Please note! This essay has been submitted by a student.
“There are seven billion living people and about ninety-eight billion dead people” (Green 151). Death is realistic part of life that people tend to believe they can escape. Humans believe that dying is the worst thing that can happen to them, but honestly there is nothing wrong with death. However dying from cancer is maybe the worst way to go out. To add to that, it is even worse to die from cancer when you are only sixteen years old. John Green’s, The Fault in Our Stars, explores the psychiatric, emotional, and physical state of ming of youth realistically coping with impending death.
Youth that is suffering from cancer often times have poor body image; they are still growing up, but they are also dying so they might become reclusive and introverted to protect themselves. In today’s society most adolescents have a very poor self-worth and idea of their body. Body image is such a major thought for teenagers, especially teen girls. Since children with cancer know they are dying they start to think differently about their bodies; “Body changes from cancer treatment can range from hair loss to the loss of a limb” (American Cancer Association). The suffering youth start to realize that they are going to die from cancer. Augustus proves this by telling the reader what Hazel believes, “The way Hazel sees it, dying makes you less afraid of other things, because hey, what do you have to lose?” (Green 162). Hazel does things that could cause her more harm than good because she lives knowing she could die at any moment. However, she is still growing as a teenage girl and faces the every day dilemmas that other teens face; “I didn’t tell him that the diagnosis came three months after I got my period. Like: Congratulations! You’re a women. Now die” (Green 14). Being a teenager and having terminal illness can cause people to stay in their homes and count the days they might have left.
Often times victims of cancer drop out of school and experience bullying, along with symptoms and signs of depression. Teens who drop out of high school are often seen as ‘stupid’ or ‘not trying’ hard enough to further their life. Although cancer kids have reasonable explanations to not be showing up to class, they still suffer from judgement from other classmates. Teenagers with cancer, like Hazel, often get their GED so that they do not have to worry about missing classes because they are having chemotherapy. However, since they usually do not go out as much because they are no longer in school; they normally lock themselves in their bedrooms and think about dying. Cancer victims count down their life, “Robbed of any semblance of a normal life ‘cancer kids’ as Green’s narrator, Hazel Grace Lancaster calls them, mark their time in days and weeks” (Syme). That is the thing that knowing about death is coming, people never stop thinking about it. Depression is common in teenagers, but more so with teenagers who know that they are going to die soon; “Late in the winter of my seventeenth year, my mother decided I was depressed, presumably because I rarely left the house, spent quite a lot of time in bed, read the same book over and over, ate infrequently, and devoted my abundant free time to thinking about death” (Green 3). Even though Hazel knows and thinks about how she is going to die, she is still alive and she has to continue to live her life, even if she does not like it.
Dying is a natural part of the life cycle and the understanding of this is healthy even though death is painful experience. As previously stated, everyone is going to die. Birth and life are a death sentence, and no matter how hard someone tries, there is no escape from death. Even though it hurts to think about and understand someone’s death, it is valuable and important to understand. Hazel knows that no matter what, she is going to die, “I understood: No wasting good lungs on a hopeless cause” (Green 116). Death is not a bad thing and can be valued, even if it hurts. Hazel believes that someone has to have sickness so that the rest of the world can live in harmony. There must be dark to appreciate the light, “Cancer kids are essentially side effect of the relentless mutation that makes the diversity of life on Earth possible” (Green 44). Even when people understand death it can still be painful and lead to depression or other psychological and mental disorders and illnesses. Many people think that having a terminal illness, like cancer, will cause the host to have depression. However Hazel believes otherwise, “Depression isn’t a side effect of having cancer. Depression is a side effect of dying” (Green 3). Since the thought of death is painful, crying is common and is actually a healthy response to dying. “Crying is a very normal reaction and can release a lot of feeling and emotions” (Talking about Dying). Negative mental health issue are often developed because the person is scared of dying.
Cancer obviously has been related to depression as well as other mental health disorders. Average teenagers go through a phase of depression or severe sadness, but teenagers who suffer from cancer will go through depression, social anxiety, and even at times Post-Traumatic-Stress-Disorder (PTSD). Illness diagnosis can lead to lead to negative mentality, “Almost all cancer patients experience some psychological dislocation in the immediate aftermath of cancer diagnosis” (Andrykowski). Depression is the most common psychological disorder that teenagers go though, and more so if they are suffering from a terminal illness. Rates of depression in teenagers with cancer are higher than they have ever been, “The prevalence of depression in individuals with cancer has been estimated to range from 0 precent to 58 precent” (Andrykowski). Even though cancer, like Hazel’s thyroid cancer with metastasis forming in her lungs, effects her lungs and thyroid, it also effects the brain of the individual who is suffering. Every part of the person who has cancer is effected, not just the location where the cancer is in the body. Augustus was not only affected by osteosarcoma because of his missing leg, but it also psychologically effected him. He is still fearful of the cancer returning and killing him, just like Hazel Grace fears her cancer killing her before she can live. Since Hazel knows she is going to die, she does not see the romanticized beauty that people make up when talking about from dying. “Because there is no glory in illness. There is no meaning to it. There is no honor in dying of it” (Green 217). Hazel knows that there is no beauty or glory in dying from cancer. She and Augustus both realize and understand the fact that one day everyone is going to die, “There will come a time, when all of us are dead. All of us. There will come a time when there are no human beings remaining to remember that anyone ever existed or that our species ever did anything. There will be no one left to remember Aristotle or Cleopatra, let alone you. Everything that we did and built and wrote and thought and discovered will be forgotten and all of this will have been for naught. Maybe that time is coming soon or maybe it is millions of years away but even if we survive the collapse of our sun, we will not survive forever. There was a time before organisms experiences consciousness, and there will be a time after. And if the inevitability of human oblivion worries you, I encourage you to ignore it. God knows that’s what everyone else does” (Green 13). Since they realize death is inevitable, both of them do not experience depression or other psychological health problems as severely as others with cancer would normal experience. i
Death is always on the mind of the introverted victims of cancer. Since people who have cancer are scared of dying, they often lock themselves away in their room and do nothing but think about the impending death. Since many teenagers experience social anxiety they are often already introverted into their bedroom, but with the added threat of dying, cancer kids will stop leaving the house all together. While these kids are locking themselves in their bedroom without an outlook on reality, all they can think about is their soon-to-come death. When a child has found out that they have stage four cancer, they often stop having the desire to live, “Immediately following a child’s cancer diagnosis, most patients experience acute stress disorder” (Clay). Due to the constant thoughts of dying, people who suffer from cancer often forget that they are alive. Augustus asks Hazel the first day they meet, “Don’t tell me you are one of those people who become their disease” (Green 32). More often than not, the individual does become a walking resemblance of their cancer, not only physically but behaviorally. Teenagers are seen to be filled with life and happiness but when they find out they are dying they let go of said happiness. When they let go of that happy, care-free, teenager vibe, they visually show cancer to anyone and everyone they meet. Hazel believe that you cannot hide cancer, “The worst part about having cancer, sometimes: the physical evidence of disease separates you from other people” (Green 144). As a result of always playing the part as a kid dying from stage four illness, the thought of death never leaves their minds.
Thinking about and knowing that death is going to happen, changes they way people see the world and the people they love. Death changes the way someone views love and how they treat their loved ones; it also changes how their loved ones see them. Hazel Grace does not know when she is going to die, but she knows it could be soon and it hurts her, “I also don’t really want this particular life. But it’s really just the sky, the sky that’s making me sad…” (Green 121). Hazel knows about her death and she hates it. She tries her hardest not to be afraid of hers and everyone’s impending death, “I wanted to try to reflect dying as I could, and part of that is frustration and anger and shortness and fear” (Green 93). Hazel and Augustus understand that they are dying and that is it healthy to talk about it because, “Not talking about death can create tension between people, even if hey are close and increase fear, sadness, loneliness, and anxiety” (Talking about Dying). They both have the effect of others treating them differently because of their cancer.
Green uses Hazel to display how having cancer changes the way people treat her. Hazel knows she is hurting her parents by having this illness. She understand that she is not at fault for having stage four, but she hates hurting them, anyway; “I hate hurting them. Most the time, I could forget about it, but the inexorable truth is this: They might be glad to have me around, but I was the alpha and the omega of my parents suffering” (Green 116). She knows that because she has cancer, she is treated differently by her parents and by other people. As a result of cancer she realizes people are afraid to talk about dying or being sick around her because no one is in the similar situation as her. Hazel tries to clarify this, “I mean I would just die—and they stopped short, looking at me as if to say ‘I’m sorry’ as if it were a crime to mention death to the dying” (Green 44). Not talking about death to the dying gives them false hope of being able to survive, and that is unhealthy and harmful for them; “It is very helpful to tell them that you are willing to talk and not close the subject down with ‘oh things will be fine’ or ‘lets not talk like that’ realize that they are dying” (Talking about Dying). Hazel’s parents do not know but they hurt her too, “Mom sobbed something into Dad’s chest that I wish I hadn’t heard, and that I hope she never finds out that I did hear. She said, ‘I won’t be a mom anymore.’ It gutted me pretty badly” (Green 117). To cause less pain to their parents Hazel and Augustus will do things that make them happy, or not do things that could harm them. Even though both of the kids do not want to, Augustus told his mother, “‘Because it’s my life mom and it belongs to me’” (Green 139).
Parents have to live with the fact that their child is dying. Parents of children who have cancer have a good intuition that they are going to have to bury their child; “The real tragedy of cancer may be that it affects all people of all ages and children suffering from he disease are often hit the hardest” (Syme). Parents have a hard time when their kid has a cold, but when their son or daughter is diagnosed with cancer they become a complete secret wreck. Parents have to live with their dying child and cannot prevent the sickness from spreading, “There is only one thing in this world shitter than biting it from cancer when you’re sixteen, and that’s having a kid who bites it from cancer” (Green 31). Parents have to stay strong for their children, “People talk about the courage of cancer patients, and I do not deny that courage. I have been poked, and stabbed, and poisoned for years, and I still trod on” (Green 107). As previously stated, parents have to be strong for their child’s sake. Often cancer kids experience some type of psychological disorder after they are diagnosed with the illness, “Immediately following a child’s cancer diagnosis most patients experience acute stress” (Clay). Support groups can help both the cancer victim and the parents through this difficult time.
Many cancer patients go to support groups to connect with others that are dealing with cancer. Support groups for teenagers who have cancer may become part of their everyday life. Often the support group is where they make friends and maintain friendships without being scared of judgement. However, Hazel, in the beginning of the book, does not like support group, “I went to support group for the same reason that I’d once allowed nurses with a mere eighteen months of graduate education to poison me with exotically names chemicals; I wanted to make my parents happy” (Green 58). Though studies have shown that support groups are a good thing for cancer patients, Hazel thought differently, “Support group featured a rotating cast of characters in various states of tumor-driven unwellness. Why did the cast rotate? A side effect of dying” (Green 5). Cancer patients who have support from not only support groups but also family and friends often have a better look on the outcome of their cancer. Support can make social pain easier to handle, “Having high levels of support from he family, classmates, the school, the hospital credits better adjustment for the child with cancer” (McDougal). The support group is supposed to make the victims understand that they are not alone in this and give them a feeling a safety and security. Cancer patients can get support anywhere, “Support groups that are offered by licensed or train professional may also be a source of practical advice and ideas about coping with changes in the body” (American Cancer Association). Support groups give the victims a chance to connect with others and make friends.
Making and having friends while suffering from cancer is an excellent way to stay happy while dying. Through Hazel’s support group, Hazel connects with a boy named Issac. In the beginning of the novel, Green expresses how they would communicate with sighs. Soon Issac brought his dear friend, Augustus, who is in remission from osteosarcoma. However Hazel does not need his information to know someone is sick, “There are a number of ways to establish someone’s approximate survival expectation without actually speaking” (Green 29). Augustus does not speak directly to Hazel until after support group is over, however, in support group he makes an impression on Hazel. Augustus knows that he does not have cancer so he is content with his life at the moment, “‘I’m on a roller coaster that only goes up my friend’” (Green 11). Having friends is very healthy for cancer patients because it makes the thought of dying alone start to disappear, “People facing cancer often find themselves facing the possibility of their own death” (American Cancer Association). Having friends and family makes asking for help much easier for Hazel. Many cancer patients are afraid of asking for help because of their weakened state feel helpless if they cannot do something on their own that a healthy individual would be able to do. Cancer victims will need help, “When a person is diagnosed with cancer, he or she may need to ask for help for the first time ever. This can include help from friends and family or outside help” (American Cancer Association). Relationships can cause the effects of cancer to be less painful and even easier on the body.
Being in a loving relationship actually makes having cancer less painful. It has been proven that people who are in loving relationships and have illnesses recover from said illness or are at least happier than they would be if they were alone. Having a relationship can save you from dying of cancer, “Almost 3.8 million people with cancer, researchers found only 45% of single cancer patients are alive after five years—only 37% after ten years” (Clay). Hazel and Augustus fell in love quickly, but they knew the possibility that their relationship would be shortened by death. Single cancer patients often die faster than those in relationships, “Cancer patients in relationships, 63% were still alive after fiver years—only 57% after ten years” (Clay). Even though Augustus does not live, he was joyful in his last moments because he had his star-crossed lover, Hazel Grace. Augustus’s goal in life was to be remembered, but Hazel reminded him, everyone is going to turn into dust one day. When he expressed his love towards her he used her own words, “I’m in love with you, and I know that love it just a shout into the void, and that oblivion is inevitable, and that we’re all doomed and there will come a day when all out labor has been returned to dust, and I know that sun will swallow the only earth we ever have, and I am in love with you” (Green 163). Having someone you love can make the fight for survival have a more determines outcome. Hazel and Augustus find this out after Hazel realizes he is dying, “Hazel and Augustus have a zeal for living and for each other that, cancer or not, is rare, and it’s a delight to see their plans unfold and relationship flourish even as they both face death” (Syme). Augustus wanted to have a pre-funeral before he actually died so that he could hear what people would say about him. Isaac and Hazel both attend and Hazel speaks about how much she loves him, “‘You gave me a forever within the numbered days, and I’m grateful’” (Green 260).
Cancer causes real, physical pain. Hazel literally cannot breathe on her own, Augustus loses half his leg, and Issac becomes blind. Hazel ends up in the hospital many times because the fluid in her lungs overflows, causing her to have difficulty breathing. Cancer is harsh on the body; however there are treatments and medications to help soothe some of the pain. Hazel explains how she can stay alive, “I woke up and soon got into one of those experimental trials that are famous in the Republic of Cancervania for not working. The drug was Phalanxifor, this molecule designed to attach itself to cancer cells and slow their growth. It didn’t work in 70 precent of people. But it worked in me. The tumors shrank” (Green 25). Hazel does not romanticize having cancer and she ever-so bluntly describes it just as it is: painful; “I had surgery called radical neck dissection, which is about as pleasant as it sounds” (Green 24). There are many other long-term and short term effects of having cancer other than having cancer and chemotherapy. Hazel will, until the day she dies, have to carry around her oxygen tank so she can properly breathe and Augustus will always have a prosthetic leg. Cancer patients carry their illness around with them, “Several other long-term conditions that can occur as a result of cancer treatment, including scoliosis, dental and facial problems, cardiac abnormalities, pulmonary abnormalities, liver damage, urinary tract problems, and amputations” (McDougal). Augustus did not have a choice in losing his leg. Osteosarcoma can be stopped by amputating the infected area, and he underwent the procedure and got a prosthetic leg. “Some people choose artificial limbs (prostheses) and reconstructive surgery after cancer surgery” (American Cancer Association). Having prosthetic limbs makes public appearances and the pain easier to handle for cancer victims.
There are many ways to cause less pain and put off the impending death. There are certain hospital and medications that children with have cancer can go to or have. “Memorial was the big research hospital, ‘Where’d you go?’ ‘Childrens,’ I said” (Green 27). In the hospital the doctors have advanced knowledge about dying, however because the victims are children they tend to withhold information about the reality of their death. “Cancer patients receive medical care in a variety of settings including large academics medical centers, small communities hospitals, and private physician’s offices. The type, extent, and quality of psychological support services that are available to patients differ enormously across these diverse settings” (Andrykowski). Hazel doesn’t want to hurt anyone when she does die, but she knows she will hurt at least her parents, so she tends to distance herself from everyone; “I’m a grenade and at some point, I’m going to blow up and I would like to minimize the casualties, okay?” (Green 99). Hazel distances herself from everyone because she knows she could die at any moment and doesn’t want to hurt more than anyone she has too. Augustus will love her no matter what and he tells her that as she tries to distance herself, “I hope you realize that trying to keep your distance from me, does no way lessen my affection towards you” (Green 63).
People who suffer from cancer, know they can die at the snap of someone’s fingers. Hazel is almost dead, basically, she cannot breathe on her own so she has help with her oxygen tank. While on-the-other-hand Augustus is safe from cancer until it comes back and he unfortunately dies. “Augustus Waters died either days after his pre-funeral, at Memorial, in the ICU. When the cancer, which was made of him, finally stopped his heart, which was also made of him” (Green -). Hazel explains Augustus as someone who lived with cancer and not just a kid with cancer. She also talks about the kind of cancer he had and how it affects people, “Osteosarcoma sometimes takes a limb to check you out. Then, if it likes you, it takes the rest” (Green 40). Hazel really wants to make clear that he was living with this and it was okay, even if having cancer wasn’t. He was happy even through his pain of the cancer spreading to his vital organs. “People facing cancer often find themselves facing the possibility of their own death. At first, some people focus on dying from cancer instead of living with cancer” (American Cancer Association).
When someone dies, whether it be from cancer or not, other people fear their own death more. When someone dies, often others think about how that could have been them. Often when people did, the people who are still alive can’t function correctly anymore. It goes even further than a state of mourning, it’s almost how Hazel was acting before she met Augustus; she locked herself in her room and just cried at the thought of his death. “Several of the defining symptoms associated with PTSD including memory, sleep, and concentration difficulties, and physical reactions, in response to cancer-related stimuli could be direct effect of disease or treatment and thus not represent a psychological response to trauma” (Andryknowski). Hazel feels this towards Augustus because, she was dying more than he was, but he died first. She lives with the rotating cast of alive and dead people in her life, and she thinks, as any normal person would; “There was quite a lot of competitiveness about it, with everybody wanting to beat not only cancer itself, but also the other people in the room. Like, I realize that is irrational, but when they tell you that you have say, 20 precent chance of living five years, the math kicks in and you figure that’s one in five… So you look around and think, as any normal person would: I gotta outlast four of these bastards” (Green 5). Even Augustus is dead, Hazel still feels him there with her and she loves him no matter what. She feels safer from her own death with the thought of Augustus being with her, “I almost felt like he was there in my room with me…” (Green 67). Hazel wants people to realize that dying is not a bad.
The only freedom people will ever achieve in life is death. The world is going to chew humans up and spit them back out. It’s going to destroy them and try it’s hardest to hurt them. People can’t stop pain and hurt from happening but they can allow happiness in their life. Augustus has a metaphor for freedom and dying and that you cannot be hurt unless people let it hurt them. “You don’t get to choose if you get hurt in this world, but you do have some say in who hurts you” (Green 313).