Turtles All the Way Down

by

John Green

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Turtles All the Way Down: Chapter 19 Summary & Analysis

Summary
Analysis
A doctor comes into Aza's room and says there's good news and bad news: Aza has a lacerated liver, but it's very mild and she won't need surgery. Mom fixates on the doctor's words that Aza will be okay. Aza asks if she needs antibiotics, and the doctor replies that they won't be necessary unless they end up performing surgery. Aza is relieved. The doctor makes notes about Aza's medications and tells her that they'll get her settled upstairs. Aza begins to panic and tries to tell the doctor that she absolutely cannot stay in the hospital. Mom and the doctor insist she stay, and Aza tries to tell herself that she's at low risk for a C. diff infection and will leave healthier than she arrived.
Aza really has no choice but to stay in the hospital, since a lacerated liver is no laughing matter, and there's no indication that she has reached a mental "rock bottom" yet that would cause the hospital to prioritize her anxiety and mental health over her physical injuries. Aza is attempting to take control of the fearful part of her identity by telling herself that she's at low risk for C. diff. She's attempting to follow Dr. Singh's advice and use language to change her situation.
Themes
Identity, Selfhood, and Mental Illness Theme Icon
Language and Meaning Theme Icon
Daisy leaves once Aza goes upstairs. Mom falls asleep in the recliner next to the hospital bed. Aza can feel Mom's breath and microbes floating over her cheek. Mom wakes up momentarily to check on Aza, and then goes back to sleep. Aza can't sleep: she knows the C. diff is invading her body. She reads through articles about infections and explains that C. diff is actually inside everyone. The problem arises when it gets out of control.
Aza's anxiety is ramping up: she believes she can actually feel the bacteria in the air thanks to her heightened anxiety. The bacteria are becoming more real by the minute. However, she also admits that C. diff is already a part of her identity—it's the part she desperately wants to not have.
Themes
Identity, Selfhood, and Mental Illness Theme Icon
Aza can't figure out when she last changed her Band-Aid. She thinks about song lyrics that talk about not being able to turn one's thoughts away from someone. Aza thinks that it's how she thinks about C. diff and it's not romantic at all.
Here, words from pop music give Aza a way to conceptualize her relationship to C. diff, which is not healthy or cute—it controls her life and makes her miserable.
Themes
Chaos vs. Order and Control Theme Icon
Language and Meaning Theme Icon
Aza's thoughts spiral: she thinks that Daisy hates her, remembers Davis's tongue, and thinks about Mom's warm breath. She thinks about her "irreconcilable selves:" Ayala, Aza, and Holmesy. She texts Daisy and apologizes for not being a good friend. Daisy assures her that they'll make up and asks if she's on good pain meds. Aza doesn't text back, but continues to fixate on her potential for a C. diff infection. She pinches her finger, but it doesn't work to make her feel real.
In the hospital, the one place that Aza desperately didn't want to be, Aza is stuck considering her multiple identities and how they work (or don't work) together. As she's forced to confront her greatest fear, she's also forced to confront herself. However, she herself doesn't feel real in this terrifying place, making her grasp on reality and her own thoughts more tenuous.
Themes
Identity, Selfhood, and Mental Illness Theme Icon
Chaos vs. Order and Control Theme Icon
Related Quotes
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Aza thinks she'll never have a normal life or be able to share a bathroom with strangers in college. Mom's breath becomes unbearable. Aza tries to ask Mom to turn over, but Mom won't wake up. Aza's brain tells her to stand up and makes a note of the hand sanitizer dispenser on the wall. Aza begins to argue with her brain about the merits of drinking hand sanitizer. Finally, Aza's brain wins. She stands and shuffles with her IV pole to the hand sanitizer dispenser as her brain tells her she's going to die from this. Aza rubs hand sanitizer into her hands and then shoves scoops of the foam into her mouth.
The spiral tightens, and Aza's mind—or “demon”—shows that it's immensely powerful. Aza is no longer in control of her thoughts or her fears, and the style of narration makes it abundantly clear that Aza's mind is both a part of her and separate from her. Structurally, this shows how the visual aspect of written language can work to convey meaning above and beyond the words themselves.
Themes
Identity, Selfhood, and Mental Illness Theme Icon
Chaos vs. Order and Control Theme Icon
Language and Meaning Theme Icon
Mom wakes up and asks Aza what she's doing. Aza is embarrassed but can't stop. She puts another scoop of sanitizer in her mouth, gags, and vomits. Mom pages a nurse and tells her that Aza is vomiting from drinking hand sanitizer. Aza knows she's disgusting and thinks that she's not possessed by a demon: she is the demon.
Aza is entirely out of control as she realizes that the dangerous part of her mind is truly a part of her mind, not something foreign. She realizes she's a single self, but now, her entire self is dangerous and turned against her.
Themes
Identity, Selfhood, and Mental Illness Theme Icon