These chapters establish the sense of “otherness” that defines cancer victims within society. Cancer is the main way that other people identify Hazel and Augustus, and it comes out in the way people interact with them. Hazel’s mother, for example, insists on celebrating Hazel’s thirty-third half birthday. Half-birthdays aren't really a cause for celebration for typical healthy teenagers, and the emphasis Hazel's mother places on the event suggests Hazel should be treated differently than a healthy teenager. The same notion underlies the idea of the “cancer perk.” Cancer kids get preferential treatment because of their illness, which is why Augustus received his driver's license despite being an apparently shaky driver. That “otherness” isn't just one-sided. Cancer can define the way cancer sufferers view themselves as well, which is why Augustus doesn't want Hazel to be “one of those people who becomes their disease.” Even so, cancer has significant influence on Hazel's social interactions, which we see when Hazel hangs out with Kaitlyn. There is a certain “unbridgeable distance,” or awkwardness, between the two girls as they shop for shoes. Hazel even laments that because of the cancer barrier, it could never again feel natural to talk to Kaitlyn. Kaitlyn can't separate Hazel from her identity as a cancer patient, and conversely Hazel can't reassume her pre-cancer identity. The one time this “otherness” falls away is in Hazel's conversation with the little girl, who addresses Hazel not knowing anything about cancer or why she has tubes in her nose. Hazel for a moment is free from her identity as a cancer patient.

These early chapters also shed light on the budding relationship between Hazel and Augustus. While their shared experience of having cancer isn't the only thing that attracts them to each other—each thinks the other is smart, charming, and of course physically attractive—it does allow them to dispense with that barrier of “otherness” we see between Hazel and Kaitlyn. Hazel and Augustus are on common ground since they're both cancer patients, allowing them to talk about things like the so-called “cancer perks” in a way they might find difficult with someone who hasn't been through the experience of having cancer. They can both recognize, for instance, the irony of the word “perks,” since these perks aren't so much a bonus for having cancer as an expression of pity that both, of course, accept but also find grating. Perhaps more importantly, however, they also begin getting to know each other beyond their experiences with cancer. Augustus makes a point of this when he asks Hazel what her story is, then interrupts when she starts talking about her diagnosis and tells her he means her story, not her cancer story. He's clear to distinguish one from the other, and it's from this point that their relationship begins to develop in a deeper way.

The existential motif appears again in this section, most notably in Augustus's story about shooting free throws on the day before he had his leg amputated. In the story he tells, he describes the freethrows as “existentially fraught,” which indicates that they're about much more than just getting a ball through a hoop. Augustus had been a star basketball player, and it's evident that basketball was an important part of his life. As he shot the free throws, however, he realized how arbitrary the activity was. He describes it as childish and essentially without any real purpose to Hazel. He doesn't say so explicitly, but his story and the timing of this realization suggest that the free throws represented the search for purpose and meaning for him more generally. It was Augustus's last day before having his leg amputated, after which he would no longer be able to play basketball, at least not competitively. This important part of his life would be taken away from him, and it seems this change prompted him to ask what value basketball really has. And if it isn't valuable to him, if it's really just an arbitrary activity, then what does have purpose? The question fits very neatly into existentialism's quest for meaning in a universe where life and death are potentially arbitrary.