A couple of days later Hazel and her parents meet with her cancer team to talk about her cancer. Dr. Maria tells them that the Phalanxifor is working, but she is still having trouble with fluid in her lungs. Another doctor says that Phalanxifor only works for a short period of time before the tumors begin to grow again. Hazel asks if she can just get a lung transplant, but Dr. Maria tells her she is not a good candidate. Hazel notes that it is no use wasting good lungs on a hopeless case. Mr. Lancaster begins crying, which hurts Hazel. She knows that she is “the alpha and the omega of [her] parents’ suffering.”
Like Isaac’s eye surgery, which cures his cancer but leaves him blind, the news about Hazel’s treatment is good, but will only buy her a bit of time. The hopelessness of her situation is heightened by Dr. Maria’s comment about her being a bad candidate for a transplant. While facing the reality of her own prognosis, she also must deal with her parents’ pain, which adds another level of stress to her life.
During the cancer meeting, Hazel remembers a time just before the Phalanxifor began working. She was in the ICU and her mother was telling her it was alright to let go. She remembers hearing Mrs. Lancaster sobbing into Mr. Lancaster’s chest, saying, “I won’t be a mom anymore.”
This experience leads to Hazel’s obsessive fear of what will happen to her parents after she dies. Her mother’s words lead her to An Imperial Affliction – she believes that if she can find out what happens to Anna’s mother, she will have an idea of what will happen to her own mother.
Before the meeting ends, Hazel asks if she can still go to Amsterdam. One of the doctors laughs at the notion of her traveling, but Dr. Maria asks why she wouldn't be able to go. On the car ride home, her parents say she can’t go unless her medical team can agree that it would be safe.
Hazel’s opportunities to do things normal teenagers not only rests in the hands of her parents, but also must be approved by a team of doctors.
After dinner that night, Augustus calls. Hazel picks up and says, “bad news.” She tells Augustus she can’t go to Amsterdam. Augustus says that he should have taken her right after the picnic, and then maybe he would have gotten laid. Hazel laughs and says probably not, but who knows. He moans that he is going to die a virgin. Hazel asks if he is really a virgin. He tells her to grab a piece of paper and draw a circle on it. He then tells her to draw a small circle inside of the bigger circle. He says the big circle is for all virgins, and the small one is for seventeen-year-old guys with one leg. They begin talking about Van Houten’s comment about the sluttiness of time. She feels like they enter an uncreated third space together while on the phone.
Augustus, like Hazel, faces significant challenges when it comes to having the normal experiences that constitute a coming of age. Losing one’s virginity is a particularly important and often stressful part of this process, but Hazel and Augustus are coming of age in bodies that are not healthy. The diagram creates a representation of how difficult this seems for Augustus. The uncreated third space is a realm in which Hazel has never been with a boy, but is able to access with Augustus. They meet there alone together without having to worry about their health.
The next morning Hazel wakes up and begins writing a letter to Van Houten about how she will not be able to go to Amsterdam and if he would just share what happened to Anna’s family, she would never tell a soul what he wrote. Afterward, she does not send the letter because she feels it is too pitiful.
Believing that she will not be able to go to Amsterdam, she decides to ask Van Houten again to write the end of the novel, showing just how important it is for her to know what happens to Anna’s family.
After writing the letter Hazel goes into her backyard and calls Augustus. While the phone rings she looks at her old swing set and remembers her father building it and testing it before letting her on it. She thinks that she would give up all of the sick days she had left in her life for a few healthy ones. She tries to remind herself that she is living with cancer, not dying from it, but finds her self-talk stupid. Then Augustus calls her back.
Hazel tells Augustus she is crying because she wants to go to Amsterdam to find out what happens to the characters after An Imperial Affliction ends. She says that her life, the grey sky, and the swing set are depressing her. Augustus says he must see the “swing set of tears”, so he comes over. When he arrives he sits on the yard beside Hazel and says he sees what she means about the swing set—it is depressing. He puts his arm around her and says that they need to do something about the depressing swing set.
Hazel’s tears show how important it is for her to know the ending of An Imperial Affliction. Her impending mortality also brings meaning to many things that otherwise seem unimportant, the swing set and the grey sky, showing the way in which her health shapes her perception of the world. Augustus is able to identify with Hazel because he shares her experience of being a young person with cancer.
Hazel and Augustus go inside and post an add on a website where people give things away. They laugh together as they make up headlines. Hazel suggests, “Lonely, Vaguely Pedophilic Swing Set Seeks Butts of Small Children.” Augustus tells her that he really appreciates her humor and intelligence, and says that she is “unprecedented.” Finally they write the post and put it up on the website. Afterward, Hazel and Augustus go into the living room and Augustus reads An Imperial Affliction to her while she falls asleep.
Like Augustus and his trophies, Hazel takes a step toward coming of age by getting rid of a symbol of her childhood that makes her unhappy because it represents a time in which she was happy. By telling Hazel that he appreciates her intelligence and humor, Augustus makes it clear that he sees past her cancer to the real person she is.
When Hazel wakes up she finds a number of emails from people who want the swing set, and tells a man to come pick it up. Augustus asks Hazel if she wants to go to support group, but she passes. Before leaving Augustus gives her a kiss on the cheek. Hazel is shocked, but Augustus ensures her that it is just friendly. He then kisses Mrs. Lancaster on the cheek, and says, see it’s just friendly.
Augustus finally makes some progress in becoming intimate with Hazel, which interestingly happens right after the swing set—a symbol of youth—is taken away. Hazel is shocked by the action because she has been attempting to keep him at a distance to prevent hurting him. Augustus plays it off by kissing Hazel’s mother, but in this scene their relationship begins moving forward.
Hazel takes another nap, and when she wakes up she finds a letter from Lidewij saying that their trip to Amsterdam was all set up. Hazel calls her mother into the room. Mrs. Lancaster appears wearing a towel, and says that she was just trying to take a bath for five minutes. Hazel asks her to call the Genies and tell them the trip is off. Her mother then reveals that the trip is still on, but she was going to wait until her father got home to tell her. Hazel is ecstatic, and texts Augustus. She is thrilled that if she can just stay alive for a week she will finally find out what happens after the end of An Imperial Affliction. She whispers to her lungs, “Keep your shit together.”
Answering the door in a towel shows the way in which Mrs. Lancaster is constantly taking care of Hazel and has little time for herself. Even though Hazel is thrilled by the news, she takes it with a grain of salt, as shown by telling her lungs to keep it together. Even though she is excited, she expects something to go wrong.