That night, Hazel gets into bed and begins reading An Imperial Affliction. She explains that the novel is about a girl named Anna who is dying from cancer. Hazel loves the book because it is not sentimental. Most cancer books involve a character starting a charity, or doing some other noble act while dying. Anna is honest about dying, claiming that “cancer kids” are just essentially side effects of the mutation of life on earth.
Hazel identifies with An Imperial Affliction because it speaks to her experience honestly. She bemoans cancer clichés that make sick people’s character seem different than healthy people, but An Imperial Affliction pushes back against clichés. She bases her philosophy of life on the ideas in the novel, which allows her to accept cancer as a basic side effect of life without any of the metaphorical resonances that are common in cancer narratives and harmful to those living with cancer.
In An Imperial Affliction, Anna’s mother falls in love with a Dutch man, referred to as The Dutch Tulip Man. The Tulip Man has eccentric ideas about curing cancer, but Anna thinks he is a con artist. Just as Anna is about to start a crazy treatment, the book ends mid sentence. Hazel likes this ending, but wonders what happens to the characters that are left behind. She has tried to write Peter Van Houten about what happens after the novel ends, but Van Houten is a known recluse and has not responded.
Hazel likes the ending of the novel because it rings true with her understanding of death and dying. By ending mid sentence the novel depicts the way death happens suddenly, leaving nothing behind are tied up. Her interest in what happens to Anna’s family after she dies stems from Hazel’s fear of what will happen to her family after she dies.
As Hazel reads An Imperial Affliction, she wonders what Augustus had thought of it. She texts him, stating that The Price of Dawn had too many bodies and not enough adjectives. He asks her to call, so she does. When she asks Augustus if he likes it, he tells her he will withhold judgment, but is wondering about the Dutch Tulip Man and whether he is a con artist. Augustus asks when he can see Hazel again, and she tells him that they can see each other when he finishes the book. She knows she is flirting with him, which is new to her, but she enjoys it.
Hazel’s interest in Augustus’ impression of the book show that she cares what he thinks, revealing her blooming affection for him. Although she and Augustus met through their cancer—the thing that makes them different than their peers—they are beginning to connect through things beyond their illness, showing that even though they are sick, they are still normal teenagers.
After school the next day, Hazel’s mother picks her up and they see a movie together. During the movie, Augustus texts Hazel, saying, “Tell me my copy is missing the last twenty pages.” He, like Hazel, begins to wonder what happens to Anna’s mother and the Tulip Man after the book ends.
Because Hazel's cancer alienates others, she finds companionship in her mother who works to understand her cancer. Again, their shared intrigue with An Imperial Affliction becomes the place where their relationship and experiences in the rest of the novel unfold.
When Hazel gets home she calls Augustus. As they talk, she hears sobbing in the background. Augustus tells her that it is Isaac crying because Monica left him. He invites Hazel over to his place. At Augustus’ house, Hazel finds Augustus and Isaac playing video games. Isaac is crying while he plays, refusing to look at Augustus or Hazel. In the game the two are running through a battlefield, firing machine guns at the enemies. Augustus asks Hazel to share any female advice she might have for Isaac. Hazel says his response is normal, to which Augustus replies, “Pain demands to be felt,” a line from An Imperial Affliction.
When Monica leaves Isaac, he begins to experience a normal part of coming of age. Because of his cancer, however, this normal part of coming of age is particularly harmful. It is different for him than other young people. He knows that he will soon be blind, and is depending on Monica’s support. And, it is implied, she is unable to cope with having to be such a support. Their understanding of pain, derived from An Imperial Affliction, is part of the philosophy they have developed to cope with life, death, and struggle.
As they play the game, they approach a schoolhouse full of children being taken hostage. Suddenly a grenade is thrown, and Augustus dives on it, sacrificing himself to save the children. Augustus is happy to have saved the children. Hazel reminds him that he has only temporarily saved them, but Augustus replies that all salvation is temporary. He bought the children a minute, which might lead to an hour, which might lead to a month or a year.
Augustus lives vicariously through his video games. The game allows him to act heroically. His focus on heroism is connected to his desire to be remembered after death. His response to Hazel's comment about temporary salvation shows a difference in their philosophies. His response also alludes to his own salvation, which is temporary, and cut short later by the return of his cancer.
After they are through with the game, Isaac says that Monica dumped him because she didn’t want to have to break up with him after he was blind. Isaac says she couldn't handle being with him. Hazel reminds Isaac that she doesn't have to “handle it” the same way that Isaac does. Isaac says that after she broke up with him he just kept saying “always” to her, which was their way of promising to always be together. That’s what love is, Isaac says, keeping a promise. He reveals that he believes in real love, but Hazel is not sure she does.
Isaac learns an important lesson through his breakup with Monica about the realities of love and relationships in the adult world. The difference is that he is also dealing with his cancer, which is ultimately the force that came between them. His questions with regard to the nature of love are an essential part of coming of age.
Suddenly, Isaac begins hitting the gaming chair and beating Augustus’ pillows. Augustus encourages him to lash out in anger. During Isaac’s freak out, Augustus asks Hazel about An Imperial Affliction. Hazel reveals that Van Houten is living in Amsterdam, and she suspects he is writing a sequel to An Imperial Affliction that reveals what happens to the family after Anna’s death. As she talks, Augustus approaches Isaac and tells him to stop beating the pillow and break something. Isaac grabs a trophy and holds it over his head. Augustus gives him permission to smash it. After the trophies have been smashed, Isaac sits down. Augustus asks him if he feels better. Isaac says no, and Augustus again says that pain demands to be felt.
These young people are feeling immense pain, which as Augustus mentions, “demands to be felt”, and they are left trying to figure out how to express it. Unable to deal with the pain in a mature way, Isaac begins smashing things, showing the extent to which he is harmed, but also his lack of ability to cope with the loss. Augustus takes part in the catharsis of Isaac’s destructive behavior by allowing him to smash the trophies. His lack of attachment to them shows he is moving away from that part of his childhood. During the scene, he is more interested in Hazel and An Imperial Affliction, showing the way his focus has changed as he matures.