Hazel has no illusions about her condition. From the beginning of the story she offers an honest and blunt narrative of her situation,
"Whenever you read a cancer booklet or website or whatever, they always list depression among the side effects of cancer. But in fact, depression is not a side effect of cancer. Depression is a side effect of dying. "(1.2)
Truth seems to be the overriding factor in her life. She shuns what is "cool" and is sarcastically witty about her reality,
"I didn't tell him that the diagnosis came three months after I got my first period. Like: Congratulations! You're a woman. Now die." (2.13)