This is a very sad book. I probably wouldn’t have picked this up if I’d known how sad it would be, although you know from the first pages that the story involves young people who’ve been diagnosed with cancer. What I like about the book is that it isn’t a story that gives itself over to one single perspective on life. The main character is dealing with many kinds of loss, and although she sometimes feels pain, despair, anger, fear, and nihilism, Hazel doesn’t make one of these responses into an avatar. If she did, you could say she was justified. Her doctors haven’t given her hope that she’ll recover. So the novel could have used one of these perspectives as a direct challenge to religious or non-religious ways of making meaning out of the experience of life. She has good grounds to challenge them on! But instead of telling a story to challenge certain ideas or perspectives, the story is told in a personal way. The health and relational challenges she experiences are the heart of the story. And those experiences do challenge ideas and perspectives, just in a naturalistic way. For example, she worries throughout the book about her parents. She feels guilty that so much of their time and attention and resources go toward her care. She knows that seeing her pain hurts them—her dad easily sheds the most tears in the book. And she both looks forward to her own death, when she’ll no longer be a burden to her parents, and she worries that her death might be destructive to them individually and as a couple. Fear could be the central avatar of her character or the central concern of the novel, but it isn’t. The focus is on the narrative, which made the experience for me as a reader more painful, and more worthwhile. That said, prospective readers might want to consider when to pick up a story that has this subject.