Hazel screams to awaken her parents. They burst into her room and rush her to the hospital. Hazel comforts herself by remembering that when the pain grows to be too much, the body shuts down. She tries to enter a space with no stimuli, a space she identifies with the moment before the Big Bang. She notes that cancer patients have an incredible amount of courage, but in that moment she would have rather died.
Although Hazel is inexperienced with many adult issues, such as love and life, she is very familiar with pain, as shown by her knowledge of how to cope with it. By attempting to enter a place before the big bang, she attempts to find a place before consciousness, which she earlier related to death. Even though she is courageous, with the pain she experiences, death would be an easier option.
Hazel wakes up alone in ICU. She hears a wailing cry in the hall, and notes that someone’s kid had died. She calls the nurse who lets Mr. Lancasterand Mrs. Lancaster in. They hug and kiss her, assuring her that she does not have a brain tumor, but she was deprived of oxygen because her lungs were full of water. They had drained most of the fluid. Hazel notices the tube coming from her lung, and is not surprised by its presence. They tell Hazel that her PET scan had revealed that no new tumors had formed.
Hazel has spent enough time in hospitals to know the wail of a parent who has lost a child. This wail has a metaphorical ring to it, as Hazel often thinks of her own death and the effect it will have on her parents. Water is introduced here as a metaphor for Hazel’s suffering, although there are no new tumors, she still suffers because of her cancer.
The nurse asks Mr. and Mrs. Lancaster to leave because they pose an infection risk. She feeds Hazel crushed ice and tells her she was out for a couple of days. Hazel praises God for good nurses. Before the nurse leaves she tells Hazel that Augustus has been in the waiting room since she entered the hospital. Mortified by the thought of Augustus having seen her in her current condition, she asks if he’s been in the room. The nurse reassures her that only family is allowed in.
Although Hazel’s gratitude to God for good nurses may be a figure of speech, the fact that she mentions God in this instance suggests that she is not completely closed off to God and Religion, even though she prefers philosophical explanations for life and death. Hazel's worries about whether Augustus has seen her shows that even though she is severely ill, she is still preoccupied with normal adolescent concerns, especially regarding Augustus.
Over the next few days, the doctors keep a close eye on Hazel. One doctor comes in with a group of medical students, who practice taking Hazel’s chest tube out, which causes her pain. She begins to think she is part of an existentialist experiment in delayed gratification. When Dr. Maria tells Hazel she can go home, Mrs. Lancaster pulls out a pair of clothes from her purse for Hazel to wear on the way home.
Hazel uses a philosophical explanation to conceptualize her situation, avoiding common religious explanations for suffering. The fact that Mrs. Lancaster has clothing ready for Hazel suggests that she is not only a caring mother, but also that she is experienced with these kinds of incidences.
Before leaving the hospital, Augustus comes into the room to visit Hazel. Her parents leave, and Augustus sits beside her. He tells her that he missed her. Augustus attempts to grab Hazels hand, but she tells him no. She says that if they are going to be friends it can’t be “like that”. He then tells her that he has good and bad news. The bad news is that they can’t go to Amsterdam until she is better, but the good news is that Van Houten has written another letter to them.
Hazels parents give Hazel and Augustus time to be alone, showing that they are accepting Hazel’s relationship with Augustus and supporting her maturation into adulthood. Hazel’s response to Augustus trying to grab her hand shows that the incident has only made her concern about hurting him worse.
Hazel does not read it until she gets home. Sitting on her bed, she opens it. Van Houten writes about Hazel and Augustus’ situation, noting that everyone in Augustus’ story has a hamartia (a fatal flaw). He states that Shakespeare was wrong when he had Cassius note that “The fault, dear Brutus, is not in our stars / But in ourselves.” Van Houten goes on to cite Shakespeare’s fifty-fifth sonnet, calling time a slut because she “screws everybody.” Finally, he defends Hazel’s decision to minimize the pain she inflicts upon others. After reading the letter, Hazel asks Mrs. Lancaster to check with Dr. Maria about whether she will still be able to travel to Amsterdam.
Van Houten’s letter challenges Shakespeare’s notion that the outcomes of our lives are in our control. For Hazel and Augustus, there is no explanation for their situation and they have done nothing to cause the situation. This idea heightens the existential questions raised in the novel. Hazel and Augustus are searching for meaning in their situation. Van Houten, however, does agree with Shakespeare when it comes to time screwing people over, which reveals his nihilistic views. His agreeing with Hazel’s desire not to harm others foreshadows the fact that Van Houten has been harmed by cancer in his own life.