Turtles All the Way Down (2017) is a young adult novel by John Green, author of the successful novel The Fault in Our Stars. The story is narrated in the first person by Aza Holmes, who suffers from obsessive-compulsive disorder (OCD) and anxiety, which greatly impact her daily life and her ability to maintain relationships. The story has been heralded as an accurate and personal depiction of OCD by the author, who has openly written about his own struggles with OCD.

Plot Summary

Aza is a 16-year-old high schooler in Indianapolis who has an uncontrollable obsession with the thought of bacteria invading her body and killing her. To deal with this obsession, Aza must compulsively cut open a small callus on her finger, clean it with hand sanitizer, then put on a new Band-Aid. Doing this momentarily relieves her overwhelming anxiety, but she must repeat this compulsion many times a day.

One day at lunch, as Aza fights to tamp down her fears that her body has been infected by bacteria, her friends Daisy Ramirez and Mychal Turner discuss the disappearance of a local billionaire businessman, Russell Davis Pickett, Sr. Pickett fled to avoid being arrested for fraud and bribery concerning a sewer project. Daisy wants Aza to contact Pickett’s son, Davis (Russell Davis Pickett, Jr.), who Aza knew years before. Aza rejects the idea, but Daisy, who comes from a poorer family and needs to save money for college, wants to try and collect the $100,000 reward that has been posted for information about Pickett’s disappearance.

When Aza and Daisy visit Davis, they find out that Russell’s company never finished work on sewer lines it was contracted to repair, and that’s when Russell went missing. Before he left, he willed his whole estate to his pet lizard, and Davis fears he’s not in his right senses. Aza and Daisy leave, but Aza and Davis start texting. As time passes, Aza doesn’t obsess over her finger as much. However, when she forgets to clean it, she gets very distressed. Davis is a distraction—first they’re texting all the time, and then they start seeing each other. This wasn’t part of the plan, but Aza can’t help feeling attracted to him. Davis, however, fears that Aza only cares about money. He gives her $100,000 in cash: If she keeps seeing him, he’ll know she cares about him and not the money.

Aza does care about Davis, but her panic attacks are more frequent than ever. When she kisses Davis, all she can think about are the germs he’s infected her with, and she wants to stop seeing him. However, Davis understands her condition, and he’s happy to take their relationship slow. Daisy isn’t happy that Aza has so much control over the $100,000, but she doesn’t say anything.

Meanwhile, Aza feels bad that she doesn’t see Daisy as often anymore. Aza wants to make it up to her, and she reads Daisy’s online blog to comment on her writing. When Aza visits the blog, she discovers that Daisy based a character on her—a character riddled with anxiety. Aza is offended, but the character is how Daisy deals with the difficulty of being Aza’s friend. Unsurprisingly, Aza and Daisy have a fight. Aza realizes there’s a lot she doesn’t know about Daisy’s life because she’s always obsessing over germs. Aza hates herself for being so self-centered even though she can’t help it; she’s so distressed that she gets into a car accident. When Aza is taken to the hospital, she’s so worried about germs that she drinks hand sanitizer. Her psychiatrist prescribes different medication for her illness.

Meanwhile, Daisy apologizes to Aza for her outburst, and Aza apologizes for being selfish. The pair attend Mychal’s art show when Aza gets out of the hospital. They walk through the sewer system, which gives Aza an idea. She worries that Russell is in the sewers somewhere because he couldn’t complete the project. She tells Davis about her theory and he believes her, fearing that his father is dead. One day, Aza finds out that Russell is found dead in the sewer system. Devastated, Davis moves with his brother to Colorado. They have no inheritance because everything is going to Russell’s pet lizard. With the mystery behind her and Davis gone, Aza can focus on keeping well and moving on with her life.

The novel ends with present-day Aza telling the reader that she has written this chronicle as an exercise given to her by her psychiatrist. As an adult, Aza went on to marry and have children, though she still deals with her mental illness.