Notes

The narrator, Hazel Grace Lancaster, is a 16-year-old girl with thyroid cancer that has “long-settled” metastases in her lungs. Her mum and regular “Doctor Jim” both think she has depression (Hazel, however, believes depression is a side effect of dying). She must carry a two-litre green oxygen tank in a little steel cart that wheels behind her.

Her mum insists she attend a support group located in the basement of an episcopal church. Hazel finds the group “depressing as hell”, with “decrepit” cookies and watery lemonade for the attendees. Only one person is over 18: Patrick, the group leader, who likes to boast about surviving what he calls “balls” cancer.

The only other group member she has previously connected with is Isaac, a 16-year-old long-faced, skinny guy with straight blond hair swept over one eye. One of his eyes is made of glass after being removed when he was a child. He now wears thick glasses which make his already large eyes appear even bigger. Hazel and Isaac communicate primarily through shared sighs of cynicism whenever other group members speak.

Hazel is deeply cynical about the group and its leader but complies to please her parents. One day, a new boy, 17-year-old Augustus Waters, who has osteosarcoma and uses a prosthetic leg, joins the group. He is leanly muscular, with short mahogany hair, and close to Hazel’s age. She becomes acutely self-conscious about her appearance, finding him attractive. Despite moving to a different spot in the circle, Augustus continues to watch her. It emerges that Augustus is Isaac’s friend, attending the support group at Isaac’s request before Isaac undergoes surgery that will leave him blind.

Though shy, Hazel, partly due to her attraction to Augustus, decides to speak up when Patrick asks someone to reflect on Augustus’s comments about his fear of oblivion. She shares her cynical worldview: everything is temporary, and eventually no one will remember those who have passed, civilisations rise and fall, and the sun will ultimately collapse.

Her perspective is deeply influenced by her third-best friend (after her parents): her favourite author, Peter Van Houten, who wrote “An Imperial Affliction”. After her bleak monologue about inevitable human oblivion, a long silence follows. The group then joins hands as Patrick leads a prayer.

After the session, Augustus approaches Hazel. They chat with Isaac, who soon departs to spend time with his girlfriend Monica while he can still see. Augustus continues to flirt with Hazel, who finds herself unexpectedly responsive and excited by the interaction.

In the church car park, Monica passionately kisses Isaac against a wall, creating loud, dramatic sounds. As Hazel’s mum is running late, only Augustus and Hazel remain as witnesses to this scene. Augustus playfully teases Hazel and places an unlit cigarette in his mouth. When Hazel criticises him for supporting a cigarette company while battling cancer, Augustus explains his metaphorical approach:

“You put the killing thing right between your teeth, but you don’t give it the power to do its killing.”

The chapter concludes with Hazel’s mum finally picking her up, and Hazel deciding to go on a date/movie with Augustus, asking her mum to record the America’s Next Top Model episodes she will be missing.

Key Takeaways

  • Character Introduction

    • Hazel Grace Lancaster: 16-year-old thyroid cancer patient with lung metastases
    • Augustus Waters: 17-year-old, one-legged osteosarcoma survivor, romantic interest
    • Both attend a cancer support group with profound perspectives on life and mortality
    • Isaac: 16-year-old soon-to-be-blind boy, connected to both Hazel and Augustus, dating Monica
    • Patrick: Testicular cancer survivor, support group leader, the only attendee over 18

  • Thematic Elements

    • Confronting mortality and fear of oblivion
    • Finding connection and meaning within limited time
    • Metaphorical resistance against / control over death (Augustus’s unlit cigarette)

  • Relationship Dynamics

    • Instant mutual attraction between Hazel and Augustus
    • Intellectual connection through existential discussions
    • Initial flirtatious interaction in support group setting

  • Narrative Tone

    • Cynical and dark humour about cancer support group experience
    • Philosophical reflections on human insignificance
    • Exploration of youth facing terminal illness

  • Symbolic Moments

    • Unlit cigarette as metaphor for personal agency
    • Support group as microcosm of life’s fragility
    • “An Imperial Affliction” as intellectual and emotional anchor