When the book opens, the narrator, 16-year-old Hazel Grace Lancaster, is heading to a weekly support group meeting for teens with cancer. Hazel was diagnosed with thyroid cancer at age 13; it spread to her lungs and nearly killed her, but an experimental drug called Phalanxifor stopped the tumor growth. She now carries an oxygen tank everywhere and has an uncertain, but greatly diminished, life expectancy. Hazel hates going to the group; she finds the discourse of hope, strength, and faith that pervades discussions of cancer—“everyone talking about fighting and battling and winning” (5)—sentimental and fake. She laughs at the group leader, who refers to the church basement where they meet as “the Literal Heart of Jesus.” But her mother wants her to go, so she gets through the meetings by exchanging sarcastic faces with a boy named Isaac, who has lost one of his eyes to cancer.

On the day the novel begins, a new person shows up at the group: Isaac’s friend, 17-year-old Augustus Waters, who has lost a leg below the knee to osteosarcoma but is now “NEC” (no evidence of cancer).Augustus is attractive, smart, and charming; he stares at Hazel and even brings her out of her shell during the group discussion when he says that he fears oblivion, being forgotten, above all things.