Hazel depicts a typical day with late-stage Gus. She goes to his house around noon, and he meets her at his front door in a wheelchair. By that time he's eaten his breakfast and usually vomited it up. They go out to the backyard, and Augustus mentions he misses Hazel's swing set. Nostalgia, he says, is a side effect of dying. Hazel and Augustus fall asleep together while listening to his favorite band, and afterward they play “The Price of Dawn.” Hazel notices the joy Augustus derives by saving her from the pixilated terrorists. She considers faking a choking incident, so that Augustus might rescue her. She thinks it might rid him of the fear that he lived a meaningless life. But she thinks better of it, imagining the potential humiliation Augustus might feel if he catches onto the ruse. Hazel thinks of how hard it is to maintain dignity when “the sun is too bright in your losing eyes.”
It's a month after their return from Amsterdam. Hazel heads downstairs to Augustus’s bedroom one afternoon to find him mumbling gibberish and lying in his own urine. She shouts for his parents and waits upstairs while they clean up. When she returns later on, they play video games and Hazel feels awkward. Augustus is extremely weak and they can't play for long. Trying to make him feel better, Hazel tells “Gus” that she has pissed the bed plenty of times. He says she used to call him Augustus. Thinking of his obituary, Augustus says he thought he was special and would have a story worth telling. Hazel takes offense at his notion of what makes someone special. She wishes it was enough for him that she thinks he's special. She says she and his family and his life are all he gets. He won't ever be a hero, NBA star, or Nazi slayer. When she tries to apologize, Augustus says she's right and the two go back to playing video games.
Hazel wakes at 2:35 a.m. to a call she's sure is to inform her Augustus has died. Instead it's Augustus asking her to help him. There's something very wrong with his G-tube and he's stuck at a gas station. He pleads with her not to call the police or his parents and to come get him. Hazel is sleepy and perplexed but she drives to the gas station, where she finds Augustus sitting in the driver’s seat, covered in his own vomit. The air is fetid and Hazel suspects the G-tube tract into Augustus’s abdomen is infected. Hazel calls for an ambulance while Augustus feebly mumbles about only wanting to buy a pack of cigarettes on his own. Hazel thinks how much Augustus has changed. His former self has been replaced by the pitiful, desperate person in front of her. Dejected and out of sorts, Augustus begins to rant about how much he hates himself and just wants to die. Hazel calms him somewhat, and while waiting for the ambulance Augustus asks Hazel to read her something. She recites “The Red Wheelbarrow” by William Carlos Williams, and then adds a further iteration of the poem focusing on Augustus.
The main focus of this section is Augustus's physical decline, which shows the realities of terminal cancer. Throughout the novel Hazel has commented on the conventions, as she puts it, of dying from cancer, noting how the person dying is expected to be courageous to the end and an inspiration to all around them. What we see in Augustus is quite different. Apart from the physical suffering Augustus endures, what's most notable about his situation is the humiliation and loss of control he experiences. He can't walk on his own and has to use a wheelchair. He can't keep food down and regularly vomits after eating, and then he urinates in his bed because he can't control his bowels. Often he seems incoherent and disoriented. The state he's in when Hazel finds him at the gas station highlights just how unheroic the reality of terminal cancer is. She says that the person he used to be is essentially gone, replaced by a “desperate, humiliated creature,” and Augustus rages that he disgusts himself and wants to die. In contrast with the convention of the cancer patient who is good-humored and brave and indomitable, Augustus is angry, terrified, and in Hazel's words, “a pitiful boy who desperately wanted not to be pitiful.”
The section also marks the sad end to the persona of “Augustus,” leaving only “Gus.” As Hazel has gotten to know Augustus better, and as he’s become more and more sick, the outsize personality and dramatic gestures that characterize “Augustus” have gradually faded. What’s left is the regular kid who is not notably heroic and who is terrified of dying of cancer. It’s the version of him that his parents know and call Gus. When Hazel talks to him about urinating in his bed, for instance, he notes with some disappointment that she now calls him “Gus” and not “Augustus” anymore. Later, at the gas station, Hazel discovers that the traits that characterize “Augustus” have disappeared entirely, and what she sees instead is a scared, suffering, “pitiful” kid. It’s significant that this episode occurs as Augustus is trying to get a new pack of cigarettes. Throughout the novel the cigarettes have been a symbolic gesture of Augustus’s attempt to exercise control over death. They’re also the exact sort of affectation that characterizes the persona of “Augustus.” Because he’s too sick to control his body, however, Augustus fails to get a new pack. That failure symbolizes his failure to control death, and it means no more unlit cigarettes, the most representative gesture of “Augustus.”
Paired with Augustus's physical decline are more conversations between Augustus and Hazel about what makes a life valuable. Augustus still equates value with being extraordinary and ideally famous. Previously he's shown a desire to do something heroic for which he would be remembered after his death, and here he laments that his obituary won't be in the newspapers. He suggests its absence means he's not “special” the way he thought he was, and what he implies is that, because a lot of people won't know about his death and remember him for some great deed, his life hasn't been valuable. Hazel takes issue with this characterization of value, and her take on value is much more personal. She says it shouldn't matter if the world doesn't know about him because she knows about him. What she suggests is that it's more important for a person to be special to those around them than to complete strangers, no matter how many those strangers number.
One could argue that the novel's author, John Green, also offers his take on what makes a life valuable, and this commentary ties into the theme of the importance of fiction. Augustus wishes he had a “story worth telling” since he believes that would mean his life was valuable. The irony is that we hear him say this because John Green is telling Augustus's story. In doing so Green uses his novel to suggest that even those who are not famous and may not have accomplished something that will be memorialized in newspapers have value. They, too, are special, even if only a few people know it. The fact that Augustus is fictional carries its own implications. Though Augustus isn’t real, Green makes it clear that his story still matters. He's important because he represents all the real people who worry how meaningful their lives are if they haven't done something extraordinary, and fiction is valuable for precisely this reason: It allows us to use made-up characters like Augustus to tell stories that give attention to issues people face in real life, and that might go untold otherwise.
John Green has also published Looking For Alaska, Paper Towns, An Abundance of Katherines, Will Grayson, Will Grayson (with David Leviathan), and has worked on a number of short stories and anthologies, most notably This Is Not Tom and Let It Snow (with Maureen Johnson and Lauren Myracle).
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As a die-hard fan of John Green novels, I have read The Fault in Our Stars six times. Augustus Waters is actually seventeen, not sixteen.
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