64 pages 2-hour read

The Fault in Our Stars

Fiction | Novel | YA | Published in 2012

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Chapters 18-20Chapter Summaries & Analyses

Chapter 18 Summary

Hazel wakes up to a call from Augustus at 2:30 in the morning. He’s stranded at the gas station and needs her help, something is wrong with his feeding tube, and he’s crying and begging her not to call 9-1-1. She leaves a note for her parents and rushes to the gas station. She finds him in his car; his feeding tube has dislodged and looks infected, and he’s covered in vomit. He came to the gas station in the middle of the night because he lost his pack of cigarettes, and even though his parents promised to get him another one, he wanted to do one little thing by himself. Hazel calls an ambulance. Overcome with shame and anger, he cries, “‘I hate this I hate this I disgust myself I hate it I hate it I hate it just let me fucking die’” (244).


Hazel reflects on the conventional cancer story that would have the patient remain dignified and good-humored to the end, never showing the kind of fear and abject bodily suffering that real cancer patients endure. In the ambulance, Augustus asks her to recite him a poem, and she recites “The Red Wheelbarrow” by William Carlos Williams (a poem written by Williams, a doctor, at the bedside of a dying child). Hazel makes up lines to continue the poem after it ends.

Chapter 19 Summary

When Augustus comes home from the hospital a few days later, he is mostly bedridden, heavily medicated, and “irrevocably robbed of his ambitions” (248). His older sisters have come back home with their husbands and children to be near him for what everyone understands is the end of his life. They fawn over him, and everyone waits on him hand and foot; Hazel can tell that he finds this degrading and exhausting. As some of Augustus’s little nephews run around screaming, his sister tells him, “‘I can only hope they grow into the kind of thoughtful, intelligent young man that you’ve become,’” at which Hazel “[resists] the urge to audibly gag” (250). Hazel and Augustus joke about how his thoughtfulness and intelligence are actually less important than his good looks. Augustus says things like, “‘It is my burden, this beautiful face,’” and, “‘Don’t even get me started on my hot bod’” (251). Augustus’s dad whispers to Hazel that he thanks God for her every day because she is still able to bring out Augustus’s sense of humor. 

Chapter 20 Summary

Hazel reflects once again on the genre of the cancer story: “One of the less bullshitty conventions of the cancer kid genre is the Last Good Day convention, wherein the victim of cancer finds herself with some unexpected hours where it seems like the inexorable decline has suddenly plateaued” (253). On this day, Augustus calls Hazel and asks her to meet him at the Literal Heart of Jesus (the church basement where the Support Group is held) that evening at eight p.m. and to bring a eulogy. An argument ensues between Hazel and her parents when her mom remarks that she is spending too much time with Augustus and they never see her anymore. She finally tells them angrily that any day now, they won’t have to worry about that anymore and storms out of the house. 


That evening, Hazel attends a “prefuneral” for Augustus. She and Isaac give eulogies, and in her eulogy, Hazel says she is glad to have had the short time she did with Augustus.

Chapters 18-20 Analysis

Augustus struggles against, and finally resigns himself to, his impending death. He makes a desperate last attempt to act independently, like his old self, by going to the store late at night for cigarettes. In Chapter 1, Augustus explains his cigarettes to Hazel as a “symbol,” a way to keep Death close without giving it the power to harm him. When this attempt to buy cigarettes ends in abject failure, with Augustus vomiting and crying in the car while Hazel calls an ambulance, the symbolic meaning is clear. He can’t keep Death at bay anymore; it has the power to harm him now.


After this disastrous outing, Augustus accepts his fate. He even organizes his “prefuneral,” a gathering at the church where Hazel and Isaac deliver eulogies that they’ve written for the occasion. This section, particularly the “prefuneral” scene, returns to the theme Augustus raises at the very first Support Group meeting: the fear of oblivion. Augustus fears being forgotten above all things, and to him, dying without having a real impact on the world feels wretched. Hazel’s eulogy addresses this fear (and maybe the fears of all cancer kids whose potential will go unfulfilled) with the concept of greater and smaller infinities, arguing that Augustus’s impact on her has been vanishingly short but immeasurably deep.

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