Sheff’s health continues to improve and he returns to his book, rejoicing that “I’m writing again. I am writing again after being unable to write a word” (292). However, he receives an phone message from Nic, his voice “brittle, breaking up” (294). He calls back and Nic reveals that he is back together with Z., has moved into her apartment, and that “we’ve been high since then. Speed balls and meth” (294). 

Sheff experiences an “eruption of the same old worry” but is suddenly “overwhelmed by fatigue and fall[s] asleep, my worry settling into a newly carved-out nook in my remodeled brain” (295). He reflects that he has “learned that I am all but irrelevant to Nic’s survival” but that it “took my near death, however, to comprehend that [Nic’s] fate—Jasper’s and Daisy’s, too—is separate from mine” (295). 

Sheff had wanted to end the book on Nic’s letter to Jasper which “served too perfectly as a neat bow on the package, a happy ending” (295). However, he must acknowledge that it is “still so easy to forget that addiction is not curable. It is a lifelong disease that can go into remission, that is manageable if the one who is stricken does the hard, hard work, but it is incurable” (295).