As the tide washed in, the Dutch Tulip Man faced the ocean: “Conjoinder rejoinder poisoner concealer revelator. Look at it, rising up and rising down, taking everything with it.”
“What’s that?” I asked.
“Water,” the Dutchman said. “Well, and time.”
—Peter Van Houten, An Imperial Affliction

This quote is the epigraph that precedes The Fault In Our Stars. Typically an epigraph is a quotation or poem that is intended to serve as a preface, summary, or link to a wider literary canon for the text that’s to follow. Often it will come from a well-regarded work, which can be a way of coopting that work’s authority and credibility to some degree. This epigraph, however, is an excerpt from a fictional book that only exists within the world of The Fault In Our Stars. The effect, once the reader realizes An Imperial Affliction is a made-up work, is to call into question what defines something as authentic. It puts a made-up quote on the same playing field as a real one, and in doing so it suggests a made-up quote can have just as much authority and credibility. The significance of this decision only becomes fully clear in the context of the story we’re told in The Fault In Our Stars. Hazel identifies so much with the book and places so much importance on the fictional characters in An Imperial Affliction that she becomes fixated on learning their fates beyond the book’s ending. The book matters to her in a very real sense. By using a quote from the book as the epigraph, The Fault In Our Stars slyly hints at the importance fiction can have in our lives. Made-up stories, it suggests, can be just as meaningful to us as real ones. The Author’s Note that follows further emphasizes this point of view.

On top of playfully advertising Green’s belief about the importance of fiction, the epigraph introduces one of the novel’s most omnipresent symbols: water. Water represents suffering in both its negative and positive varieties. An example of the negative is the pain of cancer, and an example of the positive is the pain Hazel feels after losing Augustus, which although terrible is actually a sign of how much he mattered to her and how much she loved him. The symbol is vast in that it uses a single image to encapsulate these two different ideas, which are like two opposing poles. The Dutch Tulip Man captures this all-encompassing quality by describing water with opposing names. For instance, it’s a conjoiner, meaning it brings things together, but it’s also a poisoner. It’s a concealer that hides, and it’s also a revelator that reveals. He goes on to link water and time, and his meaning is less certain here. One interpretation is that time possesses the same all-encompassing quality. It’s the thing that allows us to grow, develop, and hit our prime, and it’s also that which causes us to decay, wither, and inevitably die. And both water and time, he suggests, take everything with them in their tide.