Themes are the fundamental and often universal ideas explored in a literary work.

The Power of Guilt

Throughout the novel, characters are motivated by their sense of guilt. Stella, feeling that her parents would crumble if she were to die, religiously sticks to her regimen while she waits for a new set of lungs. Especially in the beginning of the novel, Stella’s commitment to staying healthy seems to be driven almost entirely by her sense of guilt toward her parents. Stella also feels guilty for her sister Abby’s death, thinking that if she had been with Abby, she would not have died. This guilt prevents Stella from moving on and fully opening herself up to anyone.

After discovering that Stella and Will have been spending time together, Barb shares with Will the story of how earlier in career, she allowed two patients with cystic fibrosis to be together. When one of them contracted B. cepacia from the other, he was taken off the transplant list and soon died. Barb has lived with the guilt of not keeping them apart ever since and feels determined to not let Stella have the same fate. Poe, too, is driven by the guilt of his illness. Not wanting anyone to have to take on the burden of his care after he turns eighteen, Poe denies himself the opportunity to have a lasting relationship.

Relationships Between Parents and Children

There are three relationships between parents and children in the novel: Stella and her parents, Will and his mother, and Poe and his parents. Each relationship has a vastly different dynamic, showing that the roles of parents and children can vary greatly depending on the people and circumstances in the relationship. Stella feels the need to protect her parents, fearful that if she were to die, they would not be able to handle it. Since Abby died and her parents divorced as a result of their pain, they would not have anyone without Stella. The fact that Stella feels the need to shield her parents from any bad news while she is in the hospital shows that she is more of a parent-like figure in their relationship. However, after Barb scolds Stella’s parents for their behavior, they are able to show up for Stella and reclaim their parental roles, and they eventually get back together.

Meanwhile, Will’s mother is extremely involved in her son’s treatment, while his father left after Will became sick. Will resents that his mother is trying so hard to find a cure for his condition and feels that she only sees him as a problem that needs to be fixed rather than as a person. However, Will eventually realizes that he was seeing his mother as one-dimensional in the same way he thought she was seeing him. In the end, Will recognizes that his mother is acting out of love, and the two are able to finally understand each other. Poe, on the other hand, has been away from his parents since they were deported to Colombia and is a ward of the state until he turns eighteen. Poe’s relationship with his parents is a direct contrast to Will’s, as Poe would love to be with his parents but is physically unable to.

The Inevitability of Love

The central conflict of the novel is that Will and Stella are in love but cannot get within more than six feet of one another. They know that doing so could literally kill them. However, despite Stella’s sense of logic and adherence to rules that will keep her healthy, they both find they cannot resist their feelings for one another, showing that love is something that cannot be helped even in the direst of circumstances. This theme is also explored after Poe dies. Poe had pushed away Michael, whom he loves, because he didn’t want Michael to suffer when Poe eventually died. However, Poe’s actions didn’t stop Michael from loving Poe and grieving his death, showing again that even with physical distance, love cannot be thwarted.

Rules versus Rebellion

At the beginning of the novel, Stella and Will hold opposing views on rule-following and rebelling. Stella is determined to stick to her regimen and follow the hospital’s rules. Will, on the other hand, sees no point in trying to stay healthy as he feels certain he will die soon and chooses to rebel against rules instead. Because he is stuck in the hospital, Will’s acts of rebellion are minor, such as sneaking up to the hospital’s roof or letting his friends have sex in his room. However, both Stella and Will have the same motivation spurring their actions: they both want to have some semblance of control over their suffering. Stella feels that following the rules gives her control while having an illness that causes so much to be uncertain. Meanwhile, Will feels that rebelling gives him control and a reclamation of the life that cystic fibrosis took from him. Stella begins to rebel more after meeting Will, and her compromise that they will stay five feet apart instead of six is emblematic of their finding a middle ground between following the rules and rebelling.

Surviving versus Living

Early in the novel, Stella feels determined to survive long enough to get a lung transplant. This means following a strict regimen of medication and other treatments, limiting her exposure to potential dangers, and spending a great deal of time in a hospital room. To Will, this kind of life is not truly living. Will, feeling that he doesn’t have much time left due to his B. cepacia, would rather spend the time he does have left seeing the world and experiencing new things instead of remaining in a hospital getting treatment that may or may not work. While Stella originally finds Will’s stance reckless, over the course of the novel, she longs for a fuller life, and as such, she initially refuses to have the lung transplant. Ultimately, both characters find a balance of these two ways of approaching life. At the end of the novel, Stella and Will meet in an airport, each headed for a different destination, Stella with her new lungs and Will having agreed to follow his medication regimen and make regular doctor visits. This scene reveals that while each character resolves to survive for as long as their illness lets them, they are also determined to live their lives as fully as possible.