mattress, which his parents have stripped of sheets, and they play Counterinsurgence together. His brain is so sluggish...
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In the middle of the night, Hazel awakes to her cell phone ringing. She recognizes the ring as Augustus’s, and her first thought is that his mother is calling to say he has died. Fear makes it almost impossible for Hazel to move, but eventually she answers.
Hazel is filled with relief when she hears Augustus’s voice. He explains that he is at the gas station, and that he did something wrong with his G-tube and cannot figure out how to fix it. Hazel says she will call an ambulance, but he begs her to come and help him instead. He does not want to go to the hospital, nor does he want to admit to his parents that he sneaked out of the house in the middle of the night. He begins to cry, and he sounds so pathetic that...
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Augustus spends a few days in the hospital, and afterward he seems to have resigned himself to a total loss of independence and a pitiful death. His parents set up a hospital bed in the living room, and he spends most of his time in it, weakly thanking everyone for their help. Once when he and Hazel have a few rare minutes alone, he points to a spot on the floor and asks what she sees. She is confused because there is nothing there, but it turns out he is making a pale joke: “It’s my last shred of dignity."
The following day, when Hazel arrives at Augustus’s house, she finds it full of his extended family: his two older sisters, their husbands, and his three rambunctious nephews. These little boys are constantly...
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When people tell stories about cancer deaths, they often include a phenomenon Hazel calls the Last Good Day. According to Hazel, this is a day when the patient’s decline is not quite as steep, and the pain is not quite as bad. She comments that cancer victims and their loved ones cannot know when a good day is the Last Good Day. That part only becomes clear after the patient’s death.
One day Hazel decides to stay home instead of visiting Augustus. She is not feeling well, and she knows that she needs to avoid wearing herself out. She lazes around with her family, watching TV, until Augustus calls. In a voice full of bravado, he asks her to meet him at “the Literal Heart of Jesus” that evening. Before he says...
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Eight days later, Hazel gets another nighttime phone call, this time from Augustus’s mom. Once again, Hazel steels herself for news of his death. This time she gets what she expects.
When Hazel hears that Augustus is gone, she feels like she is falling apart. She lets her parents comfort her for a while, and she calls Isaac, who seems furious. Afterward, Hazel realizes that she does not know anyone else to call. It makes her sadder than ever to think about how few people love Augustus.
Losing Augustus is horrible. At the end of his life, all Hazel had with him were memories of their short time together, but it was nice to think about them together. Now that she has nobody to share those memories with, she...
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A few days later, Hazel attends Augustus’s funeral. Again she marvels to see so many people she never even knew were a part of his life. She speaks briefly with his parents, who hug her and tell her that Augustus’s love for her was real, not just a frivolous teen thing. Hazel wonders why they are bothering to tell her what she already knows. As the conversation ends, she reflects that speaking to them feels “like stabbing and being stabbed.”
There is an open coffin, and Hazel takes off her oxygen tube so she can say good-bye to Augustus without its help. “I love you present tense,” she whispers to him. She tells him that it will be okay, but she cannot bring herself to believe herself. Before going back to...
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A few days later, Hazel visits Isaac at his house. They play a video game for blind people, but neither of them is particularly interested in winning. They mostly try to make the voice recognition software understand silly commands about licking and humping objects in the game. The computer repeatedly responds by saying, “I do not understand.” Eventually, Isaac tells the computer that he hates not having Augustus Waters in his life anymore. When the computer starts to say that it does not understand, Isaac says, “Me neither.”
After that, Isaac and Hazel give up trying to play. They just sit on the couch, and Isaac asks what Augustus’s death was like. Hazel explains what she heard from the family, and Isaac...
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A few days later, Hazel gets a message from Augustus’s dad saying that he found an old Moleskine notebook near Augustus’s hospital bed. It had no writing in it, but there were some pages ripped out. This news gives Hazel renewed hope that Augustus left her a note somewhere. On the day of the next Support Group meeting, she arrives early at “the Literal Heart of Jesus” to search the room in case Augustus hid a note for her there.
Hazel finds nothing. Her only reward for her frantic search is the breathlessness she always gets from walking around. As the meeting starts, she settles into a chair and concentrates so hard on catching her breath that she does not really pay attention to what Patrick is saying....
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One morning, Kaitlyn calls and bemoans the fact that Hazel has such bad luck in life. This is not really what Hazel wants to hear, but she tries to answer Kaitlyn’s questions about what it was like to be in love.
During this conversation, Hazel mentions the mysterious letter Augustus was supposedly writing for her. Kaitlyn points out that Augustus may have written and mailed a letter to someone else. This comment gives Hazel a flash of insight: Augustus probably wrote to Van Houten. She thanks Kaitlyn and hangs up.
Not wanting to contact Van Houten directly, Hazel e-mails Lidewij. She explains that Augustus may have sent a letter to Van Houten just a few days before his death. She asks Lidewij to find the...
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