Three days later, Augustus’s father phones Hazel. He says a notebook was discovered on the magazine rack near Augustus’s hospital bed. The pages in the notebook are blank, however the first three or four pages have been torn out. Wondering if Augustus might have hidden the pages in The Literal Heart of Jesus, Hazel fetches Isaac and they head to support group early. Unfortunately they don’t find anything. When the support group begins, Patrick asks how Hazel is doing. She says she wishes she would die. He asks why she doesn’t, to which Hazel responds that she doesn’t know. As Isaac talks Hazel thinks that she stays alive in order to notice the universe, and because she feels she owes a debt to everyone who isn’t a person anymore and to those who hadn’t gotten to be one yet.
When Hazel arrives back home, she wants to lie down but her mother tells her she has to eat to stay healthy. Hazel angrily tells her that she’s not healthy, that she’s dying and that one day her mother won’t be a mother anymore. Hazel’s mother, who didn’t realize Hazel overheard her say that, explains that she never meant it. She says she will always be Hazel’s mother, and she points out that Augustust’s death hasn’t caused Hazel to love him any less. Hazel confesses that she worries her parents won’t have a life after she dies, and her mother reveals that she’s been taking classes online to get her master’s degree in social work. She said she doesn’t want Hazel to think she’s been imagining a world without her, but if she gets her degree she can counsel other families. Hazel thinks the news is fantastic, and she begins crying out of happiness. As they watch America’s Next Top Model later, she asks if her parents will stay together after she dies. They say they will. Hazel manages to eat a few bites of pesto pasta.
The next morning Hazel wakes up panicked. In her dream she was alone and boatless in a large lake. Hazel gets a call from Kaitlyn. After talking a bit Kaitlyn suggests the torn out notebook pages might have been mailed to someone else. Hazel quickly emails Lidewij, hoping that Augustus might have sent the pages to Van Houten. Lidewij agrees to search for the pages at Van Houten’s in the morning.
While waiting to hear from Lidewij, Hazel thinks of the future she’ll never have. She comes to the conclusion that people are never satisfied by their dreams coming true, because there is always the thought that everything might be done better and again. Hazel’s mother interrupts her introspection to inform her that it’s Bastille Day, and they are going for a family picnic in Holliday Park. During the picnic Hazel considers the significance of the fake Roman ruins at the park. Though they were originally sculptural recreations, they are now old and ruined enough to be actual ruins. She imagines that Augustus and Van Houten would like the ruins. After their picnic Hazel and her parents visit Augustus’s grave.
That evening Hazel gets an email from Lidewij. She found the notebook pages. She forced Van Houten, who was very drunk, to read them, and when he finished he said: “Send it to the girl and tell her I have nothing to add.” Hazel opens the page files. She notices his handwriting varied a great deal, and she thinks Augustus must have written the pages over a period of several days, probably while experiencing varying levels of consciousness. The letter itself is a plea from Augustus, requesting that Van Houten utilize his superior literary skills to help him write a eulogy for Hazel. In the plea, Augustus says we all want to leave our mark on the world, him included, but these marks are really unpleasant scars. Hazel is different. She tries not to harm anyone or anything. The real heroes, he says, are the ones who notice things and pay attention. Augustus then describes seeing Hazel in the ICU after she was hospitalized and he found out his cancer had returned. He writes that we have no choice about whether or not we get hurt in the world, but you can choose who hurts you, and that Augustus likes his choice. He only hopes that Hazel likes hers. The final two words of the novel are from Hazel: “I do.”
The conclusion of the novel offers a concise look at how Hazel has changed over the course of the story. From the outside, the shift in Hazel’s character isn’t dramatic. She began the novel by attending the support group because she was depressed, and now we see her back in the support group and again depressed, albeit for a different reason. The difference is what Hazel has learned about suffering and love. The Hazel we initially meet thinks of herself as a source of pain for the people who love her, specifically her parents. She deliberately keeps her distance from new people and potential friends so they won’t be hurt by her when she dies. But Hazel’s relationship with Augustus has changed her way of thinking. She wouldn’t trade the pain of losing Augustus for the comfort of never having fallen in love with him, and that shift in her thinking allows her to see her parents’ situation differently. As her father has pointed out, the way Hazel feels about Augustus is the way Hazel’s parents feel about her: Whatever suffering they have to deal with because of her illness is outweighed by how much they love her, and they wouldn’t trade their time with her either.